Agenda item

Review : Ageing Adults with complex needs


8.1  The chair explained the committees review on the aging of adults with complex needs had been initiated by the committee partly in recognition of the extra costs of around 2 million a year to the council because of demographic pressures. He introduced Vicky Stoppard and Alexander Laidler. The officers introduced the paper by talking about the role of the transitioning team in making a cultural shift towards Personalisation. The team will be working with younger people as a new cohort going into Personalisation rather than more expensive services that also encourage a dependency cultural. The officers said that that the paper discusses the need for universal services to become more accessible so Personalisation can work.


8.2  The officers went through the demographic pressure and noted that there is a trend for significant increase in numbers. They noted that there are also people with mixed needs. Officers explained that Autism is on the rise with around 10 percent increase. Challenging behaviour can arise because the service is not meeting peoples needs. Officers explained that residential placements are expensive and the council need to make it more attractive  and get better at  enabling people so more people can live in own homes .


8.3  Officers stated that the budget is shrinking so the council need to be more transparent about what is available and really listen to what people want. Officers said that we need to look at day provision; so that it is more about skills development. We have created a dependency culture so we have to get it right for people entering the system.


8.4  Officers explained that the council have a new transition team working from childhood to adulthood.  This team is looking at creative ways of delivering services and working with service users. The council is looking at starting a budget from an early age. People will have one point of contact; this has come about because of feedback from service users. Officers reported that the council are looking at whole life planning for adults which will evaluate outcomes. This means the council will look if to see if we can support people to get a job or sustain a tenancy, for example, and then measure the council’s success.


8.5  Officers went on to talk about older people with disabilities and explained that social care staff have good partnership working with clinical staff. Officers explained that dementia is much more likely for people with down syndrome. They also explained that people with long term health conditions are also much more likely to develop additional health needs at an earlier age so the council have often developed the capacity to be able to respond.





8.6  Officers reported that one key issue  that the council needs to focus on is ensuring that people can access mainstream services. For example accessing swimming pools, libraries and employment. They reported that there is quite a long way to go in order to meet this complimentary need if Personalisation is to be effective.


8.7  Members asked why Southwark has such high levels of learning difficulties and officers explained there are a range of factors, including deprivation.


8.8  A member commented on the view that Day Centres do not work and commented that there seems to be a bias away from this provision. Officer responded that this is about choice and that Southwark needs to offer a range of provision. Officers commented that people can get very attached because they have no other options. Day Centres are effective at social support. Officers said that there is a need for more diversity; not just day care or home care. They explained that with Transition and there are now other options; so service users could spend one day at a day centre and another getting employment support.


8.9  A member asked about the council’s role when things go wrong and about the council’s regulatory role. Offices explained a big part of our work is safeguarding and carrying out investigations these tells us a lot about the services are not working.  Listening to people with learning difficulties is important. There are regular individual reviews. The council’s emphasis has moved to more outcomes based assessment and listening to people .Safeguarding is also related to homes, staff and strategic issues. It also often comes back to relationships and community so that those people with significant others can act as alerters.


8.10  A member asked how officers deal with situations where the support plan does not work.  They responded that sometimes it's about ongoing process: having plan and keep going back to it and talking to people. Officers explained that they have contingency plans and we work with circles of support. The council have a statutory duty to undertake an annual review; but it varies and some people are seen once a week.


8.11  A member commented that he has received feedback that older people with downs syndrome who are more sheltered can be more adversely impacted on as they grow older. Officers agreed that some people can present at a later age when parents die and there is a need to develop some mapping of needs.



8.12  A member asked if there was a fund to attract new providers and officers explained that there is a small fund for new initiatives such as cooking clubs and evening social evenings. Officers explained that they want to stimulate change.


8.13  A member commented that you talk about transition up to 25 years of age and went on to question if this was flexible. Officers commented that there is some flexibility, but unlikely to be late twenties. They reported the council are starting soon so we will have to see how it works.


8.14  A Member enquired abuts the impact of rising rents, cuts to housing benefit and the welfare cap.  Officers were asked how they thought this would impact on disabled people and any knock on effect from other boroughs. Officers said that they would get back to the committee with this information.






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