Agenda item

To receive a report from the Cabinet Member for Adult Social Care and Public Health and the Corporate Director of Social Care, Health and Wellbeing, and to consider and endorse or make recommendations to the Cabinet Member on the proposed decision to close the Dorothy Lucy Centre and re-provide the services currently provided there through various other means.

Mr B E Clark, County Council Member for Maidstone South, was present for this item, and Ms C Holden, Head of Commissioning for Accommodation Solutions, was in attendance for this and the following item.

Mrs Marian Reader and Ms Anna Ralph were present at the invitation of the Cabinet Member, as they had been the lead petitioners in opposing the proposed closure.

1.            The Chairman welcomed Mrs Reader and Ms Ralph to the meeting and explained that the role of the Cabinet Committee was to comment on and/or endorse the decision proposed to be taken by the Cabinet Member, which was set out in detail in the recommendation report. 

2.            The Chairman then asked Members if, in debating agenda items B1 and B2, they wished to refer to the information set out in the exempt appendices to these items, F1 to F3.  Members confirmed that they did not wish to refer to this information and discussion of these items therefore took place in open session. 

3.            Ms Holden introduced the report and summarised the consultation process and the further work undertaken since then to identify need and alternative provision.  It had not been possible to make a recommendation to the January meeting of the committee but a detailed proposal was now being presented for the committee’s comment, prior to a formal decision being taken by the Cabinet Member.  The proposal was that use of the Dorothy Lucy Centre for short-term respite care would end in August 2016 and for day services in March 2017.

4.            Mrs Reader addressed the committee to represent the views of local people about the proposed closure and made the following points: alternative provision to be made should be local so that friends and family could visit easily; money could be raised to extend and upgrade the centre to provide more accommodation, particularly as the elderly population was increasing; it was short-sighted to close a popular facility at which many local people had received excellent care from dedicated staff; the centre’s respite care was particularly helpful and popular; staff there lived locally and their families’ livelihoods would be affected by the closure and subsequent loss of jobs; the day services were a lifeline for elderly people locally; the centre was irreplaceable for local people. 

5.            Ms Ralph then addressed the committee, supported many of the points made by Mrs Reader and added the following: the respite care given at the centre was a vital support to those caring for a relative 24 hours a day; the centre had been assessed by the Care Quality Commission in 2013 as being ‘good’, so the proposal to close it was questioned; people living with dementia did not cope well with change and it would be difficult for them to travel to access services provided elsewhere, hence day services provided elsewhere would not work for those currently using the Dorothy Lucy Centre; there were many families which would suffer through the proposed closure and some people did not have a family to support and fight for services for them; the Dorothy Lucy Centre could be given to someone other than the County Council to run.

6.            Mr Clark referred to the points he had raised at the January meeting and added the following: the Dorothy Lucy Centre was very well regarded within the community; there was concern that there would be sufficient alternative provision for all current users to be able to transfer, especially those needing services for dementia, as there were not yet like-for-like services for all clients; day care services were proposed to remain open for one more year, until March 2017, so the whole centre could perhaps stay open for  another year; to fragment the services now would make closure an inevitable choice in a year’s time, if alternative provision of the remaining  service was found not to be viable; the fact that the centre would stay open for a  while longer was welcomed, to allow the establishment of like-for-like services.

7.            Members then made the following comments and asked questions, to which Ms Holden responded:

a)    concern had been expressed at the January meeting of the committee that the County Council was withdrawing from residential and day care provision at the Centre, and this concern was repeated. Moving all service provision to the private sector could compromise its long-term sustainability and the quality of care provided. Such a move was a retrograde step. Kent should instead retain a mixed economy of elderly care provision, with the County Council continuing to provide some services, alongside the private and voluntary sectors.  Ms Holden explained that the County Council was currently to retain four of its centres as integrated care centres;

b)    a view was expressed that, to continue to keep open premises which had been assessed as ‘substandard’, was not what the County Council wanted to be seen to be doing.  Instead, it should look to develop a long-term strategy for services for the elderly and those with dementia, to set out how those services could be provided by different means.  The challenge of providing services for these client groups was the same across the county, and making changes to service provision was never popular with those who used them. However, the proposed changes seemed to present a sensible way forward;

c)    the Dorothy Lucy Centre had been spared closure some years ago when other premises had been closed, but it seemed that there was still no solution in place.  The report referred to things which ‘could be’ provided, but the certainty that these things would be provided and would be of suitable quality was questioned. A view was expressed that there was not currently sufficient capacity in the private sector in Kent to cover the needs of those with dementia, who found such uncertainty difficult and distressing;

d)    no good, sound reason had been given for closing the centre.  Media coverage had highlighted cases of substandard elderly care provision around the country, yet a centre delivering good-quality care was to be closed; and

e)    provision of care to the elderly was inevitably an emotive subject, and the views of those campaigning to keep the centre open were understood. However, the County Council had a duty to look at care provision for the whole of Kent within the budget which was available, and to apply a strategic view to what was viable and what was not.

8.            The Cabinet Member, Mr Gibbens, gave a commitment that, if the proposed decision to close the centre was indeed taken, no closure would happen until alternative care provision was established and operating to his satisfaction.  This same commitment to continued provision had been established in the past when making changes in service provision, for example, of day services for people with learning disabilities, and was applied strictly in each case.  Mr Gibbens emphasised that cost was not the main issue in the proposal.  He acknowledged and said he appreciated Members’ concerns about the closure of a service against a background of an ageing population and increasing levels of dementia.  It was vital to plan now for services which would be needed in 20 years’ time, and how those services could best be delivered, and put in place provision which supported this. For this purpose, the County Council had developed its Accommodation Strategy. Work on this strategy had highlighted a shortage both of extra care sheltered housing and nursing care beds and had shown that people had greater needs at the time that they entered such facilities.  He assured the committee and the public that he would not allow the Dorothy Lucy Centre to close until he was satisfied that suitable alternative provision was in place.  He thanked Mrs Reader, Ms Ralph and Mr Clark for attending to address the committee and said he understood the views they had presented.  He assured them that he would not be taking a decision until later in March, and that he had not yet decided what decision this would be.

9.            RESOLVED that:-

a)    the content of the report and the work undertaken to date be noted, and

b)    the decision proposed to be taken by the Cabinet Member for Adult Social Care and Public Health:

i)             to close the Dorothy Lucy Centre, Maidstone;

ii)            to re-provide elderly frail services (currently provided by the Dorothy Lucy Centre) through existing external provision;

iii)           to re-provide dementia day services (currently provided by the Dorothy Lucy Centre) through a block contract;

iv)           to re-provide the short-term beds (currently provided by the Dorothy Lucy Centre) in the independent sector;

v)            that Dorothy Lucy Centre day provision continue to operate as is until at least March 2017, to allow time to complete a procurement exercise for a block contract and implement a transition plan;

vi)           that existing services not close until alternative provision is available for the current service users;

vii)         to give consideration to leasing the day centre part of the building to an external provider as an interim measure if they are unable to secure a suitable venue within the procurement timetable, with the understanding that they identify an alternate venue within a given timeframe; and

viii)        to delegate authority to the Corporate Director of Social Care, Health and Wellbeing, or other nominated officer, to undertake the necessary actions to implement this decision,

be endorsed.

Carried, 7 votes to 4.

NOTE: Subsequent to the Cabinet Committee meeting, the Cabinet Member had further discussion with some local Members, during which greater clarity was provided about the proposed order of closure of the various elements of the services currently provided at the Dorothy Lucy Centre.