Technical Notes 2023, Issue 9 - Older People’s Social Support Strategy/ Day Care

1. The purpose of this Technical Note is to advise Members of the intended publication of the Social Support for Older People Strategic Vision 2023 – 2029 and intention to seek approval from April 2024 of a revised service model by the Integration Joint Board on 19 January 2023, further to the successful completion of a strategic service review.

2.  In April 2021 the Health and Social Care Partnership (HSCP) re-commenced work to review formal and informal social supports for Older People which had been on pause since 2020 due to the Covid-19 pandemic. This work included delivering a Strategic Needs Analysis and undertaking significant engagement with interested parties. The aim of the review, recognising changes in the way in which people can be supported and occupancy of current day services, was to determine how best to shift towards, encourage and make use of early, preventative, and community led services.

3. In June 2021, and following provision of the Strategic Needs Analysis and outline of the rationale for undertaking a strategic review of social support for Older People living in East Dunbartonshire, the  IJB authorized  the development of a five-year Social Support Strategy for Older People.  Permission is being sought from the IJB on 19th January 2023 to publish this strategy.

4. The vision for the five-year Strategy is to develop more flexible, responsive and sustainable models of Social Support. The Strategy aims to develop a model of person-centred, community-led support that encourages a feeling of connectedness to others, a feeling of being an active participant in an individuals’ own community, strengthening social inclusion and equality. The Strategy also aims to facilitate a shift towards an emphasis on community led support for Older People, for those who are able to be supported at such activities - in place of the current default position of formal in-house or  commissioned, centred-based day care. The Strategy will make a significant contribution to Local Outcome 6 “Our older population and more vulnerable citizens are supported to maintain their independence and enjoy a high quality of life, and they, their families and carers benefit from effective care and support services" contained within the Council’s Local Outcomes Improvement Plan 2017-2027.

5. The provision of formal social support opportunities for those Older People who are most vulnerable due to physical frailty and/or increasing levels of confusion caused by Alzheimer’s, Dementia or any other mental health illness will always have a place within the Strategy, but this should not be seen as the primary means of support, and should be targeted in line with assessed needs and delivered in a way that best represents person-centeredness and value for money.

6. Following extensive engagement, regarding potential models of delivery and options appraisal sessions with key stakeholders, the draft Strategy was presented to the IJB in June 2022.  The options considered as part of the consultation were:

a) Option 1 - The HSCP continues to provide three building-based Day Centres as is the current arrangements, with one Centre dedicated to providing centre-based day care for Older People from the Black, Asian and Minority Ethnic (BAME) community. This is the status quo option. It would sit alongside ongoing support to promote existing and new community led supports for Older People via the Older People Local Area Co-ordinators Team and third sector partners. This is already in place and core funded.

b) Option 2 - The HSCP changes its approach to deliver formal building- based Day Centre support from two, not three, buildings, and one in the West and another in the East. This option includes developing a number of community led support initiatives in the East and West localities, bespoke to the specific needs to people in these communities, including BAME individuals and others who have protected characteristics.

c) Option 3 - The HSCP moves to deliver formal building-based Day Centre support from one building (locality to be determined). The remainder of the activities associated with this third option are equivalent to Option 2, including the development of other community led support initiatives.

6. The majority of stakeholders involved in the consultation process, indicated a preference for Option 2 - delivery of formal building-based social supports (building-based day care) from two geographical locations with enhanced community led support, bespoke to local communities.

7. Subsequently, the IJB authorised commencing an Options Appraisal Service Review - via an Older People Day Care Delivery Review Group - essentially to help identify, amongst other things, the commissioning model underpinning Option 2.  An Equalities Impact Assessment on the approved draft strategy was undertaken at this time, and the input of expertise from Equalities Officers from both East Dunbartonshire Council and NHS Greater Glasgow and Clyde was sought.

8.  A key group of Officers from both the HSCP and the Council formed the Older People Day Care Delivery Review Group, which commenced weekly meetings from 24th August 2022 to 14 December 2022. Membership included representatives from HSCP senior and operational management, Chief Finance and Resources Officer, Strategic Commissioning Team, Human Resources, Finance, and Trades Union organisations.

9.  The EDC ten-stage review process concluded that the officer recommended option for implementation is that Option 2 in the strategic vision process (2 day care centres – one in the East, One on the west – and an increased infrastructure of community alternatives) be delivered via a commissioning approach with the two day centres being delivered by externally contracted organisations.

10. Trades Union partners participated fully in the service review process.  Trade Union colleagues have a consistent position in that their preference is to, wherever possible, seek to maintain or increase Council run service provision and EDC workforce.  However, in this instance they accept the outcome of the review process as being fair and transparent.

11.  The implementation of the outcome of the strategic service review, should it be approved by the IJB on 19th January, is that from April 2024 all older people in East Dunbartonshire requiring formal building-based day care will receive this from one of two geographically located centres (one in the East Locality and one in the West).  This is a reduction from the current three centres. The officer recommended service delivery model deemed the best fit to deliver on the Strategic Vision would result in the re-provisioning of services for older adults from the BAME community who use the Milan Service through the two commissioned services.  This more equally meets the needs of all older people requiring centre-based day care, but removes a bespoke dedicated day centre resource which has been in place for one specific group in the East Dunbartonshire communities. The service specifications for the two proposed geographic day care centres will be subject to full Equalities Impact Assessment, following approval by the IJB, in order to ensure they are adherent to the needs of people who may have any of the protected characteristics – including culture, religion and language.

12. EDC employees currently employed in the Milan Day Centre will have the opportunity to continue in EDC employment in other roles in day services and social support.  Due process in line with EDC workforce polices will be followed to effect this change, inclusive of employee consultation and engagement with the Trades Unions.

     13. One day care centre is currently delivered in a Council owned asset – Oakburn Park Day Centre in Milngavie. No implications are      anticipated in respect of this EDC asset.