Are day centres outdated in the personalisation era?

Pictured: Pathways to Opportunities co-founders Vicky Aldred (left) and Lila Grimshaw (Neil O’Connor)

The closure of council-run day centres attracts much negative press but, as Vern Pitt reports, the personalisation era is allowing other organisations to step in and provide support

The headlines of local newspapers over the past month have told their own story: “Care homes and day centres across Hampshire to close” (Southern Daily Echo); “Day centre closure approved” (Bournemouth Echo); “Day centres and jobs culled in West Berkshire” (Reading Post).

As councils and voluntary sector agencies look to reduce costs, day centres are becoming casualties.

Hampshire Council has floated plans to reduce the number of day centres it runs from 12 to four over the next two years. Bournemouth Council is combining two day centres. And West Berkshire Council plans to nearly halve the number of day centres it provides.

“There is a long-term trend for day centres being in decline,” says Ian Thompson, head of services at the Alzheimer’s Society. This is partly due to the economic impact of personal budgets, he says. Income would have previously been guaranteed for in-house council centres or voluntary agencies funded by council block contracts.

With personal budgets, this is left to individual choices, which may fluctuate, meaning a larger customer base is needed to ensure demand remains above the minimum needed to keep the service going.

There is also the issue of whether day centres suit the personalisation era.

“Organisations are finding other ways to support people and day centres can feel a bit outdated,” Thompson says.

Indeed, day centre closures are often portrayed as day service modernisation. However, this can be misleading, says Jane Alltimes, senior campaigns and policy officer at Mencap. “It’s not just about closing day centres; it’s about finding meaningful alternatives for people,” she says.

She adds that it is a mistake to see day service modernisation as a cost-cutting measure because alternative support in the community may cost the same.

However, alternative provision is not always on offer. “Areas have been moving away from day centre provision coupled with a scaling back of all sorts of other services,” says Alex Fox, chief executive at Naaps, the national body for small community service providers.

Fox advocates a different approach, saying day centres should be looked at in three parts: the building, the services and the relationships between the clients, staff and each other. Only by asking how these can best be maintained can a council come to a good solution for modernising services, which may also save money.

For instance, Fox suggests using the building to bring in revenue from wider community groups or events to cover overhead costs, support the services it provides and allow relationships to be maintained.

The consequences of not developing a solution that meets these facets can leave people with reduced hours of care and less stability in their care package, says Emily Holzhausen, director of policy and public affairs at Carers UK. There is often an assumption carers will pick up the slack, she adds. But that has consequences.

“In some areas, closing a day centre will have been a false economy,” Holzhausen says. “If you turn to a more fragmented care package and a family can’t work as a result, you leave people in poverty, both short and long term.”

Social isolation is another problem that can follow day centre closure. Naaps is countering this through a number of member organisations that help people to interact with the community rather than just with their personal assistant.

Alternatives to day centres are available. “We have expanded much more into providing advice and information, and support work,” says Thompson. “We also have a large base of befriending projects. Demand is just different now.”

For some parts of the media, day centre closures are seen as bad. “I think these become pitched battles about the building and I don’t think that is helpful,” says Fox. “There will inevitably be some people who want to meet up and some who want to go and do their own thing.”

Councils, the media and community groups all have a responsibility to recognise that fact if disabled and older people are to get the best day services possible.

Opportunities knock

Oldham Council left a gap in the market when it remodelled much of its day care service to be activity focused, according to Vicky Aldred, co-founder of day service provider Pathway to Opportunities.

Aldred was working in social care for the council when she saw it. “They created a woodwork department, a gardening and a recycling department so if you didn’t fit into any of those categories there was nothing for you,” she says. “People with learning disabilities were having to go out of area for day services.”

Pathways to Opportunities aims to provide a highly person-centred service, avoiding the big group activities day centres are associated with.

“A hell of a lot has happened since the old days when we would all get on a bus and go somewhere,” Aldred says. “Today, for instance, we have two people going bowling and another two going to a garden centre.”

It has proved popular with a regular customer base of 37 in under a year which Aldred hopes to double by next year.

The project is entirely funded by the service users who pay out of their personal budget or their own money if they are ineligible for council funding.

Although the service maintains two centres on a former council building where people can spend the day developing relationship skills, life skills or opportunities to work, Aldred believes the key has been flexibility and a user-led approach.

“Twelve months ago I didn’t think it would look like it does today. We’ve had to change and adapt to meet our customers’ needs,” she says.

Case study

This summer, Derbyshire Council closed its Ringwood day centre for people with learning disabilities in Chesterfield. While other day centre closures are accompanied by angry protests and media outrage, MacIntyre, the charity that ran the centre under contract from the council, did not receive a single formal complaint.

In 2006, the council awarded MacIntyre a 10-year £1.6m contract to run and develop day services for people with learning disabilities to help move away from traditional provision towards helping promote service users’ independence.

Brenda Mullen, director of specialist services at MacIntyre, attributes the successful closure of the centre to a clear joint communication strategy with the council, a flexible contract with Derbyshire and a long-term approach. “We are doing more for the same as opposed to more for less,” she says.

When the decision to close Ringwood was taken, MacIntyre had already developed or was developing six services – all in community settings – to meet people’s needs, from life skills and work-related training to leisure. Having several of those in place before closing the day centre and fitting the service around the person meant clients were happy with the services.

MacIntyre’s commitment to saving £1m and reinvesting it in provision was an attractive proposition to Derbyshire. Part of its financial plan involved replacing regular buses for clients with transport only for those whose needs were greatest. The result is a more flexible and cost-effective service.

Mullen believes other councils could replicate MacIntyre’s approach to remodelling day services, so long as they keep a focus on personalisation.

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