Hampshire County Council

Adult Social Care Policy Review Committee Item 7

23 November 2005

Re provision of Respite services - Pier House

Report by the Director of Adult Services

How the conclusion in this report fits with the Corporate Strategy

This scheme will impact on the delivery of the following Corporate Aims

Aim 1 - maximising life opportunities by assisting timely delivery of caring services

Aim 5 - making sure services continuously improve

1.

Summary

1.1

This paper brings together the responses that have been received to date to the consultation that is currently being undertaken by Adult Services regarding the reprovision of respite services from Pier House which is one of Hampshire County Council Older Persons Homes.

1.1.2

This consultation focuses on the building and its fitness for purpose to meet the needs of current and future service users who require respite care.

1.1.3

The basis of the consultation is that Pier House does not meet the expectation of the Commission for Social Care Inspection in terms of being `fit for purpose' which is a term used within the Care Standards Act 2000.The main consideration here is to identify whether a building meets the needs of the current (and future) service users. With increasing frailty of residents, both physically and mentally, bedroom sizes are the most important factor. This enables care assistants to use additional equipment such as hoists and electric profiling beds to ensure safe moving and handling of residents. The Pier House building does not easily lend itself to these requirements.

1.2

Pier House, Lee-on-Solent

Pier house is a three-storey Older Persons Home formed from the conversion of a former hotel, with single storey additions to the rear. The site is small, with little on site parking. It is situated immediately on Lee-on-Solent seafront.

1.2.1

Pier House originally catered for 40 residents, this was reduced to 31 and following HSE and Health and Safety concerns the numbers were reduced in 1999 to 15.This was due to poor fire integrity of the building, and advice was given not to use the third floor.

1.2.2

During recent years the home has been used as a county-wide respite care resource and has provided a facility for early discharge of patients in hospital wishing to eventually return home. Despite extensive promotion of the services, occupancy was only 50% during 2004/05. This has a significant impact on unit costs (see below under section 1.7)

1.2.3

It has become increasingly difficult to accommodate residents either due to their increasing frailty and reduced mobility or that the building is unsuitable to meet the needs of dementia care residents.

1.2.4

The property is significantly exposed to weather elements due to its seafront position overlooking the Solent. Maintenance and repair of the property is extremely high and given the low occupancy and staffing costs, the unit costs are by far the highest in the county and are unviable.

1.2.5

Current estimated cost to bring the home up to the required standard would be in excess of £1million.

1.3

1.3.1

1.3.2

Consultation Process

The reprovision of this service is subject to a consultation period which ends on the 30^th November. The attached schedule sets out who has been consulted including the number of responses received.

The key issues that have been highlighted to date are:-

1.3.2.1

1.3.2.2

1.3.2.3

1.3.2.4

1.3.2.5

1.3.2.6

Positive location of the sea front building

Requests for further information on the level of investment that would be needed to bring the home up to standard

Additional costs that may be incurred by individual service users

Occupancy levels and how widely the service has been promoted

Positive comments on the quality of care that is delivered at Pier House

Alternative reprovision options through the use of personalised respite care.

1.4

Staff consultation and redeployment

1.4.1

There are currently 23 permanent staff employed by Hampshire County Council working at Pier house.

1.4.2

Individual and group consultation have been undertaken with all staff at Pier House. This has also included consultation with the Trade Unions

1.4.3

The options for their future employment are that they will be offered redeployment either at Addenbrooke which is 3 miles from Pier house or Hawthorne Court which is further to travel but does offer staff the opportunity to work within a nursing care environment. There is also the opportunity for staff to explore wider redeployment options within Hampshire County Council.

1.4.4

Work is ongoing with the staff and we are finalising the number of staff who have been offered and accepted redeployment within Hampshire County Council Older Persons homes or other alternatives within the County Council. Through individual negotiation there is a group of staff who have indicated that they wish to be considered for redundancy/ retirement.

1.4.5

The numbers have yet to be finalised, any costs will be accommodated within the revenue budgets for Residential and Nursing Care in 2005.

1.5

Re-provision of service

1.5.1

Alongside the consultation process work has been undertaken to identify alternative options for service users who have programmed care booking from November 2005. This consultation has been undertaken with colleagues from care management who are working with the service users and relatives to ensure that their needs are met.

1.5.2

To date of the 16 programmed care users, care management have visited 15 and have assessed how their future needs can be met should the decision to cease the provision of respite services be taken by the Executive Member in December 2005.

1.5.3

These options include re-provision both within the Independent sector and Hampshire County Council Residential Homes.

1.5.4

Provision of 7 dedicated dementia care respite care beds at Addenbrooke, Hampshire County Council Older Persons Home in Gosport.

1.5.5

Commissioning 6 additional respite beds from the Independent sector in the locality- 2 of these will be available immediately in December with 4 available from January 2006.

1.5.6

Alternative provision for programmed care users in other Hampshire County Council residential homes.

1.5.7

All of these options can be delivered within existing revenue budgets and will allow us to meet the needs of a wider group of service users such as those who are physically frail or have dementia care needs.

1.5.8

Given that there are no permanent residents in the home the reprovision of the service could be achieved by December 2005.

1.6

Financial impact of reprovision options

1.6.1

The options for reprovision will provide a wider range of service for less cost.

1.6.2

This delivers the anticipated efficiencies of reducing unit costs through the use of Hampshire County council older Persons homes and additional capacity purchased from the Independent sector.

2.

Impact Assessment

2.1

In compiling this report and developing the strategy, regard has been given to the County Councils' duties in relation to the Race Relation Amendment Act 2000 and Hampshire County Council's own race equality scheme.

No current adverse impact has been identified.

3.

Consultation with Local Members

3.1

Local Members have been briefed by letter and offered individual meetings.

To date, two responses have been received and no requests for individual meetings.

Recommendation(s)

That:

1

As part of the consultation process the PRC considers the proposals for the reprovision of respite services from Pier House, including the responses which have been received to date. All of which will be incorporated into the final paper that is to be presented to the executive Member for decision in December 2005.