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

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 retain 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 day service at Milton Grange is run by the Council and it is based in one of our buildings in Eastbourne. The service delivers support and activities to older people who have a range of physical and mental health needs associated with dementia. The aim of the service is to prevent social isolation and provide respite for carers to give them a break from their caring role or allow them to work.

The service has 22 members of staff, who are all employed by the Council. It has space for up to 45 people a day from Monday to Friday between 10am and 4pm and up to 25 people on a Saturday for the same hours. Transport to and from the day service is provided, as well as a hot lunch. Some people who use the service have complex needs that require one-to-one staffing support.

There are currently 97 people who attend the service, with most people attending for one or two days a week. The service is busier Monday to Friday than on a Saturday. The majority of people who attend the day service live in Eastbourne (76%) with the remainder living in the surrounding towns such as Hailsham, Polegate and Seaford.

The service provides physical and cognitive stimulation through a range of activities including chair-based exercise, reminiscence, arts and crafts, interactive quizzes, puzzles and games, as well as day trips. The service uses the Oomph App, which is designed to support wellbeing and provide tailored activities to meet specific needs.

What we are proposing to change

We are proposing to stop providing the day service at Milton Grange and support people to access alternative services in the community. People would be supported to look at their options by our social care staff. Where they still needed a day service, they would be found an alternative service run by another provider or voluntary sector organisation. If the proposal went ahead then people would move to their new services from March 2025 onwards.  

There are a range of day services for older people across East Sussex run by private providers and voluntary sector organisations.The building at Milton Grange would continue to be used for our residential intermediate care service. This provides a short-term multidisciplinary rehabilitation service to 37 people with a range of physical and mental health needs.

Why we are proposing this saving

While we recognise the importance of this service, the budget pressures we face mean that we have to make difficult decisions about how we spend our money. Under the Care Act, we are required to meet people’s eligible needs, but that doesn’t necessarily mean providing the service ourselves.

We have seen a reduction in attendance at this day service since the pandemic and it has been challenging to increase the numbers attending to a financially viable level. There are also day services available from other organisations that can support this group of people, potentially at a lower cost, so it makes sense to make use of those rather than committing the money required to run the service ourselves.

How people and organisations would be affected

For people who use the service the change could be difficult and  may be upsetting. Many of the clients have formed friendship groups and built up a rapport with the staff. Moving to another service would mean starting again. We may also find it harder to find a suitable service for people with more complex needs.

The primary reason that many people attend day services is to give their carers a break, enabling them to continue in their caring role and in some cases to continue working. The disruption of moving to a new service could be stressful for carers, many of whom have built trusting relationships with staff.

The day service provided at Milton Grange enables people to continue living in their own homes for as long as possible. There is a risk that failure to offer a suitable alternative could result in people having to move to residential care sooner than needed.

Have your say on the proposal

We are keen to hear from everyone with an interest, including:

• people who have used the service or whose family members or friends have,
• the staff who work for the service,
• providers who run alternative services,
• staff and organisations who work with the services or refer people to them,
• providers who support people who use the services, and
• our partners in the public and voluntary sectors who work with the service and would be affected by the proposed changes.