Agenda item

Mr Graham Gibbens, Cabinet Member for Adult Social Services and Mr Oliver Mills, Managing Director, Adult Social Services will attend the meeting at 11.00am to answer Members’ questions on this item. 

Mr G Gibbens, Mr O Mills and Ms C Highwood were present for this item. 

(1)   Mr Manning clarified that he did not share the concerns of the Chairman and Spokesperson regarding the decision to go out to consultation on the Future of Older Persons’ Provision in Kent County Council. 

(2)   The Chairman explained that following a discussion with the Director of Strategic Business Support she had requested the following information:

a.      A breakdown of the differential costs between the County Council’s in house provision and private provision

b.      Details about the number of clients affected and the number of staff affected

c.      Alternative options explored

(3)   It was agreed that as much of the discussion as possible would be held in open session. 

(4)   In relation to the alternative options explored Mr Mills explained that there had been a lot of change with the in-house provision.  In 1992 9 homes were transferred to the Kent Community Trust and a further 9 were sold in 1998/99, link service centres had also been developed along with extra care sheltered housing and the establishment of Westview.  The Council had continually been looking at the options and the needs whilst focussing on the welfare of the existing residents and staff.  The current provision had been reviewed and the proposals in relation to the 11 homes were put forward for consultation. 

(5)   In relation to the numbers of staff and clients affected.  Ms Highwood circulated information setting out the number of beds both in the affected home and within a radius of five miles of each home and alternative provision.  

(6)   Mr Christie expressed his concern about the lack of Member attendance at the consultation exercises.  In relation to a question from Mr Christie, Mr Mills confirmed that alongside the consultation no new permanent residents were being accepted into the homes.  Mr Christie had concerns about the consultation exercise and whether decisions had already been made.  If the majority of people were against closure would the Council accept that decision?  Was this a financially driven exercise or was it in the interest of the clients.  It had been said that the homes were not fit for purpose, but wasn’t it the responsibility of the Council to update and modernise the care homes, why was this not done?  Would the current residents of care homes which may close have priority for the new care homes?  Mr Christie expressed his concern about respite beds and the availability of excellent beds particularly in areas which bordered other counties and therefore had competition. 

(7)   Mr Gibbens wished to assure the Committee that the consultation would be as wide as possible, a further consultation had been agreed for Dartford.  The Council would do everything possible to enable residents or Members to attend consultation discussions.  A full briefing would be given at the Adult Social Services Policy Overview and Scrutiny Committee on Friday 25 June to which all Members had been invited and were able to ask questions.  The reasons behind this consultation exercise included dignity, respecting people’s rights and ensuring that the right services are being provided looking into the future.  Lots of work had been undertaken on care homes and the sheltered housing review provided evidence of the excellent work that had been completed.  The focus was to enable people to live with dignity in their own homes for as long as possible. 

(8)   Mr Mills confirmed that this was unquestionably a consultation exercise.  At the end of the consultation there would be a report back from the Managing Director of Adult Social Services to enable further decisions to be made.    This was a necessary exercise in light of budget difficulties, the growing numbers of older people and the capital costs of modernising standards in care homes were beyond the capacity of the County Council.  In relation to the Care Quality Commission (CQC) it was a tribute to the staff in the homes that all were either ‘good’ or ‘excellent’.  However the CQC also had a responsibility for monitoring the physical standard of homes and these were poor.   A great deal of modernisation had been undertaken but this came at a significant cost to the County Council.  In response to the question about existing residents having priority to move into the extra sheltered care, yes they would be priority if that was their choice.  In relation to respite care the Council was confident that it could purchase respite care in the light of changing needs.  The availability of beds was constantly changing, Officers were confident that people could be offered a choice of good homes in a suitable area. 

(9)   The Chairman had concerns around the timing of the exercise, was the Council sure that this was a good time to sell property.  There were also concerns around withdrawing from the care homes market and whether that would diminish the Council’s power to influence the market.   The Government was looking at how elderly care was paid for nationally, would the outcome of that commissioned work affect the future of care homes.  The Chairman asked for more details of the cost of TUPE.  Officers had highlighted the difficulties in accessing capital, was this position due to get easier or more difficult with the new Government. 

(10)          Mr Manning raised his concern that the purpose of the meeting was to discuss whether the Council should be going out to consultation on this issue, not the principle behind it.  The Chairman explained that questions had been raised regarding the timing of the exercise, and it seemed to be a proper debate to be held. 

(11)          Ms Highwood explained that in relation to the timing of selling property, the decision could not be taken in parts so considerations had also included the costs of further capital works, the availability of alternative provision etc.  The relationship with the market was much more in partnership, for example the Council was providing subsidised training for those in the market, discussions were held to help businesses be managed efficiently, and the working relationship was a good one.  The understanding from the Department of Health was that the terms of reference for the commission on how older persons’ care would be paid for in future were expected before the summer recess although this information was not available yet; this was unlikely to affect KCC’s proposals.    Regarding access to capital, Adult Social Care had had little access to capital from the Department of Health, it was unlikely that this would change, PFI funding had been available and £75million PFI credits had been secured for the current round of extra care housing. 

(12)          Mr Hotson asked when officers made a decision not to accept new clients into the homes that were proposed to be closed.  Ms Highwood explained that the decision was taken as a matter of prudence and was normal practice, if at the end of the consultation the proposal was overturned it was easy to allow residents back into the care homes, however it would be unfair to allow new residents into a home that may close. 

(13)          Mr Scholes expressed his concern about the information that might be available throughout the consultation.  Mr Scholes agreed to discuss the particular issues he was aware of with the Officers outside of the meeting. 

(14)          Mr Koowaree queried that decisions taken over the refurbishment of the buildings, regarding the consultation, would it be tailored to each individual community group.  Ms Highwood explained that in relation to the quality of buildings, some areas were neglected and required money to be spent.  However the other concern was that once significant improvements were made the CQC required re-registration and the current building would fail registration due to room size and no en-suite which would require further expenditure.  The consultation had expanded further and it was intended that it was as open and accessible to all interested parties. 

(15)          Mr Gibbens stated that he understood what a difficult process this was for residents, families and the staff concerned.  The Cabinet Member did not underestimate this concern.  It was a difficult decision; some people would be ideologically opposed and this was understood.  The process focussed on looking to the future, it was important to consult at this stage to provide the right standard of care for older people in Kent. 

(16)          The Chairman asked whether the decision not to accept any new residents into the homes should have been a key decision that should have been subject to further discussion, Mr Gibbens would consider that point for the future.  Mr Christie asked whether, if there was a majority against the proposals from the consultation exercise then the process would not proceed.  Mr Gibbens explained that the consultation would be as wide as possible and following the consultation the results would be investigated and put into a report from the Managing Director of Adult Social Services.  

(17)          Mrs Rook asked for more information, it was felt that the public needed to know what the Care Quality Commission Guidelines were, how robust Officers had been in trying to find private sector partners specifically for those homes which were proposed to close.  Who would provide the day care element of some of the homes that were both daycare and residential?  How the strategy would fit in with the national strategy?  What the differential would be, not only in cost, between Adult Social Services and the private sector and also what the service delivery would be.  There were concerns about how Members had been consulted, there had not been enough notice for briefings and a consultation pack for Members would be useful.  All Members should receive a copy of the Adult Social Services Policy Overview and Scrutiny Committee presentation and other information provided.  In addition this meeting would be webcast. 

(18)          Mr Mills explained that the Cabinet Member was committed to arranging meetings to suit both residents and Members and this was a complicated situation, the points raised would be included in the presentation at the Adult Social Services Policy Overview and Scrutiny Committee on Friday 25 June. 

(19)          Ms Highwood explained that individual decisions would be taken on each home, there may be one report but it would contain a series of individual decisions each informed by its own consultation. 

(20)          Mr Christie expressed his concern that these proposals were not obvious from the medium term plan, and was this a knee jerk reaction to Government funding cuts.  Concerns had been raised around the wages for in house staff, and the impact on affected staff wages.  Ms Highwood explained where the relevant information could be found in the medium term plan.   In response to whether there was reassurance from the budget announcement of 22 June, there had not been any reassurance received.  In response to a question from the Chairman Ms Highwood confirmed that there had been no discussion at the budget Adult Social Services Policy Overview and Scrutiny Committee meeting relating to the closure of care homes. 

RESOLVED:

That the Cabinet Scrutiny Committee:

1. Thank Mr Gibbens, Mr Mills and Ms Highwood for attending the meeting and answering Members’ questions

2. Request that Members are more closely involved in the process as it unfolds

3. Ask that as much notice as possible be given of future consultations

4. Express severe concern about the completeness of the information provided to Cabinet and Cabinet Scrutiny Committee around this decision and ask that the additional information requested by the Committee be made available for the meeting of the Adult Social Services Policy Overview and Scrutiny Committee on Friday 25 June.