Agenda Item
No.
HERTFORDSHIRE COUNTY COUNCIL
CABINET
MONDAY, 20 FEBRUARY 2012 AT 2.00PM
5
RE-PROVISION OF RESIDENTIAL CARE HOME PLACES AT JANE CAMPBELL
HOUSE, ST ALBANS
Report of the Director Health & Community Services and the Director Resources &
Performance
Authors:
Laura Fortune Senior Commissioning Manager, HCS (Tel: 01438 843535)
Gary Heathcote Head of Accommodation Solutions, HCS (Tel: 01438 843058)
Colin Cooper, Senior Estates Officer Herts Property (Tel: 01992 588114)
Executive Members:
Colette Wyatt-Lowe, Health and Adult Care
David Lloyd, Resources and Economic Well-Being
Local Member:
Allan Witherick (St Albans North)
1
Purpose of Report
1.1
To seek approval for the re-provision of residential care places at Jane
Campbell House in St Albans in the summer of 2012 when the two extensions
are built and places are re-provided at Fosse House (20) in St Albans and
Willow Court (20) in Harpenden.
1.2
To consider the future of the site of Jane Campbell House once it has been
vacated following the commencement of use of the replacement care home
places.
2.
Summary
2.1
Jane Campbell House is a purpose built residential home, constructed in
1972, providing care and support for 54 older people located in north west St
Albans. 44 places are long stay, 6 are currently being used as enablement
places and 4 are respite or short stay places. The home is one of the 26 care
homes of which the County Council own the freehold and which are leased to
Quantum Care (QC) until 2044 to provide affordable residential care places
under the terms of a fifteen year contract. The history and context to the reprovision of this home is set out in two Cabinet papers (please see the
footnote links below). On 21 February 2005 Cabinet1 endorsed the proposal to
re-provide places in homes that will become obsolete. On 14 April 2008 2,
Cabinet endorsed a fifteen year contract with Quantum Care for the purchase
of care and accommodation services for older people and also an option
agreement with Quantum Care for the development of new residential care
1
2
http://www.hertsdirect.org/mm/md/Cabinet_13.htm/050221_Care_Homes.doc
http://www.hertsdirect.org/mm/md/Cabinet_57/080414_05_Care_Contract.doc
1
places by way of extensions to existing homes or construction of new homes,
and with surrender of the leases of the obsolete homes.
2.2
There are two reasons to justify the re-provision of places at Jane Campbell:
firstly, the property is incapable of being upgraded to modern accommodation
standards at reasonable costs and so is considered to be no longer viable in
building condition terms. The building consultant’s report recommended that
the re-provision of Jane Campbell House is justified on physical condition and
therefore identified it as one of the eight homes in the Quantum Care portfolio
soon to become obsolete.
2.3
The second reason is that this home is no longer economically viable.
Quantum Care reports that demand and expectations for high specification
rooms, including en-suite facilities, is increasing. This home, which only has
shared bathrooms and kitchens, is no longer meeting people’s expectations
and is running at a financial loss. Also, the relatively small number of places
in the home and the building layout give rise to relatively inefficient operation.
Furthermore, Health and Community Services (HCS) commissioners are
shifting the provision of care to a model which provides care to more people in
their own home, rather than in a residential setting.
2.4
There is sufficient good quality provision of residential and extra care housing
elsewhere in the area. Commissioners and Quantum Care agree that with the
surplus of provision in the St Albans area and the 40 new places being
provided in the area (20 in Fosse House, St Albans and 20 in Willow Court,
Harpenden), this will be a sufficient number to replace the existing places at
Jane Campbell and still enable people to exercise their right to choose their
residential care home.
2.5
Once the extensions in Fosse House and Willow Court become available, it
would be possible to decommission the service at Jane Campbell House,
estimated to be towards the end of 2012.
2.6
Once decommissioned, the County Council would have no further use for the
obsolete home and it could be sold.
3
Recommendations
3.1
The Health and Adult Care Cabinet Panel considered a report on this item of
business at its meeting on 31 January 2012. The Panel’s recommendations
to Cabinet:“That:
(i)
the re-provision of the residential care home places at Jane Campbell
House, St Albans to the extensions to the residential care homes at
Fosse House, St Albans and Willow Court, Harpenden should proceed
and that on completion and registration of those additional places, Jane
Campbell House be declared surplus to requirements and available for
disposal;
2
(ii)
the Director Health & Community Services and the Director Resources
& Performance, in consultation with the Executive Member for Health
and Adult Care and the Executive Member for Resources and
Economic Well-Being, make the appropriate arrangements with
Quantum Care to implement the decision in (i) above”.
4
Background
4.1
Jane Campbell House is one of 26 homes leased to Quantum Care. It was
built in the 1970s, providing 54 residential care places.
4.2
The background to Quantum Care is that it was established in 1992 as a ‘not
for profit’ organisation to assume management of the majority of the County
Council’s residential care homes for older people, and to undertake a major
programme to bring the homes to registration standards.
4.3
The general principles at the formation followed those of Care in the
Community national policies, i.e. to clearly separate the roles of the strategic
social services authority, purchasing authority, regulation and provision of
service, and also to establish a long term partnership arrangement with the
newly formed and largest supplier of care services to the County Council.
4.4
The business model adopted was for the County Council to place a major long
term block contract for the delivery of residential care and day services at
specified levels, and for Quantum Care to sell the majority of its services to
the County Council with marginal capacity to private clients. Quantum Care
took occupation of the homes under normal, full repairing, commercial leases
and paying market rents.
4.5
Cabinet received reports in 2005 and 2008 on the future of the County
Council’s care homes and agreed a process by which places in obsolete
homes could be re-provided. This is in the form of an option agreement for the
grant of leases which enable the construction of extensions to existing homes;
re-development of existing homes; or the development of new homes on new
sites provided by the County Council, and provided for the Corporate Director,
People and Property, in consultation with the Executive Member for
Performance and Resources, to be authorised to agree the property contract.
Jane Campbell House is specifically mentioned in these papers as one of the
first homes due for re-provision.
5
Case for re-provision of places at Jane Campbell House
5.1
Since the 2008 decision, the County Council has been implementing its
Accommodation Strategy for Older People. This strategy emphasises the
need to provide a sufficient number and broad range of services which would
offer older people more control over their lives and more choice as to how
their needs are met.
3
5.2
National research indicates that a third of people admitted to residential care
could have managed in flexicare, which is Hertfordshire’s model of extra care
housing. Hertfordshire County Council is a partner in flexicare schemes in
nearby Hemel Hempstead, Watford and Welwyn Garden City, although these
prioritise people with a local connection. Although there is presently no
flexicare in St Albans district, Leacroft and Caroline Sharpe House sheltered
schemes are due to be rebuilt as flexicare. Dependent on planning
processes, Leacroft could provide 43 units from late 2012 and Caroline
Sharpe House could provide around 40 places by 2013. A third site has been
offered for 40 places which is being considered.
Despite the emphasis on flexicare and care being provided in people’s own
homes, there continues to be demand for residential care places including in
the catchment area of Jane Campbell House. The direction for residential
care provision is fewer but larger care homes. Details of the needs analysis,
population data and provision of other care homes in the area are outlined
below.
6
Needs Analysis
6.1
The table below indicates the population of over 65s in the St Albans district
over the next 20 years. It is expected that there will be an additional 2,600
people aged over 85 by 2030, and therefore the numbers of people aged over
85 will double over the next 24 years.
6.2
Care Home and flexicare provision and admissions in St Albans:
Population over 65
St Albans people aged
65-69
St
Albans:
People
aged 70-74
St
Albans:
People
aged 75-79
St
Albans:
People
aged 80-84
St
Albans:
People
aged 85 and over
St
Albans:
Total
population aged 18-64
St
Albans:
Total
population 65 and over
St Albans: Total - all
ages
2010
2015
2020
2025
2030
5,500
6,600
5,900
6,500
7,700
4,800
4,900
6,000
5,400
6,000
4,100
4,300
4,400
5,500
5,000
3,300
3,400
3,700
3,900
4,800
3,000
3,500
4,100
4,900
5,600
83,900
86,600
89,900
92,500
94,300
20,700
22,700
24,100
26,200
29,100
137,400
143,900
150,500
156,700
162,000
Sources: ONS 2009 Mid Year Population estimates and Projecting Older People’s Population
Information (POPPI) System
4
Care Home Admissions data 2010/11
6.3
There are over 1600 places in homes and flexicare schemes within a five mile
radius of Jane Campbell House, plus planning applications in for two new 63
and 64 bedded residential care homes within two miles of Jane Campbell
House.
6.4
ACSIS data (Hertfordshire County Council’s HCS case management system)
shows that 50 people were admitted to care homes in the city of St Albans in
2010/11. Of these 50 people, 20 people were admitted to the three Quantum
Care homes in the city: Jane Campbell House, Vesta Lodge and Fosse
House. The other thirty people went to homes in the surrounding area shown
on the map (see Appendix 2).
6.5
Quantum Care confirmed that in the last year it has become increasingly
difficult to fill vacant places at Jane Campbell House, and the current
occupancy level this year to date is stable at 96.7%. Despite many viewings,
the feedback from potential residents has been that whilst the home has a
pleasant atmosphere and a high quality of care, the environment is
antiquated, and in particular most bedrooms are very small, and have no ensuite facilities. Many viewings in the last year have resulted in people
choosing other Quantum Care homes, or competitor homes with en-suite
facilities. There have also been several residents who have moved into Jane
Campbell House purely on a temporary basis, whilst waiting for a transfer to
another home with more modern facilities. Only 54% of people who currently
reside at Jane Campbell came from the St Albans area, with the remainder
previously living in areas such as Watford, Rickmansworth and Barnet. It is
felt that the 40 places in the new extensions in Fosse and Willow are sufficient
to re-provide the places at Jane Campbell even with the levels of expected
growth.
7.
Extensions at Willow Court, Harpenden and Fosse House, St Albans
7.1
Building work has started to extend Willow Court and Fosse House, and the
extensions will make both of these homes 80 bedded homes. The homes will
each provide an additional 20 en-suite bedrooms together with communal
accommodation, and are due to complete by August 2012. These larger
homes would be compliant with the County Council’s preferred model of
having fewer, larger homes that can benefit from improved economies of
scale. There are no plans to extend Vesta Lodge, as town planning policies
require the retention of a number of mature trees on the site which inhibits the
ability to add capacity to that home.
7.2
It is planned that any residents of Jane Campbell House around this time can
be moved to one of the extra places with en-suite facilities with little disruption,
or alternatively to a home of their choice.
7.3
The additional places will be brought into the care contract with Quantum
Care, and therefore the de-commissioning of the service at Jane Campbell
House will have minimal impact on the Care Contract purchasing requirement
5
as there will only be four long stay places short of the bed space threshold
mentioned in the Option Agreement.
8.
Property Implications
8.1
Construction of the extensions commenced in May 2011, and is programmed
to be finished in August 2012. Residents would move from Jane Campbell
House to other homes over a phased period to be agreed between the
residents, families, the County Council and Quantum Care.
8.2
The Option Agreement entered into with Quantum Care in December 2009
allows the County Council to put in place arrangements to determine the lease
with Quantum Care of Jane Campbell House and to gain vacant possession.
It is anticipated that Jane Campbell House could be handed back to the
County Council by the end of 2012.
8.3
The County Council would have no further use for the obsolete home and it
would be surplus to requirements and could be sold. It is anticipated that a
purchaser would wish to bring forward a scheme for re-development of the
site, either for residential or for healthcare purposes.
8.4
Disposal of the site would generate a capital receipt estimated to be c £2.6m,
based on an assumption of planning permission being available for redevelopment of the site for housing purposes and without any onerous
conditions or restrictions. An important part of a disposal strategy will be the
ability of an applicant to demonstrate to the Local Planning Authority that there
are sufficient suitable care places available in the area, as has been set out
earlier in this report.
9.
Consultation and Involvement
9.1
Quantum Care hosted a meeting with the families from Jane Campbell on 16
January 2012. The general feeling from this meeting was that families would
not be choosing to move their relatives; however many people realised that
the proposal does provide a positive solution to the current challenges at Jane
Campbell House, and this way does maintain continuity of care.
9.2
Families praised staff at Jane Campbell House for the excellent standards of
care they currently receive, and sought reassurance that their relatives would
receive the same standard and continuity of care if they move. There were a
few families who raised concerns about the possible effects of such a move
on residents, particularly those with dementia. Both Quantum Care staff and
officers from Health and Community Services and the Specialist Mental
Health Team gave reassurance that the health, safety and wellbeing of
residents is a main priority. Full support would be given to ensure that the
move is handled as smoothly as possible, and in line with guidance issued
from the Association of Directors of Adult Social Services, the Social Care
Association, and best practice guidance on home closures published by the
6
University of Birmingham in 20113 .This considers the likely impact on
residents having to move homes.
10
Staffing Issues
10.1
There are no staffing implications for the County Council. Quantum Care is
following its own HR policy and procedures, and has notified staff of the
proposal. There are no TUPE implications.
11
Equalities Implications
11.1
The Equality Act 2010 requires the Council, when exercising its functions, to
have due regard to the need to (a) eliminate discrimination, harassment,
victimisation and other conduct prohibited under the Act; (b) advance equality
of opportunity between persons who share a relevant protected characteristic
and persons who do not share it and (c) foster good relations between persons
who share a relevant protected characteristic and persons who do not share it.
The protected characteristics under the Equalities Act 2010 are: race,
disability, gender, age, sexual orientation, religious belief and pregnancy &
maternity.
11.2
Members must be fully aware of, and have actively considered, the Council’s
statutory obligations in relation to equalities. This will include paying close
attention to any equalities impact assessment produced by officers.
11.3
An Equality Impact Assessment (EqIA) has been undertaken and is detailed
at Appendix 1 to this report. The action plan which is step 5 in this document
will be kept under review.
12
Financial Implications
12.1
Replacement of the care home places has no immediate implication on the
revenue budget for the purchase of residential places as the County Council
pays a standard price per place, irrespective of location.
12.2
The capital cost of the extensions is being funded from the County Council’s
capital programme, and paid though a development agreements made with
Quantum Care for each home.
12.3
For the property revenue account, there is an increase in the rent paid by
Quantum Care at each of the newly extended homes and an end to the rent
paid by Quantum Care for the decommissioned home. The net change in
rents payable by Quantum Care will be reflected in the property revenue
budget for 2012/13.
3
Achieving Closure, Good practice in supporting older people during residential care closure,
http://www.birmingham.ac.uk/news/latest/2011/06/08JuneCareReport.aspx
7
8
Appendix 1
Equality Impact Assessment
Completion of this template should be proportional and relevant to the anticipated impact
of the project on equalities. It can be tailored to your project. For support please email
equalities@hertscc.gov.uk.
STEP 1: Responsibility and involvement
Project title
Lead officer
completing the
assessment
Re-provide Beds at Jane Campbell Care home to beds at
extensions in Fosse House and Willow Court in St Albans and City
District Council area
3. Promoting
independence,
personalization
Laura Fortune
Council for
and early
Senior Commissioning
intervention
the Future
Manager
5. Enhanced
workstream
Accommodation Solutions
commissioning
and
procurement
Contact details
Laura.fortune@hertscc.gov.uk
Date
completed
1 November
2011
Others involved
in preparing
assessment
Gary Heathcote Head of
Accommodation Solutions
Sam Cheekory Operations
Manager at Quantum Care
Assessment
review date
1/5/2012 and
further
STEP 2: Identify the project objectives and scope of the assessment
Project objectives:
– Intended outcomes
– Purpose and need
This re-provision project is part of the
Accommodation Solutions Team plan to
deliver a range of suitable modern
accommodation options for all client groups
taking into account need, diversity and value
for money
Stakeholders:
– Internal, external, local Member
HCS commissioning dept, Herts Property ,
local Members, Quantum Care, individuals in
need of accommodation with care or
support.
STEP 3: Available data and monitoring information
Available equality information
What does the data tell us about equalities
Data and monitoring information
All contracted providers are required to
demonstrate effective equalities policies and
procedures
9
Available equality information
What does the data tell us about equalities
Complaints/ enquiries
Complaints are monitored for equalities issues
Equality issues are addressed and actions
plans monitoring through contract monitoring
visits
Our Joint Strategic Needs Analysis includes a
breakdown of minority groups which is further
analysed through our District profiling. This tells
us we need to ensure suitable accommodation
is available for all groups with support needs.
Audits or inspections
Local knowledge consultations/
engagement
A paper commissioned from the IPC supported
the HCS decision to provide ‘culturally
competent’ services rather than specific
services for minority groups. This is addressed
through all development and new builds
programmes.
A study conducted by University of Birmingham
stated: ‘If moves to other care homes are
planned and conducted well, this guide
suggests that care home closures might be able
to improve outcomes for older people (if they
were in a poor environment before) and might
be able to support people through very difficult
changes without making things very much
worse for them in the mean time.’ (2011)
Training is provided for staff in Quantum Care
homes and for contract officers within HCS
which addresses equalities issues, either within
wider subjects or in sessions specifically on
equalities.
Equality information from national
sources
Other
Gaps identified – do you need to collect
more data/information or carry out
consultation?
Information regarding equalities issues for the
protected group is recorded on individuals’
service/ support plan records.
STEP 4: Impact Assessment
Protected
characteristic
Age
Opportunity to advance
equality of opportunity and/or
foster good relations
All services in Jane Campbell
The review of the person’s care
Care home are for people over needs prior to the move
the age of 65. The service
provides an opportunity to
specification deals with the
enhance or improve equality of
generic care requirements for
opportunity. The details of this
people and the service is
will be captured and reviewed in
expected to consider individual the individual’s care plan. This
Potential for negative
impact
10
Disability
Race
Gender
reassignment
Pregnancy and
maternity
Religion or belief
Sex
Sexual orientation
needs in the care plan
action will be kept under
constant review
The current building (Jane
Campbell care home) is not
suitable for people with
complex disability. This is one
of the reasons as to why the
beds need to be re-provided
as the environment is difficult
for people
Consideration has been given
to this. There is an expectation
in the contract that QC
provides appropriate and
individualised services for
people of different
races/nationality, this is
monitored regularly
There are no people in the
current service that fall in to
the category, however if
someone did enter the
service, it is expected that QC
would provide appropriate and
personalised services.
There is no one in the service
with this protected
characteristic as everyone is
over the age of 65.
The new extensions at Fosse
House and Willow Court are
built with rooms that are “home
for life” standards and therefore
this can foster more opportunity
for people if they do become
disabled to remain in the home
rather than having to move on
This issue will be monitored
prior , during and following the
move to ensure that any new
staff involved in the provision of
care continues to provide
individual and enhanced level of
care to cater for all people
regardless of race/nationality
Training is given to all staff on
the all of the protected
characteristics and if a person
was to take up residency with a
gender reassignment, this
would be monitored on a regular
basis
Should the client group change
at this new home , this category
will be considered
Steps will be taken to ensure
that faith needs will continue to
be met in the new home and
arrangements will be put in
place to ensure people are
continued to be taken to existing
places of worship or see their
faith leader at the home This will
be reviewed prior , during and
following the move and the care
plans and action plans updated
The service is reviewed
We will aim for equal
regularly to ensure that it is
representation in the new home,
not favouring one gender over although this will be kept under
another
review
Steps will be taken to ensure
Consideration has been given that needs will continue to be
to this. There is an expectation met in the new home and
in the contract that QC
arrangements will be put in
provides appropriate and
place to review this issue prior ,
individualised services for
during and following the move.
people of different Sexual
Care plans and the action plans
orientation, this is monitored
will be updated Training and
regularly.
appropriate marketing and use
of images are used
The service is monitored to
ensure that it is not just
focussed on one faith group
and to provide an environment
and ministers/faith leaders of
all faith groups are welcomed
in the home Faith needs are
captured in individual care
plans and plans are put in
place to cater for this
11
Marriage & civil
partnership
Some services are specific to
single people due to room size
The conclusion of your analysis
Select
one
Yes
Adjust the policy
The County Council managed the
move for people from old Quantum
Care homes to new homes in the mid
1990s with no reported negative
impact. National best practice guidance
has also been considered. At present
the existing practice which stems from
conducting good quality care
reassessments should mitigate any
negative impact and to remove barriers
or better advance equality.
There many be opportunity for
people to share accommodation
in the new home thereby
fostering enhanced opportunity
for married people or those in a
civil partnership
Give details
The action plan below outlines details for
immediate and initial actions. However there
may be other actions which are not known
at this stage so the action plan will need to
be kept under contact review and updated
as appropriate. It is proposed that this is
delegated to the Director of HCS to request
regular updates from Commissioners and
Quantum Care to ensure that actions are
added to ensure that any potential negative
impact on the residents during , prior and
after the move to other homes are
minimised and that all opportunities to
further enhance equality are maximised.
STEP 5: Action plan
Issue or opportunity
identified
Consultation of residents ,
staff, relatives
Building and Environment
suitable for all people moving
to new extensions at Fosse
House and Willow Court
Risk of prioritising one group
over another for project
management time and
assessing people for their new
home
Action proposed
Consultation & needs analysis
to ensure fair transparent
process adjusted to meet all
needs. Residents and staff
advised that their needs will be
kept under constant review to
ensure that there is no negative
impact as they move from their
existing home to the new
home.
Building plans checked and
project and contractors
managed effectively.
Environment is suitably
equipped to meet the
requirements for all the
protected characteristics
QC to identify named lead
within the organisation to
ensure that the transition is
managed and all assessments
are conducted. HCS staff
conduct good quality
assessment processes.
Commissioning keep this under
Responsibility and
target date
HCC and Quantum
Care
January 2012
Herts Property and
Quantum Care
August/September
2012
Summer 2012
12
Issue or opportunity
identified
Action proposed
Responsibility and
target date
review during and after the
move
Potential for new service at
other QC homes to be
perceived as less welcoming
to minority groups
Any concerns or issues to be
captured during the case
reassessment and review and
regularly monitored.
Training programmes to be
promoted. Training uptake
monitored through contract
management
For any people
transferring to new
QC homes, ongoing
checks will be
conducted through
routine monitoring
Continue to keep this
under review as part
of the project.
Service user experience will be
gathered through contract
monitoring processes.
Develop services in
accommodation with good
accessibility
Ensure marketing materials
portray diverse group of older
people
13