This paper brings together work that has been undertaken by Adult Services and Property, Business and Regulatory Services regarding Stocklands, which is one of Hampshire County Council's Older Persons Homes and Day Centres. This work has focused on two key areas of the overall asset management of the building and its fitness for purpose to meet the needs of current and future service users. Stocklands has been assessed by Adult Services as not meeting 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 issue 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 Stocklands 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. Stocklands Stocklands is a two storey purpose built older persons home with an adjacent day centre built in 1972. Part of the home also accommodates the In-House Home Care service, a voluntary sitting service and Adult Placement staff. Stocklands is a home that provides care to 50 residents who are mostly physically frail but there are a number of residents who have degrees of Dementia. It was built in the 1970's for a much fitter resident group and was not therefore designed to take the more dependent resident admitted today. 43 of the current 50 bedrooms are very small and below 9 sqr meters, which means that it is very difficult to access for moving and handling equipment to enable staff to assist residents. The layout of the building with long corridors also presents difficulties for residents with mobility problems. Toilet facilities are particularly difficult to access and require modernisation. Access to bedrooms for wheelchair users is also a major issue with restrictive access, and is not acceptable to the Commission for Social Care inspection standards (the standards stipulate that 12 sqr mtrs is required). It has become increasingly difficult to accommodate potential residents whose needs are either high physical dependency or dementia care due to the layout and facilities of the home in terms of `fit for purpose'(table attached). A recent (second) fire safety audit has confirmed that there are a number of shortcomings in relation to fire integrity and safety of the building, and there is a need to undertake some immediate remedial work to improve the overall fire safety of the building. This is currently being addressed. If the building was retained for a longer period, major fire safety work would need to be carried out and this would be of significant cost. Given the factors raised in paragraph 1.4.1, and in order to bring the building up to modern requirements/standards, major work would be required on bedroom sizes, which would reduce the capacity to about 30 beds from the current 50, as well as upgrading all the facilities. This major structural work, as well as the fire safety work has been estimated by Property Services to be in excess of £1.5m at current prices. The adjacent day centre (which is a separate building) is also in need of some modernisation in relation to toilet and bathing facilities. However for the day centre, plans are being considered as to whether this can be retained as an ongoing operational unit but will be subject to further technical considerations and discussions with Property, Business and Regulatory services. Day care across Hampshire generally is also subject to a current review. Re-provision for existing service users There are currently 41 permanent residents at Stocklands (+ 3 in hospital and 3 respite beds - at August 06). The majority of these residents were admitted from within a 5 mile radius of the home. 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 staff of the home) to discuss concerns about moving and alternative accommodation options. All residents will have individual needs assessments, the outcome of which will inform the consultation process and any subsequent decision about the future of Stocklands There are other local authority homes within a 10 mile radius, as well the opportunity to assess the impact that the new ENHANCE Forest Court (within 1 mile of Stocklands) might offer. Other opportunities will also exist in the independent sector homes. 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 prevent unnecessary dependency but is usually where older people prefer to be. There are already a number of services within the locality to support older people to remain at home, including social clubs, meals on wheels, sitting services and transport. There is also the development of extra care housing, which both the District Council and private providers provide and are keen to develop. Extra Care Housing is where people have their own tenancy, similar to sheltered housing, but where care is provided on site in accordance with people's assessed care needs. It therefore provides a complete alternative to residential care, and at a much reduced cost to the Department, as " bed and board" elements are met by the individual. 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 are in the process of being established. Staff There are currently 55 permanent staff equivalent to 37 whole time equivalents employed by Hampshire County Council working at Stocklands. The options for their future employment are that they would be offered a number of options within the service sector including an opportunity to relocate to the new service at Forest Court, as well as other local authority homes. There will also be an opportunity for staff to explore wider redeployment options within Hampshire County Council. Consultation Process The reprovision of this service is subject to a 12 week consultation period. This is compliant with the Hampshire Compact and Cabinet Office guidance and will include:- The regular service users of Stocklands (as indicated in Paragraph 1.5.1) with their relatives have now all been met, to ensure that individual needs assessment of those service users, is taken into consideration in making the decision. Generally both service users and their relatives have not expressed surprise at the proposals for the residential accommodation. However for Calmore day service, a considerable amount of concern has been expressed at the loss of what is seen as a valuable service. Work is ongoing to identify potential options for service users and care management input is assisting that process with individuals. The Homes' staff and the Day Centre staff have now all been seen by Human Resources and for all, employment options are being explored with a very positive approach by staff. Local and county voluntary organisations (such as Age Concern) have been advised and responses are currently awaited. Local health colleagues have been advised through the PCT and a response is awaited New Forest District Council has been advised of the proposals and a response is awaited. Further work has started in looking at accommodation options for future service users. Both the local Member and MP have received a copy of the report to the Social Care Executive of the 28 July 2006. The local member has also attended one of the consultation meetings (with service users and relatives) of the Day Centre briefing sessions on 18 August, and was given a tour of all the services on the Stocklands site. At the end of the consultation period a report will be submitted to the Social Care Executive with a synopsis of the outcomes of consultation. Financial Impact The current gross annual budget for Stocklands is £873,977 for 50 residents with a net figure of £530,000 pa. The unit costs are £354 pw and the occupancy for 05/06 was 95%. In considering the impact of reprovision, the staffing costs form a large part of the revenue costs of the running of the home, and this will be dependent upon the number of staff being redeployed, which will become clearer during the consultation period. The cost of re-provision for future service users will depend on the extent to which residential care will be replaced by extra care in the community, as referred to in paragraphs 1.6.3 and 1.6.4. In the short term, if the loss of local In-house capacity results in an increase of local purchasing of residential placements this will be based on an average net cost of £232 per place per week and is dependent upon how many residents can be placed in other Hampshire County Council homes. | 