Transforming Care, NHS and austerity measures in local authorities

18 August 2015

I visited 15 services this week and was really pleased to see a significant number of our staff who have been promoted internally. I am very keen that people join CMG not just for a job but to make a career with us and a number of people have progressed from being support workers to managing residential homes and supported living services. The majority of Regional Directors have also been promoted internally. We are hoping to develop a ‘Next Steps’ programme in a few months to give a more structured development path for people with potential who want to be promoted and develop their career with us.

I have talked before in my blog about the Winterbourne View programme, now called ‘Transforming Care’. I have two frustrations: the lack of progress since the awful abuse at Winterbourne View took place about four years ago and the lack of involvement of community based providers who have the expertise in how to support people with complex and challenging behaviour in the community. I am pleased to say that following a discussion with NHS England’s Director of Transformation, she has agreed that it will be helpful if the provider sector in England could come up with a proposal as to how we could provide greater leadership and input into the process of designing new services as a replacement for assessment and treatment units. A workshop will be taking place in early September, attended by representatives of all the major provider representative bodies in the sector following which there will be a report which will be considered at the Transforming Care Provider Forum which I will be going to for the first time at the end of September.

Michael Fullerton, our Clinical Director and I, also had a meeting with a specialist NHS Trust last week to discuss the idea of setting up a community based crisis team. I think it is essential that we have effective crisis services in place otherwise people will continue to be inappropriately admitted to assessment and treatment units and we won’t see the number of in-patient beds reduced to the level required. Following that discussion, we are now proposing to establish a national pilot site in London for Transforming Care. If this gets off the ground, it will provide us with an opportunity to explore new service models that more effectively support people in the community and prevent inappropriate hospital admissions. There are several other pilot sites in the country but surprisingly given its particular population and characteristics, not one in London at the moment. I am very keen for CMG and other competent social care providers to be involved in looking at how we can re-shape our services so that we aren’t overly reliant on institutional hospital settings.

On a final note, we had a very clear reminder last week that austerity is still very much here. A Local Authority contacted us to say they had reviewed the fees for two of the people we support and that they both need to be reduced by over 40%. I know both individuals concerned and that is complete nonsense. It is disappointing that the Local Authority didn’t have the courtesy of looking at the individual’s needs with us as the provider who knows them best. We will be doing our own assessment using the ‘care funding calculator’ which is a recognised tool for identifying how much money should be spent on an individual and we will be responding robustly. The last time a Local Authority told me our fees should be cut by 40% it was for a group of people with profound and multiple learning disabilities. I said to the Local Authority that the only way the fees could be cut to that extent was by stopping all meaningful activities, not taking people out, leaving them in their chair and just providing basic personal care and that if that was what they wanted, they should find a different provider. Interestingly, nearly two years later, those two service users are still with us on the same fees. Whilst it is really important that we work in partnership with our Local Authority partners, there are occasions where we need to stand up for vulnerable people we support and we will not accept fee cuts that are detrimental to them.

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