Fair Access to Care - Consultation Outcome

Approximately 1,000 consultation documents were distributed including over 300 in easy English. These were sent to representative groups of users (including the Disability Equality Forum, WECODP, the Advocacy Project, Action for Pensioners - Older People's Forum, the Care Network, HUG - users of mental health services), voluntary organisations, other partner agencies (PCT, AWP), B&NES staff, some individual users and independent sector providers and members of the Council Executive and the Social and Housing Services Overview and Scrutiny Committee.

In addition a consultation meeting was organised which was primarily aimed at users (for notes of this meeting see Fairer Charging report). Pam Richards also attended a meeting of the Action for Pensioners health and social care group, the Physical and Sensory Impairment Group, a B&NES Social Services managers meeting and a management meeting of the PCT in order to provide clarification and receive comments.

Written Responses

Service Users 71 (a high % were people attending day centres)

Carers 3

B&NES staff 18

NHS staff 3

Vol. orgs 19

Representative group 14

Not stated 9

TOTAL 137

Question 1

Are there risks to independence/ needs which we have not identified in our table which you think should be included ?

Yes 30

No 49

Comments

There were relatively few comments. The selected comments below sum up the main concerns raised.

`Does not take account of deaf people's needs'

`I think most things are mentioned'

`If people who need a little help to access social contact or development opportunities do not get it they will become depressed because they will be on their own all the time'

`We are concerned that the Council will only meet the needs that are eligible and in setting the eligibility criteria a Council is allowed to take its resources into account. "Does that mean if a Council is at the end of the year short on resources that a person being assessed may not receive the services that they are really entitled to because there is a shortage of resources'

`Does not take account of the social needs of very disabled people'

`Limiting people's choices who need social and emotional assistance'

`I need help with paying bills and with understanding information and with meeting people in the community'

`What does specialist help mean?'

`I am mentally ill. When I am well, I need little support, but when I am not well I need a lot of support to keep me safe. Is the line in the right place for me?'

`If people need some kind of transport, will they get it ?'

`If I did not come to a day centre I would be bored to tears'

`Give money to people who need help more'

Question 2

Is the banding easy to understand ?

Yes 58

No 17

Most people found the banding reasonably easy to understand but the comments below reflect that concepts were difficult particularly for people with a learning difficulty

Comments

Needs careful study.

Not clear about when cleaning, shopping and laundry would be an eligible service. Need to look at difference between availability and willingness of family/friends to assist.

Some things need to be easier to understand for people with learning difficulties.

All symbols are good.

Very difficult to understand

Too long - ideas were very hard.

Easy to read - but ideas were hard.

It is not clear who receives and responds to this document, but it is unsuitable for ordinary citizens.

Question 3

Do you think we have drawn the threshold in the right place ?

Yes 34

No 16

Not sure 24

Comments

`Some deaf people will lose out.'

`People should be given help to have a good quality of life. If they are not they are more vulnerable to health problems'.

`Concern about service for a regular bath or shower and aids/adaptations for this'

`Aspects of the parenting role including taking children to school, for appointments etc should be above not below the threshold. Maintaining the parenting role as far as possible is vital for disabled parents (a) because of the impact on the children if we do not support this and (b) for very many disabled parents in terms of their own self-esteem, wellbeing and continued independence as someone with self-worth'

`I think you have really tried to get things fair. Hopefully these guidelines will be for assessment purposes. For instance should an adult with learning disabilities who is cared for by a very elderly relative and cannot possibly go out on his/her own be deprived of all social outlet (now in low)'.

`To some extent, but for people in lower bands quality of life is important.

Some moderate and low band people will fall through the net as some in the two lower bands like myself'.

`People who need part-time help and do not get it, will suffer. I know people in this situation. No two people's situations are alike'.

`People may miss out if they have a mental difficulty and illness'.

`Don't like the line - people need to be treated as people and not put on lists'.

`We want to know why you have not got enough money'.

`People doing assessment may see things differently.

`If you do not give a service to people who need a small amount of service to help them, they might get worse'.

`People that need help some of the time; it might be the only time that they are able to go out or participate in something due to their disability and not able to go to college or voluntary work, so they will be at home all the time'.

`We are not sure where the line would be in reality. How it would affect people in real lives'.

`The category like "Help some of the time and a little help sometimes" should be above the cut-line. Because it may involve safety of a person'.

`I think people should get help if they need it (even if it's a small amount)'.

We also had a written representation from the West of England Coalition of Disabled People. They welcomed our consultation process which they felt had involved key stakeholders from the beginning. They welcomed the proposal for our threshold -

` WECOP is aware of the difficult financial situation the council faces and we therefore acknowledge the courage and commitment of the council to services for Disabled and Older people as setting the threshold at a higher level would have seemed an attractive cost saving measure.'

They suggested that we should include in the needs list - being unable to travel without support or without use of an accessible vehicle.

WECODP sought clarification on the inclusion of carers (carers are entitled to services in their own right). They also expressed concern about the staff resource implications of conducting reviews with all service users.

The Care Network also sent in a written response. They felt the language of the document was complex and it was not easy to see who was entitled to a service. They felt it should be made more explicit that the criteria were also for carer's services. Nevertheless they felt that the needs were covered. They felt the threshold was broadly in the right place but felt that wider aspects of parenting role should be included because these impact on the whole family.

The Care Network felt that there must be adequate sign-posting to alternative services but were concerned that where these services did not exist then carers would be expected to fill the breach.

Pam Richards

Strategic Planning Manager

Adult Care and Commissioning Services

7.02.03