Care Homes Decision Questions

Why did you arrive at this decision?
Every single service user was assessed. We looked at their needs and how they could be met. Some, for example, shouldn't have been in residential homes as their needs were for nursing homes (which councils do not run). We also identified a lack of capacity in the independent sector for some care needs, such as dementia, and as a result, retained some of our homes to provide this specialist service.
Why is this happening?
The option to do nothing is simply not an option. Failure to act now will deny services to people in the future who will need them and this is a hugely increasing issue. In less than four years, those aged 60+ will increase by 14% and the figure jumps to 37% by 2021 and to 78% for those aged 85+.
Why is this happening in Staffordshire?
This is happening throughout the country with councils having to modernise their care and support for older and disabled people. The historic residential and institutionalised model of care and support is no longer workable and is no longer what the majority of people want.
What does this mean for residential care in Staffordshire?
This is not about ending residential care. Where someone needs residential care - residential care is what they will get. The county council already 'buys in' residential care services for around 3,000 individuals. Individuals affected by our recommendations amount to over 300 older people - many of these will have an opportunity to remain where they are (figure based on November 2007 and includes those in the six services being retained), and 180 disabled people. 90% of all current residential care in the county is already operating in the independent sector.
Can you identify when affected residents in each of the homes will be moved and is there a deadline?
There is no deadline for any home to close. There are times we are going to avoid for obvious reasons, such as December (Christmas) and January (post-Christmas). The timing will largely be directed by alternative placements and care plans.
With the homes remaining open, will they eventually close?
These recommendations take account of our plans over the next few years. Therefore those staying open will not be closed in the foreseeable future.
How will alternatives homes be identified?
Through independent choice by the service users and their families and tailored care plans.
For those with disabilities, this will be achieved through a programme of new residential homes, which we will build, and through supported living.
What about respite care? All those who currently receive respite care will continue to do so. This will be achieved by working with the service users and their families.
How many people responded/took part in the consultation process?

Involvement	Numbers
Meetings in homes	682 residents and families
Calls to Agencia	411
Forms returned	237 letters and emails
Letters from other organisations/people	14

What happens to residents that are severely ill and it is thought a move could have a detrimental impact on their health?
In this instance we would delay any move to allow treatment to take place or for a re-assessment of their needs and risks to be carried out.
The county council has committed to paying any additional costs i.e. to make it cost neutral to the individual. Won't these new homes simply increase their rates to make more money?
No. The county council and independent care homes have successfully negotiated the fees, within reasonable limits for placements (in the last six months).
The county council has agreed to give financial support to families who may have to travel further distances within the county. Will this apply to the families of new service users entering the system?
This may be possible. Regardless of this process, support we provide to families and carers is based on an assessment and we apply such support on a case by case basis.
The county council has agreed to give financial support to families who may have to travel further distances within the county. What happens to families who have to travel just outside of the county, lets say an additional 5 miles, and other families who may have to travel a far greater distance within the county?
This may be possible. Regardless of this process, support we provide to families and carers is based on an assessment and we apply such support on a case by case basis.
Where and when will new services be identified and rolled out? Current services will continue as normal for those who need them. For those with disabilities the new individual care plans will be developed with service users and carers after the cabinet decisions, over a period of up to six months. We anticipate that this will be implemented over a further period of up to two years dependent upon services available and individual situations.
Are alternative placements immediately available?
Yes, there are places, but we need to ensure that people's needs will be best met based on their individual care plans. We will be working closely with residents and their families to do this and identify suitable alternatives.
What timeline are you working to in seeking alternatives for residents?
We will work with residents and carers at their own pace to look at choice and availability in line with their needs. Care plans will be completed for everyone to identify the type of home that best meets their needs which will result in a list of appropriate homes for them to choose from.
To what extent was the budget the driver behind these recommendations?
This was not looked at in isolation. A range of other important factors were considered including assessed needs, the condition of the buildings, refurbishment costs and the availability of appropriate alternative places. We have actually ploughed extra money into Adult Services to enable us to invest in the future and make improvements.
Will any of the current buildings be used?
No, apart from the six being retained. None of these buildings have been deemed viable or appropriate to the needs of those in our care. They are simply not fit for purpose. It will be more economically viable and cheaper to create new purpose built facilities in the long term. The homes retained for older people either have had or will have refurbishments. The disability homes will be maintained during the longer transition period.
What will happen to the buildings?
All premises will be subject to a separate set of council decisions and options will be in the Cabinet report. Alternative usage for the health or care of older people or vulnerable persons will be a high priority.
If a building is closed where will the cash raised from the sale go? Options will be presented in the Cabinet report for re-investment or re-use of the land. The capital from that will be used to progress and promote the Changing Lives programme. This is not about sending money back to the main council budget, it is about re-investment in service packages.
Are there going to be any new services?
Further Extra Care Schemes are coming to Staffordshire next year and we aim to introduce smaller residential units across the districts. Together with our housing partners, we plan to bring at least one Extra Care scheme into every district. The local PCTs also want to work with us to develop sites for health facilities. Next year will be an exciting time in terms of planning and development as we look to improve the future of our services. This is very good news.
Of the employees that work in the homes that are to close, will they transfer to another position, or will they be made redundant? Obviously this will present a mixed position and there will be mitigating measures. However, the reality is that some staff working with older people will be faced with redundancy. However, there will also be a greater demand for such roles in the independent sector.
What is the stance of the Unions?
We are continuing discussions with the Unions.
Comparative figures to illustrate how much cheaper it will be per week in the independent sector

Older people's care homes:
The average price from April 2008 will be £200 per week, per resident more in Staffordshire County Council homes than in independent care homes. It will also be £300 per week, per resident more than in Extra Care sheltered schemes.

Disability care homes:
The average price for supported accommodation will be £300 per week, per resident less than at present (and nearly the same for residential care).

Last Modified: 14/11/2007 13:09:26
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