Smaller social care charities are faring worse than larger ones as council cuts bite. Vern Pitt examines how two charities from different ends of the scale are coping with the downturn
(picture: Lyn Costelloe of the Little Red Bus Company is concerned about the future of smaller charities)
With services throughout the UK, Alzheimer’s Society is experienced in dealing with councils that demand more for less.
Ian Thomas, the charity’s acting director of services, favours a positive approach when faced with demands for cheaper services.
He says providers must be prepared to have services decommissioned by councils and then to be re-commissioned to provide something different and more efficient.
“I have worked in other sectors, such as housing, where we have done this before and you have to look at decommissioning and re-commissioning services,” he says. “It’s about working in partnership and being realistic that there’s less money. It’s about asking what you can deliver for what cost.”
Sue Phelps, the charity’s acting director for Wales, went through the process last summer. In August 2010, a dementia information, advice and social support service for early onset sufferers faced closure after Rhondda Cynon Taff Council withdrew funding from the charity.
The council felt it needed better value for money because the service was reaching only 20 people.
Within a month, the charity had submitted a plan to reshape the service. It proposed a new befriending service for groups and individuals. Taking advantage of the charity’s size, an Alzheimer’s Society staff member from a neighbouring area would train staff in the new set-up.
The plan also included proposals to open a network of dementia cafés. Operating from existing establishments, they would provide informal meeting places for people with dementia and their carers, as well as an opportunity to access information and advice about the disease.
Alzheimer’s Society estimated it would more than double the number of people it reached in the area, for the same cost, by the end of 2011 through reconfiguring services – a plan that persuaded Rhondda Cynon Taff Council to resume its funding.
Phelps attributes the success of this approach to longstanding relationships with the council and good communication. The charity emphasises the importance of working with charities as partners, not adversaries. Thomas has sympathy for those on the other side of the negotiating table: “We know commissioners are in a difficult position at the moment and they are going to have to make difficult decisions.”
He says the situation at the charity is made easier by the fact that nearly 70% of its income comes from donations allowing it to run projects without council funding.
The charity has been approached by other councils in Wales about delivering efficiencies. Phelps says it has been consulting service users to ensure it is meeting their needs. This will form a key part of any proposals it makes to councils to reform services or renegotiate contracts.
“We have got the advantage, certainly in Wales, that we have government backing for dementia care provision,” she says. “It is very high on the agenda.” Indeed, dementia is widely acknowledged as an area in which investment in early intervention services can save money across health and social care, a message Thomas says he is keen to reinforce whenever contracts are renegotiated.
However, there are lingering concerns about the effects of further funding restrictions. “You can’t reinvent services indefinitely. There may be a point where we would have to consider other options and reduce the service in some way,” says Phelps.
Little Red Bus
North Yorkshire community and public transport provider the Little Red Bus Company faces uncertain times despite its efficiency. By the end of the 2010-11 financial year it will have lost 15 of its 52 public sector contracts, worth £437,000. Others are up for retendering in April.
Chief executive Lyn Costelloe says it provides 60,000 community transport journeys a year for vulnerable people, alongside public transport services. She says if North Yorkshire Council were to tender for this service on a commercial basis, it would cost £480,000 a year. Little Red Bus is paid £50,000. “The council gets a good deal,” she says.
These efficiencies derive from the company’s network of community and public transport services in partnership with other providers in the county, which is designed to integrate services and reduce duplication. This is backed by a scheduling system that takes bookings from a variety of sources and a live database of vehicle availability so bookings can be taken on demand.
“If we are providing a bus service to school for children, we will pick up people on the way back perhaps to visit a social care service or hospital or the shops,” says Costelloe.
However, its community transport service is dependent on the Little Red Bus having its central costs covered by contracts to run public transport services and Costelloe worries Little Red Bus and its customers will lose out as a result of the retenders.
She says that, on price, Little Red Bus cannot compete with larger commercial operators for public transport services, but it offers greater value by running its community transport services alongside. The council has yet to decide on what basis to award the fresh contracts.
In addition, North Yorkshire Council is set to take control of a £70,000 budget for concessionary fares from Harrogate Council. The fund subsidises some customers’ travel to the tune of 50%, but Costelloe fears the move will spell the end of concessions for community transport and she will be forced to double ticket prices.
The value is not just monetary. “Sometimes [for our customers] getting out for a coffee morning is much better than pills,” she says “It’s much more cost-effective than day care.”
Steve Thomas, a Little Red Bus volunteer driver, points out that the service is more than about transport. “We also look out for people,” he says. “We often go to people if they are not there or the curtains are closed. Then we alert social services. That is something that would be sorely missed in the community.”
Stella Nichols, 88, has arthritis in her back and both knees. She cannot walk far without a rest, and carrying heavy loads is out of the question. So, when the local bus service near her house in Harrogate was cancelled in 2006 because of a lack of passengers, she faced being cut off.
“Where I live I can’t walk to get a bus and, even if I could, coming back with shopping would be impossible,” she says.
When she found out about the Little Red Bus she immediately signed up and has been a regular customer of the on-demand transport service since. Nichols says it allows her to remain fully independent, visiting her GP or the shops on her own, and, importantly, not to impose on her two grandsons.
She says the staff go the extra mile, even helping her to walk up her driveway in the recent snow and ice.
But she is worried that a cut in funding will leave her without this vital help.
“I daren’t even think about it,” she says. “I would probably have to have just one trip out a week, but I can’t possibly do all my shopping in one day because I can’t carry it.”