Decision No: CAB068 - 10/2008

Forward Plan No: AS03033

This record relates to A01 on the agenda for the Decision-Making

RECORD OF EXECUTIVE DECISION

27/10/2008  

DECISION-MAKER:

THE CABINET  

PORTFOLIO AREA:

Adult Social Care and Health  

SUBJECT:

Review of City Council Residential Care Home Provision in Southampton.  

AUTHOR:

Jane Brentor  

THE DECISION

To approve the proposals / recommendations contained in the report without modification as set out below.
(i) To agree the implementation by the Executive Director of Communities, Health and Care of a closure programme for two of the SCC provided residential homes, Whitehaven Lodge and Birch Lawn, which takes into account an approach that manages such change in the best interests of each individual customer.  

REASONS FOR THE DECISION

1. This proposal is in line with reducing demand for residential care provision. Southampton City Council financially supported 680 people in residential care in 2002 and only 521 in 2008. This is an overall reduction of over 20% and the trend is even, showing no potential for reversal in the foreseeable future.

2. The unit cost of some of our in house provision is not favourably comparable to that available for purchase from the independent sector.

3. There is significant capital investment required to bring some of our homes to a reasonable standard.

4. Research to date has demonstrated that independent providers are not prepared to invest in, or run, our homes as an alternative to retaining the provision in house.

5. It is not feasible to close all of the homes because it is not possible to re-provide for existing residents due to lack of sufficient alternative provision in the independent sector. There is likely to be a continuing demand for some residential provision, especially for people with dementia, for the foreseeable future. The recommendation takes into account a desire to balance provision in the light of reduced demand, rather than a withdrawal from the market completely. This is due to the acceptance of the market impact of internal provision.

6. It is in line with procurement policy to purchase more residential care externally.

7. Individual budget holders will use money differently probably using less residential care or, if residential care is wanted, then homes of a higher quality will survive better.

8. Reinvestment of capital achieved by releasing site values could bring the existing homes to a standard that increases quality and improves the attractiveness of such provision to individual purchasers using individual budgets and would also make the option of outsourcing specific provision more viable. However, it is not recommended that disproportionate amounts of capital are reinvested in these homes due to the reducing overall demand, changing market provision and the low quality of the infrastructure that exists in these 1980's built low value buildings. A separate paper would be required to inform any proposal for further investment to remaining in house provision. This would need to be considered when the consequences of new approaches to the provision of social care have had an impact and would be informed by occupancy rates of remaining homes after the implementation of this decision.
 

DETAILS OF ANY ALTERNATIVE OPTIONS

1. Initial enquiries have been made with two independent health and social care providers to ascertain views on taking over the provision of care under a transfer arrangement or a ‘Trust’ arrangement. Neither would be willing to do so due to the poor state of the homes, the cost of taking on TUPE arrangements, the location of the homes making private placements unlikely and their own organisations’ intentions to diversify.

2. The option of replacing one or both of the elderly frail providing homes with a ‘new build’ home utilising the ‘LIFT’ company’s design and build skills on a potentially vacant site in Southampton (such as a closed school site) has been considered. However, experience of recent work with BUPA, a not for profit organisation, has demonstrated that the cost of building to current CSCI standards, even paying this back over a period of 25 years via the weekly bed price, makes residential care provision non viable financially. It is seen as inappropriate to tie the Council to a 25 year or longer contract for a service where demand is diminishing.
 

OTHER RELEVANT MATTERS CONCERNING THE DECISION

Cabinet received representations from residents of the two care homes, their relatives, staff, Union representatives, Members of the Council and other interested groups.  

CONFLICTS OF INTEREST

The decision-maker(s) did not declare a personal or prejudicial interest in the matters set out in the report  

CONFIRMED AS A TRUE RECORD:

We certify that the decision this document records was made in accordance with the Local Authorities (Executive Arrangements) (Access to Information) (England) Regulations 2000 and is a true and accurate record of that decision.

Date:

Decision Maker:

27/10/2008

The Cabinet

Proper Officer:

Judy Cordell

SCRUTINY

Note: This decision will come in to force at the expiry of 5 working days from the date of publication subject to any review under the Council's Scrutiny 'Call-In' provisions.

Call-In Period

28 October 2008 to 24 November 2008

Date of Call-in (if applicable) (this suspends implementation)

04/11/2008 14:49:48  

Call-in Procedure completed (if applicable)

14/11/2008  

Call-in heard by (if applicable)

Overview and Scrutiny Management Committee  

Results of Call-in (if applicable)

At the meeting Cabinet agreed to keep their original decision taking into consideration the following recommendations from Overview and Scrutiny Management Committee:(i) To investigate a LIFT scheme to fund a multi-layered residential offer for older people. (ii) To make available the Primary Care Trust minutes to show that full discussions about alternatives have been exhausted.(iii) To provide the Overview and Scrutiny Management Committee with evidence that demand for respite in the City is met. (iv) That the work associated with recommendations (i) - (iii) above are completed as quickly as possible.