Contact: Colin Hardy, [email protected] 07718 146800

1 Summary

1.1 The Executive Member for Children and Families received a report in January 2008 identifying the need to undertake consultation with consumers and stakeholders in order to seek views on how the Aiming High for Disabled Children development programme should be taken forward. Over 300 parents and partners have taken part in the programme of consultation events and the comments of partners are being collated. A summary of the views expressed is included in section 3.

1.2 The opportunity has also been taken to consult with parents and partners to establish views in relation to the level of overnight short break care necessary in some areas of Hampshire as some existing service contracts are coming to an end and it is necessary to tender for some services to be in place by April 2009.

1.3 This report includes a confidential appendix identifying the volume and potential value of overnight short break services where tenders are to be sought, which is commercially confidential and not for publication.

1.4 The Children and Young People Select Committee has established a work programme to seek the views of parents and partners in relation to overnight short breaks which sits alongside the broad consultation in relation to Aiming High

1.5 This report identifies the key features of the Aiming High service development programme and includes the time scale to develop a service improvement and commissioning strategy. The report also seeks authority to commence re-tenders for some existing services. The tenders will include arrangements to vary services, in order that potential future service changes can be accommodated as the longer term commissioning strategy is developed and considered by Members.

1.6 It is anticipated all contracts will be for up to a four year period within a framework approach that would seek proposals from providers to offer overnight short break services. Within this approach the volume and value of services is agreed with providers each year. This approach will best support the potential to make changes to existing services as new services develop whilst also offering some security to service providers and continuity for service users.

1.7 The views of parents and carers expressed so far in consultation do not suggest that any less overnight short break service is required, rather that additional service opportunities are required to allow greater flexibility and choice. However over time it is possible that parents and carers would choose a more regular pattern of evening, weekend and holiday support as these opportunities develop and the need for overnight services may be affected.

1.8 The Executive Member has approved that tenders should be sought for domiciliary services to support parents and carers of children with a disability and it is intended to also include these services, with a potential value in excess of £1m a year, within a framework approach. In this way existing service providers will have an opportunity to consider diversification and new providers could be encouraged.

1.9 This framework approach to re-tendering for existing services could also be adopted as the commissioning strategy for new services is developed later in the year.

1.10 The services to be included in the framework approach are summarised below

· South Hampshire

Tender for up to a 4 year contract to provide 1000 overnight short break `bed nights' a year. Tenders will be invited to provide this service in one or possible two locations to support carers in the Havant, Fareham and Gosport areas

· Western Hampshire

Tender for up to a 4 year contract to provide 800 overnight short break `bed nights `a year. Tenders will be invited to provide this service in the New Forest and Andover areas.

1.11 A separate tender is also proposed for an existing service in North and East Hampshire, where currently the National Children's Homes manage a long stay residential care service at Linden Avenue in Basingstoke. The current contract, which has been in place for 10 years, ends in December 2008. It is proposed to extend the existing contract to 31st May 2009 to allow for continuity of service for existing residents, all of whom will be over 18 years of age in May 2009. This will support transition plans with Adult Services.

1.12 It is then proposed to tender for a new 4 year contract for 5-6 places for longer stay residential care services. The tender will invite interest in providing this service in one or possibly two locations in Hampshire.

2 Recommendations

1 That the Executive Member for Children & Families approves that tenders should be sought for the provision of overnight short break services in South and Western Hampshire to commence on the 1^st April 2009

2. That the Executive Member approves that tenders should be sought for a long stay residential care service for Disabled Children to commence on the 1^st June 2009

3. Summary of consultation

3.1 7 consultation events have been held for parents, carers and partners and over 300 people have attended. The consultation events provided an opportunity to brief partners about the Aiming High service development programme and sought views in the following key areas within the Core Offer and the Full Service Offer

· Services currently used and views on future needs and service gaps

· Experience of transition to adult services

· Assessment of need and the threshold for access to services

· A specific focus on short break services and how broader opportunities can be developed

· Information and advocacy services

· Participation and support

3.2 Responses to these issues have been collected during discussions and a newsletter was produced at each event summarising the key issues raised. Questionnaires are still being returned and the following summarises the key issues which have emerged so far.

· Many participants felt improvements could be made to the way agencies provide information about services and also that an independent advocacy service would be valued

· Concern was expressed about the extent to which a commissioning plan can be jointly developed with the PCT and jointly funded in delivery in view of the uncertainty surrounding the allocation of funds to the PCT for Aiming High and for implementation of the National Palliative Care strategy

· Many participants raised issues of definition and focus of services, including eligibility criteria and how more open access to targeted and specialist service could be developed

· Respondents asked how it will be possible to ensure that universal services make consistent provision for disabled children within their core funded provision, accepting that additional care support may be required for individuals to be able to take advantage of some universal service. For example, the provision of care support to assist a young person access a youth facility or a swimming pool and ensuring that the facility is suitable by ensuring that there are trained staff and that there are safe and appropriate play facilities for disabled children

· How the service development programmes in extended services in schools, in Children's Centres and through early years provision are coordinated and influenced to ensure open access to universal service with a clear statement of minimum expectation for children with a disability

· Access to transport services is a key issue for many parents and carers, in particular access to more flexible home-school transport to accommodate after school events.

· Coordinating and simplifying assessment of individual need across agencies with clearer service thresholds and service eligibility statements

· Reviewing sufficiency and capacity to ensure existing services are appropriately targeted and that additional services address priority needs, in particular addressing inequity in service provision

· Ensuring that the priorities of partners are focused on the agenda for change. E.g. through access to leisure and the recently announced grants to improve play provision

· The need to expand the range of short break services to include after school, weekend and holiday short break service

· Development of the Direct Payments service, including promoting better access to skilled carers

· Many parents and carers valued the support local groups are able to offer and a broader network with appropriate child care would be valued in order to support local participation.

4 Aiming High for Disabled Children

4.1 There are two main policy areas associated with the Aiming High for Disabled Children Programme, the need to develop a Core Offer and a likely duty to develop a Full Service Offer.

4.2 The Core Offer is largely a need to make a commitment to issues of principle and process and the Full Service Offer is focused on expanding the extent and nature of services which provide a break to children, young people, their parents and carers.

Core Offer

4.3 The key elements of the Core Offer are summarised below and will be implemented by a commitment across the County Council and through the way in which partners work together to support service improvements

· Information- that is accessible, available, relevant, joined-up and user focused

· Transparency - of resources, service availability, eligibility criteria, needs analysis and planning

· Participation - in that families are in control of their own services and are engaged in shaping service and monitoring outcomes. This will include ensuring that opportunities exist for local forums, satisfaction surveys and service user groups

· Assessment - that is coordinated, integrated, avoids duplication and undertaken by trained staff

· Feedback - Feedback should be sought from consumers and stakeholder to influence how services are developed. This will include advocacy services.

Full Service Offer

4.4 Draft guidance has been published and includes the following key features. It is anticipated that the final guidance will seek to ensure that there is a base line assessment available and that the new funds are focused on developing additional service opportunities. The Full Service Offer should make clear how existing and new services will:-

· Be sufficient to meet the needs of severely disabled children, their families and carers including those with complex health needs

· Be age appropriate and ensure that vulnerable groups are able to access short breaks, including children on the autistic spectrum, those with complex health needs and technology dependencies, those with moving and handling needs that require aids and adaptations, those with challenging behaviour and severely disabled young people aged over 14 years of age

· Short break services should be wide ranging and tailored to individual needs and should include

- Overnight breaks in the family home and else where

- Breaks during the day with care in the family home or else where

- Breaks available in universal settings delivered through the support of befriending, sitting or sessional services

- Breaks available when help is needed including responding in emergencies

- Services should be well promoted by information and culturally sensitive

Funding

4.5 The Aiming High programme is funded from 2008/9 and the following table sets out the ring fenced grant to be made to Hampshire. The allocation in 2008/9 is described as infrastructure development funding and further detailed guidance on the focus and monitoring of spending from 2009/10 is awaited. Early indications are that both the capital and the revenue must be committed to additional short break services using the likely broad definition as follows.

"An additional service received to support caring and to promote positive activities for young people"

(Source - Council for Disabled Children 2008)

4.6 A project group has been established to lead the process to consult with service users and stakeholders and a project plan identified to ensure that, by the autumn of 2008, Members can consider a service improvement and commissioning strategy to utilise capital and revenue budgets from 2009/10. The project approach is envisaged to be time limited, perhaps initially to March 2009, as a reasonable network of partnership forums exists to underpin much of the necessary engagement work. The existing network involving partners has made a significant contribution to service developments, including extended services in special schools, improvements to the joint aids store and establishing broad consultation and participation opportunities.

4.7 It is thought that a match fund allocation has been made to PCTs although it is known this is not ring fenced. It has not as yet been possible to confirm what may have been, or will be, allocated to Hampshire PCT. The Council for Disabled Children is pressing nationally for some confirmation and guidance as to scale and intended purpose and the Hampshire PCT has been asked to clarify the funding position over the next 2-3 years to support the development of short breaks for disabled children with health care needs.

Project Plan and time scales

4.8 £70,000 has been made available in 2008/9 for infrastructure developments and additional project support has been established through the joint commissioning unit with the PCT, by an additional secondment and through existing strategic and operational inputs. Further support from the FSU will be required as the commissioning plan and base line audit emerges.

4.9 The following summarises the headline time plan for the project in 2008/9

· Broad consultation with parents and stakeholders completed by the end of April 2008

· Report to the Executive Member for Children and Families in May 2008 to determine tendering for some overnight respite services in South and Western Hampshire, where existing service contracts come to an end in March 2009

· To complete tender process for these services by October 2008 in order for any new providers are able to commence services in April 2009

· By September 2008, to have completed more detailed discussions with existing users of some residential services run by Hampshire and the Primary Care Trust in order to consider what improvements are necessary

· Report a draft commissioning plan to CSDMT in September 2008 with indicative resource allocations for potential capital and revenue programmes

· To report further to the Executive member for Children and Families in October 2008 on a draft service improvement and commissioning plan

· Hold further feedback events for service users and partners in October 2008 to consider the draft commissioning plan

· By October 2008 to have concluded consultation with service users, staff and partner agencies on the best way to ensure assessment of need and decision making about access to services is more responsive to children, their parents and carers. This will include consideration of integrated care management processes with the PCT

· By March 2009 to report to the Executive Member identifying service changes and improvements to commence in 2009/10 utilising additional resources

· By April 2009 have commenced implementation of any necessary changes to the way in which partners should collaborate together in undertaking assessment of the needs of children and their parents

· Service change programmes and new services beginning to be delivered by April 2009

5. Current provision of overnight short break services.

5.1 The following chart shows the total overnight short break services currently available in each area.

5.2 Some of these services are provided by HCC residential care units and the following summarises the current purchased services where contracts are due to end at the end of March 2009 and where tenders should be let for new contracts to be in place by the 1^st April 2009.

South Hampshire

5.3 An overnight short break service purchased from KIDS.

5.4 Overnight short break service are purchased from Portsmouth City Council at Beechside in Drayton, North Portsmouth.

5.5 An additional service managed by the Hampshire PCT at Bedhampton House is available in South Hampshire and a review will be undertaken jointly with the PCT to consider with parents and carers options for the future.

Western Hampshire

5.6 An overnight short break service is purchased from the Rose Road Association in Southampton. The cost is shared 55% HCC and 45% Hampshire PCT.

5.7 Andover and District Mencap provide an overnight short break service at Stephen's Ark in Andover.

North and East Hampshire

5.8 The National Children's Homes provide a service in Basingstoke offering 5-6 longer stay places. This contract is not part of the short break service but the contract ends in December 2008 and a new arrangement must be considered to ensure service continuity for young people who are in some cases in `transition' to adult services. The current residents are will all be over 18 years of age in May 2009 and Adult Services will assume financial responsibility as residents reach age 18 and move on services are agreed. As these consumers move to adult services there will be a need for longer stay residential provision for children and young people.

6 Future provision of short break services

6.1 The requirement to develop a broader range and a better choice of short breaks is contained within draft guidance and it is anticipated a base line audit will have to be developed in order that additionality can be demonstrated in spending the grant from 2009/10.

6.2 Guidance, from the Department of Children, Schools and Families, confirms that Local authorities should develop a better choice of short break services, to include breaks within and outside the family home and not limited to overnight services.

6.3 The views expressed within consultation events confirm the value parents place on overnight short breaks but also confirm that a broader range of services should develop, building upon the present position rather than replacing overnight breaks.

6.4 There are issues of equity of access to be addressed and the chart at paragraph 5.1 illustrates the current position where children with a disability in South Hampshire have less than 50% of the access to overnight short break services than in other parts of Hampshire.

6.5 A full service audit is being undertaken, which will include the extent of other forms of short break service available and the results will influence how the commissioning strategy develops as opportunities could be taken to address equity of access across a broad range of services utilising additional funds in 2009/10.

6.6 This audit will include reviews of current HCC and PCT services and specifically will include a review of the NHS respite service at Bedhampton in Havant, where opportunities to transfer NHS obligations, and resources, to the County Council are being explored.

6.7 Members will be aware that there has been a previous feasibility study to consider if a new build project could be supported on land at Rachel Maddox School in Havant to replace the Bedhampton House service, where the building is approaching being unfit for purpose. Capital requirements are likely to be in excess of £3m and no provision has been made in capital programmes. Estimates of revenue requirements exceed the current budget for the service held by the PCT by a considerable measure.

6.8 Options for future service provision will be explored with current service users and partners should the obligation transfer to the County Council.

6.9 Additional funds are available from 2009/10 to develop a broader range of short break services and there is no indication from parents and partners that fewer overnight short break service is required in the future to meet needs. It is therefore proposed to seek tenders for overnight services in the current configuration, with caveats to allow for changes in service volume as the overall commissioning strategy is developed.

6.10 This approach will also be necessary to support parents exercising a choice of service through potential extension of the Direct Payment scheme, which has implications for providers of service in that parents and carers may wish to be more in control of the pattern of service that they wish to access. As other services develop the demand for overnight short breaks could be affected.

7 Implications

7.1 The proposals in this report are expected to support the County Council's corporate priorities as summarised below

· Making Hampshire safer and more secure for all by enabling disabled children to have greater inclusion and involvement within their local community

· Maximising well-being by ensuring every disabled child can have the best possible start in life

· Enhancing quality of place, through developing opportunities for all citizens to be included within their local community.

7.2 The proposal to tender for overnight short break services will also support all the outcomes of the Children Act, in particular to ensure the health and safeguarding needs of children with a disability and their families are addressed.

8 Consultation

8.1 Seven consultation events have been held for parents and partners to consider the implications of Aiming High for Disabled Children and to identify priorities for development. Over 300 people have attended.

8.2 In addition presentations have been made to a number of special needs forums and parents events in schools to support discussion on the issues. Over 1000 questionnaires have been sent out and results are being analysed in order to proceed with work to identify a commissioning strategy for service improvements and developments to commence in April 2009.

9 Legal implications

9.1 Amendments to the Children Bill currently before Parliament include proposals that local Authorities should have a duty to provide sufficient short break services to meet the needs of the local population. Further guidance is awaited as to the conditions of the grants to support service improvements available from 2009/10.

10 Financial implications

10.1 The chart at paragraph 4.5 shows the allocation of additional funds that have been announced and guidance is anticipated as to how `additionality' of service opportunities will be audited. It is known that both the capital and revenue allocations should be focused on developing the Core Offer and the Full Service Offer required within the Aiming High programme.

11 Personnel implications

11.1 None identified at this stage.

12 Impact assessment

12.1 Service tenders will include a requirement that service providers ensure equity of service opportunities and adopt anti discriminatory practices in relation to staff and consumers. The intended commissioning strategy to be reported to members later in 2008 will include arrangements for ensuring equity of access.

13 Crime prevention issues

13.1 Crime prevention issues have been considered and no adverse implications have been identified.

14 Views of the Local County Councillors

14.1 No comments have been received.

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.

None