The report of the Director of Health & Wellbeing (Document “B”) follows the Council’s decision on the 18th 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.
Permission was sought by the Executive on 10 January 2017 to go out to consultation on the future of Holme View residential home and this recommendation was granted. This consultation commenced on 16th January and ended on 19th April 2017. This report presents information on the views expressed as a result of the consultation.
It provides details on how people using the services provided at Holme View will have their needs assessed and what alternative provision will be offered as a result of their assessments, if the decision is made to decommission the services at Holme View.
Recommended that -
(1) The Executive approves the closure of Holme View as planned within the Great Places to Grow Old delivery programme during autumn 2017, subject to reprovision of services being identified to meet all eligible individual needs, including day service users.
(2) The Executive approves for the Local Authority to pay any top ups for the 22 residents for up to 2 years if recommendation is made to close Holme View.
(3) The Executive approves the approach to manage the move of residents which could include support to enable a person to settle into their new home with existing staff from Holme View.
(4) Authority is given to the Director of Corporate Services to dispose of the building in line with Council Policy.
(Health & Social Care Overview & Scrutiny Committee)
(Lyn Sowray – 01274 432900)
Minutes:
The report of the Director of Health & Wellbeing (Document “B”) follows the Council’s decision on the 18th 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.
Permission was sought by the Executive on 10 January 2017 to go out to consultation on the future of Holme View residential home and this recommendation was granted. This consultation commenced on 16th January and ended on 19th April 2017. The report presented information on the views expressed as a result of the consultation.
It provides details on how people using the services provided at Holme View would have their needs assessed and what alternative provision would be offered as a result of their assessments, if the decision was made to decommission the services at Holme View.
The Health and Wellbeing Portfolio Holder introduced the report and stressed that all members had visited Holme View, some on more than one occasion and that she and the Strategic Director had met residents.
The Strategic Director reminded members that the original proposal to close Holme View a number of years ago had not been taken forward because of quality issues which were being experienced in care homes in the district. She advised members that this had improved and the number of homes that were inadequate had reduced from 26% to 5% since the previous year. She acknowledged the work of colleagues in the CCG in achieving this. She added that the delay had made the decision harder and expressed sympathy with the families and individuals affected. She stressed that the Council was committed to improve provision and currently had 162 empty beds in the district for specialist dementia provision and 52 for those with nursing needs. She referred to investment in extra care provision in a number of locations including Abbey fields and the Bronte school site. She stated that the council was committed to more personalised provision and had invested heavily in home care. She referred to the direction of travel set out in the Home First document that had been approved by the Executive.
She acknowledged that the care in Holme View was good and that the CQC had given it a rating of Good. She recognised the commitment of the staff but accepted that they were working in a poor environment. The rooms were small with no room for a hoist. The council had worked with families and individuals who had put forward ideas to find out whether it was possible to implement them. The authority had looked into the possibility of renting a floor in a home nearby but the owner did not want this. Consideration was given to whether Holme View could be brought up to standard but this would have involved closing the home for at least one year and the number of rooms would have been reduced. If Holme View was to be kept open some residents would have to move out in the future because it would not be possible to care for them in Holme View.
She concluded that the view of the authority was that Holme view was not viable and that the feelings of families and individuals were being recognised to ensure that transition was supported to make residents feel safe and secure in their home.
A group of Family, Friends and Relatives of residents at Holme View attended the meeting one of whom spoke on their behalf in opposition to the proposed closure and raised the following points:
While understanding the position regarding long term viability of Holme View they felt that those 22 vulnerable residents be allowed to remain at Holme View. Some of the residents were receiving end of life care and had chosen Holme View for the last few months of their life. Relatives and residents would not have chose Holme View if they had been made aware that it was closing. Health and Wellbeing included emotional well being as well as physical wellbeing. Moving home would cause residents stress and their health and wellbeing would not be positively safeguarded by the closure. While the building and rooms did not meet the CGC regulations this had not been highlighted in the CQC rating. Elderly and vulnerable residents were being denied the right to choose to stay in a CQC rated good home that they saw as home.
He asked for clarification in respect of top up fees and whether residents may have to move again after two years if they were not able to meet the fees. He stressed that Holme View had been rated as good and urged the Executive not to agree to its closure which would not be in the best interests of the residents and requested that it be kept open for the lives of the existing residents.
In response the Strategic Director confirmed that top ups would be guaranteed for a minimum of two years and would be reviewed annually.
With reference to how the closure would be managed the Strategic Director advised members that each person would be reviewed and reassessed and anyone on the brink of specialist nursing needs would be identified to minimise the number of moves and to work with families to find an appropriate care home of their choice. During the transition from Holme View to a new home key workers would be identified who would visit the new home with residents to familiarise themselves with their surroundings. The Council would have a significant role in passing on relevant information to the new provider. This process would take a number of months to get right. It was important that staff who knew the residents made the move and supported residents in their new home. It would not be in the residents best interests to move them when they were unwell and as Holme View did not have specialist nursing facilities so moving them early would be a better option.
In response to a member question regarding the feasibility of refurbishing Holme View the Strategic Director reported that home was built in the 1970’s and would need substantial remodelling which could not be undertaken in phases. The work would take approximately 12 months to complete. Consideration would have to be given to the health of residents while the work was undertaken, in terms of noise and respiratory issues. She added that only one room had a hoist. Substantial refurbishment would be required to bring the home up to CQC standards. The building had narrow corridors and housed frail people with a number of conditions. Consideration had to be given to the health and wellbeing of the staff in moving, handling and supporting people with challenging behaviour in a small space.
With reference to the staff at Holme View, members were advised that there were a number opportunities for redeployment. Work was being undertaken with hospitals to develop short stay places. Investment was being made in new services for end of life care in a person’s own home. There was a shortage of staff in the care market and undertaking new roles should be possible.
With reference to the Equalities Impact Assessment the Strategic Director explained that the option of providing different premises was explored and this was not possible. Consideration was given to keeping Holme View open for the foreseeable future but it was not possible to predict how long this would be for, as some of the residents were in their early 60’s so this could be for between 2 and 10 years and the issue of refurbishment would not have been addressed.
Residents, family and friends were thanked for their productive suggestions made during individual and group sessions. It was noted that the process to mitigate the impacts of the proposals had been explored thoroughly.
The Strategic Director confirmed that that there was capacity in the sector to accommodate the residents of Holme View with over 200 empty beds, 162 of which were specialist dementia and 52 were specialist nursing beds. She reiterated that top ups would be for a minimum of two years to be reviewed on a case by case basis.
The Health and Wellbeing Portfolio Holder noted that the CQC had reported to the Health and Social Care Overview & Scrutiny Committee that a substantial number of homes had moved from Inadequate to Good and one was now outstanding. She emphasised the need to comply with CQC standards and noted that to bring Holme View up to those standards would involve substantial refurbishment. She added that this had been one of the most difficult decisions the Executive had been face with and that issues and options raised by families had been explored in full and reasons given why they could not be pursued.
Resolved -
(1) That the closure of Holme View be approved as planned within the Great Places to Grow Old delivery programme during autumn 2017, subject to reprovision of services being identified to meet all eligible individual needs, including day service users.
(2) That the Local Authority pay any top ups for the 22 residents for a minimum of 2 years if recommendation is made to close Holme View, this is to be reviewed on an individual basis annually.
(3) That the approach to manage the move of residents which could include support to enable a person to settle into their new home with existing staff from Holme View be approved.
(4) Authority be given to the Director of Corporate Services to dispose of the building in line with Council Policy.
ACTION: Strategic Director Health and Wellbeing
(Health & Social Care Overview & Scrutiny Committee)
Supporting documents:
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