Contact: Vincent Oliver, Head of Service - Residential / Day Care for Older People, Ext. 5720

1 Summary

1.1 The following decisions are sought.

1.1.1 That approval be given to adding both Intermediate Care and Nursing Care to the Core business of the In-House Residential Care Homes for Older people, subject to the necessary joint funding streams being available with Health.

1.1.2 That approval is given to adding an additional number of beds (up to a maximum of 9) as a result of the Cash for Change initiative.

2 Reasons(s)

2.1 There is a need to respond to the Health modernisation agenda in partnership with the Social Services Department, with particular reference to the issue of delayed discharges from hospital.

2.2 This provides an opportunity to sustain future viability of the In-House Residential Homes and to improve the quality of the buildings.

3 Other options considered and rejected

3.1 To maintain the status quo of the current core business may make the Residential Care Homes future more vulnerable.

4 Conflicts of Interest declared by the decision-maker or a member for officer consulted

4.1 Not applicable.

5 Dispensation granted by the Standards Committee

5.1 Not applicable

6 Reason(s) for the matter being dealt with if urgent

6.1 Capital funding streams are currently available from the Department of Health which need to be accessed now.

Approved by: Date of decision:

Councillor Felicity Hindson

Contact: Vincent Oliver, Head of Service - Residential / Day Care - Older People Ext: 5720

1 Summary

1.1 The purpose of this report is to seek a variation to the current policy on the core business of the In-House Residential Care Homes and to add intermediate and nursing care.

1.2 There are a number of significant factors affecting and influencing the development of in-house residential care for Older People. In particular is the Health modernisation agenda and the impact of the new Care Standards Act 2000.

2 Background

2.1 On the 24^th July 1998, the then Adults' Services Sub Committee approved the recommendations that the core business for Local Authority residential care would be:

i) The provision of care for Older People who are functionally very dependent due to mental incapacity; primarily those with moderate to severe dementia but also and including those with other mental incapacity.

ii) The provision of care for Older People who are functionally very frail due to physical frailty.

2.2 This policy is being implemented incrementally, particularly as part of the Capital Re-investment programme currently underway.

2.3 In the last year the Government agenda has been addressing the issue of delayed transfers of care (bed blocking) and the impact of the new Care Standards Act 2000, which has led to a significant change in the overall resource available.

2.4 Work has already started on identifying if current In-house services could diversify into intermediate care services and possibly nursing care for the County's residential care facilities for older people. This has now been accelerated by opportunities that have recently become available as part of the Government's `cash for change' agenda. This is both in terms of the availability of capital and revenue funds to develop alternative and additional resources to reduce delayed discharge.

2.5 A considerable amount of joint work has been undertaken with both the local health economies of the Primary Care Trusts / Groups, Health Authorities and more latterly as part of the new Strategic Health Authority Agenda. In particular is the work of the North and Mid Hants Health Authority delayed transfer of care project.

3 Proposals

3.1 Following a review of existing HCC residential care homes, up to a maximum of 9 additional places are planned to be brought into operation between January and March 2002, subject to minor improvements being made and all the necessary permissions sought. This will further potentially reduce the number of delayed discharges from hospitals. The distribution of these potential developments / beds are:

North / Mid Hants - 1

South East - 5

South West - 3

3.2 For the medium term, from April 2002 onwards, it is proposed to look at five schemes across the county, converting existing HCC residential care homes into part intermediate care / core business or nursing home / core business homes. Schemes have been identified as part of local commissioning needs with health colleagues and reflecting local health / care economies.

4 Financial Implications

4.1 Short term measures:

Those projects that can be brought into operation within the next two months, with a maximum of 9 extra beds will have both a capital and revenue budgetary requirement.

4.1.1 Capital costs are still being estimated by Property, Business and Regulatory Services. Current estimates are in the region of £60,000.

4.1.2 Revenue costs would include additional care staff in each of the units to cater for the higher needs of potential short term residents. Whilst the potential additional capacity is targeted for the winter period it is likely that the beds will be required longer term. Based on this assumption a full year cost for each extra bed would be £4,500 in staffing, costing - total of £40,500 per annum.

4.2 Intermediate term measures

4.2.1 Further work is required to identify all costs, both capital and revenue and this will be the subject of a further report in due course.

5 Recommendations

5.1 That the variations to existing core business and the developments be approved.

Section 100 D - Local Government Act 1972 - Background Documents

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act

NONE