The calm before the Storm

It is the final days of calm before the storm and a hush has descended.

All the ‘flurry’ over the past couple of weeks about the New Strategic Direction, Care Homes Strategy and Executive pay has past; the in-year budget cuts have been achieved; the budget planning process for the coming year has been agreed; the grids of what ifs and how’s are prepared; the time of the group meeting to begin discussing the implications is set.

The literally 1000’s of man hours put in by officers, then countless meetings and many a sleepless night has been had, certainly by this Councillor at least, has I hopes produced a set of proposals and rationales that can handle whatever is demanded.

In short the Comprehensive Spending Revue is almost upon us!

A revue that is simply required as a correction in the state spending of this country that has over 13 years of labour mismanagement got totally out of hand, those who say the depth of the correction is not necessary, I personally think they are just sticking their heads in the sand and hoping it will all go away, it will not. If we do not get the spednign of the coutry into balance, the cost of state borrowing will be a weaker pound, inflation creeping in, base rate rising to hold inflaction in check and the cost of mortgages rising, which will put millions of more people into negative equaity struggling to pay their mortgages. The cuts in state spending are needed and needed now, the thoguhts of rising mortgage costs will send shivers down most peoples spines.

Of course human nature tells us that we might be able to agree that it needs to happen in the round but of course that is different when it affects a service we cherish, then the cuts should be somewhere else, simples yes? , err no.

To some extent I think the real job of being a Councillor is just beginning, for the past few years it has been about managing a centralised Agenda, reporting back on a scale you would not believe possible and making the organisation as efficient as possible to deliver low council tax rises, which since 2005 we have done and done well, taking a very inefficient organisation and taking it to now being rated as the 2nd most cost efficient County Council in England and highly regarded as a 4 star (the highest rating) Authority.

Now the funding is being cut but so are the shackles and its for us here in Suffolk to decide how we want to shape our services in the future, its about making difficult decisions and making the right decisions in a way that has not be possible under labour that is the freedom, the difficulty and the challenge ahead.

But for now we wait, speculate at to the scale of what is to be announced, as each day passes and we hear that the PM has stepped in here and this and that will be ring fenced and none of it bodes well for Local Government!

Residential Care Homes the future

Today I presented to the Cabinet of Suffolk County Council a paper asking for permission to go out to consultations as to how best to stop being a provider of residential care homes and instead buy the rooms for people from the private sector. 

In addition I also had quite a few press interviews with journalists and both Look East and Anglia Tonight and I had the opportunity to meet and talk about the proposals with some of the Care Home Managers who will be effected by the changes, I thought what they said gave me a really interesting take on things, I hope as we visit all 16 of Suffolk’s County Councils homes I can continue to learn what people really think and that when the team work up our final proposals for March our thoughts are all the better for having undertaken such an extensive programme of meetings.

I also had a first in that I was interviewed by Look East ‘down the wire’ which meant rather than be asked questions by an interviewer standing beside a video camera I had to look directly into the lens and be interviewed by Susie Fowler-Watts who was in the studio in Norwich, sounds simply until you do it!, the most distracting part is that you stare into the camera and see the lens system moving as it adjusts as you wait for the questions in one ear. I watched it later with Lisa my partner and she could not stop laughing!

For me I think in the interviews and my speech to introduce the paper I hope I got across how important to me and the team it is to go out to each home and meet with Residents and explain why we are doing, what we are doing and how we can support them during the process. 

What I said in my speech was:

‘Can I start by welcoming the visitors who have come here for this paper today[the care home managers I had the opportunity to meet with].

As the Councillor responsible for this county’s adult care services, I am very much aware of how this issue affects the lives of some of the most vulnerable people in our county, and, therefore, how important it is that, whatever we decide to do, we do with extreme sensitivity, consideration and care.

In my own family I have experienced the need for, and the loving environment that a good care home provides people in their twilight years and I also know from personal experience that a care home is more than facts and figures, more than the number of beds and more than ratings for this and that, it is a loved one’s home. 

Firstly I think it is important to explain why this paper is being discussed today.

In June we launched our Suffolk Flexicare Strategy, which aims to bring together Councils, Health Partners, Care providers, the Voluntary sector and communities to look at our demographic pressures and what the residents of Suffolk are telling us so we begin to shape the services we will need to meet those aspirations.

At the same time we are, along with councils across the country, facing unprecedented necessary cuts to our funding as central government work towards reducing the deficit we have in this country, after 13 years of a Labour Government.

At the same time, we consider it our moral duty to protect the most vulnerable in our communities, and that’s a corner stone of what we as Councillors and I don’t just mean Conservative Councillors, I mean all of us here, are about.

The Council’s New Strategic Direction is our plan, across all our service areas, to improve outcomes for people while we are receiving much less money.  We are determined to find ways of shielding the people of Suffolk from the worst of the financial climate.

This paper is a first step along that road, with regards to how we care for older people in the county.

I must stress that point: this is just the first step. I have heard a number of people say that when they read it in the media or heard it on the radio it was the first they have heard about it, just as with a child’s first step, it is the first step, in the way a council does things this paper is how we first propose a strategy, so be definition this is where we first heard things in Cabinet, in the democratic domain.

What we are looking to do as a result of this paper is consult residents and families in our residential care homes about the best and most cost effective way of providing long term care in future.

It will be part of a dialogue, which has already started – information about the proposals has already gone out to families, care home staff, residents and their carers as we published this paper last week.

The next steps will include public meetings at all 16 council-run care homes, which I will be attending with officers to hear what people have to say.

The public consultation period runs for 12 weeks from November to January, and people’s feedback will be a crucial part of our final decision next March.

This is an important and emotive issue.

Each care home is different, and we must do our best to support and ensure the wellbeing of all residents, and I firmly believe the paper asks for Cabinet to agree a consultation that will sensitive to this.

Nothing will change before Cabinet takes it final decision in March, when any decision and its outcome will be carried out sensitively and with the needs of our residents in the forefront of our minds. Until then, nothing will be changing. 

So let us remind ourselves why we are making these proposals.

Firstly as it says in the main body of the report, on page 22, paragraph 20, in Suffolk today there are 67,000 people aged over 75 years old by 2015 this will rise to 77,000 and by 2030 127,000 of us, almost double, will be over 75, in Suffolk we are an aging population and must recognise this pressure.

What every national and local survey tells us, not in some sort of 49% of people said this and 51% of people said that but almost 100% ‘of people surveyed said’ we want to stay in our own homes and so that must be our number one priority when we are designing services.

What we also know is that today, when that burning ambition is no longer possible because of a person’s frailty or increased memory loss there are 5,500 Residential Care beds for those of us who need them.

To some extent when I heard different people speak of our proposals I think many people thought that the vast majority of those beds were provided in Council run homes and I suspect it comes as a bit of a  shock to many people to learn that in fact the county council in terms of the number of homes and beds it provides is quite a small player, in our 16 homes we provide 526 beds of which 50 people pay for themselves and so in our own homes we support 476 people, we are 9.5% of the total provision across Suffolk.

Yet we actually support 2,300 people, that’s over 75% of the number we support, we do so very successfully, in private homes. That’s almost 40% of the total number of those who live in residential care homes across Suffolk and contrary to some of the unhelpful comments UNISON have made in their recent press release, is not a damming indictment of the council nor means we would not have the ability to deal with any care home failures, just as last year, we would have precisely the same role and abilities to support the market when a problem occurs.

It is true that the quality of care provided by council-run homes is high, and compares favourably with the best homes operated by the independent sector. Both provide a warm, loving, caring and professional standard for people to enjoy in their twilight years.

However, because the vast majority of those we support we do so in private homes we know that the cost to the council to provide residential care is significantly higher than it is for the equivalent private homes. 

At less cost, they are able to provide equal or better standards of care in their homes, at better value. 

Given the extreme budget position we face, and the need to make sure we make the most of all our available resources, it would therefore be odd if we didn’t explore the potential options contained in this paper.

At this stage I want to pay tribute to the staff in all our homes at this very difficult time as they maintain our high quality and standards and also begin this difficult consultation process and very uncertain time. Their commitment and support is exemplary and I recognise the difficult position they have been placed in as they to continue to manage their home in the coming months. I say Thank You to all our staff for what they have done and I know what they will continue to do.

It is also absolutely essential that we look to meet the demand going forward. 

As I said older people tell us that they want to live independently in their own home wherever possible.  For this reason we must focus on supporting people to do more themselves: by moving away from running care homes, the council can develop more community-based support services to do just that and so respond to the new demand.

Our New Strategic Direction is all about enabling people to decide what they need, when they need it. With this in mind, long term care is not always the best option by any means.

Through Suffolk Flexicare we are working with our partners to deliver outstanding and sustainable housing and related support to older people by 2020.

By working with our partners in health and the voluntary sector, we are already seeing creative ways to provide more responsive services in people’s communities. This reduces spending, cuts out unnecessary bureaucracy and, most importantly, provides better support to our customers.

Equally the introduction of personal budgets is making a huge difference to the way in which people can decide what they need, when they need it, even purchasing services in some cases using a direct payment.

By continuing our dialogue and providing essential information at every step of the process, I am confident that we can agree on the best solution for the older people we support, their families and carers.

I welcome the interest and debate. I want to hear from communities about options for the future but everyone has to bear in mind that the county council has an agreed policy through the New Strategic Direction.

There is a need to respond to the budget crisis, a need to empower communities and a need to manage these uncertain times and find a way that, together, we can support our older residents through the current difficult climate and into a better, more sustainable future.

However it is very easy to sit in an office and council chamber here in Ipswich and make coldly logical decisions about how to allocate money.

I fully understand that, for those who live in our care homes, such logical reasoning doesn’t count for much.

That is why we are taking great care with this review. 

That is why the managers of our care homes are working hard to reassure people: answering their questions; explaining how they can influence our decision on the best option for each home.

That is why I and my team will be visiting every single care home and I will be inviting Councillors to come along to those meetings as well.

And finally that is why I commend this paper to Cabinet so we can consult on the sensible options before use and bring a paper back to Cabinet in March 2011 with our considered opinions as to the way forward.’

A number fo constructive comments were made by Councillors which are taking on board.

Now we embarking on the 16 care home visits which I do not expect will be easy but as the officers and I have discussed and as I said in my speech we really do want to take this time to think about each home on a individual basis and to explain first hand to Resdients, Familes , Carers and Staff what we are about.

Postcard from Birmingham

What a difference a year makes as I travel on the train to Birmingham, this time last year we were in opposition and looking forward to winning a general election, this year in coalition and facing up to what looks like its going to be a really tough day on 20th October the day of the Comprehensive Spending review.

As I near Birmingham and sit quietly planning my conference which plenary sessions which fringes which receptions and which restaurants, or is that which restaurants which drinks receptions which fringes something like that; my phone rings and my day changes when I get a call from the Central Office team that the question I tabled has got through and I am to present myself to the conference desk at 3:15pm, I am now on a deadline – clearly the recent publicity around the New Strategic Direction has certainly pushed Suffolk up the list of Local Councils to watch, err……think that’s a good thing!

So I check into my hotel, unpack and head off the conference to make myself known at the desk, a brief chat, I drew the high nubmer so go last, and its into the main hall for the Big Society plenary session. I take my place in the reserved seat for the speakers from the floor and natter to the others who are going to ask a question of the Local Government team. The debate begins and surprisingly Eric Pickles quite early on asked for contributions form the floor. Not a good start as the first name called is not there but at least that pushes me up the list, next speaker, then the next then the next, a bit nervous now as one to go before me, then in comes George Osborne and wife and Eric Pickles decides to stop the contributions from the floor and makes his speech instead, my big moment dashed! Oh well never mind!

Later at a drinks reception I am introduced to Eric and mention that he cut me short earlier in the day, he did not seem fussed at all! The next couple of days pass without incident and I enjoy talking to old friends attending different fringes on Social Care, Health, Housing and Local Government tax and efficiency. I also attended a closed meeting with the local government team which was very different from years past gone are the days of Eric giving a rousing speech of once more unto the breeches dear chums, once more push and we’ll be there instead we are getting down to the ‘nitty gritty’ of government and the relationship with us in Local Authorities.

During the course of the conference the Residential Care Home papers for the cabinet meeting on the 12th were published and nothing really happened on the Monday but by the Tuesday the press were making enquires and I agreed to go on the Mark Murphy Show on BBC Radio Suffolk on the Wednesday morning, I got up early took my notes and papers to Breakfast and was back in my room waiting for the call just after 8am sitting in my room with my notes around me, Mark Murphy was on form and it felt quite a tough interview particularly as I had not been able to hear what people on before were saying. His questions were quite quick fire but I tried to get across the maths of what we are doing and how we were going to go to all the care homes to explain our thoughts.

He then rather unexpectedly moved onto the Chief Executive’s pay following comment made by a few people the previous day, again I was out of that loop being in Birmingham and so as not quite ready for that; but was able to answer the questions as much as anything because I am simply staggered that in the face of the scale of the issues before us, people seem to be able to rally behind such calls. I suspect in part this is because it is actually quite difficult to articulate just how much she has achieved in terms of the organisational structure change that has taken place and got us to a place whereby we can propose something radical such as the New Strategic Direction and be in a position to start its implementation, something we could not have done before her arrival, equally from the start of her employment we said we wanted to become know not just as an organisation that has successfully become more efficient but we want to be known as the most cost efficient County Council in England, last year under her stewardship we can second only to Kent not a bad achievement but difficult to get across just how important both of these things are when we look towards the cuts that are coming, shielding Suffolk from the worst of those and delivering on our promise of low council tax rises.

I ‘checked in’ with my Director afterwards and she was concerned that I did not really get the maths of why we need to look at how best to deliver the Residential Care Homes. I was disappointed with her comments but really pleased to be able to have another go at doing just that on Anglia Tonight who kindly interviewed me at the conference at lunchtime and I was able to talk about how we indeed to deliver a ‘as good if not better’ standard of care at a cost saving to us.

Reflecting on the conference and writing this blog on the train home, I supposed I noticed a couple of things doing the three days; firstly the slightly surreal airbrushing out of the coalition, we won, the rest is mere detail!, as one world weary colleague put it. The second as and by far the clearest message coming from the conference was about the Comprehensive Spending Revenue in a couple of weeks time, not one Westminster MP was saying anything, which it my mind is quite worrying, clearly they have taken the decision that they did not want a conference of gloomy looking delegates with the worlds media camped on the door step and in the halls.

All in all a few good days spent talking politics, good keynote speeches, interesting fringes and good company; there were one or two receptions, a couple of kind invitations to dinners with the area teams and I seem to recall a couple of lively discussions into the wee small hours in a bar of the Copthorne hotel.

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