Agenda item

The Future of Residential Care Homes for Older People Owned and Operated by Surrey County Council

Meeting of Cabinet, Tuesday, 22 February 2022 2.00 pm (Item 34/22)
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Decision:

RESOLVED:

1. Cabinet agreed that the council continue to operate Abbeywood while options are explored regarding development of the site for alternative adult social care services or a joint development with NHS/partners, accept that the building may need to close if large scale essential maintenance or development is required, and if no alternative developments are identified, Option 3 – support residents to move to an alternative care home and close Abbeywood.

2. It was agreed by Cabinet that residents are supported to move to new care homes, Barnfield is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care services.

3. It was agreed by Cabinet that residents are supported to move to new care homes, Birchlands is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care services.

4. It was agreed by Cabinet that residents are supported to move to new care homes, Chalkmead is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care services.

5. It was agreed by Cabinet that residents are supported to move to new care homes, Heathside is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care services.

6. It was agreed by Cabinet that residents are supported to move to new care homes, Keswick is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care, community or NHS services.

7. It was agreed by Cabinet that residents are supported to move to new care homes, Meadowside is closed and further investigation is undertaken to confirm if the site can be redeveloped for alternative adult social care services.

8. It was agreed by Cabinet that residents are supported to move to an alternative care home and close Orchard Court and explore opportunities for developing the site for alternative adult social care services or a joint development in partnership with the NHS or other organisations.

9. That the responsibility for implementing the decisions agreed are delegated to the Cabinet Member for Adult Social Care and Health in consultation with the Executive Director of Adult Social Care and Integrated Commissioning.

10. That after considering all aspects of each recommendation and if it is decided that more than one care home should close, a phased approach to care home closures will take place with a view for care home closures to be concluded by the end of 2024. Planning will recognise the need for a staff consultation and be supportive of resident and staff needs. Please note that the council will follow the good practice principles detailed below in the ‘What Happens Next’ section of this report and ensure comprehensive support is provided to residents, their families, advocates and staff.

That if the decision is taken to close any of the homes, the alternative use of any site will be prioritised in the context of Adult Social Care’s Accommodation with Care & Support Strategy that has already been endorsed by Cabinet as a key priority. Should any of the sites be considered unsuitable for a new service as part of the Accommodation with Care & Support strategy, the options appraisal process (as set out in the Council’s Asset and Place Strategy 2019) will be used to determine future use.
That Cabinet note that there may be a provider interested in vacant possession of one or more of the buildings and further discussion will take place regarding this which may necessitate an additional report coming back to cabinet in the future.

Reasons for Decisions:

It is recognised that through the consultation process most people indicated a preference that the council modernise and refurbish the care homes. However when everything is taken into consideration; the challenges with the properties, best use of taxpayers money and the strategic aims of the council, we regret to say that we are recommending that care home residents are supported to move new homes and all eight care homes are closed before the end of 2024.

The council’s Health and Wellbeing Strategy is based on a community vision for Surrey that describes what residents of Surrey and partners think Surrey should look like by 2030: By 2030 we want Surrey to be a uniquely special place where everyone has a great start to life, people live healthy and fulfilling lives, are enabled to achieve their full potential and contribute to their community, and no one is left behind.

The detail provided in this report provides evidence to suggest that the eight care homes are at the end of their natural life span and investing in the services will not provide environments that are fit for the future. Deciding to support care home residents to move to new care homes and then closing the care homes will enable to council to work with partners and invest in services, detailed in the next paragraph, that will empower older people in Surrey to lead physically and emotionally healthier lives and reach their potential.

The council:

is committed to working with NHS and private care providers to develop specialist facilities to support people who need intensive support and as Surrey’s population grows and ages, appropriate care is available to support people who have complex care needs
is investing in more preventative services to help people stay healthy and happy in their local communities for longer
is committed to providing 725 apartments by 2030 in extra care housing, offering people their own front door with care and support always on hand

The council continues to help transform social care to enable people who do not need to be supported in a care home to lead independent lives and work with our partners to ensure that people with complex needs can receive care which is truly tailored to their needs.

The council’s commissioning strategy for older people 2021-2030, recently approved by the council’s Cabinet, aims to champion greater choice, quality and control for older people through:

meeting the increasing demand for care home placements offering personalised care for high and complex needs
helping to ensure that people eligible for social care support are offered the same standard of care as those who can afford to pay privately, reducing health inequalities

The eight care in-house homes run by the council are not best placed to meet the aspirations and commitments outlined above as they are operating towards the end of their economic life span and will require significant investment to maintain them over the coming years. Major investment is needed in all of the homes in some or all of the following areas:

· replacement of boiler and heating distribution system

· roof replacement

· replacement of hot and cold-water systems

· kitchen refurbishment

· bathroom modernisation and updating

· replacement of flooring

· replacement of windows and doors

· updating electrical systems

· updating of lifts

· remodelling of open staircases in 6 of the 8 homes (to support people living with dementia)

Expectations of what a residential care service can provide have changed since the services were opened and the council’s codesigned long-term commissioning intentions for services for older people focusses on supporting people to live in their own homes or extra care settings for as long as possible and access specialist residential care services if needed later in life.

Ongoing significant investment will be required to maintain or to make changes to the structure of each care home to ensure that:

a more dignified and safer environment, to live and work in, can be provided
each care home can continue to comply with building and other regulatory requirements.

The council’s 2030 Net-Zero Strategy focuses on reducing scope 1 emissions (Green House Gas) and scope 2 emissions (production of energy used by a building) from buildings. It is estimated that the care homes currently contribute 1,371 tonnes CO2-eq emissions annually and decisions on the future of the care homes has the potential to impact on meeting targets.

It is considered that investment would be better made in supporting the development and use of modern services that can meet the aspirations of Surrey residents and are in line with council strategies.

(The decisions on this item can be called in by the Adults and Health Select Committee)

Minutes:

The report was introduced by the Cabinet Member for Adults and Health who explained that the proposals being discussed impacted eight care homes managed and run by the County Council, following their transfer back from the Anchor Trust in 2019. The following key points were made:

· The homes provided good quality services, and the residents were supported by trained, dedicated and excellent staff who worked tirelessly and had been heroes throughout the pandemic.

· All eight care homes provide residential care and short-term respite care. Two homes also provide day services.

· The homes were built in the 1970s and 1980s and were initially run by the council until they were contracted out to Anchor Trust in 1999. In 2019 they returned to the council and it was only on their return that the council aware of issues with the infrastructure including with the water systems, heating, drainage, roofs, lifts etc. It also became evident that the design of the buildings did not meet current expectations and that they were inappropriate for individuals with certain conditions, for example severe dementia, as six of the eight homes have open staircases and units on different levels. And vitally, there is a risk that infrastructure could fail at any time which could result in residents having to be relocated at short notice.

· Only 25 out of the 433 rooms have en-suite facilities. The council’s aim is to provide an environment where people living in a care home live in comfort and in a home where the design of the building, with support from staff, ensures privacy and dignity is maintained. Shared facilities have proved to be challenging, in terms of infection control for illnesses such as norovirus, flu and Covid.

· A consultation took place between 11 October 2021 and 5 January 2022 and was a listening exercise. During the consultation one-to-one conversations with residents were conducted by staff in the care homes, residents were also invited to complete on-line or paper questionnaires. Meetings also took place both, virtually and face to face, on a one-to one basis and for groups of residents, staff and relatives. Where relatives were unable to attend in person meetings were held on-line.

· Although most people indicated a preference for the council to modernise and refurbish the care homes. It seems that the homes will, unfortunately, no longer be fit for the future and it is uneconomic to make the changes that would be required in order to make them sustainable for the future.

· It was being recommended that the care home residents are supported to move to new homes and all eight care homes are closed, using a phased approach, before the end of 2024. There are currently 406 registered care and nursing homes in Surrey, offering a total of 11,599 registered beds so plenty of sufficient care choices for older people in Surrey.

· Dedicated support would be put in place for residents, their families, staff and all other relevant stakeholders.

Members commented that they felt reassured that staff and residents would be supported if the closures went ahead. Some members commented that they had some of the care homes due for closure in their respective wards. The care homes were well established and had become community hubs. The service provided by staff was exemplary but the buildings themselves were not conducive to providing quality care for the future. It was explained that if the buildings were to close they would undergo full asset reviews.

The Local Member for Woking South commented that he was concerned that the consultation responses had not been listened too and that residents would have to be moved multiple times if the buildings closed. The decision to close the homes would also be contrary to the councils position to invest in social care. The Cabinet Member for Adults and Health explained that a thorough consultation had been undertaken but the conditions of the buildings was a paramount factor to the decision being recommended. The intention was for residents to have one move to a home that’s right for them. The Leader hoped people understood the rationale to close the homes and that it would be better for residents to live in more appropriate accommodation with modern facilities.