Day Centre Activity in Waverley : Community Overview and Scrutiny Committee on 03/03/2003

Waverley Borough Council Committee System - Committee Document

Meeting of the Community Overview and Scrutiny Committee held on 03/03/2003
Day Centre Activity in Waverley

At an earlier meeting, Members of this Committee asked for a report about Day Centres to be presented. This report is designed to update members on the current situation in respect of Day Centre activity in Waverley, focusing on the five “core day centres”, their current position and various developments/opportunities.

APPENDIX D

WAVERLEY BOROUGH COUNCIL

COMMUNITY OVERVIEW AND SCRUTINY COMMITTEE
3RD MARCH 2003

Title:

DAY CENTRE ACTIVITY IN WAVERLEY

[Wards Affected: All]

Summary and Purpose

At an earlier meeting, Members of this Committee asked for a report about Day Centres to be presented. This report is designed to update members on the current situation in respect of Day Centre activity in Waverley, focusing on the five “core day centres”, their current position and various developments/opportunities.

There are no resource implications arising from this report.

Consideration of this matter was deferred at the last meeting.

Introduction

1. At earlier meetings of this Committee, members asked for a report about day centres in Waverley. This report aims to meet that request and:-

provides background and demographic information;

details how the day centres are resourced;

gives comparative data from other local authorities across the county;

provides a current situation report; and

outlines some of the developments for the future.

Background

2. In most counties, unitary and metropolitan districts in England, the provision of services for older people is the responsibility of the Social Service Department of the County Councils.

3. In Surrey, since 1948, this has not been the case and the Borough and District Councils directly manage the majority of day centres. In a few cases, voluntary groups are grant-aided by local authorities to fund day centre activity. The table shown at Annexe 1 provides information from other Surrey District/Borough Councils’ budget books regarding gross expenditure and income on day centres and Meals-on-Wheels services, which they operate/support. The figures shown are for 2002/03. There are marked differences in philosophy and approach to day centre funding between the various Boroughs and Districts. The figures, therefore, illustrate the situation but would need to be carefully refined to provide considered comparisons. However, they do show that, broadly speaking Waverley’s contribution towards the day centres and Meals-on-Wheels service is very cost effective for this Council.

4. In Waverley there are six major day centres providing services for older people viz:-

Brightwells Gostrey Centre, Farnham

Cranleigh Day Centre

The Denningberg Centre, Godalming

Farncombe Day Centre

Haslemere Day Centre

Milford and Villages Day Centre

5. The Denningberg Centre has always operated independently of the Council and has not sought revenue or capital funding from the Council in the last decade. The other five day centres have been termed the “core day centres” which the Council, as a matter of policy, would wish to support on an on-going basis and all five have been admitted to the Sponsored Organisation Scheme (SOS). This report concerns itself with the five core day centres.

6. Unlike most local authorities in Surrey, in Waverley, the five core day centres are not directly managed by the Council but managed by voluntary groups with varying levels of grant-aid from Waverley Borough Council although the situation has become more consistent over recent years as dedicated day centres have opened and been operating five days per week. Historically, there had been significant differences in service provision between the various centres, reflecting both the geographical area and development of the individual groups. However, with the anticipated completion of the Haslewey Centre in Haslemere in 2003, all of the five core day centres will have dedicated property from which to operate and all will have the facilities and opportunity to open at least five days a week. As from 2003, each of the five core day centres will, it is anticipated, be receiving commensurate sums towards their running costs.

7. The work and role of day centres for the elderly accords with the Council’s vision statement - “To enhance the quality of life in this green and pleasant Borough, now and for the future, through strong local leadership and customer focused service.” and align with the Council’s Objective (No. 22) “Support activities which enable older people to live their lives to the full”

8. Day Centres provide a stimulating and safe environment for older people, providing a range of facilities - meals, chiropody, bathing, hairdressing, activities, advice and general support. The intention is to improve the quality of life of older people and,

where possible, to provide services to enable the more vulnerable to remain in the community and in their own homes, for as long as possible. This work is consistent with the Council’s partner agencies policies and priorities – e.g. the Primary Health Trust and Social Services.

Demographic Factors

9. The population statistics for elderly people help to illustrate the nature of the growth in the older population and, in particular, those over the age of 80 and provide evidence for the need for day centres and their operation.

10. The 2001 Census reports that the UK population has grown by 17 per cent since 1951 with a big increase in the number of people aged 85 and over, 1.9 per cent of the population.

11. Waverley has the highest population of those aged 80 and over in the County of Surrey, with some 1,352 people between 80 and 84, 2,139 people between 85 and 90 and 1,093 people over 90. The 50–54 age group has seen an increase of 34.5%, and the over 90 group represents the largest age group increase since 1991 (56.1%).

12. The Table below provides a comparison of figures for 1991 and 2001 for Waverley.

13. Clearly, not all of these people will require or want services provided by day centres, but indications are that the population requiring such facilities is likely to grow both numerically and in the range of services required. As people age, the added years tend to be associated with increased dependency and there can be more need for support for people living alone who might be at greater risk of isolation and exclusion from society. It is evident from the clientele at Day Centres that there is an increasingly aged and frail group of people using the centres.

The Nature of Existing Need

14. Historically, the Council has provided resources to enable day centres to provide for older people who are of retirement age but do not have significant support needs. For example, the Council does not provide funding to cover the wages of Care Assistants, Bathing Attendants, or other staff who provide “care”. However, as time has gone on, the day centres have recognised that there is an increasing need to assist people who are becoming ever older and frailer and, in some cases, moving towards dementia. There are significant issues surrounding the care and support of such people – not least the legal responsibilities and potential liabilities in doing so in relation to both staff and customers.

15. An important factor is the dynamics between those who like to use day centres as a social club e.g. who are well, active etc; and for those who need more help and assistance and who may be confused and incontinent. Experience – in Waverley and elsewhere - shows that these two groups do not mix well, and if a day centre starts to try to meet the needs of too many people with high levels of need, there is a danger that those who need less care and support may stop using the centre seeing it as somewhere for those with high levels of need. Another risk is that if a centre has a reputation for being a place providing day care rather than social activities, it will deter the recently retired age range from wanting to use the centre. There is a real issue about whether centres are there to provide services and activities which enable people to maintain their independence and an active social life, or whether they are for high dependency clients who have a range of care needs.

16. Social Services assesses an individuals’ need for assistance from others in order to live safely and as independently as possible within the community. Levels of risk/need are defined (by Social Services) in terms of the frequency with which help is needed:-

“High risk”: Without the provision of community care services, the person’s current care/living arrangements will break down or become unsafe within the foreseeable future * and/or

the person is alleged to have been the victim of adult abuse or without the provision of community care services they will be highly vulnerable to being a victim/perpetrator of adult abuse within the foreseeable future*.

*(Note: under normal circumstances “foreseeable future” is defined as being within approximately 12 weeks)

· “High need”: People who need daily or continuous help or support with the essential activities of daily living.

“Moderate need”: People who need some support or assistance to assist them to manage independently. They require this help several times per week but less often than every day.

“Low need”: People who need help intermittently (less often than once per week) or require support to improve the quality of their life rather than to strengthen essential supports for daily living.

17. The day centres were established largely to meet low dependency needs e.g. social support, refreshment and in some cases bathing and chiropody. However, there is an increasing need/demand for provision from medium and even high dependency clients.

18. In the past, the Council’s previous Housing Committee expressed the view that the day centres supported by the Council should offer services to older people who fall into the low to moderate need category. In this way, the day centres can offer a vital social and preventative service, which will enable people to remain within the community for a longer period of time. All the day centres do accept wheelchair-bound and less mobile people, but their capacity to deal with clients who are incontinent and/or confused varies.

19. The issue of how to deal with people who have high needs has come about not because of a conscious decision to provide services for new high need clients, but rather that some of the existing clientele have aged further and moved into the high need/high dependency category. This causes some concern for day centre committees and staff as they recognise how important day centre routine is for these people, and yet they are not necessarily funded or equipped to provide the requisite levels of care.

20. Over the years, some of the day centres have been successful in securing funding from Social Services or the Health Authority to enable them to provide services for and manage frail, confused clients. Such monies were used to employ Care Assistants. However, such revenue funding tends to be allocated – at best – on a three yearly basis, and often awarded annually, so the day centres concerned find it difficult to plan with any level of financial certainty/confidence about the next year. Where funding has stopped, day centres have felt themselves under considerable pressure to continue to provide services for those clients which, in turn, puts them under financial pressure. There is no easy resolution to this conundrum.

Staffing and Volunteers

21. In order to run the day centres professionally, all five core day centres have their own managers and three have deputy managers. However, in order to provide the range of services/activities provided and to undertake fund-raising activities, each of these day centres rely heavily on dedicated volunteers. Like all service providers, day centres are required to operate on a professional basis in the light of Health and Safety legislation, food hygiene, and so forth, and not least because of the evermore litigious society in which we operate.

22. Like most voluntary organisations, all the day centres have concerns about the difficulty of recruiting and maintaining volunteers. Often, due to the increasing age of current volunteers and because of the greater demands placed upon the remaining volunteers, they are leaving and not being replaced. Lack of volunteers is a problem that is likely to grow rather than diminish in the future, and impacts upon the services a day centre can provide.

Day Centre Development

Haslemere Day Centre

23. The new Haslewey Community Centre designed to meet the needs of Haslemere residents and surrounding areas is due for completion in March 2003. It is intended that Haslewey will provide a 5 days per week Day Centre facility, and is currently under construction at Lion Green, Weyhill, Haslemere. The Council has donated the land and awarded £400,000 matched funding to enable this development. The centre will act as a Community Centre available to all people in Haslemere, but one of its main activities will be the day centre operation. The Centre will comprise:-

Reception Area
Lounge
Dining Room
Catering Kitchen and Stills Room
Bathroom
2 Activities Rooms
Hair-dressing room
Medical room
Office
Toilets

24. A revenue grant of £41,000 from Waverley is being proposed under the Sponsored Organisation Grant scheme for the new Haslewey Centre for 1st April 2003, thus bringing it in line with other day centres operating 5 days per week.

Farncombe

25. Farncombe Day Centre is the smallest of the day centres and its facilities include:-

Lounge
Kitchen and servery
Dining Room
Hairdressing Room
Chiropody Room
Office
Quiet Room/Area
Toilets
Use of bathroom at Bowring House

26. Most recently, the snack bar area was refurbished in May 2002. The refurbishment involved demolishing the semi-circular snack bar and refitted with mobile Grundymaid food service units. These new units have improved the storage and floor space area, and are easier to clean, improving the hygiene standards for that area of food serving. The snack bar area is now considerably safer for older people as it has a non-slip floor covering, and the Grundymaid units are designed with safety in mind.

Cranleigh Day Centre

27. Cranleigh Day Centre is the next smallest after Farncombe, and facilities at this day centre include:-

Lounge
Kitchen and servery
Dining Room
Hairdressing Room
Office
Toilets
Use of the bathroom at Rowland House.

28. Cranleigh Day Centre Committee has now signed a new lease which makes it responsible for the repairs and maintenance of the building. There are proposals in respect of the redevelopment of Rowland House that could affect the day centre. The redevelopment of Rowland House may give rise to the opportunity to enlarge the facilities at Cranleigh. It is not envisaged that the day centre will cease at any time to provide a service whilst changes to Rowland House take place.

Milford and Villages Day Centre

29. Milford and Villages Day Centre is the newest of all of the day centres having opened in 1998. Facilities comprise:-

Lounge
Kitchen and servery
Dining Room
Hairdressing Room
Chiropody Room
Craft Room
Quiet Room
Office x 2
Toilets
Bathroom

Brightwells Gostrey Centre, Farnham

30. The Brightwells Gostrey Centre is the oldest of the day centres and operates from premises at East Street. The first floor of Brightwells Gostrey Centre is occupied by the WRVS Meals-on-Wheels service and the MoW are cooked in the Day Centre kitchen. Facilities include:-

Lounge cum Dining Area
Kitchen and servery
Second lounge and activities area
Hairdressing Room
Bathroom
Office x 2
Toilets
Laundry Room

31. Brightwells Gostrey Centre is currently reviewing its situation regarding the proposed East Street redevelopment scheme. As members will be aware, the proposals for the East Street Regeneration Project necessitate the re-provision of day centre facilities elsewhere in the area. The Management Committee has submitted a comprehensive report of its requirements as a functioning day centre necessary to continue to provide a high quality service to its clients, with differing needs. The Committee has asked that the new premises be of an increased size and that it includes:-

Main Room – Lounge/Dining Room
Common Room
Garden Room
Kitchen and servery
Offices x 3
Hairdressers Room
Reflexology/massage/spiritual healers room etc.
Bathroom/Chiropody Room
Laundry Room
Toilets

32. The Committee has also asked, inter alia, for the following -

Computer/IT Room
Recreational Cookery Room
TV Room
Music Therapy Room
Visiting Service office space

Revenue Funding Sources

33. Each of the five core day centres are given revenue funding under the Council’s Sponsored Organisations Scheme. Broadly speaking, in 2002/03, each of the five core day centres operating five days per week were given a Waverley grant of £40,000 towards day-to-day running costs. This sum tends to meet just under half of each day centre’s annual running costs. In addition, Milford and Villages Day Centre is awarded an additional £3,500 in recognition that this property is not owned by the Council and the Council does not carry out any repairs or maintenance. It is expected that this approach will be adopted for Cranleigh Day Centre (which has recently signed a full repairing lease) and Hasleway, once completed.

34. It would be fair to say that each of the five core day centres are concerned about the level of funding provided by the Council, as this does not meet their costs. A number of day centre committees are using their reserves to augment their revenue budgets. This is not a sustainable position, even in the medium term.

35. All of the core day centres look to other sources of funding to supplement their income. Most common sources of additional funds are from Social Services to provide bathing services and the Primary Care Trust for monies for specific services such as therapeutic support or care assistants. It appears unlikely in the current economic climate that Primary Care Trust and/or partnership monies will be readily available in the future.

36. Other sources of funding for the day centres also include charitable trusts, donations and fund raising activities and charges for services such as hairdressing, bathing, and chiropody. Annexe 2 illustrates how the day centres supplement the Council’s grant by generating other revenues Day Centre Committees consider that, with a diminishing number of volunteers, and with ever more voluntary organisations trying to raise money, it will be difficult to sustain revenue funding from non-Waverley sources.

37. In November 2002, the Council’s Chief Executive met with other Surrey Chief Executives to examine the approaches taken by the Borough/District Councils in Surrey to the provision of Day Centres and Meals-on-Wheels. It was recognised that there is no consistent approach taken by Surrey County Council to the funding of Borough/District Council supported day centres and that a joint approach to Surrey would be made in due course with the intention of asking for a review of Surrey County Council’s role.

Officer Comment

38. Committee Members, volunteers and supporters of day centres provide an excellent service to many of the more vulnerable people in the Borough. Without this significant voluntary effort, the Council would not be able to provide these services at such a modest cost to the Council.

Recommendation

There is no recommendation as the Committee asked for an information report.

Background Papers (DoH)

Surrey Officers Group, Bench Marking Exercise June 2002, Clare Traynor.
2001 Census figures www.statistics.gov.uk/census2001/census_news.asp.

Contact Officer:

Name: Mr John Swanton Telephone: 01483 523375
E-mail: jswanton@waverley.gov.uk

comms/o&s2/2002-03/083

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