HERTFORDSHIRE COUNTY COUNCIL
CABINET
MONDAY, 20 FEBRUARY 2012AT 2.00PM
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)
1Purpose 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.
1.2To 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
2.1Jane 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 re-provision of this home is set out in two Cabinet papers (please see the footnote links below). On 21 February 2005 Cabinet[1] 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 places by way of extensions to existing homes or construction of new homes, and with surrender of the leases of the obsolete homes.
2.2There 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.
2.3The 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.
2.4There 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.
2.6Once decommissioned, the County Council would have no further use for the obsolete home and it could be sold.
3Recommendations
3.1The 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;
(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”.
4Background
4.1Jane Campbell House is one of 26 homes leased to Quantum Care. It was built in the 1970s, providing 54 residential care places.
4.2The 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.
4.3The 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.
4.4The 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.
4.5Cabinet 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
5.1Since 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.
5.2National 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.
6Needs Analysis
6.1The 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.
6.2Care Home and flexicare provision and admissions in St Albans:
Population over 65 / 2010 / 2015 / 2020 / 2025 / 2030St Albans people aged 65-69 / 5,500 / 6,600 / 5,900 / 6,500 / 7,700
St Albans: People aged 70-74 / 4,800 / 4,900 / 6,000 / 5,400 / 6,000
St Albans: People aged 75-79 / 4,100 / 4,300 / 4,400 / 5,500 / 5,000
St Albans: People aged 80-84 / 3,300 / 3,400 / 3,700 / 3,900 / 4,800
St Albans: People aged 85 and over / 3,000 / 3,500 / 4,100 / 4,900 / 5,600
St Albans: Total population aged 18-64 / 83,900 / 86,600 / 89,900 / 92,500 / 94,300
St Albans: Total population 65 and over / 20,700 / 22,700 / 24,100 / 26,200 / 29,100
St Albans: Total - all ages / 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
Care Home Admissions data 2010/11
6.3There 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.
6.4ACSIS 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).
6.5Quantum 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 en-suite 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
7.1Building 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.
7.2It 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.
7.3The 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 as there will only be four long stay places short of the bed space threshold mentioned in the Option Agreement.
8.Property Implications
8.1Construction 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.
8.2The 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.
8.3The 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.
8.4Disposal of the site would generate a capital receipt estimated to be c £2.6m, based on an assumption of planning permission being available for re-development 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
9.1Quantum 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.
9.2Families 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 University of Birmingham in 2011[3] .This considers the likely impact on residents having to move homes.
10Staffing Issues
10.1There 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.
11Equalities Implications
11.1The 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.
11.3An 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.
12Financial Implications
12.1Replacement 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.
12.2The 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.
12.3For 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.
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 .
STEP 1: Responsibility and involvement
Project title / 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 areaLead officer completing the assessment / Laura Fortune
Senior Commissioning Manager
Accommodation Solutions / Council for the Future workstream / 3. Promoting independence, personalization and early intervention
5. Enhanced commissioning and procurement
Contact details / / 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