Decisions, Decisions, Decisions

BudgetLast week I blogged about the next few months nationally but as a Councillor my and others focus is far more on the local issues and for us at the County Council it’s a mixture of two heady things Devolution and Budget, now you know you are a local gov geek when you use the word ‘heady’ to describe what is essentially rather dry subjects however important both are to Suffolk.

For any Council deciding where to spend its funding in the coming year is its biggest decision.  The one that effects the quality of services it provides and importantly for our most vulnerable residents the quality of aspects of their lives. Thus, it’s the single biggest decision we have to make in our annual cycle.

Last week, Suffolk County Council Cabinet started the process of sharing each department thoughts on the budget they would require and the debate then starts that will take the next few months through to a Full Council meeting to debate and decide.

I try to work hard to get out there with our #WeAreListening events and I have lead more public consultation on things that are happening than the Council has ever undertaken, both in terms of surveys people can fill in on line, to town and village hall meetings. We have commissioned Ipsos Mori and others to provide the backbone to these events with statistically valid polling. Our desire to ask people what they think is critical to me as we have a number of tough decisions to make. But hey, let’s be clear, asking people is but one part of the decision making process, debate in the Conservative group is another, as is the debates at Full Council.  All are component parts into trying to make the right decisions. People often are not going to agree, but, we make the best decisions we can to serve the wider population of Suffolk and to make sure the organisation has the financial resources and capacity to deal with the often more hidden issue we have to deal with.

A couple of weeks ago, I did a sort of reply piece on Mark Murphy’s BBC Radio Suffolk show to address some political pot shots from the opposition about Care Homes and how they are funded and the extent to which SCC work with them for the good of residents that was on the day before’s show.  In essence, I provided context to oppositions Councillors comment that implied we provided all the places a few years ago and now we sold everything off to the private sector. What we actually did was bring in a private provider to provision the 9% of the Suffolk total number of beds we were the provider of.  But, beyond the political point scoring, it was a really good debate highlighting one of the many discreet services provided few people hear or know about, unless faced with such very tough and difficult choices.  As an adult there are few things more daunting than that of care provision for one’s parents and loved ones.

Often the debate is about roads and this year many of us will have seen the significant investment £10M we have made over and above our normal expenditure on the highways. Yet, few of us actually know which of our neighbours receive some form of care service support or hear about the discreet Children’s services to protect our young people from harm. Getting Mrs. Smith out of bed each morning and helping her wash and dress, those hundreds of care beds we provide for people who can’t afford to pay for them themselves and all of these services to the most vulnerable in our communities largely go unnoticed. But we all, me included love to moan about pot holes for its the universal services, our roads.

So over the coming months there will be the chance to have your say and for the Cabinet to set out its plans for the coming year’s budget and when you do, it is important to say what you would divert money from to address something else.   For these are the debates your Councillors will be having as well.

Suffolk Flexicare Conference

Making my point at the Conference

Making my point at the Conference

Last Wednesday week we held the return conference, Suffolk Flexicare 2, almost 2 years to the day after Flexicare 1, in the same location of Newmarket racecourse. In some ways it was slightly surreal seeing my successor as Cabinet Member for Health and Adult Care chairing the meeting after living and breathing adult social care in Suffolk for 4 years, but Cllr. Dr. Alan Murray did so with great aplomb, as I know he will do the role, we even share a joke about being a double act hopefully more Morecombe and Wise that Dr. Jeckle and Mr. Hind not sure which I am but in my closing remarks I said I have short fat hairy legs and he wears glasses, sorry sort of an in-joke on the day.

Alan and I are working together as he learns the ropes on what is a vast and difficult service area and of course he brings to it an added dimension with his considerable experience in Health.  I hope as we debate the coming years budgets my experience in this service area will be useful as collectively we grapple with the demands of an ageing population and less money to provide services indeed provide services across all areas of the Council’s service delivery for the people of Suffolk, a challenge I now have political responsibility for. In many ways the issue of finance and our ageing population go hand in hand, I think we all have a vision of what we want, now we have to work out how we afford it.

The day was a mixture of key note speakers from the excellent Stephen Burke of United for all Ages a really intelligent think tank on the subject of housing in our society to Stephen Javes, CE of Orwell Housing who delivered his usual challenging thoughts on the way forward for social housing and in particular Extra Care Housing which is Suffolk is called Very Shelter Housing a kindly reference to Judith Hawshawk the powerhouse who pioneered such a thing in Suffolk before she so untimely past away. Their speeches were interspersed by a number of speakers who offered a different perspective of being form local voluntary organisations and older people who talked about their aspiration for their future housing needs.

Amongst the break out sessions was one I am particularly proud of, hosted by SCC’s former officer Dan Gaul now of Change3C who was presenting the Housing LIN tool for understanding the ageing population numbers drilled down to town and villages. I am proud as this is something he and I worked on together when I felt it was absolutely vital in planning terms for local planning authority officers and Councillors to be able to translate national ageing data set at and into their community level and I am proud to see this now available to all Councils through the Housing LIN.

I closed the day and focused on two things really firstly the notion that actually getting housing right for older people can be about aspiration and needs rather than settling for something that addresses their needs and the challenge to move and create an environment where Developers, social entrepreneurs and Registered Social Housing providers can come forward, invest and delivery the vast number of schemes we will need to see to address the needs of this one part of our ageing population needs.

Rupert Murdock’s Boardroom

A couple of weeks back I was invited along to a roundtable being held by Forster Communications and United-for all ages. The theme was Housing for all Ages and the event was one of a series of roundtable discussions as they look to produce a sort on manifesto for intergenerational housing in England.

The event was supported by News International in that they were kind enough to let the event be held in their Docklands headquarters on the 13th Floor overlooking St. Katharine’s dock and possibly one of the best views out over London I have ever seen, the discussion was not bad either!

The 4 key themes were:

Are older and younger people’s expectations of a home unrealistic?

Should older people share their homes or pensions with younger family members?

How do we get younger people housed and keep older people secure?

Are too many people living alone when they could benefit from communal living?

The room was a mixture of experts in the various fields of housing from Shelter to Property developers and I suppose I was invited along because it was hoped I could add a little something about the actual practical planning progress through a planning authority and how the demand side of things affect planning authorities core strategies or not as the case may be.

What did come out loud and clear was real problem that the absolutely proven need to build more houses seems to be swamped in a sea of concerns that will result in an ever lowering of build numbers and an ever increasing risk to people of all ages from having to live in poor overcrowded accommodation.

A couple of weeks ago Nick Boyles MP said that he considered our lack of house building to be the biggest social injustice of our time, he is absolutely right. Housing is at the route of so many precursors to using expensive health, care and social services and the cost of not providing suitable housing for a whole lost generation is immense, not to mention hugh pressure of our NHS.

We must start building more houses, usually something everyone can agree on, just as long as you obviously understand that means somewhere else, not near them!

For my part I talked about the challenges of a two tier area where at the County Council level we are responsibility for planning for our aging society and yet the District and Borough grant the planning permissions and often their focus is not on what the demographics are telling us. I also spoke of our Suffolk Flexicare strategy to address this and of our next Conference we are planning, two years on from its launch, at Newmarket Race Course on 5th June – The Suffolk Housing with Care Conference 2013: A move to Helpful Housing: creating choices in independent housing with Care – a conference I hope will report on progress, address the challenges ahead and how we deliver the programme I’ll be annoucning shortly.

My thanks to Stephen Burke for asking me along and I really look forward to the publishing of the report and I’ll post a link here on my blog when it’s out.

Adult Safeguarding Conference

Today I was in London for the Annual LGA conference on Adult Safeguarding, a serious issue and one we all need to occasionally think about as we visit with people and discuss the impact of cuts on our services.

Just before the conference I meet with James Mumford from the Centre for Social Justice who is writing a report for the Centre on strategies to address our aging population and the current state of the services available as we get older. Whilst it meant getting up far too early and a rather delayed journey courtesy of Network rail. James and I have a good hour and a half to chat about the state of services in general and the approach I am trying to see us drive forward in Suffolk. We agreed that eh would be coming to Suffolk to hear more from Officers on Suffolk Flexicare and to show him a round a couple of our Extra care housing scheme’s. I could wax-lyrical on extra care and its pivotal role in the delivery of housing for our aging population but you’d never have the time to scroll all the way through it and I am reminded one of my New Year’s resolutions was to make my blogs shorter!

Back to the Conference of the various excellent speakers the one I found most interesting was Zoe Lodrick MSc. BA Hons (1st). UKCP, wow!. Zoe is a UKCP Registered Psychotherapist and an experienced Trainer and Consultant. Her back ground includes over 14 years experience working at Portsmouth Area Rape Crisis Service (PARCS) providing psychotherapy to women and men who had experienced rape, sexual assault and/or childhood sexual abuse; and she provides training and consultation to professionals who work with victims/survivors of sexualised traumas (whether therapeutically or within the criminal justice system).

Her presentation was also about why people in abusive relationships often stay with their abusive partner, something I suppose I never really understood and the challenges that presents from a safeguarding point of view; she also went into aspects of people’s behaviour and responses when faced with a perceived threat (especially sexual threat). you know occasionally you sit, listen and realise you haven’t got a clue on a subject and really learn something new, of course that is why you take the time to go beyond the simply definition of a role and try to learn more. but…….!

Someone one told me the key thing with youth is to capture it before it realises it does not know everything; what I know is that as I get older I realise I know about less and less about more and more.

The Mark Murphy Show

Today I was interviewed on Mark Murphy’s show ahead of the BBC One Panorama Programme with Dame Joan Bakewell tonight, talking about our aging population, who is going to pay for their care and some of the initiative ways people are taking care of themselves.

Tonight they will discuss the national figures and I suspect it will make for worrying reading, in Suffolk what we know is that today there are 715,000 people living here, 140,000 some 19% are aged over 65; 40,000 6% of us are aged over 80. Today 10,000 people live with dementia Suffolk.

By 2015 the number of people aged over 65 will have increased to 169,000, rising to 211,000 by 2025 – an increase of 50%; the number of people aged over 80 will have increased to 46,500 rising to 67,000 by 2025 – an increase of 63% and by 2015 the number of people with dementia will have increased to 11,700 rising to 16,000 by 2025 – an increase of 60%.

It is too easy to think we face an overwhelming challenge, but as I said to Mark with all of this in mind we are working hard to work out ways Suffolk can be at the forefront of aging well.

If we are to succeed, we must make essential changes that could amount to revolutionising the way in which we offer care and support to Suffolk’s older people in future.

To start with Suffolk County Council has to change, last September we launched the New Strategic Direction because despite the then Labour Government saying KEEP CLAM and CARRY ON, we knew cuts and big ones at that were coming our way at a time when we also know we need to do something radical to address our aging population.

Different Councils are starting to talk about how they are going to deal with the coming cuts many are talking about becoming more efficient which whilst we will continue to be more efficient we know that other Councils have not been on the sort of efficiency journey we have been on since the Conservatives took control of the Council in 2005, we have saved over £60M of operational costs and are now rated as the second most cost efficient County Council in England and so we cannot find the savings that way.

That’s why we are changing through the New Strategic Direction vision.

That’s why we have launched Suffolk Flexicare which is about all local public services and providers looking at our whole care structure from housing to health care with all of Suffolk’s public bodies engaged in this work.

That’s why we are launching Suffolk Circle to change people’s perception of help and networking, support not charity.

That’s why we are working on new ways for our strong third sector, charities, community groups and social enterprises to be empowered to delivery services.

Beyond the national debate about how we pay for care for our aging population, beyond the demographics, we are determined that Suffolk shall be at the front of changing the perception of getting older and of caring.

Maybe just maybe tonight the programme will touch on the very embryonic thoughts about the value of caring, not just the unbelievable difference you can make to the life of another person whether they be your partner or parents but to the economic success of the country. In Suffolk there are 98,000 carers and if they stopped caring tomorrow the county care services would collapse, conversations about how we as a nation value that care is really important, conversations are just starting up around this and I hope the Royal Commission takes this debate on board.

I hope tonight’s programme picks up on the first conversations around, how we as a nation, value carers and encourage caring for another as a worthwhile profession; in short, how do we recognise that without making payment which we simply cannot afford.

Professor Heniz Wolff calls it care4care and we are very keen on this debate, its very very early days but we are working on it , so you heard it here first, Suffolk care4care, as with all the very best thinking we are determined that Suffolk should and will be at the forefront of such things. 

But what is care4care well it’s the theory that for every hour you spend caring for another, whoever that is, you bank that hour and one day if you need care yourself you can cash it and another person provides the care you need for free in the knowledge that they are banking that hour as well; and because everyone is giving of their time freely it cost the county nothing beyond the administration. Sounds simple, but is in fact full of if’s, but’s, and maybe’s that make it a very complex thing indeed, but we are working on it.

So, there you have it in a nutshell, Suffolk has an aging population and is getting less and less funding from Central Government to deal with it; but we are working on it, with Suffolk’s New Stratergic Direction; with Suffolk Flexicare; with Suffolk Circle; with Suffolk’s care providers and the third sector and long-term with all of us here in Suffolk working towards the Bigger Society David Cameron is talking about nationally and that’s what I told Mark Murphy this morning.

Suffolk Flexicare Conference

Yesterday I hosted a major Conference at Newmarket Racecourse where about 150 Local Politicians, District and Borough Planners, Care Providers, Community Groups and Health and Social Care professionals from across Suffolk came together with the County’s ACS team to discuss how we want the care offer in Suffolk to look like in 10 years time and beyond.

I opened the day with a speech to try to set the context of what was before us and what we needed to do during the course of the day to move the debate along.

“Good morning everyone!

I am delighted to welcome you to this important conference.

I believe that the timing of today’s event couldn’t come at a more crucial moment as we consider how to effectively deliver services to older people in the unique and challenging times that lie ahead.  

My name is Colin Noble, and I am the portfolio holder for Adult & Community Services at Suffolk County Council. I am very pleased to see so many of our partners and colleagues here at today’s event.

I cannot emphasise enough how important this shared and united approach will be to our collective success over the coming years.

In preparing my notes for today I thought to myself why is today so important, and I did not have to look far, my mother is 65 and my father is 70 and they are as we say ‘getting older’ who knows what the future will bring, ideally I would like them to be in perfect health until their late 90’s and ‘drop off their perch’ quickly, but I know that might not be the case and not only will they and our family need to address their care needs, those needs may well be quite different and what I know is that we will need options.

Depending on their needs we might need support in their own home, we might need to consider a great flat in a Extra Care housing scheme, sorry as I see Judith in the Audience sorry very sheltered housing, or they might need a bit more support provided in a residential care home, options but not just for my parents but options across our lovely county for all our parents and older residents.

Looking slightly further ahead, not only will our parents need those options but so will we and the steps we are taking and will take in the future will profoundly effect the choices we will be able to make to address our future needs.

So what are the things that we believe we know in these uncertain times?

Firstly, that we face an unenviable combination of challenges.

For a start, the harsh financial environment, and I know one of our next speaker Adrian will talk about how this can affect the best laid plans, its implications are becoming ever clearer.

Unprecedented times of austerity are with us, and we cannot avoid the necessity of severe spending cuts to public services.

We also know that the impact of people living longer and needing care and support will place many pressures on the services we deliver.

The number of people with dementia is also increasing, and I know today we will heard about the alarming increases we are going to see here in this county and we must provide services to support not only dementia sufferers but also their families and carers.

Today

715,000 people live in Suffolk

140,000 19% are aged over 65

40,000 6% of them are aged over 80.

Today 10,000 people live with dementia.

By 2015 the number of people aged over 65 will have increased to 169,000 rising to 211,000 by 2025 – an increase of 50%.

By 2015 the number of people aged over 80 will have increased to 46,500 rising to 67,000 by 2025 – an increase of 63%.

By 2015 the number of people with dementia will have increased to 11,700 rising to 16,000 by 2025 – an increase of 60%.

With all of this in mind, it is too easy to think we face an overwhelming challenge. But it is with this challenge in mind that we are holding this conference so that we can start the work to meet this challenge together.

If we are to succeed, we must make essential changes that could amount to revolutionising the way in which we offer care and support to Suffolk’s older people in future.

We have a lot to be proud of in Suffolk, our next speaker, Sue, will talk about some of the great services things that are being provided today in Babergh District, across

Suffolk we can also be proud of our pioneering approach to our extra care or very sheltered housing.

However we cannot afford to stand still and we must keep moving forward if we are to respond to the challenges that face us.

We have to recognise that the expectations that people have of public services are very different and we need to adapt and innovate to keep pace.

We must create an environment here is Suffolk where demand is recognised not is some global sense but in each town and village where we live and re-shape all aspects of our organisations so we are ‘open for business’ from granting planning permissions to commissioning and supporting care providers if we are to have the capacity to meet that demand and the expectations of those people we serve.

The Government’s strategic direction for adult social care is epitomised by the personalisation of social care, and this approach is also being reflected in the future direction for the NHS.

By putting the emphasis on people as the best judges of the decisions that affect them by taking control of their lives, we will have to think very differently. This is especially the case for the county council and NHS in their roles as commissioners, purchasers, providers and planners of services.

The county council’s Cabinet agreed the Flexicare strategy in December last year as a response to these challenges.

Today’s conference presents us with the opportunity to agree and endorse this joint approach. This means all of us leaving this conference with a clear understanding of what we will do and how we can contribute to bringing services for older people into the 21st Century.

We produced the Flexicare strategy because the challenges and issues that we face are so pressing that we believe we should take a lead in enabling the partnership working that is central to the way we meet these challenges.

The Flexicare strategy is founded on the recognition that none of the challenges that we face can be tackled alone.

There is no problem that impacts only on one agency or organisation; to get the best outcome for Suffolk people we have to work together to make a difference. 

At the same time as providing outstanding and truly modern services, we must make sure they are as efficient and cost effective as possible.

Flexicare is about giving people ‘control and choice’ over how they maintain their independence and live happy and healthy lives.

This spearheads the personalisation agenda by empowering people to take the decisions that affect their lives. We need to think differently about how we develop a range of services, including care and support in the home, housing and supporting Suffolk’s family carers.

The third element of the strategy is prevention. We cannot champion and enable independence if we do not work together to minimise the impact of long-term conditions that affect every aspect of older people’s lives.

This is not only about having the services and support in place for older people but also how to enhance the health and well being of Suffolk people as they age.

If more, older people could enjoy active and healthy lives, involving exercise and social opportunities, they will not only live longer but may never need more intensive support such as home care – a significant saving.

Collectively this is our strategy, which proposes a clear way ahead.

It gives us an exciting opportunity for us to deliver together in a way that will improve services for a generation.

I would argue that we cannot fail to seize and do all we can to make sure this strategy is a success.

Today’s programme is designed to make us think about what the future should look like, what we should be doing and how we are going to do it.

With our collective imagination, hard work and creativity we can really ‘make a difference’.

Today will be challenging and hopefully enjoyable as we look ahead to where we want to be and I am looking forward to working with you to make it happen!

Thank you.”

It truly was a remarkable day with a wide range of speakers from private care home developers and providers talking about their difficult planning journey; County Council staff talking about the new services we are rolling out; to a community groups talking about what they are setting up in their community to help people with Dementia.

The 4 different workshops ran through the day and asked the very difficult questions about what services will we deliver in the future and how can we improve the lives of older people across Suffolk in the years to come, there certainly was no chance to sit at the back and have a snooze

At lunch time I asked the Councillors in the room to joint me and senior ACS staff to a private room and over a sandwich or two, we have a ‘Chatham House rules’ debate about the political challenges about what we want to do in the future in our two tier local government structure, to say this session was useful is an understatement and I got a real sense of what we need to be doing to move the agenda forward in a political context.

For me and I said so in my summing up of the day in the late afternoon, the litmus test for any conference is how many people stay to the close and remarkable over 80% of those there at the start of the day saw it through to my closing remarks. The Waverney table stayed until the end and most of them had a journey of over an hour and a half to get home and on a Friday night to boot!

The key challenge from such a complex and great day is to keep the momentum up so from the conference will come a number of briefing papers aimed at different groups and the launch of Suffolk Flexicare 2 coming to a venue near you, if you would like to get involved in this care revolution please let me know and I’ll make sure you are added to the list.

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