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18.Oct.2010

The Cabinet at Swindon Council has given its initial backing for the creation of a social enterprise providing all adult health and social care services in its area.

The arrangements would see employees from the local authority and Swindon Primary Care Trust transferred across under TUPE to the new vehicle. This would, if implemented, be the first time such a social enterprise had been set up in England for these services.

The social enterprise is the preferred option of the director of adult social care at Swindon Council and the PCT. However, Swindon’s director will now prepare a full business case examining its feasibility and the various other options available.

The move is part of a continued drive to integrate health and social care services for Swindon.

The Cabinet papers also point out that the NHS Operating Framework 2010/11 requires PCTs to stop directly providing services – “as a result, arrangements for the transfer of NHS staff to a new organisation such as another NHS provider, local authority or social enterprise, need to be in place by 1 April 2011”.

Under the plans, the preferred option for children's services is for relevant PCT staff to be TUPE-transferred to the council, also with effect from 1 April 2011.

The Cabinet has authorised the council’s group director for children to enter into new National Health Services Act 2006 Section 75 Agreements with the PCT for the commissioning of services with a pooled fund and for the provision of services from next April for a three-year period.

This will be “on such terms as the Director of Law and Democratic Services may consider necessary to protect the Council’s interests and those of NHS Commissioners, and subject to completion of due diligence and identification of risk mitigation in relation for finance, TUPE and human resources issues”.

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18.Oct.2010

Local authorities should not use the Big Society as an opportunity to transfer some of their functions and teams in competition with existing civil society organisations, a study of third sector bodies conducted by the Commission for Rural Communities has warned.

The report – following a survey of more than 70 community and voluntary groups and local authorities – said councils and other public bodies should be encouraged to carry out and support asset transfers for long-term social and financial outcomes, not just short term cash receipts.

The respondents to Economic conditions for organisations contributing to the Big Society in rural England also called on the government to provide more clarity on issues such as how the Big Society will be supported (including financially), how the role of local authorities is going to be affected, who should deliver essential services in rural areas and how this would happen, and what the expectations are for joint working between councils and the voluntary and community sector.

“Central and local government should avoid dismantling what works, ‘reinventing the wheel’ and duplicating efforts,” it was argued.

Other key recommendations include:

• Funding should be made accessible with simpler application and management processes, “including the adoption of more standardised processes to save organisations their scarce time and resources and encourage them to get involved in new projects”
• The government must take measures to ensure that civil society organisations are not viewed as soft targets when implementing spending cuts. “This might include ring fencing of funds that are passed down from central government to local authorities to be allocated to the Big Society or civil society sector”. Similarly, vulnerable groups should not be disproportionately affected by spending cuts.
• The government needs to understand that the Big Society, although cost efficient, is not cost free and some communities do not have the capacity to get involved. “Ongoing and long term funding as well as professional support is still needed to carry on delivering their services and taking on additional responsibilities”
• Mechanisms should be put in place to ensure that vulnerable groups’ voices can be heard when building the Big Society
• The actions and experiences of civil society and the local parish and town councils need to be “recognised, celebrated, supported and built on”.

The groups largely welcomed the Big Society concept and believed they were well placed to deliver its ambitions, the report said.

“At the same time, many have concerns about their capacity to take on more responsibility, not least because of the effects, and anticipation, of funding cuts,” it added.

“To date many have been able to absorb cuts in income and ensure that provision of services is maintained as much as possible by cooperating with others and/or seeking new sources of income. However, others have been forced to reduce their services or withdraw them completely.”

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15.Oct.2010

The Localism Bill will contain a “powerful” new right for voluntary and community groups to challenge local authorities to consider alternative ways of running services, the Decentralisation Minister said yesterday.

In a speech to SOLACE’s annual conference, Greg Clark called on councils to strengthen their ties with the third sector, arguing that there was a greater need in the current economic climate for the “diversity, innovation and cost savings” such groups can offer.

The minister praised in particular the voluntary sector’s contribution in education, tackling worklessness, the environment and social care. He said the new right of contestability would give groups the chance to offer a better alternative.

Central government was not giving power to councils to then see it recentralised locally through a monopoly of local public services with voluntary and community groups – including charities, social enterprises, co-ops and housing trusts – pushed out, he added.

Clark said: "The spending review will inevitably present councils with some tough choices in the town hall, but councils must resist any temptation to pull the drawbridge up on the voluntary sector. We expect councils to devolve and empower people and maintain strong links with voluntary and community groups.

"Right now in a tight economic climate there is a greater need for the diversity and innovation voluntary and community groups can offer. Reinforcing monopolies of local services by retrenching into the town hall is not the way forward. Opening up more of councils' budgets to have it carried out by voluntary organisations can improve effectiveness, increase resilience and save costs."

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12.Oct.2010

The Royal Berkshire Hospital is to charge Oxfordshire County Council £10,000 amid claims that the local authority is not doing enough to prevent “bed blocking”, according to a report by the BBC.

The hospital has suggested that some patients are having to remain on wards because of a lack of care provision.

The BBC said Royal Berkshire’s chief executive, Ed Donald, had confirmed the charges in a report. They will be backdated to April.

John Jackson, Oxfordshire’s director for social and community services, called for a new approach.

He told the BBC: “That is about stopping people going into hospital who don’t need to go in and actually getting people out very quickly from hospital.”

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12.Oct.2010

Close to 1,000 residential care homes do not have a registered manager in place even though it is a legal requirement, the Care Quality Commission has warned.

The commission said the failure to have a registered manager – which is required under the Health and Social Care Act 2008 ­– might not present a direct risk to residents’ safety, but could mean care homes are less able to identify potential concerns and address them quickly.

Conditions have been placed on all those care homes without a registered manager in place requiring them to address the issue by 1 April 2011.

The 2008 Act came into force on 1 October, although the requirement to have a registered manager in place was also a requirement of the previous legislation, the Care Standards Act 2000.

The CQC has so far registered care providers operating about 20,000 adult social care service locations under the new regime.

The watchdog explained that not all care homes need to have a registered manager – those who manage their own services on a day-to-day basis do not need to also register as managers.

Cynthia Bower, the CQC’s chief executive, said: “It has been recognised in the care sector for some time that there is a shortage of experienced and qualified managers. While we have been undertaking the enormous task of re-registering thousands of care services, the scale of this has become clearer.

“The lack of a registered manager does not necessarily mean that people are receiving poor care, but we know from experience that care services without leadership can struggle to address any problems that may arise. Good-quality care is led by good management.

“We know that some providers struggle to find suitably qualified people to take on this role. The sector as a whole needs to take a robust approach to seeking solutions to the shortage of registered managers. It cannot be allowed to continue indefinitely.”

Bower warned that the CQC would use its enforcement powers where appropriate.

“If a care provider is genuinely trying to appoint a registered manager and the quality of care is good, it might not be in the service users’ best interests for us to take enforcement action immediately,” she said. “But if we find that people are being put at risk because there is no registered manager, then we will take action.”

An estimated 1,300 providers of adult social care and healthcare have not applied for registration under the 2008 Act. According to the CQC, this figure includes those who have been difficult to contact and may have ceased operation.

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06.Oct.2010

Local authorities must be at the heart of healthcare commissioning, especially in “Cinderella services” for the vulnerable, the Local Government Association has argued after submitting its response to the government’s health White Paper.

The LGA claimed councils were ideally placed to take the pressure off GPs by ensuring vulnerable children, dementia sufferers, people with learning difficulties and the homeless get the services they need.

The association said town halls, not just doctors, should play a key role in commissioning services, particularly in those areas where they have most expertise. These areas include: mental health; health and wellbeing of homeless people; long-term conditions; drug and alcohol dependency; dementia services; services for children and young people; services for people with learning disabilities; HIV/AIDS services; carers’ services, older people’s services and free nursing care.

The LGA said its key messages included:

• Its strong support for the increased public health role for local government
• The need to create strong and focused health and wellbeing boards to provide effective local leadership and coordination of services for everyone. “These must be given a statutory footing and be seen as equal to GP consortia and the National Commissioning Board”
• The scrutiny of the National Commissioning Board, health and wellbeing boards and GP consortia was very important, as was the need for them to be locally accountable
• The need for urgent clarification on funding of patient and public involvement in 2011. Funding for Local Involvement Networks runs out in March, but the replacement Health Watch does not go live until April 2012, it pointed out.

Cllr David Rogers, chairman of the LGA’s community wellbeing board, said the government’s shake-up was an opportunity which – if handled properly with a clear allocation of roles and good communication between councils, GPs and NHS bodies – could be “a real shot in the arm for health”.

But he warned: “Councils need to be at the heart of commissioning, especially in the areas they have experience and expertise in like so-called ‘Cinderella services’ for the vulnerable. GPs are inexperienced here and there’s a real risk they may not see the incentive of commissioning services where success isn’t easy to measure, or might outsource commissioning for these groups, breaking a vital link between an individual’s health and social care services.

“Decisions on where to spend money and commission services need to be taken locally. Councils know their residents’ needs best and using available funding as they see fit will keep people healthier and reduce the burden on the health service.”

Rogers added that health and wellbeing is “much more than just doctors and nurses”. He said: “The foundations of local government in the 19th Century were in the need to beat typhoid, cholera, poverty and poor housing. The challenges may have changed but councils are still best placed to improve their residents’ health in many ways, whether it be promoting nutritious food and exercise, or helping people quit smoking or excessive drinking."