Agenda item

The Director of Adult Social Care and Safeguarding submits a report outlining recommendations to be made to the Executive for the development of intermediate care and residential beds facilities.  The Commission is recommended to note the report and make any comments.

The Director of Adult Social Care and Safeguarding submitted a report outlining recommendations to be made to the Executive for the development of intermediate care and residential beds facilities that would be provided directly by the Council.

Councillor Kitterick reminded Members of the declaration he had made in respect of this item.

The City Mayor advised the Commission that he was confident that the chosen site for the new facility was the correct one.  He reconfirmed the Council’s commitment to the provision of the facility, stressing that capital funding would remain available for it.

Members supported the choice of site for this development, noting that there was good public transport access.  Members also expressed that sustainability options should be fully considered.  For example, it was suggested that, if a single storey building was provided, there would be no lift maintenance costs.  It therefore was suggested that the design process should properly assess the impact of such options.

The Director of Adult Social Care and Safeguarding noted that a priority for adult social care was supporting people who were at vulnerable points in their lives.  This needed to be done in a way that was affordable to the Council and incorporated the best elements of good design.

Alistair Jackson, Chief Executive of the Leicester Quaker Housing Association (LQHA), addressed the Commission at the invitation of the Chair.  He drew particular attention to Appendix B to the report, which set out anticipated staffing costs for a 30-bed intermediate care unit, expressing concern at the differences in staffing costs between what was proposed for the unit and what the LQHA understood was being proposed following fee negotiations.  This was demonstrated in information tabled by Mr Jackson at the meeting, a copy of which is attached at the end of these minutes for information.

At the meeting of the Adult Social Care Scrutiny Commission held on 14 August 2014, an amendment to the above minute was agreed as follows:

“……and what the LQHA understood was being proposed following fee negotiations with independent residential care homes in the City.   This was demonstrated in information tabled by Mr Jackson at the meeting, a copy of which is attached at the end of these minutes for information”.

Mr Jackson then made the following comments:-

·           Although the LQHA provided residential care, a significant number of residents went there direct from hospital, so needed a level of intermediate care;

·           The Council stated that a registered manager was needed at the facility, but the cost shown in the Council’s report was a lot lower than the salary paid by LQHA;

At the meeting of the Adult Social Care Scrutiny Commission held on 14 August 2014, a further amendment to the above minute was agreed as follows:

The information provided as part of the fees review proposal, reflected a lower salary for a Registered Manager than LQHA pays their Registered Manager. The indicative salary for the Intermediate Care Registered Manager was higher.

The following two amendments (in italics) were also agreed:

·           In the Council report, Senior Care Assistants were to be paid more than the registered care manager in a care home funded by the Council;

·           The fees proposals for providers were that, when a manager was not present, cover would be provided by someone paid £6.70 per hour.  LQHA could not consider doing that as, in their view, it would mean that inadequate management cover was able to be provided; and

·           LQHA was receiving fees that had been set two and a half years previously.  Consequently, the Association had a shortfall of approximately £800 per week, which would fund two care assistants, and a total shortfall to date of approximately £50,000.  This was causing problems financially and operationally for LQHA.

The Director of Adult Social Care and Safeguarding advised the Commission that an intermediate care unit was different to a residential setting, in that an intermediate care unit would be required to accept people for stays ranging in length from a few days to up to six weeks.  The unit also would have to respond to requests for admissions out of hours and with a two-hour turn-around.  The repeatedly changing resident group would require greater management capacity than a typical residential home. In addition, there would be a regular turnover of users at the intermediate care unit who had nutritional and hydration problems, as well as an on-site café, hence additional catering resource would be required.

In reply to a question from the Commission about partnership working with the NHS, the Director of Adult Social Care and Safeguarding explained that the provision of intermediate care by social care services were part of a co-ordinated continuum of services.  Officers had explored the possibility of bringing some bed bases together, but consideration had to be given to issues such as the physical environment required for a NHS facility, l, so this sort of joint facility was not considered to be the best environment for people who were closer to being independent  enough to go home. 

However, current and proposed facilities had been developed with partner services. For example, therapy services had had an input in to current provision at Brookside Court.  The aim was to provide a very good, “homely”, environment through co-operative working with NHS partners and this had been very successful in enabling people to return to their homes and live there, (including with some support where needed).

It was suggested that it could be useful for the Commission to receive plans for the development, before it progressed too far, to enable Members to review the scheme.  This would provide reassurance that matters such as whether the unit was of an appropriate size and potential issues such as how problem patients would be dealt with had been considered.

The Commission asked what services would be provided at the new unit.  In response, the Director of Adult Social Care and Safeguarding explained that the Council already had a successful model at Brookside Court.  This facility would close when the new one opened, but the model would be used for the new facility and expanded.  Members were welcome to visit Brookside Court to see these facilities for themselves. 

In response to further questions, the Director of Adult Social Care and Safeguarding advised that a decision to close Brookside had been included in the decisions regarding the Council’s elderly persons homes and was hoped that a capital receipt could be achieved.

The Commission expressed disappointment that information on the intermediate care unit had not been provided earlier in the decision-making process.  In addition, concern was expressed that a decision on how to proceed with this facility was scheduled to be taken the day after the proposals were scrutinised, as this did not give time for consideration to be given to any challenges to the proposals made during the scrutiny process.

RESOLVED:

1)     That it be noted that a decision on the provision of intermediate care and short term residential beds facilities is scheduled to be taken by the Assistant Mayor (Adult Social Care) on 27 June 2014;

2)     That the Assistant Mayor (Adult Social Care) be asked to note the Commission’s concerns about the timing of the scrutiny of the proposals in relation to the proposed date on which a decision is scheduled to be taken on these proposals;

3)     That the Director of Adult Social Care and Safeguarding be asked to submit a report to the Commission providing information on:-

a)     the plans for the new building to be used for intermediate care and short term residential beds, including the cost of the building across its whole life;

b)     unless already included under a) above, sustainability options such as using a single storey building that does not need a lift; and

c)     the way services would be delivered at the new facility, including how the behaviour of service users would be managed; and

4)     That the Scrutiny Support Officer be asked to present a scoping document to the Commission for a review of the value-for-money of proposed staffing levels at the intermediate care and short term residential bed facility, this review to include the resolution of outstanding fee arrangements.