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Protecting front line services

Response to David Johnstone article in Express & Echo, 7 Apr 06

If Mr Johnstone has been protecting front line services why has there been a freeze on recruiting home care staff in Exeter and other areas over a prolonged period of time?

This has had the effect of forcing care out into the private sector to enable them to fulfil their contract hours and they have struggled to cope effectively.

If Mr Johnstone is guaranteeing the protection of a high quality service why are the recently appointed block contract providers unable to meet their care responsibilities in many cases, relying on sub contractors and 'in house' care to plug the gaps?

They are unable to recruit due to the low contract prices therefore they will take whatever quality of staff they can get to work for the wages on offer. Little evidence of quality provision there.

If Mr Johnstone wishes to improve the quality of service provision why is the project known as the Business Improvement Group (BIG) specifically tasked with reducing costs as the guiding factor in their brief? Why is this group targeting the front line care managers - social workers, occupational therapists, community care workers - who work directly with clients in hospital and their homes carrying out the assessments, identifying the care services they need, advocating for them and supporting them both at home and through the care placement process where needed.

It is this group, in addition to the middle managers, on whom the redundancy axe will fall to make savings. Little evidence of quality provision there.

Greater value for money

If the aim of the process is a more effective way of spending public money and a potential reduction of the directly employed workforce from approx. 4000 to perhaps 1000 as recently put forward at a presentation, why is it that no Director / Assistant Director posts are under consideration for redundancy?

In such a reduced structure there is no need for a Director plus 3 Assistant Directors; a reduction of a least one post would cover the cost of 6 or 7 of our low paid front line staff, possibly more.

How will Mr Johnstone ensure that care provision cartels will be prevented and that care provision will remain affordable to clients? Recent dramatic increases in charges to clients have started to produce clients refusing services, as a result of cost rather than need. Residential / nursing home placements at DCC banding fee rates are almost impossible to find in a large number of areas. This leads to very vulnerable clients or their families having to top up those fees if the client is to be placed.

Currently DCC absorbs those residential clients in their 'in house' facilities without the need for a top up, what happens once they are outsourced? This adds to the SSD budget deficit and makes the private sector look cheaper as a result of the client making a much higher contribution in the private sector. Where is the protection of an affordable and quality service there? Where is the ratepayer value for money if they have to pay the full cost of top up themselves rather than have it spread equally through the tax system?

As commissioners, how will quality standards be maintained without a control system of in house provision?

Developing & providing alternative services

A lot of recent innovations in social care in Devon have been developed and trialled using 'in house' services in a flexible manner in partnership with others. Who in future will enable that flexibility and innovation to happen?

If all 'in house' provision is outsourced how will emergency needs be met and how will civil emergencies be accommodated? The ability to respond with facilities and suitably trained and experienced staff would be greatly reduced, making it questionable that SSD would be able to meet its responsibilities within multi agency emergency planning.

Risk Factors

Mr Johnstone has said that the proposals are high risk, high risk to whom? To some of the most vulnerable and neglected members of society, to staff, to Devon County Council or to Mr Johnstone and his senior colleagues? Certainly the services to the client base are at risk, if that is the case then DCC are at risk in failing in their duty of care, staff livelihoods certainly, there don't seem to be many risks to anyone else.

If Mr Johnstone has identified a risk, has he put in place a risk assessment of the proposals in order that those risks may be minimised, to the clients, to the authority and to the health & welfare of staff who will need to deal face to face with the public over these issues, in addition to concerns over their jobs with the ensuing strains on their families?

Information Technology

In order to produce savings, far greater reliance is to be placed on communication systems of various types. The current system in use is currently not user friendly, difficult to use and for the field workers it does not do the job they need it to do. There is nothing in the proposals to identify the plans for a way forward with these issues.

Currently the availability of screens for staff to use in the front line offices and in the field is so limited that staff regularly queue to use the facilities available and work levels are affected. There will be massive resourcing needed to put this equipment in place and to update existing facilities and technology, none of which has been costed.

There are suggestions from recent presentations that office bases in localities may be reduced from approx. 160 to approx. 20, or maybe as low as 3.

If this is to happen the implications for communication systems are even greater. Another knock on effect of this would be a reduction in local knowledge and local service delivery, a loss of work time in travelling to appointments together with an increase in travel costs and a loss of opportunity for clients to call at offices. Cost factors in respect of this do not appeared to have been factored in. Removing a work force from a community also has economic implications for that community.

Overview of Proposals

The proposals put forward by Mr Johnstone are flawed and high risk in an area which demands security. Despite that, no detailed costing has been evidenced to justify such serious and wide-ranging changes.

If, as he alleges, 'in house' services are seriously overpriced, how can people who have allowed such a system to be in place for so many years be trusted to plan an effective way forward.

Senior managers have not placed themselves at risk in this process, but maybe the spotlight should initially be on their competence rather than on the posts of some very low paid front line staff.

How can such senior managers be trusted to protect staff interests when for a number of years they have been content to pay homecare staff below the minimum wage when they travel between houses on home visits to care for clients and then hide behind an old Employment Tribunal decision taken under different rules when asked to put the situation right. Again squeezing the lowest paid staff who have the least opportunity to be listened to.

Despite Regulations requiring employers to consult, the authority has denied the recognised unions any opportunity to fully consult on the proposals being put forward.

Despite repeated request unions have been denied access to the elected members who give consideration to the proposals at various stages in their progress and that lack of access continues. Again how can such managers be trusted in these issues?

A big driver for these changes appear to be cost savings resulting from a poor budget settlement, this is evidenced by services originally advised that they were safe and being retained 'in house' now being lumped in with all other services and being disinvested in order to save on back office costs.

Not evidence of clear thinking or good vision.

If the budget is a major driver why were OLM Consultants used at £850 per day to plan something which should have been within the capability of highly rewarded senior managers? OLM coincidently the same organisation which supplied the heavily criticised computer system CareFirst, which in a modified form will be relied upon in this process.

Staff have unnecessarily been made anxious due to the threats to employment and services by the secretive and inefficient way these very serious problems have been handled.

Conclusion

Unions have not sought to be obstructive in this process and have played their full part in the consultation process for the homes already in issue, it remains to be seen how they are affected by these proposals. This is the only area where unions have been allowed to consult. We recognise the need for change and are prepared to meet with management to plan an acceptable way forward.

Unions do not consider that the current proposals have been thoroughly thought through, costed and all the implications taken on board. They have the feel of a knee jerk reaction to pressing problems as evidenced by the constantly shifting parameters being set.

Our position is that there needs to be a joint planning process put in place where all views are taken into account allowing a plan which has a broad agreement to be produced.