Contact: Mary Downes, County Manager ext 7217

1 Summary

This report advises the Social Care Policy Review committee of the outcomes of the Best Value review of residential care for older people.

A detailed report outlining the work of the review and the options for the future provision of long term residential care was presented to a workshop for members of the Social Care PRC on 31 May 2002, a copy of which is at Appendix 1.

This report outlines the proposed action plan for improving the delivery of services following members' endorsement of the preferred option of the review team and challenge workshop. The preferred option was Option 2: the maintenance of a mixed market of provision, but with a changed focus to meet increasing need for nursing care and for care for the elderly mentally ill (EMI).

2 Introduction

Headline conclusions from this review are:

· Consultation with users, staff and relatives indicated mostly high levels of satisfaction across a range of topics, and across all types of homes surveyed;

· The area of least satisfaction related to perceived inadequate staffing levels and the impact this had on residents;

· Consultation with users with dementia was carried out by an external organisation and highlighted the need to develop dementia-specific Policies and Standards for nursing and residential care settings;

· Comparison work indicated that Hampshire shows a stable and average performance compared with other local authorities;

· Competition work indicates that whilst activity levels are comparable with other authorities, Hampshire's unit costs are low; and its in-house costs are particularly low;

· The challenge workshop established six criteria against which strategic options were appraised;

· A preferred option of maintaining the current mixed market of provision, but changing the pattern of services delivered, was put forward for recommendation as the County's Council's strategic direction;

· Costed sub-options to address the desired changes in services need to be developed further;

· These costed sub-options should explore the proportionate mix of internal and external provision needed to address the gaps in the current market.

3. Background/Context

The scope of this review has examined permanent residential care across both in-house and independent sectors, a service that cost the County Council over £32 million pounds (net) in 2002/01. It is important to recognise, particularly in respect of this review, the national and local context within which residential care services are placed. Members will be aware that government announcements such as the "Cash for Change" funding have required the County Council to address delayed transfers of care as a priority, which in turn has required the Social Services department to respond rapidly with proposals that impact upon the current market and upon our own provision. The residential care market has been and is still, subject to considerable volatility. The introduction of the Care Standards Act, the subsequent relaxation of the "absolute" nature of some of the standards and the timescales, and most recently the announcement of yet more regulatory change only serves to emphasise the difficulty in attempting to review a service when the goalposts are changing so frequently.

As a consequence, the review has concentrated on determining a broad strategic direction for the purchase and provision of residential services, determining criteria against which they should be measured, listening carefully to users, staff and relatives, and examining how Hampshire performs in comparison with other local authorities, rather than prescribing a specific role for in-house provision or a pricing strategy for the independent sector. These matters are addressed in the action plan.


4 Action Plan

The action plan outlines a programme of work which will enable the department to refine and deliver the strategic direction approved by the Policy Review Committee at its meeting on 31^st May 2002. The action plan is structured around the six criteria against which the options for service delivery were appraised. These were:

_ Address gaps in the market regarding types of provision;

_ Respond rapidly to changing agenda;

_ Improve market capacity to enable timely appropriate placements;

_ Meet user aspirations and values;

_ Secure value for money on behalf of residents of Hampshire;

_ Achieve market sustainability for the future within available resources.

The action plan is attached at Appendix 2.

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