Contact: Rea Mattocks, (01962) 847200: rea.mattocks@hants.gov.uk

1. Summary:

1.1 The following decision is sought:

1.1.1 that the Executive Member requires officers to cease the consultation process on changing the eligibility criteria in relation to which needs are met; and

1.1.2 to ensure that consultees and other interested parties are encouraged to continue to forward to the department ideas generated in response to the consultation.

2. Reason

2.1 This report relates to the community strategy in that it supports the aim of "Maximising Well-being" by ensuring that Adult Services respond effectively to the needs of its users and carers.

3. Other Options considered and rejected:

3.1 None

4. Conflicts of Interest declared by the decision maker or other Executive member consulted

4.1 None

5. Dispensation granted by the Standards Committee

5.1 None.

6. Reason(s) for the matter being dealt with if urgent

6.1 None

Approved by: ........................................... Date of decision: ................

Councillor Patricia Banks

Executive Member for Adult Services

Contact: Rea Mattocks, (01962) 847200; rea.mattocks@hants.gov.uk

1. Summary

1.1 This report updates the Executive Member on the consultation process so far, including the likely impact on service users and on the Wellbeing Agenda. The report also follows further investigation by the Leader of the County Council as he accompanied care professionals on home visits in Andover and saw some of the care decisions being made by staff in the Basingstoke area. The Leader has asked that the Executive Member consider discontinuing the consultation on Eligibility Criteria at her next Decision Day, and keeping the criteria at critical and substantial.

1.2 The Government's Fair Access to Care Services Guidance (FACS) was outlined in the first report to the Executive Member on 28 July 2006 and is attached at Appendix I.

1.3 This report relates to the community strategy in that it supports the aims of maximising well-being, by ensuring that Adult Services responds effectively to the needs of its users and carers.

2. The Consultation

2.1 The Executive Member for Adult Services agreed a consultation process at a meeting on 28 July 2006. As required by law in accordance with the Hampshire Compact, this consultation was to last 12 weeks from 1 September to 28 November 2006. The consultation process was designed to inform organisations and individuals of the Department's proposal to adopt eligibility criteria at critical only for community care assessments and to consult on this proposal, its implications and the issues surrounding implementation. The process had sought views from the following:

Organisations of and for users and carers

Private sector providers

Voluntary sector providers

Voluntary organisations

NHS

District Councils

Staff

Organisations representing Black and Minority Ethnic Groups

2.2 The department has circulated some 12,000 paper copies of the consultation document as well posting it on the website. Numerous responses have been received. The emerging themes from the consultation are :

_ Agreement that we should spend our resources on those most in need, or at risk

_ That with limited resources we cannot be all things to all people

_ That if we are consistent and fair, people will be able to live with this

However concerns were expressed about :

_ the impact on carers and a belief that where a customer has carers they would not be deemed to be in critical need and would be left to cope alone or until breaking point

_ respite may be withdrawn

_ withdrawing low cost packages to high numbers of service users may result in higher more expensive packages later

_ withdrawing from preventative work may result in increased crisis work, which could have been avoided with earlier preventative input

_ low level support provides preventative care and keeps people at risk on the "radar"

_ the impact on quality of life (social isolation, loneliness and mental health)

_ the fine line in differentiating between critical and substantial

_ transition from high volume support for children to a reduced service as an adult when age is the only change

_ the department may not investigate less serious abuse

3. Financial Position

3.1 The Executive Member will have received an update on the financial position at today's meeting. The financial pressures at the August monitoring show £12.6m, a reduction of just under £5m from the May monitoring position. The direction of travel still appears to be downwards.

3.2 The Savings

The potential savings arising from a change in the Eligibility Criteria to critical only are difficult to calculate. The reduction in costs if a decision were made to only provide care to those whose needs are assessed as critical is difficult to calculate. If services to 5% of the people in the substantial category ceased, then £2.7m savings will be achieved. However, it is almost certain that the vast majority of people would move to the critical category as the definition states for example, "there is or will be an inability to carry out vital personal care or domestic routines". The words "will" or "will be" in each line of the criterion mean the people are highly likely to be reclassified as critical. If the service provision levels changed, each individual user would need to have their current community care needs re-assessed and it is thus impossible to state categorically the amount of savings that would be achieved by re-assessments.

4. Likely Impact on Individual Users and Carer

FAC makes it clear that existing users must be treated in the same way as potential service users and this means that if upon reassessment a user's needs were still considered to be substantial, that they would be at risk of losing a service. The legal position is thus at variance with Members' intention that this proposal should not have an impact on existing service users.

5. The Well-being Agenda

5.1 The Executive Member will know the Government's intention in the White Paper "Our Health, Our Care, Our Say" is to provide early interventions, to prevent people moving into residential or hospital care and to promote their well-being through public health, local government and the voluntary sector. If the decision is to move to critical only, then it is likely that people in substantial need could deteriorate more quickly and require larger care packages. It is also going to be more difficult to get prevention services embedded in the culture of the organisation if the criteria are tightened.

6. Conclusion

The consultation to date has yielded a significant response. Many of the responses have included suggestions on providing a more efficient service, which the Department is keen to explore. For that reason, it would not wish to stop receiving responses in this vein.

8. Recommendations

In the light of responses received, the financial analysis, the apparent conflict between the proposal and the Wellbeing Agenda, that the Executive Member requests officers to :

8.1 cease the formal consultation process on changing the categories of eligibility criteria in relation to which needs will be met

8.2 ensure that consultees and other interested parties are encouraged to continue to forward to the department ideas generated in response to the consultation.

OR

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have been relied upon to a material extent in the preparation of this report.

NB: the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

(Quote list of documents here: either "none" if 1 or 2 above apply; or list the relevant letters, memos, etc. and their location)