Hampshire County Council

Executive Member - Adult Social Care Item 1

24 February 2006

Re provision of Service at Courtbourn Older Persons Home, Farnborough

Report by the Director of Adult Services

1

Summary

1.1

The following decisions are sought:

1. The Executive Member support the proposal to consult on the options for the re-provision and improvement of services currently being considered at Courtbourn and that the process of consultation is completed by the end of May 2006 with the outcome presented to them for decision in May following a consideration of the issue by the PRC.

2

Reason(s)

2.1

This decision supports Aim 1 of the Corporate Strategy by - maximising life opportunities by assisting timely delivery of caring services and Aim 5 - making sure services continuously improve.

2.2

Courtbourn, built in 1900, is a two storey converted building , which had a major extension in 1987. The site is quite large and is located in a major residential area.

2.3

Courtbourn originally catered for 46 residents, reduced to 39 in April 2003 (removal of all the double bedrooms) and then to 29 in July 2004, as a result of major concerns with fire safety following consultations with Hampshire Fire and Rescue Service (9 bedrooms closed in the link wooden construction building).

2.4

It has been concluded that Courtbourn 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, both physically and mentally, bedroom sizes and access to other common areas are the most important factor. This enables carers to use additional equipment such as hoists and electric profiling beds to ensure safe moving and handling of residents. The building does not easily lend itself to these requirements, nor would it currently meet the requirements for the provision of services to older people with dementia given the layout of the building.

3

Other options considered and rejected

3.1

None

4

Conflicts of interest declared by the decision-maker or other Executive Member 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

Not applicable

Approved by:

..........................

Date of decision:

.........................

Councillor Patricia Banks

Hampshire County Council

Executive Member - Adult Services

24 February 2006

Re provision of Service at Courtbourn Older Persons Home, Farnborough

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 work that has been undertaken by Social Services and Property Business and Regulatory Services regarding Courtbourn, which is one of Hampshire County Council's Older Persons Homes.

1.1.2

This work has focused on two key areas these being the overall asset management of the building and its fitness for purpose to meet the needs of current and future service users.

1.1.3

It has been concluded by Adult Services that Courtbourn 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 (a table identifying the key factors included in the regulations on `Fit for Purpose' is attached). The main consideration here is to identify whether a building meets the needs of the current (and future) service users. With increasing frailty, both physically and mentally, of older people the size of bedrooms and access to other communal areas are an important factor. This enables carers to use additional equipment such as hoists and electric profiling beds to ensure safe moving and handling of residents.

The Courtbourn building does not easily lend itself to these requirements nor would it currently meet the requirements for the provision of services to older people with dementia.

1.2

Courtbourn, Farnborough

Courtbourn was built in 1900 two storey converted building with a major extension built on in 1987. Unfortunately as part of that extension it had a two storey wooden construction link, which does not meet the current fire regulations. It is situated in a major residential area and has large grounds.

1.2.1

Following the extension in 1987, Courtbourn catered for 46 residents who, although physically frail, were at that time quite mobile and had a high level of self care. The home had 9 double bedrooms at that time and by April 2003, this was not considered as appropriate for the dignity and choice of residents. The capacity was then reduced to 39 (leaving 1 double bedroom) with a second reduction to 29 in July 2004 as a result of the concerns identified in fire safety strategy audit involving Hampshire Fire and Rescue Service.

1.2.2

It has become increasingly difficult to accommodate potential residents whose needs were either high physical dependency or dementia due to the layout and facilities of the home. This includes: very long corridors with slopping floors on the upper floor where most of the bedrooms are; difficult-to-access bathrooms/toilets; long distances between bedrooms and bathing/toilet facilities; and the inability to install the latest moving and handling equipment, both fixed and mobile. This presents limited opportunities to accommodate the type of resident who now needs residential care.

1.2.3

The capacity in the home has been reduced due to the restriction on its use. The occupancy in 2004/5 was only 82%, this is due to the reduced capacity because of the restricted use of bedrooms and fitness for purpose of the building. In addition, there is also an overall reduction in demand for the type of service offered by the home in the Farnborough area.

1.2.4

Given the configuration of the building, it does present difficulties in being able to manage efficiently the deployment of the workforce and ensure a safe environment. This environment has been further compromised because of the fire safety concerns, necessitating additional staff resources and therefore increasing unit costs.

1.2.5

It has been recognised as part of the recent discussion between Property, Business and Regulatory Services and Adult Services Department that there would be significant costs in meeting the requirements of the fire survey and upgrading the facilities of the home (refurbishment) even without carrying out major structural work required to meet the needs of present day service users. This would be in excess of £1.2M at current prices.

1.3

Re-provision for existing service users

There are currently 23 permanent residents at Courtbourn (at 7 December 2005). The majority of these were admitted from within a 5 mile radius of the home, whilst others came from the Basingstoke and Alton areas. As part of the consultation process, all residents will have an opportunity with their relatives to have a meeting with a Care Manager (supported by the staff of the Home) to discuss alternative accommodation options.

1.3.1

There are 6 other local authority homes within about 12 /15 miles of Courtbourn which may provide potential accommodation options, whilst other independent care homes could be considered if appropriate.

1.3.2

No other permanent residents are currently being admitted but 4 beds have been identified to provide respite care if required.

1.4

1.4.1

1.4.2

1.4.3

Re-Provision for future service users

Adult Services' strategic direction is for older people to be supported to remain at home, rather than moving into residential care. This not only prevents unnecessary dependency but is usually where older people prefer to be.

It is therefore projected that the need for residential care will diminish as more older people remain at home for longer. This is borne out by the Department's activity data for 2005. From February to December the number of older people in residential care in Alton and Aldershot fell from 333 to 311. At the same time, services to older people in their own homes increased. The number of older people receiving domiciliary care rose from 729 to 801.

There are already a number of services in the Aldershot area to support older people to remain at home, including social clubs, meals on wheels and transport. In particular there is extra care housing. This is where people have their own tenancy, similar to sheltered housing, but care is provided on site in accordance with people's assessed care needs. It therefore provides a complete alternative to residential care, at a much reduced cost to the Department, as the "bed and board" elements are met by the individual.

1.4.4

It is proposed that any decrease in the overall residential care capacity will be replaced by additional extra care that is available at an affordable rent. A comprehensive strategy has been developed to address how to increase the provision available from registered social landlords, and specific discussions have begun with one provider to upgrade one sheltered housing scheme into extra care.

1.5

Staff

1.5.1

There are currently 34 permanent staff employed by Hampshire County Council working at Courtbourn. There are only 6 full time workers in that number and a temporary Registered Manager.

1.5.2

It is not envisaged that any of these will be put `at risk' due to the service changes outlined in this paper.

1.5.3

The options for their future employment are that they will be offered redeployment within one of the 3 homes within a 5/10 mile radius. There will also be the opportunity for staff to explore wider redeployment options within Hampshire County Council.

1.6

1.6.1

1.6.2

Consultation Process

The reprovision of this service will be subject to a 12 week consultation period. This is compliant with the Hampshire Compact and will include:-

The regular service users of Courtbourn will be consulted (as indicated in Paragraph 1.3) to ensure that individual needs assessment of those service users is taken into consideration in making the decision. Homes staff and care managers, voluntary organisations including Age Concern, Hampshire and a local Carers group, which represents users with similar needs to those users of Courtbourn, will be consulted

1.7

1.7.1

Consultation with Partners

Plans are in place to consult with the local PCT on the proposals to re-provide services from Courtbourn.

1.8

1.8.1

Consultation with Staff

Consultation with Trade Unions and Staff briefing sessions will take place in February informing them of the proposals that are being put forward in this paper and the plans that are in place to offer re-deployment within Hampshire County Council.

1.8.2

Once the consultation has concluded and the results evaluated, the outcome will be presented to the PRC for comments and then the Executive Member asking for the relevant decision.

1.9

1.9.1

Financial impact

The gross annual revenue budget for 23 residents for Courtbourn is £665,581 net £475,670 due to reduced occupancy this equates to £556 gross per resident per week and net £398.

1.9.2

Due to the low occupancy of the service, the difference between the budgeted level and the actual expenditure is currently being used to manage other financial pressures within the service. The 06/07 revenue implications have been included in that years budget build process.

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 adverse impact has been identified.

3

Consultation with Local Members

3.1

Briefing meetings will be taking place with Local Members and any views expressed by them will be included in the Report which follows consultation.

Recommendation(s)

1

The Executive Member support the proposal to consult on the options for the re-provision and improvement of services currently being considered at Courtbourn and that the process of consultation is completed by the end of May 2006 with the outcome presented to them for decision in May following a consideration of the issue by the PRC