A Feasibility Plan for The

Appendix 1

Jubilee

Day Service

A Feasibility Plan for the

Re-provision of the day service at jubilee in St Albans

Introduction

As part of the refocus of the countywide review of day services for older people in 2006, three areas have been highlighted as needing a more detailed review. One of these areas is Jubilee Day Service in St Albans which serves the district of St Albans and surrounding areas.

This feasibility plan covers the options for re-providing the day services that are currently run at Jubilee. The day service provides a service to older people and people with a physical disability. In this feasibility stage of the project relevant information has been gathered about the day centre, which has been analysed and options are presented.

Background

Jubilee Day Service is an HCC ACS in-house day service that can accommodate 30people per day Mon-Fri.

The day centre runs with 13members of staff (including non-care staff) equating to 12 full-time equivalents.Consideration must be given to possible TUPE issues if a new service is provided as an alternative.

The day service is located in a leased building that has been for many years identified as unsuitable due to its layout, non-feasibility to alter, lack of safe access for service users who are transported and lack of suitable parking facilities. For some years a search has been ongoing for an alternative and a site was finally identified. However capital funding (£3.5m) for the new build project has now been withdrawn and the business case has weakened due to falling numbers of referrals and attendance over the last seven years.

Needs analysis

JubileeDay Service currently has 70 people on the books and operates a Mon-Fri service. This number is changing rapidly due to the smoking and charging policies. This number has decreased since March 2007 from 90 service users

Service users can be categorised as follows:

31 older people with high needs physical disability (who are allocated an average of 12 places per day)

27 older people with lower needs physical disability (who are allocated an average of 7 places per day)

10younger adults with mental health problems or a physical disability (who are allocated an average of 4 places per day)

3 people with a learning disability (who are allocated an average of 1 place per day). These people all attend Butterwick day service on other days.

On average, 25 places are booked per day. Average attendance at Jubilee is 74%.

There is no waiting list

The service is evidently running at below capacity

This can be summarized in this table:-

Total / Mon / Tues / Weds / Thurs / Fri / Average per day
Older people with high needs/ physical disability / 31 / 12 / 10 / 12 / 17 / 12 / 12
Older people lower needs / 27 / 6 / 11 / 5 / 4 / 10 / 7
Younger adults with a physical disability or mental health problem / 9 / 2 / 3 / 7 / 4 / 2 / 4
People with a learning disability / 3 / 2 / 1 / 1 / 2 / 0 / 1
Totals / 70 / 22 / 25 / 25 / 27 / 24 / 25

The analysis of service users needs has been carried out with the in-house team that provides the service. This is sufficient to produce this feasibility report. A further desktop analysis was carried out by the ACS care management team who broadly concurred with this analysis. A review/assessment of need will need to be carried out by the local ACS care management team before a decision is taken about moving individuals to a new or different service. Priority will need to be given to resourcing this.

Options Appraisal

OPTION

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DETAIL

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COMMENT / RISK

1. Do nothing.

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This is not an option as the service is not appropriately provided.

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Service continuing at site increases risk of an accident or safety incident.

2. Decommission Jubilee and provide services as follows.

2a. Reprovide service,or part of service with Quantum Care.

2b. Lower need service users to be placed with voluntary service providers.

2c. Service users with learning disabilities to be moved to Butterwick Day Services.
2d. Younger Service users with physical disabilities to be moved to Greenhills in Hemel Hempstead or Garden City Day services in Welwyn Garden City, or Borehamwood Multi-purpose day centre or Drum in Watford.
2e. Some service users to be allocated direct payments.
2f. Some service users may benefit from more intensive home care or BreakAway for Carers (sitting) service. /

VestaLodge in St Albans has a spare lounge and can be used to take up to 10 places for elderly frail clients.

• This service would take approximately 2 months to establish.

Services run by Age Concern or other voluntary services to take service userswhose needs can be met in this way. There are ten services in St. Albans who receive some degree of HCC ACS funding.

• Work is ongoing to confirm capacity.
• Age Concern have indicated willingness to develop appropriate service if needed and funded.

• Some existing service users already attend Butterwick and Greenhills on alternative days.

SST/Local team to do full re-evaluation of service users to include consideration of use of direct payments

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The cost of this service would be cost of Quantum service plus any potential staffing.

TUPE would apply in relation to in-house staff,if they transferred. There may be capacity to move staff within existing ACS services.

The procurement route for transferring a service from Jubilee to Quantum will have to be considered.

There may be a cost implication to enhance voluntary services.

• Risk - resource allocation from SST/local team to assess Service users.

• Staff issues may arise. One to one consultations are necessary.

3. Reprovide service at an alternative site on a like for like basis.

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Alternative site not easily identified. A new build is c.£3m+. Efficiencies can be obtained by other options.

Communication

Key Contacts

Name / Role / Email Address
Vacancy / Manager, St Albans , Hertsmere etc Service Solutions Team
David Quirke-Thornton / Area Manager – Day Services West / David Quirke-Thornton/Hatfield/ACS/HertsCC
Vicki Underwood / Manager – Jubilee Day Centre / Vicki Underwood/Hemel/ACS/HertsCC
Adrian Smith / Area manager EPD St Albans / Adrian Smith/ACS/HertsCC
Mark Lobban / Head Of Strategic Commissioning and Major Project Management / Mark Lobban/Hatfield/ACS/HertsCC
Sue Fox / Project Manager / Sue Fox/Hatfield/ACS/HertsCC
Jenni Lynch / Programme manager – Accommodation for older people / Jennifer Lynch/Hatfield/ACS/HertsCC
Guy Pettengell / Head of Operational Contracts / Guy Pettengell/Hatfield/ACS/HertsCC
Jawahar Dhutia / Contracts Officer – Home Care and Day Care / Jawahar M Dhutia/Hatfield/ACS/HertsCC
Dee Millar / Contracts Manager - Care Homes and Day Care / DeeMillar/Hatfield/ACS/HertsCC
Susan Street / Voluntary Sector Commissioning Officer / Susan Street/Hatfield/ACS/HertsCC
Gill Borg / Transport Commissioning & Planning Manager / Gill Borg/Hatfield/ACS/HertsCC
Maureen Harwood / Transport Manager / Maureen Harwood/Hatfield/ENV/HertsCC
Amanda Smith / Resources Manager – Transport / Amanda Smith/Hatfield/ENV/HertsCC
Penny Soper / Head of Communications, ACS / Penny Soper/ACS/HertsCC
Alison Brown / Communications Officer / Alison Brown/ACS/HertsCC
Vicki Holmes / HR Officer (ACS) / Vicki Holmes/CSERV/HertsCC
David Parry / Director of Care and Development, Quantum Care /
Vince Long / Accounting Manager / Vince Long/ACS/HertsCC
Keith Price / Unison Rep. / Keith Price/Hertford/CSERV/HertsCC
Mark Deacon / Unison Rep. / Mark Deacon/Hertford/CSERV/HertsCC

The following stakeholders have been briefed in writing as to the current situation:

Staff

UNISON

Local Members

Relevant voluntary organisations i.e. Age Concern Hertfordshire and Carers in Hertfordshire.

In addition, a press statement has been prepared and a letter for service users and their carers.

Cost Analysis

The existing service costs approx. £275k per annum.

A Quantum Care service excluding TUPE costs would cost £26.50person per day. A 10 place service for 5 days a week would cost £68,900k per annum. This would meet the needs for people with high needs based on the data above.Importantly, there is capacity for a seven day service at Vesta Lodge which could add significant value to respite for carers.

If TUPE applied then Quantum Care would want the costs identified and paid subject to further negotiations.

A new voluntary sector service would cost £28k per annum (estimate from Age Concern).This would be for between 20 and 25 people per day depending on location. Capacity in existing services would need to be maximised before a new service was funded.

A further analysis of transport costs will be needed. HCC transport is already provided for many service users at Jubilee Day Service. Staffing costs will need analysis when a decision is confirmed. These can not be specified in detail as costs will depend on individual decisions, subject to TUPE. For purposes of quantifying efficiencies £50k has been assumed

The capital cost of a new build for a replacement service was £3.5m (excluding land cost).

In summary the costs of new reprovision (excluding transport) will be a maximum of £68,900+£50,000+£28,000 ie £146,900. This deducted from £275,000 is £128,100 potential saving, per annum. It must be emphasised at this stage that this is a variable figure.For these purposes a worse case scenario view has been taken.

Recommendations

It is recommended that option 2 be pursued. This will achieve substantial cost saving, whilst ensuring appropriate services continue to be provided.

Service users will need a review/assessment to determine exact alternative needs.

A project plan and communication strategyhas been written.

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