East Sussex funding gap: Have your say on the day services at Hookstead

Our funding gap

East Sussex County Council (the Council) has a net budget of £538.1 million for the year from April 2024 to March 2025. Our net budget is the money we have to spend which is financed by business rates, council tax receipts and the revenue support grant we get from the national government.

We expect our net budget for next year to be a similar amount. This means that we are facing a financial gap of £55 million for 2025/26. The financial gap is the difference between the funding available and the cost of keeping services at their present level.

Most local authorities are facing similar pressures. We face this gap even though we are a well-run and efficient council which has saved £140 million since 2010 and found new ways to work effectively through difficult times. Unfortunately, the cost pressures we face now are so great that efficiency alone is not enough and the limited reserves of money we have available would not be enough to meet the financial gap. Most importantly, reserves can only be spent once and could not repeatedly fill the financial gap which councils face every year. It is also not possible to close the whole gap by raising council tax as the increase that would be required is beyond the limit set by national Government.

We are legally obliged to close the financial gap and balance our budget. This means that some tough decisions will have to be made and reduced services are possible in all areas. When making these decisions, our priority will be to maintain protection and support, wherever possible, for the most vulnerable people in our community.

There is more information about why we have to make savings and what we are doing to highlight the issues local authorities face with the national Government on our website at https://www.eastsussex.gov.uk/your-council/finance/east-sussex-our-funding-gap.

Social care support

Adult Social Care and Health is a department of East Sussex County Council. We work with people aged 18 and over who live in East Sussex. We help people live healthy and independent lives, whatever that may look like for them. We look at people's strengths, capabilities, support network, community and difficulties and work with them to find solutions.

The Council has a legal duty to provide social care support to those who are eligible. About three quarters of the East Sussex budget goes on providing social care for children and adults, with adult social care accounting for nearly half of the budget (48%). Care and support for adults is not free and we charge for most of our services. The amount people pay depends on their financial situation, but most people have to pay something towards their care, with the remaining costs paid by the Council.

Nationally, social care is under pressure due to a combination of demographic, financial, and systemic factors. East Sussex is no stranger to this, facing unique challenges which impact on the need for support and services in the county. Around 25% of the East Sussex population is over 65 compared to a national figure of 18%, average wages remain lower than the national average and 30,000 people in the county are living in some of the most deprived areas of England. We have also seen a 40% increase in the average weekly cost of providing care in East Sussex since 2020.

As people live longer, they may require care and support for longer, and their care and support needs are likely to become more complex over time. There is also evidence that the cost of living challenges have increased demand for care, as well as making people less able to afford their contribution towards the cost of care.

As social care is such a large part of the Council’s budget, we will need to make savings to services in this area too. Reduced services are likely, and we will need to review staff numbers, but the amount we need to save can’t be achieved through reducing the workforce alone.

Developing the savings proposals

Given the financial gap we are facing, we know it is impossible to avoid some of our residents being negatively affected by the difficult decisions that we need to make. We have tried our best to identify proposed savings that would have the least possible impact on people’s care and wellbeing.

We know too that many of our external partners in the NHS, local authorities, providers and the voluntary, community and social enterprise sector (VCSE) are experiencing their own pressures in terms of demand for services and funding challenges. Where we can, we’ve tried to take that into account in looking for savings.

Our priority in Adult Social Care and Health is to meet our legal duties under the Care Act. To help us to do this, we have identified funding areas that we think need to be protected when we are looking at savings options.

The priority funding areas are:

• Community care budget: This budget covers the cost of care that is provided to adults who are eligible for social care support because of a disability or health condition. This budget is already under pressure because more people need our help, the cost of providing care is increasing, and our residents are increasingly struggling to pay their contribution towards the cost of care.

• Carers: As well as protecting the budget for community care which funds support for people who are eligible for social care support, we have tried to protect the direct support we provide to unpaid carers who are looking after their family members and friends. This is because carers play an invaluable role in meeting care and support needs for so many residents and reduce the amount of support residents need from other services.

• Voluntary and community enterprise sector (VCSE): These organisations make a huge contribution to preventing, reducing and delaying the need for care and support from the community care budget. For this reason, we want to protect the funding that we provide to support this sector as far as possible, particularly where we can demonstrate that services are supporting our statutory duties and other priority funding areas.

• Frontline workers: We need to ensure we have enough social work staff and occupational therapy workers to carry out assessments and put care and support in place. We also need to retain enough financial assessment staff to ensure we are funding those who are most in need and that people pay the correct contribution.

• Care market: We need to ensure we have enough staff so that we can support the care market and ensure we have a good supply of services that deliver the best value.

How the service works now

The Hookstead day service is run by the Council and it is based in one of our buildings in Crowborough. The service delivers support to people with a learning disability and has several aims including to:

• prevent social isolation,
• enable vulnerable adults to learn and maintain skills, and
• provide respite for parent/carers.

The service currently has 13 members of staff, although there are some vacant posts. The staff are all employed by the Council. There are three sessions a day, from 9am to 12pm (known as AM sessions), 12.30pm to 3.30pm (known as PM sessions), and from 4pm to 7pm (known as twilight sessions). The service is open Monday, Tuesday, Thursday and Friday and has space for up to 31 people for the AM and PM sessions and up to 17 people for the twilight sessions. The service is closed on a Wednesday.

There are currently 42 people attending the day service, with around 70% of the spaces filled for the AM and PM sessions and nearly 50% of the spaces for the twilight sessions.

Some clients require a smaller, quieter setting as they struggle with large groups and noise.

The majority of people who attend the day service at Hookstead live at home with their family. Most people who attend live in Crowborough and the surrounding area in Uckfield.

The building-based daytime sessions include art, cookery, music, baking, journalism and gardening. The twilight sessions focus more on social activity and include supper clubs, music nights and a movie evening. The community sessions are sports and a dinner/social in a local pub.

There is also a supported living service based in the same building. Some of these residents attend the Hookstead day service and the supported living service uses the day service space when the service is closed on a Wednesday.

What we are proposing to change

We are proposing to close the Hookstead day service and find people places in an alternative service run by the Council or by an alternative private or voluntary sector provider.

If people want to continue using a Council-run day service, the best option would be St Nicholas, our day service in Lewes. We are proposing to extend the opening hours of St Nicholas, returning it to a five-day a week service. This would increase the number of clients who could be supported by 20% (increasing the number of sessions available by 105). This would allow us to offer a place at the day service to everyone currently attending Hookstead, if the service can meet their assessed care needs.

St Nicholas would continue to offer three sessions a day. However, the timings of those sessions would need to change to manage the increase in client numbers. Changing the times of the sessions would ensure people have the support they need over lunchtime, as well as providing enough non-contact time for staff to do admin tasks and attend team meetings. We would continue to have a standard client-to-staff ratio of 5 to 1 and provide one-to-one support to clients where they are assessed as needing this.

The table below sets out the proposed changes to session times at St Nicholas:

There would also need to be some changes to how the service works to support more clients in the most cost-effective way. This would be achieved by reducing the community-based activity and focusing our energies on continuing to provide engaging and stimulating building-based activity at St Nicholas.

The St Nicholas day service only has one accessible bathroom. To meet the needs of an increased number of wheelchair users, a new accessible bathroom would be essential.

There are also day services run by other providers that could offer an alternative service if people did not want to attend St Nicholas. For example, The Barn in Crowborough and day services in Kent are geographically closer to Crowborough than others in East Sussex.

The Ferns Supported Living service would continue to be based at Hookstead. Residents of the service would be affected if they attend the day service and would be offered support to look at their alternative options.

Why we are proposing this saving

While we recognise the importance of these services, the budget pressures we face mean that we have to make difficult decisions about how we spend our money.

We currently run two day services in the west of the county. Given the financial pressures we face, it is important to get the best value from the services we run ourselves. The fact that we could potentially accommodate everyone from Hookstead at St Nicholas would allow us to reduce the number of services we are running. This will mean we can make savings from both the staff costs and the other building-based costs.

There are fewer providers offering day services for people with a learning disability in the west of the county. The services that are available are mainly in Crowborough and the surrounding area. This is why we are proposing to close Hookstead instead of St Nicholas.

The supported living accommodation in the Ferns wouldn’t be directly affected by these proposals, although residents who use the day service would be affected by that change.

How people and organisations would be affected

For the clients attending the service, the uncertainty about what would happen and the move to a new service if it went ahead could be stressful and difficult to cope with. People may be worried about how the change would affect their service, including transport, activities they can take part in, seeing the staff they like, and maintaining their friendship groups. This applies both to those attending the service which we are proposing to close and to those attending the service that would be expanding to accommodate more people.

Making changes to the St Nicholas service would mean we had space for everyone from Hookstead. What might be different is the days and times when people are able to attend. It is unlikely that we would be able to offer people the same day and or exact times that they have now. People’s travel time to reach the day service is likely to be increased too.

Clients using the St Nicholas service would also see changes to their service and may also be offered different days and times for their attendance.

The family and carers of those who use both the services would also be affected by the proposed changes, both in terms of the stress of moving services and the potential for changes to days and times. It is possible that changes to when people attend the service may affect carers’ ability to take a break or maintain their employment.

We know there are some clients who attend both services who would find it challenging to use a busy day service. Combining the two services would mean that St Nicholas was full and clients who need a quieter environment might find it isn’t suitable for them. Consolidating the two day services into one building would also limit the number of spaces we have for new clients in the west of the county. This may mean that clients who need a quieter environment and new clients would need to be found alternative services from the private or voluntary sector.

Both services are currently closed for one day a week. Hookstead is used by Ferns tenants and other Council staff when it is closed, while St Nicholas is used occasionally by other Council teams. We will use the consultation to explore the options for the building in future if the day service stopped using it.