Archived decisions

CARE ATTENDANTS

1. Care Attendant Schemes were established as a joint-funded (Social Services and Health) scheme to enable disabled adults (under 65) to live in the community by providing personal care at home. They were established at a time when more intensive complex care at home and support was not widely available. The environment in which the service operates has significantly changed since the development of the NHS and Community Care Act. These changes include Direct Payments, the Independent Living Fund, Supported Housing and NHS funding. Through these funding streams and with the increased expectation of living in the community, a growing number of people are being supported in their own homes, including individuals with greater and more complex support needs.

2. It is recognised that when it works consistently, the Care Attendant schemes can manage very complex care needs. However, there were a number of concerns about the current situation:

· the size of the service, given the geographical area covered and low density of service required, is well below the optimum to provide effective rostering and cover for leave, training and sickness absence

· small numbers of staff and clients per patch lead to issues of consistency and covering

· there is an increase in proportion of working time spent travelling between users; as a consequence unit costs have increased significantly, given the lack of economy of scale

3 In March 2003 the current service employed 32 carers to help 96 physically disabled adults to live in the community. 7 carers worked in the Alton scheme, 9 in the Basingstoke scheme, and 16 in the Winchester/Andover scheme. However, of the 96 clients, only 53 received their support solely from the Care Attendant schemes. The remainder received a combination of support from Care Attendant and the independent sector. Within the same areas independent domiciliary agencies support a further 179 physically disabled adults to live in the community.

4 Different options were considered for the future service provision and an options appraisal was carried out. After consideration, the executive member has agreed with the option of purchasing the care attendant service via the independent sector, which is how the majority of services are already provided for adults with a physical disability.

5 The advantages of this are:

· Care attendant funding is directed to the most appropriate clients

· Increased flexibility is possible from a service which is a large scale provider

· The service is cost-effective with reduced administration costs

· All staff and care regulations are the responsibility of the agency

· Independent living fund can be used to purchase the services

· Contracts can be sought with local providers for each area on a Primary Care Trust basis and therefore local health requirements can be considered as part of the service specification

6 The proposed changes will not effect the size of care packages for users; we have been stressing this in our contact with carers. There are opportunities for staff to move to similar jobs within the Council, to ensure their expertise is not lost.

7 It is anticipated that more care hours will be purchased for the same expenditure.