Following on from the meeting held on 1st July the Scrutiny Commission will, in relation to the Elderly Persons Homes Proposals: -
· Continue to gather evidence from various sources, including other local authorities (Hampshire).
· Receive information from officers in response to questions raised at the 1st July meeting.
· Receive those residents of elderly persons homes/family members who have been invited to come forward and give evidence.
· Summarise and conclude the two meetings, formalising any recommendations/comments to the Executive.
Minutes:
The Scrutiny Commission were informed that Officers had responded to the questions asked at the Special meeting of the Scrutiny Commission held on 1st July 2013, and this report was circulated prior to the meeting.
Family members of residents of elderly persons’ homes were also present at the meeting and were given an opportunity to speak at the appropriate part of the meeting.
Members were informed that, following this meeting, a report would be prepared setting out the findings of the Scrutiny Commission to be fed into the consultation process. Following further discussion it was suggested, and agreed that, due to the complex nature of the information gathered from a wide range of sources that a further meeting of the Scrutiny Commission be arranged to finalise the full findings.
At this point the Scrutiny Commission gave detailed consideration to the responses prepared by officers to the questions asked at the last meeting and further questions were asked, summarised as follows: -
1. What are we going to do to ensure long term care of the elderly?
Members were informed that the predicted rise in aging population had been factored into predictions for elderly care up until 2030
Members were informed that contact had been made with Hampshire County Council around their partnership working and the provision of nursing care within their elderly persons care homes. Further information was awaited and would be fed into the Scrutiny Commission feedback report.
2. The cost of care for Leicester City Council now?
Members noted the comparisons of costs of In House Elderly persons Homes and the Independent provision and were informed that staff within City Council homes were paid at, or above the National Minimum Wage, whereas in the Independent Sector were more likely to be paid at the National Minimum Wage.
3. If numbers are falling, why is this? We need better data on this.
Members note the various reasons for the reduction of numbers and were informed that the City Council were not able to actively market their facilities and were only able to give potential residents a choice of what facilities were available across the City and it was then a matter of choice.
4. Will members of the Executive be visiting the city care homes?
Members of the Scrutiny Commission expressed a view that it was important for members of the Executive to re-visit care homes to gain an understanding of the feelings of residents/family members /staff.
5. Instead of the cost of 1 x 60 bed purpose built facility, what would be the cost of adapting 4 homes?
Members of the Scrutiny Commission considered in detail the information set out in the response by officers and the NHS around the issues relating to the provision of intermediate care in 4 units, alongside other short term care and permanent residents.
At this point in the meeting members of the public present were invited to address the Scrutiny Commission: -
i) Philip Parkinson – Interim Chair – Healthwatch Leicester
Stated that in his opinion the Council and the Scrutiny Commission faced a dilemma. The City Council had a tradition of providing high quality care.
It was clear that existing residents/carers do not want any change at all and did not want homes to be handed over.
Residents/Relatives at Nuffield House did not want to be moved elsewhere.
Real challenge for next generations who might have much higher expectations and involve investment.
Real concerns if homes were handed over, standards would slip.
Real challenges would have to be faced with funding levels cut by the Government and one of the options on the table would have to be followed.
ii) Member of the public
Can’t mix profit and care.
Been told that a block had been put on people coming into City Council homes and this had meant numbers had diminished.
Concerns over people choosing to go elsewhere, they did not have a choice and a lot of private sector homes were not of a good quality.
The Assistant City Mayor responded by stating that she had asked on previous occasions about whether people were being put off coming to council homes and had been told that this was not the case. An offer to fully investigate these claims had been given subject to information being forthcoming, no such information had come forward. The assistant City mayor-re-iterated her promise to investigate allegations but stated that evidence was required.
iii) Cynthia Bromiley
Stated that relative was resident in Nuffield House and since threat of closure had been announced by the City Council her condition had deteriorated. Enquiries had been made of homes in the private sector and the outcomes had not been helpful with the potential need for top up fees should her mother move and require care above her current banded rate.
Officers responded by stating that they paid for care in private sector on banded rates, dependant on need. If level of care moved into the next band then the Council would pay but this would be assessed on an individual basis.
Assurances were given that, should residents of council elderly homes that were to close need to be moved out every effort would be made to ensure that they, and family members, were taken to look at other homes and that any move would be assisted and all possible support given.
iv) Rinku Chandarana
Relative of resident at Herrick Lodge.
Produced documentary evidence contrary to evidence previously referred to that council elderly persons homes were asked not to take residents.
Copies of the extracts of the report referred to were copied and made available to members and officers and the Chair stated that this information would be accepted as evidence.
In concluding it was agreed that a further Special meeting of the Scrutiny Commission should be arranged during the week commencing 5th August, in view of the extra information still required and that a request be made to the Executive to put back the decision date to allow time for the Scrutiny Commission to formulate comprehensive recommendations and allow the Executive to fully consider all of the necessary detail available. The Chair and Vice- Chair would consult on a suitable date for the Special meeting.
The Scrutiny Commission drew together the following list of questions for officers in response to their report arising from the 1st July 2013 meeting: -
Will members of the Executive be visiting the city care homes
· Commission felt it important that Executive members should re-visit city care homes to gain an understanding of the feelings of residents/family members/staff.
Instead of cost of 1x60 bed purpose built facility etc.
Staffing
· Clarification sought as to the meaning of ‘Hours Absorbed’ (page 15, last para)
· Identify what tasks were not done as a result of staff ‘absorbing’ other tasks
· Were costs of agency staff included in the total costs for each Unit and would they have an impact on the costs of the respective Unit and therefore skew the comparison figures given.
· How much of the comparison figures quoted were the cost of agency staff and how much was paid to agency staff in the figures quoted on pages 6/7 compared to our own staff
· Outcome of Councillor Patel’s investigation into reasons why people are selecting private sector homes compared to city council facilities
· Service Delivery Model (page 12) 2nd bullet point not clear and requires further explanation
Intermediate Care Building
· More information required on precise location of proposed building and indication of what the building would look like (is it wards etc.)
· Where would funding be sourced, what if funding could not be sourced
· How long would building take to construct
Service Delivery Model
· Separate Staffing Teams, is it cost effective
· Page 14, 3rd Bullet Point – question whether this was just a training issue
· Definitions required on respite/intermediate/nursing care
· We could offer similar facilities over 4 current sites, with structural changes, but at what cost
· Economies of Scale – more comprehensive figures required for accurate comparison and assess the longer term viability of facility
Other Information
· Information awaited from Hampshire CC around the nursing care provided in the Elderly Persons Homes
· Information tabled by Rinku Chandarana – source of report requested.