[speaker001:] Erm, coming onto the other issues I wish to raise. I was delighted to see that th on the if you are now considering buying extra funds to see an encouragement residential home places [incomprehensible] There is however an important issue where you get shall we say a quality development in a rural area, and I mean a quality development, which would be probably has to be above the rates quoted here where talk a discussion with the owners because they may not be available to local people and that does concern me a bit in rural areas. So I think I'm asking for just a bit more, more talks and where there is a, a home or homes in a rural area that may be the only home in that area, so it is available to local people that Social Services come in and there in an understanding in planning authorities first and now the actual criteria we're working on because most local people will think that home is for local people. It may not be open to those people that need support. So that concerns me Chairman and I hope that issue can be addressed by the director in, in some way before the home is built. Erm, transport and equipment, Chairman, we've heard a lot about minibuses for schools, and coaches. I believe we should look at our, I think a hundred and ten vehicles, very carefully for safety checks because we do have tail lifts on them which closes the use, if there's a wheelchair as an emergency exit. There are issues which driver training and what we're doing in that because those vehicles are quite large, they are actually minibuses as such from the public's point of view, and they are carrying people that need the best possible care and attention in their transport. At least accident should occur so I'm asking for a review of those to see if we ha we are buying the right vehicle or not. It is an important issue. It's the same as saying should we have a diesel engine or a petrol engine because a diesel engine is less than inflammable fuel-wise than petrol and I think these issues should be raised. Chairman, I, I could go on but I, I think I'd like other people to have a say. I think those are the main points I wished to raise and Mrs next and then Mr. Mr Chairman, erm, I'll keep my comments slightly. Once again I must congratulate the officers for the excellent budget. They are extremely pleased with it. Erm, once again, the problems are being addressed in to a certain extent regarding residential homes and we're very pleased with that. Er, there's just one or two points that I, I'd like to ask. Erm, page twelve, er forty eight. Is this been raised before. Is this something new for the new budget provide more training for carers and are we going to advertise it to carers if we are? and the other point is transport and equipment. Erm, for day centre. Er, once again I may have missed something in 's report and perhaps last year's budget, a new member of staff is going to be. Erm, what about all the rest? Well. well oh no no no health and safety We'll pick up all the questions at the end if that's okay. That's it, thank you. Thank you. Mr followed by a Mrs. Thank you Chairman. Erm, to some extent I, I, I what was saying. I'm sorry to see that although we've got a large increase in budget, which is of course always very welcome, that we haven't perhaps addressed improving the quality er as much as we might have done, although we've got a lot more home help hours that may be classed as an improvement, but er there are many other areas where we could perhaps encourage improvement in community care er with a bit of thought. But my main Chairman asking questions on what the er director has to say. [clears throat] Are these projectural figures which he showed us the cash flow chart over there looking like half a pyramid? Erm, how much flexibility do we have if there is a sudden epidemic, if flu virus for instance which can make a tremendous intake or, or people requiring care. Have we got sufficient er leeway there? Under the erm of page three where we have that I assume can be solely used for residential and nursing home care, won't be used for anything else take it back. Erm, you'll have to bear with me because I just marked the page as I went through. Normally you get so many people speaking you get time to organize yourself [LAUGHTER] Oh yeah, the, the twenty pounds premium that they're proposing to be paid to the and area. Is that on existing beds or will it be for new beds only? Er, turn over the page again somewhere I believe. Oh yes, and the which we propose to be introduced hundred thousand. Have we any idea as to how much that may grow by over the next two or three years? Er going to be expended to certain groups of individuals or is it going to be open to anybody? Er because appreciate when you introduce something new that's costing a lot of money it can grow out of all proportion if you're not careful and it's much harder to take it away than it was to introduce in the first place. Er so one would like a little bit more clarification there perhaps. Er I think my other question falls on the. I don't know whether we're doing those things. Yes, everything including as well Right thank you Chairman. And there one personal explanation when I saw appendix A as opposed to the information on appendix five under page two I've got appendix five And then there's the annexation following that. Erm, under the banding system Mr Chairman, and as I say, it's purely er to clear it in my mind... we've got residential points A and B and we have a manual system for nursing homes but the C one I'm not sure whether should be in nursing homes or residential homes. When it comes to appendix A it's got B and C under the residential homes sector as far as. I'm a bit confused I'll try and explain. Thank you. A Mrs followed by a Mrs. Thank you Mr Chairman. Er I don't know how Mr could actually say his first comment about quality and improvement. I assure one area a growth of three hundred and fifty, the vast majority of whom will be actually at the production line for home care assistance etcetera etcetera etcetera. Surely that's going to improve the quality of, of provisions? It's bound to improve the quantity but I would suggest it will also improve, improve quality and care that we're providing. Erm, Mr, Mr Chairman I, I'm not going to answer Mrs 's comments, although I don't know whether the jibe about the was aimed my way. I'm not against pamphlets if they're going to be lines in communication. I've not been against lines of communication, I've been against excessive expenditure on such. Erm but erm sitting in a traffic jam this morning I was very concerned to learn that taking effect from tomorrow the government is changing the grant for adaptation for severely handicapped people. The ceiling was or today is fifty percent, tomorrow it will be er fifty thousand pounds, tomorrow it will be twenty thousand pounds and erm I'm very much tying this in with para four four eight on page ten. I wonder if the, the director plans to talk about the cri criteria we will work towards with the independent erm living fund and I wonder if we could possibly accommodate something within the criteria because I think the number of people involved needing adaptation to their home over about five thousand is fairly small but for those people it will make the difference between them being able to remain in their own home or within the community care package, a vast sum of money being needed to be spent on them to accommodate them within residential accommodation. So I am very concerned about this erm latest piece of legislation. Thank you. Thank you. Mrs followed by Mrs. Yes, you will all know my interest in mental health... erm personally because of my son and I am very pleased that under four point five two erm that the extra workers are going in t for support. Er that is very welcome, and also that there will be help at the weekends because as I've often reported before, that's often when things escalate at weekends for some unknown reason. Erm, four point five four. I would like to know erm the two or three buildings I er it may be difficult at this time but how many residents will be in each building? Because these will be resent as we know that have individual needs in individual ways and they often rub off one against the other if they live in closeness as we all do. I was once in a ward with nine other people for a year and I know how, except when passed away, I know how that can really get on one another 's nerves and erm the individual needs that they will have I know will be erm so difficult if there are too many living in very closeness. Sometimes it can be close harmony but then often it's not, unfortunately. And is an allergy doctor that ever visits these places, because I don't know about that. I would like to have information on that because often allergies erm are at the root of a lot of the problems. And regarding the rent of the centre the, the people who have gone home. Are they coming onto your support workers calling on the families at this time to help them erm because this will be the time when the families will need help and also naturally the residents who are normally at the centre, having got used to the centre, as we know, there could be difficulties there and I'd like to have the please. Thank you. [clears throat] Mrs followed by Mr. Thank you Mr Chairman. I think that following on from what Mrs was saying that erm certainly I could do with an expert allergist here because I am suffering with an intensive allergic reaction to what Mr said
[speaker002:] [LAUGHTER]
[speaker001:] earlier but I do realize that that was his way. Erm I've apologized to you, and particularly to the people who write the dictionary that I don't actually know the opposite of deja vu but it's what I'm suffering from. I'm hearing things now that I have not heard in fifteen years that I've been on this County Council and I would suggest erm to Mr that when he's talking about things that this County Council ought to print, and I think the one suggestion he came up with is very sensible, he could perhaps follow up with a catalogue of those things which he considers need doing that after a hundred years have not been done. Thank you Mrs. Very succinct. Er, caught me on the hop. Sorry Mr followed by Mr. Thank you Chairman. Erm, it is particularly impressive to see so many plus signs on the budget, particularly and I think there's to be I assume this is a standard thing
[speaker002:] [LAUGHTER]
[speaker001:] Er Right Er one other comment from the er Association for the Disabled. They were particularly impressed with the additional two and a half million for home care with the resources to go with it, together with the additional and also of course the eight hundred thousand for the er scheme. Erm, those were the comments I would like to make. One question please er relevant to the workshop that took place er at Hospital. I thought that was a particularly er constructive day session, a lot of ideas came from it and I am sure that there will be a number of actions to be warranted from it. Some of those actions may require resources. I would just like to whether in principle the resources are irrespective of. Thank you. Mr followed by Mr. Thank you very much. At the last meeting of the committee I did in fact congratulate the director and his staff for the way in which community care had been implemented current year and I'd certainly like to congratulate him on the way he's presented er proposals for next year. Erm, I, I think the evidence is both in the current year that in care in the community is working very successfully. Erm at previous County Council and the previous committee, together with the officers, planned extremely thoroughly and er the funding that was provided for this year both internally within the County Council and externally from the government was sufficient to provide the sorts of levels of service that we, we anticipate. I think that when we look at, I mean there's no doubt that we have got significant and welcome, and let's not be, welcome improvements of service for this year. Er but for as long as all of us sit here we will always be looking for further improvements. I mean, we don't stand still at this because what will seem a very good service this year will look like a lousy service in five years' time so let's not pretend the fact that we haven't achieved everything we've achieved this year in some previous years means that we haven't made any improvements because I think one of the key areas where in fact er improvements have been made in previous years, and to a certain extent, one could say reading this I was worried by an apparent admission of very much reference or very much expenditure on them in the provision of day centres, because I think that a key element in care in the community and the fact that today so successfully this year has been the fact that a major number of th and I don't think there's any disagreement over this, a number of day centres, very efficient and very effective day centres, were developed, funded, provided mainly in the conurbation areas and I think Mr is right to highlight the fact that, as so often happens in these instances, it's people who live in conurbations who get the best deal because it's, it's more economical, it's easier to provide a centre for a large number of people than it is for a small number of people. And I suppose he that's an area where one is worried about quantity and quality because it's in a way you can always provide more quantity I imagine at a lesser cost by going into a conurbation than you can by going into rural areas. One of the things that does, I'm not being Chairman, just asking questions, but one of the things that slightly concerns me because I know that in his document the director has put about providing day care type facilities in rural areas and I remember at our last meeting, the last meeting at one, we discussed specifically and area, erm it does, does worry me a little whether the absence of any capital expenditure on our part means that we may be providing day care facilities in some areas but it'll be of a very much lower quality or a lesser quality than we may be providing anywhere else in the areas like and and. I think it's very important that we don't neglect er people who live in rural areas and that we do in fact ensure that they get the same sort of provision erm that they do elsewhere. So you know just picking up Mr 's point, I h we mustn't confuse, I mean I agree that quantity is one of the measures of quality but it's not the only one. You, you can put more resources into things and not necessarily provide something better so I think that one has to try and do the two together. Erm s that's my general s there's no doubt that there are a great deal of activities there as always of course when one is spending a lot of new money quite rapidly, one has to monitor it very carefully to make sure that it's being effectively spent, and I'm sure the director and this committee will continue to do that. Can I just ask two questions then at the end? Erm quite rightly the director said that predictions in terms of residential admissions and nursing home admissions would be easier to make this year than last year and I accept it was very difficult then year but I'd just like to know how close the actual outcome is likely to be to the original prediction, really for information, not because I think you could have got it any closer than did but it would be just interesting to know what the s the gap was. Now the other question I was just going to ask was on appendix er erm it's oh yes here we are appendix five bottom of page two and it's talking about the condition of people on the higher rates to residential homes in the area. One of the things about when you are old and move to a residential home I think one of the important things is that you want to go and live close to your loved ones, if you have any, and it does just worry me that if you happen to be a person who is resident in and your loved ones live in, under these terms if you went to a residential home in you wouldn't qualify for the higher rate and that seems to me to be wrong. It seems to me that it ought to be our policy that we ought to try and locate people who go into these sorts of residencies as close to the people who will be concerned for their welfare as possible erm and that therefore there would be a strong case for making that sort of exception in those cases. Thank you. Mr followed by Miss. Thank you Chairman. Chairman, I welcomed this paper altogether. There are so many things in it that are good. There are one or two things that do bother me. I am very pleased for instance that the unit is to be opened at and I would like to know if there are any other places in mind for disabled problems. As far as mental health is concerned, Mr surely must be living in another age. Terrific strides have been made in mental health in this county erm lots of it under voluntary and it is very much to be commended. I am very pleased to see what is going on in the coming year. Erm, the, just, incidentally just to show I read the papers Chairman erm on page ten it is laying not laying. Thank you. Erm I do think that you've made the point that the additional staff we do have three hundred and forty three, three hundred and fourteen, is it three forty three? too high. Yes Anyway, Three six three, three six three. Erm and I do think that the press should be notified of what's going on in this for this year. It's a very considerable stride forward altogether and you know I highly commend it. Thank you very much. Thank you Mr. Erm Oh incidentally, sorry Chairman,. Erm are we continuing trading or because I, I fear that in, in in particular and with due respect to the Chairman I think the hospital discharges at the moment are leaving a little bit to be desired. Thank you. Nothing to do with me.
[speaker002:] [LAUGHTER]
[speaker001:] I don't take that personally. Erm Mr followed by Mrs. Thank you Chairman. Erm I was interested to note the reference to day care in the area. Erm it's always difficult in rural areas because the distribution of population and the comparatively small numbers involved. I know the mental health on th on the health service side are facing the same problems and I was wondering to what extent the director had been talking to the District Health Authority on, on those lines. The other thing I was interested in was the increase of ele of occupational therapists and I just wondered what the realistic expectation was of being able to recruit them because as far as I know they are a scarce resource er and not easy to find. And the last thing was, I'm not at all clear what was meant by the principal voluntary organized a organization for the mentally ill and I just wondered what was, what was his view in that respect. Thank you. Thank you Mr. Mrs followed finally by Mr. Thank you Mr Chairman. Erm, yes I think it's an excellent budget, very pleased with it. There's just one thing, page eleven. I would like a little more detail on the branch for voluntary organizations. I know there's a new committee that deals with this but could we have a bit more detail about the amounts and who they go to. It would be quite a useful thing to know I think. Thank you. Mr. Chairman, just a very quick point erm referring to four point four two residential care noting that the. The County Council's own homes has improved during the past year. I noticed, during a recent visit to, that they were offering a twenty five percent below capacity. I wonder if this is characteristic of all our homes and whether this is likely to continue, and whether any thought has perhaps been given to using this surplus accommodation for day care facilities? Thank you. Right I'm gonna ask the director, who I think is going to pick up most if not all of your points, there may be the odd point he'll pass sideways in my direction. Well thank you very much Chairman and I'd like to thank members for their, for their comments and the general welcome for the budget. Erm first of all to deal perhaps with capital spending. Erm, there is in fact a, which a number of members have referred to, there is in fact a hundred and fifty thousand being spent this year on day care capital as a result of the two and a half million package which members agreed in October and that has obviously gone to voluntary organizations for them to spend. We are obviously aware of the need for capital expenditure but fortunately we have got through the big capital programme in advance before the, the current which the treasurer may wish to comment on of the county's overall capital programme, of which er of course there are, there is competition from other committees. Er [cough] will not be in that category because it will be totally funded by the Department of Health ah as and when it comes along. Erm, there will be [incomprehensible] thoughts but er we are certainly er [noise obliterates speech] sort of the major programme that we have had. I think it is the revenue side that is important. To stay in the day s centres for a moment. Er we, this budget actually includes about three quarters of a million increase in d in expenditure on day care. Erm on the adult side. It's split up in various places including the funding of and a full year and the other providers which are so there's a total of three quarters of a million there. And, perhaps going back a bit and looking at the history of the last ten years, it is important to realize that we have developed small centres as well as large ones. The county's own er developments have included,,,,, and and of course particularly in other areas especially within we've worked with the existing voluntary organizations in developing their centres rather than necessarily developed our own, and I think that mixed pattern has been very helpful. I mean, going back to nineteen eighty three for instance, in the whole of er area there was no adult day care at all and in at that time there was only the Road day centre for the learning disabled which, with the best will in the world, is not the jewel in our crown. Erm
[speaker002:] [LAUGHTER]
[speaker001:] the er, erm, so I mean, we really have made major strides and I think if members look at the location maps I mean you can see just how we how widely spread the day centres now are. That is no for complacency and there will obviously be towns where these developed and members. Another thing which came across in your comments from more than one member was the question of quality. Ah, absolutely crucial. There is no point in just having money, spending it and having no regard to where it goes. But I think we've got to remember that the, the people who really determine the quality of the users of our services, the clients, it's they who say yes, this is what I want, this is th this is what I'm after and that is why I hope that we will be able to target on things that come out of the consultation progress s process, things like evening and weekend working that people want and, rather than simply churning out more nine to five Monday to Friday day care, what people want is it targeted to their needs where they are and it's that sort of quality that I think is so important. We also of course have got sophisticated, I hope, complaint systems now and those are another important way and we're always trying to improve our quality control and quality assurance mechanisms. The, as far as publicity is concerned, I think once the scheme starts to, to really move I think we will see a very significant ah availability of publicity on a wide scale of people. Er but I do take the point that er Mr made. The longer serving members of the committee will remember a series of booklets on mental health, mental handicap and physical handicap across the county and we're looking at that in the context of the major changes now and seeing whether those should be repeated. They were produced in conjunction with the health service, they ran to about sixty seventy pages each and I think we were widely welcomed. They are still very relevant that they are still very relevant Chairman and could very well be used again. I think they need updating and we have started to look at. Thank you. Erm er cos we would need a glossy.
[speaker002:] [LAUGHTER]
[speaker001:] Erm on the mental health strategy erm yes we do need to sign up for that. I think the committee has already indicated its views but I don't think that is its views where they may not have entirely coincided with a particular District Health Authority are really part of a dialogue towards consensus rather than any fundamental difference put it that way. Er, we have some points that we want taken on board such as the relevance of CPMs in the primary care team each team and that sort of thing but I don't think they are fundamental differences, they are, as I say, dialogues towards consensus. Erm, the homes in the rural areas and fees. And perhaps I can tie that in with the, the comment from Mr about people from having loved ones in I am bound to say that this hasn't been a major feature of our er er
[speaker002:] [LAUGHTER]
[speaker001:] in fact that would be catered for by other provisions because erm under the directive on choice, any individual has a right to er say that they would like to go to a particular home. We w er we would, we would only need to pay for them at the rate where they lived. In other words, they would have to meet the difference. Unless there were special factors involved and although I cannot recall a situation where we've paid for a person to go into that's for members to discuss, not me, but we have certainly paid an enhanced rate where somebody wanted to go to to live near their daughter who was in and we felt that was a legitimate reason for paying a higher rate and, and, and we did do so, so there are other types of flexibility. What this is intended to do is to put structural change into it, to say to home owners, if you come to the area, particularly those built-up areas where there is such a shortage of homes, you can be sure that you will get higher rates and to answer another question, we are,a that would be applying to existing people as well as to er otherwise in the budget allowance for that. The erm safety on the transport yes I mean I am very happy to say that we will ask the, the staff to look at that and perhaps I can just clarify the meaning of that paragraph ah in four point eight when it says a m a new member of staff it means a new member of staff will be responsible for health and safety not just one person on his own.
[speaker002:] [LAUGHTER]
[speaker001:] Erm the er users and carers. That would we feel is certainly in a coordinating way and if somebody for instance er say you've got a husband and wife living together, one of them suddenly becomes handicapped in a particular way, what we are planning to do is trying to develop programmes which will enable the carer to have to go on training at the County Council's expense to enable them to look after somebody in their own homes and it's a type of thing we want to develop. I'm not saying we have done this in an ad hoc way up to now but what we want is to try and develop a programme for this and I think that should be a very useful and, and frankly I would expect it to grow er over the years as the need develops. I think peop it's clear that that could be a very useful part of er of there being care in people's homes. Erm the on the po projections and the flexibility for the flu virus. Erm, yes, we have made a, a projection but the treasurer and I and er Mr may wish to comment through you Chairman. Er we ha we are aware that there is a need for flexibility. We will know by the first of April this year rather more than we know at the moment but you're right it can go up and down, but there are lots of budgets in Social Services which are subject to this and it's part of our job to try and manage that during the course of the year. To take child care for instance, we can suddenly get two or three ah admissions to secure units at a cost of two thousand pounds a week and that's er you know a hundred thousand a year per child so we can really there are other votes that can, can absorb that sort of money. Did you? Well yes, yes Mr Chairman. Just to say that we do monitor the numbers going into, to residential care very very closely so we would we would be able to tell sort of reasonably early in the year if things were going erm way of our projections of our predictions and er we would obviously be coming back to you to see to er to change our budgets erm if, if that proved necessary. My fear Mr Chairman was that the very we've been talking about can be weeks or months Yes, yes I mean it could be nothing may happen at all may descend on us and everybody's and we've run out of money. You'd, you'd expect me erm er [clears throat] with my finger on that pulse to have made that point to the directors, may be help me make it several times during our sort of discussions about er both this year's budget and next year's projections. Erm er the other things we're doing which hasn't mentioned is that we're doing an actuarial assessment of the probable erm let's min not mince our words, death rate, sort of the drop out rate if you like of, of placements because takes people who are in there out at any period during the year or the future and we need to have some sort of projection for that as well. So we're, we're looking at er er both input and the output, if I can put it so crudely, in terms of er occupancy of er we look at the demographic trend and the correlation We certainly do. Erm, what we have done is is because what is important is to look at that particular and try and get as good an estimate as we can because, let's face it, if we over-budget then in fact we're wasting money which could otherwise be really targeted on community resources. Erm, as far as the growth of the independent living fund is concerned. If the er nas we know what the national figure of growth is for next year. If that is repeated in we would expect about five hundred thousand pounds to be included in next year's, that's the ninety five six, special transitional grant in respect of erm er the independent living fund so that's quite a significant increase next which will be scheduled for the year after the budget we are now considering. Erm, on annex A, Mr is quite right and there is a mistake there. Erm the, on appendix five and annexe A is of course is of course an annexe to it [incomprehensible] and I apologise for this. On page two er bands that should th the heading, nursing home, should come after band C and not before it. The annexe is right, the erm individual appendix is not. I'm sorry for that mistake. Well spotted. I'm grateful to Mr for. Perhaps he may have an interest in this matter.
[speaker002:] [LAUGHTER]
[speaker001:] Erm, reference was made to the erm changes in the s so- called er living grants. Er the situation is that what has happened is that government has lowered the mandatory ceiling from fifty thousand to twenty thousand. District councils still have discretion to make grants in excess of twenty thousand pounds and er as Mr there can be th there are a limited number of those in the course of the year. We have no indication yet that any district council is thinking of reducing the amounts it pays merely because the mandatory limit has lowered from fifty to twenty. Erm, we are aware of a number of those take place and if necessary we'll have to enter into discussions with the district councils er about and there is an element of give and take there. There's still the statutory position with the occupational therapist of this department makes a recommendation to the er on the f on the proposals submitted to us by the district council but it's purely a, a lowering of the mandatory limit, the discretionary limit remains the same and it remains to see how that will work in practice. The erm Mrs referred to the buildings for the mental health. Erm I think we probably envisage those as no bigger than six at the outside people in any one house, domestic scale housing is what is envisaged there. And the question of allergy doctors I must confess is outside my remit. Er but perhaps I could talk about the Centre, which is not. I meant the Health Centre. Yes, I, I thought that. I was going to say, the Centre is still operating although it may be reduced in size. To the people from the people who've gone home ob we hope this' ll only be for a few days and some have gone er to other homes just for the time being. We felt although fi the County Fire Officer was saying this morning that perhaps the main crisis has peaked during, during the last twenty four hours. We felt better be safe than sorry. Erm and also to prevent the handicapped people and perhaps for the very elderly it can be a little bit of an adventure. So we've er we felt that was we only had to cope with if the worst came to the worst. Erm but we will try and reverse that and er erm one particular parent from House er who is a member of this council has er certainly been following the events with some interest.
[speaker002:] [LAUGHTER]
[speaker001:] Erm the er Mr referred to the growth as being a standard for the future. Well er that's outside my hands but I think we should say that there should be significant growth next year as the new er as the third tranche of the community care special transitional comes in but of course there are more responsibilities. I mean, let's not beat about the bush here. We are taking responsibility for people who we were not taking responsibility for before so it isn't sort of entirely buckshee money which we distribute, there are real responsibilities here. Erm, the er question of the forecast for this year on residential work. What we did was we based our forecast, which I think Mr raised that point, we based our forecast on the admissions that we did at the Department of Social Security and I'm glad to say that we have been significantly under that level and partly I think because er we've had people who have genuinely diverted into home care and who've been able to which is why we've put the pressure on home care and on the occupational therapy services and partly because erm the, there were some inappropriate admissions I must say that. Erm, very few Is significantly low ten percent? Oh yes even though it would be more than that, it would be nearer twenty five. Erm Which is isn't surprising in the first year. I don't think anybody will be much surprised. It could have gone either way in a sense. I'm glad it's th gone this way and not the other way. I think the committee as a whole wanted to be cautious because as has been said earlier our main prime responsibility must be to those who need rest home or nursing home care and have nobody else to fund them. That's our bottom line. Erm, glad Mr spotted the tarmac laying error. Sorry about that. Erm we certainly will continue assessment training and er develop that as far as we can. Erm as far as the, the numbers of staffing are concerned, I would repeat what the er treasurer has already said and that is we do not know the conditions attached to these grants yet, if any. They were due out on December the second and as members will know I'm involved in those discussions on behalf of the. There is still no indication, as of last Friday, er meeting that the government has anything to say and there's a further meeting er in London tomorrow which I'm going to. Erm, we are indeed talking to Health Authority about the matters that were mentioned but can I come on to occupational therapists because I'm very glad to say that erm we are able to recruit occupational therapists in this county. Erm we set up I think a very successful service and if I could just mention a sad note here,me some members will know who was the county occupational therapy coordinator largely designed the service here and I'm very sorry to say that er she died the other day but her service is very much a tribute to her and we do in fact have a large number of people who will want to come and work for us as OTs because it is a good service and I'm sure that you will agree with that. Could I have a point of information there Chairman? Could I ask, it seems to me that erm in Hospital anyway, that erm no referral come we, we get nobody from unless they are referred by the ward sister. Is that the case? to us come from hospital discharge. Certainly the hospital discharge and certainly it is the case that th normally they come through the ward sister. Indeed, the government is about to bring in new regulations which will mean that the hospitals must nominate a named person for each patient who is responsible for liaising with us on discharge. And that will be welcome. I mean in some cases be left with the ward sister and I think in general that's who they will nominate. The principle is that the, the decision to discharge somebody is based on a clinical decision presses the button to start the process and but I mean that's, that's how it works. Thank you. Erm, the principal voluntary organization for the mentally ill. What we had in mind there is a parallel organization to the ones that already exist for other client groups. We have the Association for the Disabled for the blind, we have Age Concern but there isn't a for the mentally or for mental health or for whatever it might be called, and these groups are very useful in providing a focal point for liaison between statutory organizations, including the health service, and the users and carers, and providing points of lobbying concern, points on which we can comment and that that increasingly is the way we're working in the community care consultation process. Mr referred earlier to the views of the Association for the Disabled on proposals and that is very very important and I think increasingly it will be the committee's concern to if you like have very s acute listening ears to, to what is needed and what is, what is wanted in the community and organizations like this can be very important in not just lobbying in the crude sense but providing a real medium of communication and I think that that would be helpful. Mrs referred to the schedule of grants for voluntary organizations. Er last years's were reported er under the er Chairman's action procedure to the committee and I'm sure the county secretary can assist you with a copy of a schedule which was in fact a statutory background paper. Here's that piece of er Thank you There'll be more to come Yes, thank you Next year's will of course be going through the new procedure Chairman I think those were the main, main points that were mentioned. Thank you very much for that very comprehensive answering of all the queries and comments that were made and thank you to members for Oh no, there was one other point. Mr mentioned the er. The situation there is that the, there're, if you have double rooms as doubles then there would be, we do have a relatively low occupancy but the committee had decided to move towards double rooms being used as single occupancy only and on the, I've got the latest figures for the first of January in front of me just by ch really just by chance
[speaker002:] [LAUGHTER]
[speaker001:] that is taking into account the occupancy will be eighty seven percent Well, I think we've had a wide-ranging debate and I'm very grateful to all members for er their input in into the debate. Erm there are just a couple of points that the director [clears throat] hasn't touched on erm because they're probably outside his direct remit. The one I think mentioned was the me the question of mental health capital funding for day centres. Erm, it does fall into the area of discussion with the... responsibility to provide the er the capital funding for those buildings and I think that's a view I would certainly take at this time er with regard to the other health authorities in but it's erm it's er primarily a health r health erm authority responsibility. We are obviously under joint financing prepared to erm er progress a lot of the, our side of the staffing of it. The other area I wanted to comment on erm is related to that actually. other remark, which I can't let go unchallenged, that ninety percent of mental health work in the m community is looking after the worried well. I, I don't know where he gets that figure from. It's an outrageous claim erm I don't think it's substantiated by any research whatsoever. I've heard it repeated on the radio recently and even the Secretary of State didn't go so far as to use the ninety percent figure but was talking about the seriously mentally ill and the not so seriously mentally ill. The problem in terms purely of resourcing is if, if one doesn't look after the not so seriously mentally ill they very rapidly c become the very seriously mentally ill with considerable financial resourcing problems and also enormous manpower problems because they do then tend to need twenty four hour close supervision nursing and not care in the community which can be done on a part-time basis and the implications of that are frightening. There's a national debate going on t we're not gonna crack it here this afternoon and I don't want to get in there but I just wanted to put the other side of the er of the coin to that. And the final point I wanted to make, although yes, we do welcome the special transitional grant second tranche of ten point eight million pounds, and it would be churlish not to, it is nevertheless a reduction on what the share of it was last year erm s of the national total so there is actually a reduction in the share that is getting this year, and alongside that, and of course hence the need for the recommendation in the budget, is that we've actually lost very specifically one point eight five six million in the rollover grant from last year's erm S T D tranche which we are specifically asking and very grateful to policy and resources for, hopefully, erm we're asking and we're hopeful they will underpin it and the Chairman is here and er er has nodded in that direction I think it's fair to say.
[speaker002:] [LAUGHTER]
[speaker001:] Em, but that's the reason is that there's, there's a shortfall of the government funding of one point eight five six on that rollover funding which we think it would be unfair to ask this committee to find out of you know cuts in other areas within our, within our budget and that's the reason for the recommendation. So can I therefore, having had a very full debate, put the recommendations on page thirteen to the committee, including the erm relatively small capital programme set out in appendix one and ask you to approve recommendations A to F. Is that agreed?
[speaker002:] Agreed
[speaker001:] Thank you. I regret to say that I forgot to give the Vice Chairman's apologies for non-attendance. I spoke to her last night. She's confined to bed with her second attack of flu in, since er since December, so that's why she's not here today. My apologies for not saying so at the beginning. Thank you all for attending, oh we do have to formally, formally move into part two and that's for one purpose only, and that's to approve the minutes of the last meeting Can I, can I just draw attention to an error under paragraph one nine two, the date at the beginning of the second line should be first December, sorry first October, nineteen ninety three, not tenth of December. Subject to that, can I have your agreement to er sign part two minutes as correct? Thank you. I declare the meeting closed.
[speaker002:] [talk in background]