To report to Cabinet the results of the recent consultation on the future of the Council’s Careline service; and seek its decision as to how it wishes to proceed in light of these consultation results and other updated information.

 

This report recommends, as a variance to the Cabinet’s currently adopted preferred option, that the Council explores further the response received from Colchester City Council as part of the North East Essex Health and Wellbeing Alliance to create a combined telecare service that aligns with the Alliance’s aims and objectives for an integrated health-system approach.

RESOLVED that Cabinet -

 

(a)   notes the outcome of, and feedback from, the recent customer, resident and stakeholder consultation on the future of Tendring Careline – that was based upon balancing best value principles with the needs of our existing customers, who now have a wider range of options available on the open market, at more comparable rates than the Council can continue supplying the service for;

 

(b)   notes the decision to terminate the third-party contract with AE Partners Ltd (YourStride) which, irrespective of the Cabinet’s resolution in respect of (d) below, will reduce the pressure on the capacity of Tendring Careline – which, for some months, has been dealing with a growing and increasingly unmanageable volume of calls from residents outside of Tendring; and bring about a cost saving to the Council;

 

(c)   authorises the Director of Planning and Communities, in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to review and if necessary, vary or terminate other third-party contracts at suitable timely junctures as part of the move towards the fulfilment of any final preferred approach;

 

(d)   confirms that, having considered the contents of this report, it still wishes to continue, in principle, with the preferred option (Option 2) of ceasing the telecare and lifting/response provision of the Careline Service, in its entirety, including service delivery under third-party contracts with remaining service provision solely relating to the Council’s Out-of-Hours and CCTV service – albeit subject to (e) below;

 

(e)   authorises the Director of Planning and Community, in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to explore further the third-party proposals that were submitted to the Council through the consultation;

 

(f)   subject to (e) above, requests that third parties be invited to put forward a formal detailed proposal for further exploration within one month of this decision (i.e. by close of business on Monday 16th December 2024) as the starting point for Tendring District Council’s consideration;   

(g)   requests that the Portfolio Holder for Partnerships reports to Cabinet in February 2025 to provide an update on the opportunity explored in line with (e) above in respect of the third-party proposals, as well as an updated recommendation for a final Cabinet decision on the future of Careline informed by updated financial analysis and with a detailed transition plan;

 

(h)   subject to (g) above, acknowledges that there may be additional costs arising from the change in timescales set out in this report, and requests that the financial impact is included within the report to Cabinet in February 2025; and

  

(i)    authorises the Director of Planning and Community in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to assess different options for the continued provision of the Out-of-Hours and CCTV service and to implement any necessary changes, as necessary, following the Cabinet’s final decision on the future of Careline.

 

Earlier on in the meeting as reported under Minute 71 above:-

 

(i)     Councillor Scott had declared an Other Registrable Interest in relation this item insofar he was the Chairman of the Autumn Centre and many of the clients at the Autumn Centre were also clients of Careline. Councillor Scott therefore withdrew from the meeting and left the room whilst the Cabinet deliberated on this matter and made its decision.

 

(ii)    Councillor Chapman BEM had declared an Other Registrable Interest in relation to this matter insofar as her Mother was a customer of Careline.

 

(iii)   Councillor P B Honeywood had declared an Other Registrable Interest in relation to this matter insofar as a member of his family was a customer of Careline.

 

(iv)   In response to a question raised by Councillor Honeywood, the Monitoring Officer (Lisa Hastings) had stated that, as Councillors Chapman BEM and Honeywood were not Decision Makers on this matter, she was prepared to grant them both a Dispensation in order to allow them to remain in the meeting for this item.

 

Cabinet considered a detailed report of the Partnerships Portfolio Holder (A.11), which reported to Cabinet the results of the recent consultation on the future of the Council’s Careline service; and which sought its decision as to how it wished to proceed in the light of those consultation results and other updated information. The report also recommended, as a variance to the Cabinet’s currently adopted preferred option, that the Council explored further the response received from Colchester City Council as part of the North East Essex Health and Wellbeing Alliance as to whether to create a combined telecare service that aligned with the Alliance’s aims and objectives for an integrated health-system approach.

 

Members recalled that the Careline service had been established in 1987 and provided monitoring and response/lifting for approximately 1,859 service users in Tendring, including sheltered housing residents. Continuing the core Careline service required significant investment, creating cost pressures amid budget constraints. The findings of a 12-month review of the service had been reported to Cabinet on 26 July 2024 along with five potential options for the future of Careline, including information on their financial, equality and other implications.

 

Those options were summarised as follows:

 

·      Option 1 – Maintain current position (remain in the market, which would require on-going financial support);

 

·      Option 2 – Provide an Out-of-Hours Council service only (leave the market, focussing on the Council’s core business and ceasing telecare and response/lifting);

 

·      Option 3 – Reduce shift pattern to 6 hourly shifts (remain in the market, staffing changes required, which would require on-going, additional financial support);

 

·      Option 4 – Remove the responder/lifting service (remain in the market, removal of one element of the service, which would require on-going, additional financial support); and

 

·      Option 5 – Termination of third-party contracts (remain in the market and service Tendring District Council residents only via the Careline scheme, which would require on-going, additional financial support) and cessation of the TSA accreditation.

 

At that July 2024 meeting, Cabinet had agreed, in principle, the adoption of Option 2 as its preferred option – i.e. ceasing telecare and lifting/response services, focusing solely on Out-of-Hours and CCTV services. An extra £300,000 had been allocated to support service users transitioning to alternative provisions, along with a further £446,000 to support other potential one-off costs.

 

In order to properly address the Council’s duties around best value for its residents, a consultation exercise had then been carried out to invite feedback from customers, residents and other key stakeholders including organisations that the Council provided services to under contracts. Consultation had also been carried out with TDC staff impacted by the potential changes, albeit acknowledging that a final decision on the future of the service had yet to be made.

 

That six-week consultation exercise had been carried out between 19 August and 30 September 2024. As part of the consultation process, almost 4,000 letters had been issued to the circa 2,000 Careline service users and their next of kin, each with a unique customer number with the aim of tracking responses and guarding against the possibility of double-counting. A separate communication to Sheltered Housing Scheme residents had provided assurances that their 24-hour emergency assistance would remain unchanged at this time.

 

It was reported that 1,062 submissions had been received in response to the consultation, which had been considered a good level of response from which reliable feedback could be gauged. Some of the notable messages coming back through the consultation responses were summarised as follows:-

 

Of the 1,062 responses:-

 

·      589 were from Careline users (56%);

·      395 were from friends or family of users (37%); and

·      78 were from the public or others (7%).

 

In respect of future options for the Careline service, 72% (the clear majority) of respondents stated a preference for Option 1; with 10% preferring Option 2; 6% preferring Option 3; 7% preferring Option 4 and 5% preferring Option 5. This had indicated a clear preference amongst service users and their next of kin for maintaining Careline in its current form. However to do so would, as had been explained in the July 2024 Cabinet Report, require considerable ongoing financial support from the Council with competing calls on its resources. 

 

Cabinet was informed that service users had been asked if they would be prepared to pay an increased fee for a telecare only service. 48% of respondents had said that they would be prepared to pay more, but the levels of increase being suggested as being acceptable by those respondents would not, on current analysis, be sufficient to eliminate the current projected shortfall in revenue. An increase in fees, as indicated, would also result in Tendring District Council charging customers at a rate above current market levels thus not offering best value for money. With 48% of respondents indicating a willingness to pay increased fees, it followed that 52% of customers would not be prepared to pay an increase and would potentially seek alternative provision if fee increases were introduced.

 

With the Cabinet’s preferred Option 2 in mind, 60% of the service users that had responded to the consultation indicated that they would, if necessary, be willing to move to an alternative trusted provider but 80% of those had stated that they would want assistance with that process to make the best decision.

 

Members were made aware that, both during and following the consultation exercise, there had also been some contact from third party organisations either expressing an interest in potentially taking on all or part(s) of the Careline Service or otherwise inviting discussion about how a service could be delivered in an alternative way through partnerships or other means.

 

There had also been early discussions following the response to the consultation, and acknowledging the Council’s role as a partner to the North East Essex Health and Wellbeing Alliance, to explore the potential to work with Colchester City Council, through its trading company Colchester Commercial (Holdings) Ltd, on their proposal to establish one combined telecare service to serve the whole of the North East Essex area. This option could support the Alliance’s objectives for an integrated health-system approach that worked in harmony with NHS health provision and the emergency services. This option might offer a potentially positive and direct response to the consultation feedback – particularly in light of the strong preference from service users to retain a Careline Service, albeit with a limited appetite to pay higher fees; some willingness to transfer to an alternative trusted provider; and a clear request to provide support to service users through any transition.  

 

However, the detail of this opportunity would need to be explored to establish if it could offer the proposed potential benefits in terms of continuity, security and value for money for existing Careline users; retention of job opportunities for staff under local authority terms and conditions; and the achievement of economies of scale that could address current concerns around the budget and Tendring residents having to subsidise the Careline service. It was important to stress that with any proposed joint working, the implications of the proposed delivery model must be properly assessed in order to establish whether this was a viable option. It was therefore recommended by the Portfolio Holder that additional time be incorporated into the timetable for exploring this opportunity in more detail, along with other third-party proposals, before Cabinet committed to implementing a preferred approach. 

 

Alongside carrying out the consultation exercise, Officers had also continued to review, in further depth, a number of the contracts that Careline had in place for the provision of services to external bodies. On further consideration and with the approval of the Leader of the Council on 24 October 2024 it had been decided to serve notice to terminate the largest of the Careline contracts – i.e. that with AE Partners Ltd (YourStride).

 

As a consequence of that contract coming to an end in February 2025, it was necessary to revisit a number of the financial assumptions in terms of the options highlighted above, in order to provide the most up to date position, with the aim of presenting those to Cabinet in early 2025 before any final decisions on the future of Careline were taken. The revised assumptions were still expected to demonstrate that all options, apart from preferred Option 2, would still require ongoing budgetary support and subsidy. 

 

Currently, Option 2 remained the preferred option pending further consideration of the financial and other implications as well as the results of the consultation. However, as a variation on that preferred option, it was also proposed that more time was incorporated into the overall programme for completing the review of Careline to allow for the full and proper exploration of the proposals described above and elsewhere in the Portfolio Holder’s report.

 

Given the significant impact of third-party contracts on resources and the budgetary position of Careline (as demonstrated through the urgent decision to terminate the YourStride contract), it was also proposed that Officers be authorised to continue reviewing other existing third-party contracts and, where necessary, proceed to vary or terminate them accordingly before, and without prejudice to, any final decision of Cabinet as to the future of Careline.

 

It was proposed that the preferred Option 2 be revisited in early 2025 for Cabinet to make its final decision and that, at this stage, the previously suggested date for implementation be adjusted from the end of March 2024 to the end of June 2025. Although there might be some savings secured through the termination of the YourStride contract and review of other third party contracts, it was likely that there would be an additional cost from this change in timescales which would need to be considered alongside the exploration of the collaborative working with partners highlighted earlier. It was therefore difficult to provide an expected cost at this stage, which would therefore need to be reviewed as part of the planned report in February 2025.

 

Option 2 (or the potential variation) provided that any remaining service at Tendring would focus solely on the Council’s Out-of-Hours and CCTV services. Officers had been carrying out further exploration of different ways in which an out-of-hours service could continue to be provided by the Council across different permutations of retaining the operation in house, outsourcing and/or redistributing duties across different services. The approach to be taken, having particular regard for the Council’s statutory duties to provide telecare services for its sheltered housing tenants, would be an operational matter for Officers to conclude following further analysis and the final strategic decision from the Cabinet on the future of Careline.

             

In the light of the fact that feedback from the recent customer, public and stakeholder consultation had presented alternative approaches that warranted more detailed and proper consideration and additional time incorporated into the programme and next steps in order for that consideration to take place and given that it was also necessary to factor in the full implication of terminating the YourStride contract when carrying out that further work along with any changes that might need to be made to other third-party contracts:-

 

 It was moved by Councillor Placey, seconded by Councillor Kotzand:-

 

RESOLVED that Cabinet -

 

(a)   notes the outcome of, and feedback from, the recent customer, resident and stakeholder consultation on the future of Tendring Careline – that was based upon balancing best value principles with the needs of our existing customers, who now have a wider range of options available on the open market, at more comparable rates than the Council can continue supplying the service for;

 

(b)   notes the decision to terminate the third-party contract with AE Partners Ltd (YourStride) which, irrespective of the Cabinet’s resolution in respect of (d) below, will reduce the pressure on the capacity of Tendring Careline – which, for some months, has been dealing with a growing and increasingly unmanageable volume of calls from residents outside of Tendring; and bring about a cost saving to the Council;

(c)   authorises the Director of Planning and Communities, in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to review and if necessary, vary or terminate other third-party contracts at suitable timely junctures as part of the move towards the fulfilment of any final preferred approach;

 

(d)   confirms that, having considered the contents of this report, it still wishes to continue, in principle, with the preferred option (Option 2) of ceasing the telecare and lifting/response provision of the Careline Service, in its entirety, including service delivery under third-party contracts with remaining service provision solely relating to the Council’s Out-of-Hours and CCTV service – albeit subject to (e) below;

 

(e)   authorises the Director of Planning and Community, in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to explore further the third-party proposals that were submitted to the Council through the consultation;

 

(f)   subject to (e) above, requests that third parties be invited to put forward a formal detailed proposal for further exploration within one month of this decision (i.e. by close of business on Monday 16th December 2024) as the starting point for Tendring District Council’s consideration;

   

(g)   requests that the Portfolio Holder for Partnerships reports to Cabinet in February 2025 to provide an update on the opportunity explored in line with (e) above in respect of the third-party proposals, as well as an updated recommendation for a final Cabinet decision on the future of Careline informed by updated financial analysis and with a detailed transition plan;

 

(h)   subject to (g) above, acknowledges that there may be additional costs arising from the change in timescales set out in this report, and requests that the financial impact is included within the report to Cabinet in February 2025; and

  

(i)    authorises the Director of Planning and Community in consultation with the Leader of the Council and the Portfolio Holder for Partnerships, to assess different options for the continued provision of the Out-of-Hours and CCTV service and to implement any necessary changes, as necessary, following the Cabinet’s final decision on the future of Careline.