Executive summary

This consultation claims to be about changes Merton Council are looking to make regarding day opportunities for people with Dementia and older people with additional needs.

It looks like decisions have already been made.  At the Council Budget meeting on the 1 March 2023, the Labour administration voted through their decision cut funding to Eastway Day Centre based in Morden down to nothing by next April.  The Liberal Democrat group strongly opposed this decision and suggested alternative ways to achieve a balanced budget for 2023-24. The Liberal Democrat group do not agree with the administration that their decision to join two services together based at the Dementia Hub in Mitcham and in other (unspecified) parts of the community is fair or reasonable, and it unnecessarily disrupts the lives of vulnerable people and their carers.

A clear reason for these changes has never been advanced. By forcing through significant budget cuts in advance of setting out the reasons for changes – indeed using the savings to help balance Merton’s budget – it appears as though the motivation for changes is purely financial.

Listening to Residents

The Liberal Democrats have talked with many residents, service users, carers and health and care staff, all of whom agree this is the wrong decision.  The service provided at Eastway Day Centre is used and greatly valued by many people – some with dementia, some with other care needs. 

Eastway is conveniently located and accessed by both residents from the East and West of the Borough. Community transport is already in place to bring those residents to Eastway who require it.

The provision at Eastway is unique in the Borough, in that it caters for those who are further along in their Dementia journey, as well as those without Dementia.  Many of the activities provided at Mitcham Dementia hub would not be suitable for this latter cohort of residents. This is reflected by conversations that Councillors have had with carers, one of whom said:

“My father has attended [Eastway Day Centre] 3 days a week for 7.5 years since his stroke.  He does not have dementia and although he is 79 his cognitive function is not getting worse.  Eastway provides him with socialisation, a sense of community, activities and exercise he will never do at home and significantly helps his cognitive function. Without the day centre he would be sat at home, in the chair, for 24 hours a day, 7 days a week. He would have to be in a care home as my mother would not be able to manage alone.”

Eastway provides a community space for those with dementia to share a hot lunch and have conversation with friends.  They can stay for a morning coffee or an afternoon tea or all day. This length and choice of stay is not offered at Mitcham Dementia Hub – people need this flexibility.

The staff at Eastway are highly regarded and much appreciated by residents of Eastway who feel their health and wellbeing is tended to.

Having engaged with many people, we found a depth and breadth of unmet need – which is counter to what the council claim.  The reason we believe the service user numbers have declined is because the council does not advertise the service, nor does it make the service known to people and has instead chosen to run the service down over the past years. 

As with all services, improvements could be made - the offer at Eastway could be enhanced with increased activities tailored to people with dementia or additional needs.  The introduction of Virtual Wards and greater numbers of people being looked after in the community mean more carers needing help and support, which Eastway could potentially provide with the right funding.
 
Eastway provides a service model that works, “a good offer”, the number of people with dementia is rising and will continue to do so for some time yet. If Eastway were to close there would no longer be an offer from the Council for respite care for carers of those residents accessing the provision at Eastway.  A service lost. This would have to be paid for privately at considerable extra cost to residents requiring this service - not all of whom would be able to do so and in the midst of a cost of living crisis.  As one resident told us:

“…This is the only respite I get giving me an opportunity to visit dentists, doctors and osteopaths.

Last Tuesday I received the attached letter [To Eastway Day Centre Service Users from LB Merton’s Adult Social Care, Integrated Care and Public Health Department, dated 17/3/23].

I am still in a state of shock that Merton would be considering closing Eastway that is the only centre catering for support of older people in the borough.

We know from the news that Dementia is increasing among the older population. We need more services not less.

I do not know how I am going to cope!”

People are understandably strongly opposed to the decision to close Eastway.

But we already knew this

In 2016 the council undertook a mini taskgroup review of day care services at High Path Day Centre and All Saints Day Centre.  The review found that: “ ...when people experience a reduction in their day services (eg day centre places) or lose them altogether, there can be a devastating impact as they can be left socially isolated, bored and lonely, and important friendships and support networks are lost. The knock-on effect for families can be severe, - often with extra financial and emotional strain on already overworked family carers”

Alternatives being considered by the council

The Liberal Democrat group are grateful to the Alzheimer’s Society for all the fantastic work they do for the residents of Merton.  We would not want to see their services diminish and we know residents would welcome the new initiatives being developed. 

But there is little information to be able to answer the consultation question ‘Please tell us if you agree or disagree on the proposal to join some of the services provided at Eastway and the Dementia Hub together to develop a new enhanced community-based model at the Dementia Hub in Mitcham and in other parts of the community?’ The question is framed so that the respondent either agrees or disagrees.  Which is difficult to do when there is nothing about how adult social care packages could be affected, or direct payments, or whether there would be staff to support a community-based model.  Also, we question whether it is appropriate to mix the client groups, does the model really ‘enhance’ each set of experiences.

Older people with additional needs seems to have been added in – we would like to understand what the additional needs are in this context.  For example, does this refer to the community of learning difficulties/autism, or another group?

The current slightly younger people will become older people, and so we will be interested in seeing their views coming clearly through the consultation.

We note there seems to be two pieces of work looking at day care opportunities.  Is it one for ‘older people’ and a separate one for people with learning disabilities/autism, or is it the same piece of work?

We also note that whilst carers are mentioned, we cannot see anything that specifically asks what carers need to be able to continue supporting their loved ones – despite them being the people who will be bearing the brunt of any upheaval to services.

In conclusion

Ultimately, the Liberal Democrat group have serious concerns about the impact upon people with complex or advanced dementia, and upon people who care for people with dementia.  We seek assurance that unless and until good quality day respite care, and high-quality care for people with advanced/complex dementia is in place for a seamless transition, Eastway should NOT be closed.

If the administration hold firm to their decision to close Eastway - against our and residents’ strong objections - closure will be a major adjustment for people with dementia and their carers currently using it and they should be prepared and supported for the change.

Our priorities for day care services are:

a)      Built around the needs of all service users and carers;

b)      Reliable, flexible, affordable, easily and sustainably accessible by all residents across the whole borough;

c)      Designed for the long term, not ad hoc and piecemeal.

d)      Available within the Borough with transport if required

e)      Quality respite for carers.

Liberal Democrats Merton

25 May 2023