Archived decisions

Contact: Richard Ellis 01962 847284 [email protected]

1. Summary:

The following decisions are sought:

That the Executive Member:

· agrees the first three schemes in phase one of this proposal. The three schemes (129 units in total) are Downing Court, Fareham, Abbey Court, Basingstoke and Warner Court, Andover.

· agrees that the first three year investment requirement of £372,000 will be funded as a one-off from the budget contingency as a pump-priming option.

2. Reason

2.1 This report concerns the revenue funding of enhancing sheltered housing schemes to extra care standards by establishing twenty four hour care and support on site in existing fully accessible buildings.

2.2 Enhancing existing schemes is one strand of the developing Extra Care agenda, which also involves the commissioning of a number of new build schemes around the County.

2.3 The aim of the proposal for night care is to move towards a full Extra Care service. Several opportunities for enhancing existing sheltered housing have been identified in conjunction with the Supporting People Strategic Review, working with Registered Social Landlords. These services can provide early opportunities to increase the options of older people who are no longer able to remain in their own homes and ensure the speedy delivery of Extra Care capacity.

2.4 Attached to this report is a business case which identifies a net revenue investment of £372,000 in the first three years to establish the service in three schemes (129 units), which would be paid back by the end of year 5 through savings.

3 Other options considered and rejected

3.1 Rely on market forces

3.2 Conversion of existing sheltered housing schemes (full refurbishment)

4 Conflicts of interest declared by the decision-maker or other Executive Member consulted - None

5 Dispensation granted by the Standards Committee - None

6 Reason(s) for the matter being dealt with if urgent - Not applicable

Approved by: ............................................... Date: ..............................

Councillor Felicity Hindson

Executive Member for Adult Social Care

Contact : Richard Ellis 01962 847284 [email protected]

1. Summary

1.1 This report concerns the revenue funding of enhancing sheltered housing schemes (Tranche 1) to extra care standards by establishing twenty four hour care and support on site in existing fully accessible buildings. The term Enhanced Sheltered Housing is being used to distinguish this from new build Extra Care Housing, which will have greater facilities. However it is one strand of the developing Extra Care agenda and will meet the minimum standards for extra care.

1.2 Attached to this report is a business case which identifies a net revenue investment of £372,000 in the first three years to establish the service in three schemes (129 units), which would be paid back by the end of year 5 through savings. If we are to proceed, we need to agree how this will be funded, and the recommendation is that funding should come on a one-off pump-priming basis from the Adult Services budget contingency.

2. Context

2.1 On 24 September 2007 Cabinet agreed the development of a long term strategic approach to the provision of a new generation of housing support and care for older people. The overall target was to produce 400 new places in Extra Care Housing over a five year period, 2008 - 2013. Two hundred new places were to be provided in four new services, and 200 new places through joint contracting and enhancing existing services.

2.2 The four new build services are seen as flagship examples of Extra Care, demonstrating that the County is ambitious in commissioning high quality services for older people, with these as the first. In addition, enhancing appropriate existing services will provide much needed additional capacity as part of a transitional process.

2.3 The Supporting People Strategic Review of Housing and Support for Older People has identified a number of existing services that are suitable for enhancement and has identified an addition £700,000 per annum to revenue fund day time housing related support.

2.4 Commissioning new models of service will require some social care revenue investment in the short term that will result in much better, more popular and cost effective services in the long term.

2.5 This business case attached to this report presents a model for building Extra Care capacity in existing services and the investment costs of setting up tranche 1 (129 units) and indicative costs of two further tranches.

3 Recommendations

3.1 The following decisions are sought - That the Executive Member:

· agrees the first three schemes in phase one of this proposal. The three schemes (129 units in total) are Downing Court, Fareham, Abbey Court, Basingstoke and Warner Court, Andover.

· agrees that the first three year investment requirement of £372,000 will be funded as a one-off from the budget contingency as a pump-priming option.

4 Opportunities for Commissioning

4.1 The aim of the proposal for night care is to work towards a full Extra Care service. Several opportunities for enhancing existing sheltered housing have now been identified in conjunction with the Supporting People Strategic Review. Working with Registered Social Landlords, these services can provide early opportunities to increase the options of older people who are no longer able to remain in their own homes.

4.2 The three schemes identified for Tranche 1 are:

District	Scheme	Provider	Capacity
BASINGSTOKE	Abbey Court	Sentinel	51
ANDOVER	Warner Court	HVHS	38
FAREHAM	Downing Court	Fareham BC	40
TOTAL			129

By providing night cover in suitable settings, through a variable block contract, people will be able to remain in-situ rather than transfer to residential settings, and equally others will be able to move into enhanced sheltered housing rather than straight into residential care. This will enable users and carers, care management, provider agencies and other staff to experience this enhancement as a useful step towards the concept and style of Extra Care Housing, given that new build options will take much longer to achieve. It will also alleviate the current difficulty around critical mass; ie not being able to refer people with high needs/ continue to support people with higher needs in sheltered housing for want of night care which typically is difficult to fund on a one off basis until sufficient people need it, in the same setting, at the same time. There will also be an opportunity to link with other Adult Services strategies such as both the personalisation agenda and the re-ablement project.

5. Financial Impact of funding Enhanced Sheltered Housing

5.1 Although Extra Care is a more cost effective option for funding housing care and support than other models such as in house residential care or domiciliary care, there will be a short term cost during a period of transition. The amount and duration of this additional cost will be determined by the speed of change. Responsibility for funding will then revert to local areas. The full details are in the Business Case attached.

6 Remodelling and contracting

6.1 This report proposes that funding for night cover needs to be established in services through a variable block contract to produce 129 individual units of enhanced sheltered housing. As an example, Abbey Court in Basingstoke was originally designed to be an Extra Care service. Due to financial pressures in the Adult Social Care Department, the scheme has not been funded to provide 24 hour care. Through commissioning a night care service, and by attracting new funding through the Supporting People programme, it will now be possible to provide the level of care and support required to provide a real alternative to residential care.

6.2 For other services small capital works may be necessary which will be funded by the County Better Housing Options capital budget. Current examples of that are the installation of a lift at Rowan Court in Eastleigh and an extra staff room at Downing Court in Fareham. Rowan Court has attracted match funding from the District Authority and the Service Provider, who will also be carrying out additional enhancements to the scheme.

6.3 It should be noted that the terminology used to describe the range of housing and support options can be confusing, with a number of terms used such as sheltered housing, very sheltered housing, enhanced sheltered housing, senior living and extra care housing. These terms reflect the historical development of housing solutions. In Hampshire Adult Services we use the term `Extra Care Housing' to describe the new build schemes with a full range of facilities, and the term `Enhancing sheltered housing to extra care standards by the provision of night time care' to describe precisely that (as per this report). Other terms are sometimes more widely used in the housing sector such `sheltered or very sheltered housing' and stem from Housing Departments' traditional role in providing sheltered housing with or without warden facilities (also known as Part 2 or Part 2 and a half housing). Some housing schemes were originally built some years ago with the concept of having additional support and care associated with them, but such support never materialised as funding was not forthcoming. This therefore explains why a few housing schemes might have been referred to by some partner agencies as `extra care housing' when we would not yet categorise them as such.

7. Equalities impact assessment and risk assessment

7.1 The attached Business Case sets out the necessary equalities and risk assessment information.

7.2 Access to the services will be monitored for inclusiveness.

7.3 Impact assessment will be incorporated into the nominations and referrals processes.

8 Consultation

8.1 Consultation has taken place extensively within Hampshire County Council with the following Departments ; County Treasurer's, Adult Services, Supporting People, Extra Care, Project Board Sub Group B and externally with Local Authorities and Registered Social Landlords

9 Financial Implications

9.1 Full details of the financial implications are contained within the attached Business Case.

10 Conclusion

10.1 The Hampshire approach to Extra Care is both ambitious yet practical. It will concentrate on new build as the best practice solution to the strategic objectives and supplement this with a programme of increasing Extra Care capacity through a series of small scale capital and revenue investments into existing Sheltered Housing schemes. This is informed by the experience of other authorities which has shown this to be a responsive and flexible way forward to meet the expressed need from users, carers and care managers.

Section 100 D - Local Government Act 1972 - background documents

The following documents discuss facts or matters on which this report, or an important part of it, is based and have 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

Appendices

1. Assessment Criteria

2. Business Case: Extra Care Housing - Enhancement of existing sheltered housing schemes

APPENDIX 1