Great Places to Grow Old (GPGO) is an integrated programme to address the accommodation and support needs of older people, including older people with dementia.  It includes the development of housing, extra care housing, short term rehabilitation, respite care/crisis support, residential and nursing care.

The programme promotes independence and wellbeing for older people with the aim of reducing the overall reliance on intensive forms of care support by expanding services that help people stay at home, or return home after a crisis.  This includes the development of resources and support which can be tailored for individuals enabling people to remain in their own home and be independent for longer.

The Strategic Director Adult and Community Services will submit a report (Document “AR”) which sets out the Council’s decision on 18^th February 2014 to include in the budget proposal for Adult and Community Services, a reduction in the provision of two in house residential homes over the next 2 years, one of which was closed in January 2015.  This decision is included in the plans within the GPGO delivery programme which was approved by Executive in January 2013.

As a result of changes in the local market and acceleration of joint commissioning proposals with health partners, permission was sought and a decision was made in September 2015 to defer the consultation on the future of Holmeview. 

The report reviews a range of information regarding in-house services and independent provision and permission is sought from Executive to go out to consultation on the future of Holmeview.

Recommended –

Permission is sought from Executive to go out to consultation on the future of Holmeview Care Home.

Overview and Scrutiny Committee: Health and Social Care

Great Places to Grow Old (GPGO) was an integrated programme to address the accommodation and support needs of older people, including older people with dementia.  It included the development of housing, extra care housing, short term rehabilitation, respite care/crisis support, residential and nursing care.

The programme promoted independence and wellbeing for older people with the aim of reducing the overall reliance on intensive forms of care support by expanding services that help people stay at home, or return home after a crisis.  This included the development of resources and support which can be tailored for individuals enabling people to remain in their own home and be independent for longer.

The Strategic Director Adult and Community Services submitted a report (Document “AR”) which set out the Council’s decision on 18^th February 2014 to include in the budget proposal for Adult and Community Services, a reduction in the provision of two in house residential homes over the next 2 years, one of which was closed in January 2015.  This decision was included in the plans within the GPGO delivery programme which was approved by Executive in January 2013.

As a result of changes in the local market and acceleration of joint commissioning proposals with health partners, permission was sought and a decision was made in September 2015 to defer the consultation on the future of Holmeview. 

The report reviewed a range of information regarding in-house services and independent provision and permission was sought from Executive to go out to consultation on the future of Holmeview.

The Strategic Director explained the rationale behind the proposals, stating that many people were wanting to stay in their own homes, with the expansion of Extra Care making this option more feasible.  With the pressure on  hospital beds, the focus was very much on short stay and supporting people in their homes and enabling them to have quality care.  Thus this report set out what the market could support in residential care homes.

The Health and Wellbeing Portfolio Holder stated that a revised Appendix 1 had been circulated which contained up to date figures and that a Equality Impact Assessment had also been updated and circulated, following a period of consultation. She added that 2 years ago the proposal to close the home could not be supported as there was inadequate alternative care provision available, however the Council was now in a better position in the context of improved provision in the independent sector and hence the time was now right to go out to consultation on the future of Holmeview.

A number of relatives of the residents of the home were present at the meeting and they made the following points in relation to the proposals:

·         That Holmeview was an excellent facility that should remain open.

·         That the report failed to address a number of issues, in particular there was already a proposal to increase Council Tax to meet the shortfall in adult social care costs.

·         That reliance on the private sector to meet the shortfall in adult social care provision would not add value in the quality of the care provided to residents.

·         That the proposed alternative provision was not adequate as it required improvement.

·         That all residents and relatives wanted was a setting that provided a good level of care and was outstanding.

·         That moving towards a model of home care was not viable for people who had dementia and required specialist dementia care.

·         That the standards in the private sector were not the same as the Council’s standards.

·         That ensuite provision stipulated by the Care Quality Commission was unsuitable for someone with dementia and that the level of care offered to residents at Holmeview was second to none.

·         That will the Council continue to pay top up fees when residents transfer?

·         That the proposed alternative provision had only been judged adequate, and adequate was not good enough.

·         That not all the current residents would be suitable to be transferred to the proposed new facility  and therefore what would happen to those residents.

·         That would staff at Holmeview be able to transfer to ensure continuity of care?

The Leader stressed that this was only the start of the consultation phase and that the rationale behind the proposals was the long term sustainability of Holmeview, and in no way was it a reflection on the quality of care provided at the home.

In response to some of the issues raised, the Strategic Director stressed that it was not the intention to force people to move to the Gateway home, and that all other available provision would be looked and that residents will be given the opportunity to choose a home appropriate to the their needs. 

In addition the service will also look at the issue of staff transfer nearer the time of transition.

In relation to the Care Quality Commission standards, the Council could not control what the private sector does as the same regulations applied to all Care Homes.

The Strategic Director also cautioned against some of the press coverage around this issue and stressed that the health and social needs of residents would be fully assessed, and that it was the Services intention to  work closely with families going forward to ensure the best outcomes were achieved.

In relation to top up fees it was pointed out that these would only be paid for the first year, however this was an on going issue with a number of homes.

The Portfolio Holder stated that she appreciated that this was a distressing time and process for all concerned,  however no decision would be taken today; that  views expressed by relatives would be taken on board and that the Council was keen to provide a good level of care, which was in accordance with statutory standards set by the CQC.

The Strategic Director confirmed that going forward, all residents and relatives would be consulted on the proposals which would take place over a 12 week period, where issues around assessment and support would be looked at.

Resolved –

That a consultation be undertaken on the future of Holmeview Care Home.

ACTION:       Strategic Director Adult and Community Services

Overview and Scrutiny Committee: Health and Social Care