Agenda item

Councillor Moore introduced the item and made reference to the previous meetings of the Scrutiny Commission that had discussed this area of work, and had been held on 1^st July and 11^TH July 2013. Responses by officers to the questions raised by members had been circulated and an opportunity had been given for Members to seek further information from officers on the responses given.

Councillor Moore stated that there was now a need to draw this review by the Scrutiny Commission to a conclusion so that a report could be prepared, setting out the conclusions reached, for consideration by the Executive.

Member’s attention was drawn to the Responses report circulated and to an additional sheet ‘Elderly Persons Homes – Financial Implications’ that had been drawn up by the Chair and had been tabled at the meeting.

Capital Expenditure

Current Funding is:

Funding already approved                                                                         £3.0m

Sale of EPH Sites (Preston, Herrick, Elizabeth, Nuffield)                    £1.41m

Sale of Brookside                                                                                        £0.4m

NHS Funding                                                                                               £1.23m

Total Current Capital Funding                                                                £6.04m

(Table drawn up at the request of the Chair)

Revenue Expenditure (table provided by officers)

Councillor Moore stated that, in relation to provision of intermediate and residential care, she had visited one of the homes referred to in the proposals and had come away with the impression that there were no conflicts regarding the provision of these two areas of care within one facility.

Members had an opportunity to question and comment on the options reported as follows: -

Councillor Alfonso – concerns that funding not in place to retain or re-furbish existing homes, funding would likely be sourced from elsewhere within the City Council therefore affecting other services. Therefore she could see no other option than Option A.

Councillor Joshi – having looked at all options reported and having taken into consideration all the information available Option A – 1 Intermediate Care Facility, No EPHs or Brookside (Revenue Expenditure Table). Noted that moving people with care was important.

Councillor Willmott – Not here to make a decision. The City Council is in business to provide public services. Clearly been failure to invest properly to ensure retention of this service, figures tabled lacked credibility. Figures given give maximum costs for running local authority homes but minimum costs for income. At the last meeting it was established that the running costs of EPHs were similar between local authority and private sector homes, the difference came with staff wages and staff ratios. Conflict with Living Wage agenda by Deputy City Mayor.

Private sector care market was at risk of collapse, large debts and number of providers have gone bankrupt over last few years. By putting all eggs in one basket could lead to serious problems.

Suggest that, between now and full Council, all options available to the City Council, not taking the options tabled tonight at face value. Ther was a way forward that was not one of the options reported at the meeting.

Councillor Fonseca – Prefer Option A (Revenue Expenditure). Duty of care to support all people who need us, not just those in EPHs.

Councillor Chaplin – Expressed horror that consideration being given to close EPHs when elderly population is rising. Gov’t is not demanding that we close homes, we also know that additional costs compared to private sector are down to staffing costs. Short-sighted to  be considering closures now. Not reassured by the various versions of figures circulated, the Executive required accurate figures. Issue rests on sale of existing sites, what if sites were not sold, would this jeopardise whole intermediate care plans.

It was also apparent that all refurbishments of existing homes were not required immediately. En-suite facilities had also proved to be detrimental as this meant that certain elderly persons were then not likely to leave their room.

Provision of intermediate care and residential care within one site was purely a training issue. Information shared from Hampshire County Council showed that joint provision could be achieved within one facility. The City Council should in fact be approaching the Department for Health and NHS with view to assuring that nursing care was provided within residential homes.

Concerned re: equality issues for Herrick Lodge residents.

Concluded by stating that options worked up had not been thoroughly costed and assessed.

Chair – Re-iterated that Scrutiny Commission could not make a decision, but rather it would be making recommendations to Executive.

If staff were paid at a level similar to the private sector then the City Council would be able to retain homes, we chose to pay our staff a living wage. If other options of providing care were explored it could prove to be cheaper. Some people opt to go to private sector homes, often to be near families, and there was a need to strengthen inspection regimes in private homes and we needed to look at how best this could be done.

Regarding sale of EPHs, some people have said that this would be fine as long as the services were retained, purchasers of the EPHs must therefore be vetted thoroughly. There was however a need to respect the skills of staff and voluntary redundancy must be offered. The Scrutiny Commission were pursuing the issue of providing nursing care in homes.

Unhappy about proposal for a 60 bed unit (Option A) but was happier about several smaller units locally and the retention of EPH provision in the City.

·         Use funding set aside for 60 bed unit to fund re-build smaller units on sites of 4 homes providing residential/intermediate care.

·         Work with DoH and NHS to provide nursing care on site

·         Monitor work of private sector

·         Look at provision of Extra Care and nursing care in homes.

·         What sort of provision were those private providers who have expressed interest in our homes looking to provide

Councillor Willmott – not prepared to recommend the sale of any of the City Council EPHs to private sector. Not sure of the viability of re-building 4 homes. £6m quoted was only available if the sites of other homes were sold. Support the pursuit of Extra Care and Nursing Care in homes.

The meeting adjourned to allow consideration of the various Options tabled. It became apparent that certain information was not available at the meeting and that officers had not had an opportunity to cost the alternative options put forward.

Councillor Joshi – Having listened to debate still of opinion that Option A (Revenue Expenditure) was the favoured option.

Chair – uneasy around Option A as this would not offer residential care in future should we want it.

Propose Option C (Capital Funding) – Re-Build 3 EPHs to provide intermediate care. Also look to provide Extra Care and look at the Hampshire model. Use the budget available in a more creative way.

Councillor Willmott – Amendment - suggest keeping all 8 homes and re-furbish where appropriate, provide residential and dementia care where appropriate and that the City Council look to make available funding for Extra Care provision.

Chair – stated that there was a divergence of opinion. Could take a vote but there was obviously a need for further information that was not available to members and officers at this meeting and that there was a need to get some of the figures referred to firmed up.

It was suggested that a report would be prepared recording the discussions that had taken place at this meeting and, following the draft report being circulated to members for comment, it would be referred to the Executive as a record of the views of the Scrutiny Commission members.