"Meals-on-wheels": Cllr Denise Carr sets the record straight

1.00.00pm GMT Mon 10th Nov 2008

• Cllr Denise Carr writes: I would like to respond to the concerns which have been raised about changes to the "meals-on-wheels" service. The aims of the new service are to offer more independence and choice, better nutrition and help to combat the social isolation that can attend old age.

The Council now offers anyone who needs help a Self Directed Support assessment and personalised support and advice, which meet their individual needs. We want to ensure that services are planned around the person and not the person fitted into Council services. The Council currently offers both a hot meal-at-home and a frozen meal-at-home option: the food is exactly the same, but while the hot meal is heated up in the van en route, the frozen meals are delivered once a fortnight and the customer is provided with a small freezer, if required, and a small "servotherm" heater specially designed to take an individual meal. The price charged by the Council is also the same for both (£3.10), though the cost to the Council of the hot meal delivery is much greater of course and the service is heavily subsidised.

Each person who currently receives a hot meal-at-home has received a letter and fact sheet from the Council explaining the changes, and, over the next few months, each will be contacted by Social Services staff and offered the frozen option with support if needed, or, if required, a re-assessment of their needs under Self Directed Support. They may choose to transfer to the frozen meal at home option - but this is NOT the only option. They may choose to address meal requirements differently as part of their individual support plan, including help with shopping, cooking etc., taking lunch at a local day centre or lunch club, or with support from family or friends.

Each person's needs will be looked at individually to determine the most appropriate solution for them, including the need for daily or frequent contact - and carers or relatives who wish to be involved in the Self Assessment and support planning will be welcome to do so.

Concerns have been raised about the loss of the daily contact provided by the hot meal delivery driver, who is required to hand the meal to the customer and to report to Social Services if there is no answer or if the person is in difficulty. However, the meal service is a meal service not a social care service, and I would be concerned about vulnerable older people whose only contact with the outside world was the daily delivery driver and who would be at risk without this call. We can and must do better - and if there is a need for daily contact this will certainly be included in those users' assessments and support plans. There is also the careline/telecare option for people who live alone and are at risk. However, a large proportion of people on the hot meal service are on the moderate needs band (we are one of the few Councils who still provide services for people on moderate needs, as well as substantial and critical), so it is highly likely that they will be able to manage the frozen meal service and will not be relying on the daily call to ensure that they are safe and well. Nevertheless, the savings from switching to a frozen meal only service will be used to fund the extra home care support that some people will need.

A change in services for older people is always an anxious time and the Self Directed Support approach requires individuals and their carers/relatives to think in a different way about what they would really like and how best this can be arranged. Staff will be handling each case as sensitively as possible and have allowed plenty of time for the transition.

In addition, as we proceed to let the tender for the new frozen meals service starting in May 2009, the Council will be looking for a range of meals which offer better quality and choice than under the current contract.

Cllr Denise Carr is the Cabinet Member, Adult Services, Health & Housing

• Extract from 'Community Meals Service Scrutiny Task Group Report - Executive Response' [May 12 2008]:

' . . 5 Financial Implications

5.1 The net cost of the meals service to the Council is approximately £250,000.

Cabinet should note that Richmond currently provides the highest number of

meals per thousand older people of any of its comparator outer London

Boroughs. It also provided nearly double the national average per thousand

population.

. . 5.3 Savings are expected from the change to supplying only frozen meals at

home (recommendation 7), however some of these savings will be offset by

the additional cost of providing assistance to some service users to heat up

their meal (through home care providers), with the remainder available for re-

investment in the meals service.

. . 7. Risk Assessment

7.1 The major risk arising from proposed changes to meals delivery that follow

from the task group recommendations report relate to the concerns about

residents who have previously had a hot meals service and will now receive a

frozen service. A small number of these people may require assistance with

the preparation of frozen meals to ensure that they are able to eat them. To

mitigate against this risk all service users changing from a hot meal to a

frozen meals service will receive an assessment of their individual

circumstances, and will be provided with specific assistance to prepare meals

if this is required.'

Related Links:

• Minutes of meeting of Cabinet, 12 May 2008

• Community Meals Service Scrutiny Task Group Report - Executive Response [May 12 2008]

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