Equality Impact Assessment
Adults Services, Provider Redesign: Greengate Lodge and Rawalpindi House Residential Care Homes
1. Management of the Equality Impact Assessment
Lead – David Harris, Interim Service Manager (In-House Residential Care)
Contributions from -
§ Lakhveer Bhakar, Admin assistant
§ Gurmeet Singh, Admin assistant
§ Rejoice Mayo, Care First Data
Date: 12th May 2011
Linked Papers:
Cabinet Report – Redesign and reprovision of council-run (in-house) provider services - Adult Social Care November 2010
Cabinet Report - Redesign and reprovision of council-run (in-house) provider services - Adult Social Care May 2011
Cabinet report Appendix - Consultation Report
2. Background
Over the past decade Newham has worked to increase choice, rights and inclusion for older and disabled people. This has been achieved through a range of approaches including the redesign of day services for people with learning disabilities, investing in employment and preventative services, reprovision of a number of residential facilities, Supporting People schemes and housing developments, the introduction of personal budgets and the redesign of older people’s services.
The approach to adult social care provision in Newham has for some time now, been driven by the national personalisation, Putting People First and Right to Control agendas. In line with this ongoing programme of improvement, Adults Services is seeking to transform the way in which it delivers adult social care which will result in the following:
· Independent, enabled residents rather than dependent service users.
· Better outcomes for our service users (including disabled people and older people) through increased choice, quality of care and value for money.
· Transparency of allocation of resources linked to need.
· Opportunities for all service users to make a personal support plan, enabling them to choose and shape the care they receive.
· Timely and responsive services that meet need and lead to enhanced levels of customer satisfaction.
There is also a need for Adults Services, along with all other Council services, to demonstrate that it is using resources in the most efficient way and to provide services that offer the best value for money. Any social care services that Newham provides directly must be able to demonstrate how they support the above outcomes. As part of our transformation we want to ensure that those residents who currently live in our residential care homes have access to high quality support and facilities that give them a better quality of life, whilst offering value for money for the taxpayer.
A key component and anticipated outcome of the Transformation is the promotion of equalities and the elimination of discrimination.
3. Proposals
Over the last year, there has been a detailed analysis of the ability of Newham’s in-house social care services to demonstrate how they meet the criteria of value for money, service user choice, demand and service needs, offer quality care and support individuals to achieve quality outcomes. They should also offer good quality environments if they are buildings-based services.
The analysis of Greengate Lodge and Rawalpindi House residential care homes for older people indicated that they were very expensive compared to external residential care that was of a similar or higher standard, so did not represent value for money. The demand for the services had fallen as users were choosing other care homes or alternatives to residential care. A report was put to Cabinet on 18th November 2010, and the Mayor in Consultation with Cabinet agreed that a formal consultation on the proposed closure of the two homes should commence.
A detailed consultation has been undertaken and after due consideration of people’s views and impacts of change, officers are recommending to Cabinet (26th May 2011) that both Greengate Lodge and Rawalpindi House should close.
The reasons for the recommendations in relation to closures include:
· The services are expensive and do not represent value for money
· There are viable, more cost-effective services available elsewhere in Newham
· Demand for these services has dropped considerably over the last 18 months as less people are choosing residential care
In addition, the buildings and environment are not of a particularly high standard. Rawalpindi House was rated just one star under the Quality Rating by Care Quality Commission (these ratings ceased in October 2010) . This rating of 1* (adequate) is below the quality threshold that is acceptable under Newham’s Policy for commissioning external regulated provision. Another concern is the inability of the two homes to support people with higher needs, meaning that it is not uncommon for people to have to move on to other provision if their support needs increase.
It is acknowledged that there has been considerable opposition to the proposed closures by service users affected and their families. However, a number of people have actively chosen to move or make alternative plans. The consultation in relation to the closures has not identified viable alternatives to the proposals that meet the criteria.
Greengate Lodge is a residential care home based in Plaistow housing up to 32 older people. At end March 2011, there were 16 permanent residents plus 4 people using respite beds. Greengate Lodge is divided into 4 wings, one of which cares primarily for Caribbean residents, and another for Asian residents.
Rawalpindi House is a residential care home based in Canning Town housing up to 32 older people. At end March 2011, there were 19 permanent residents plus 6 people using respite beds. Rawalpindi House is divided into 4 wings with one dedicated respite wing.
The proposals support Newham to achieve objectives in line with national and local policy:
- to ensure choice for local people and for resources to be allocated primarily through personal budgets
- to redirect money which is currently allocated based on estimates of needs in order to be used on services that meet actual need
- to develop a model of provision that is high quality, responsive, competitive and accountable
- to maximise value for money of provision that is fit for purpose
- to maximise employment for working age adults
- to decommission services not delivering high quality, evidenced outcomes
- to decommission provision that cannot deliver value for money
- to provide a safety net of provision that would otherwise be unavailable in the market
- to ensure services that require premises, operate from buildings that are fit for purpose
4. Identification of policy aims objectives and purpose
This Equality Impact Assessment (EqIA) has been carried out to address the obligations under the Equalities Act 2010 with particular reference to sections 10, 29 and 149. (Relevant sections and case law references are set out in the Appendix) Initial screening identified that these proposals would have a particular impact on current (and potential) residents all of whom are older people or older disabled people with social care needs, so a full EqIA has been undertaken. This document focuses on equalities implications if these two older people’s residential care homes - Greengate Lodge and Rawalpindi House - were to close. These two residential homes have been part of a public consultation to consider the future of a number of services provided by the London Borough of Newham.
Full regard has been had to the requirements of the Equalities Act 2010 and proper regard has been had to the nature and extent of the duties owed by it and the development of the definition of the duties owed, so far as is appropriate, under cases on predecessors legislation.
The target group involves all permanent residents living in these two homes all of whom are older men and women aged 65 years and over, assessed as having social care needs.
The EqIA is a way of estimating the likely equality/diversity implications of the possible closure of the two residential homes, on the current permanent residents. It will determine whether or not the impact or effect has a negative, neutral or positive impact on some groups or individuals.
In summary the assessment in relation to the following protected characteristics is that:
1 Socio economic disadvantage
There is no equalities impact on residents – Neutral impact
2 Gender
There is no equalities impact on residents – Neutral impact
3 Age
There is a positive equalities impact on residents – Positive Impact
4 Disability
There is a positive equalities impact on residents – Positive impact
5 Ethnicity
There is no equalities impact on residents – Neutral impact
(although this is perceived by families to be negative)
6 Religion (EA 2010 s10)
There is no equalities impact on residents – Neutral impact
7 Sexual Orientation
There is no equalities impact on residents – Neutral impact
5. Legislative Considerations
The following section provides more detail and examples of our approach to considering our obligations under the Equalities Act 2010, and how we have taken in to account clarification and learning from recent rulings. Our key findings and recommendations and action are set out in sections 7 and 8.
149 Public sector equality duty and due regard
(1) A public authority must, in the exercise of its functions, have due regard to the need to—
(a) eliminate discrimination, harassment, victimisation and any other conduct that is prohibited by or under this Act;
(b) advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it;
(c) foster good relations between persons who share a relevant protected characteristic and persons who do not share it.
In carrying out due regard to the above the project team has met with residents, their families and friends individually, in groups, in friendship groups and any other way identified by residents and with advice from independent advocacy. The project team is made up of senior managers and qualified social workers, all of whom are aware of and deliver non discriminatory practices. The project group purposefully explored the option of friendship groups and cultural groups sharing their thoughts on any future accommodation and support options should the homes close. This opportunity enabled and will enable residents to maintain relationships and cultural practices that are important to them if the homes do close. The project group helped to facilitate communication between residents/ families and Newham’s external providers to explore meeting the group’s needs. The project team in carrying out its duties fostered a trusting supportive relationship with all residents and will continue to do so.
(2) A person who is not a public authority but who exercises public functions must, in the exercise of those functions, have due regard to the matters mentioned in subsection (1).
The project team, in the course of its work, has communicated its responsibilities to the Equalities Act 2010 to all of Newham’s external providers and will continue to do so.
(3) Having due regard to the need to advance equality of opportunity between persons who share a relevant protected characteristic and persons who do not share it involves having due regard, in particular, to the need to—
(a) remove or minimise disadvantages suffered by persons who share a relevant protected characteristic that are connected to that characteristic;
(b) take steps to meet the needs of persons who share a relevant protected characteristic that are different from the needs of persons who do not share it;
(c) encourage persons who share a relevant protected characteristic to participate in public life or in any other activity in which participation by such persons is disproportionately low.
In carrying out due regard to the above the project team have ensured that all opportunities to support and consult with residents in ways that are most appropriate have been taken. The project team has used a variety of methods to communicate with residents and where appropriate used interpreters, for example. The project team has communicated information in a variety of ways including but not exclusively in easy read, Question and Answer sheets, in group meetings and individually. When an individual’s protected characteristic prevents or limits participation, all steps to minimise this have been taken using the above methods plus through one to one independent advocacy. Where people lack capacity, we will allocate an Independent Mental Capacity Advocate (IMCA) in line with the Mental Capacity Act 2005.
(4) The steps involved in meeting the needs of disabled persons that are different from the needs of persons who are not disabled include, in particular, steps to take account of disabled persons' disabilities.
In carrying out due regard to the above the project team has ensured that when necessary support has been provided to enable maximum participation in all communications with residents. The project team has been mindful if residents’ routines, characteristics, and personalities, all of which can be affected by an individual’s disability (in this case, dementia) where a resident has shown to be lacking capacity to make a decision regarding a change of accommodation and who has no appropriate person to advocate for them, the services of an Independent Mental Capacity Advocate (IMCA) has been sought. The project team will use information gathered by the IMCA to inform a decision, in this case a change of accommodation (if this is required should the home close, or be longer appropriate to that individual’s needs).
(5) Having due regard to the need to foster good relations between persons who share a relevant protected characteristic and persons who do not share it involves having due regard, in particular, to the need to—
(a) tackle prejudice, and
(b) promote understanding.
In carrying out due regard to the above the project team has ensured that they have expressly acted in the individuals’ best interest whilst taking into account the opinions of families and friends. The project team has sought to ensure that any persons involved in a resident’s accommodation and support have an holistic understanding of the person including which disabilities are responsible for which behaviours and which behaviours are products of an individual’s personality. This information has allowed for support planning that eliminates prejudice based on person’s behaviour.
(6) Compliance with the duties in this section may involve treating some persons more favourably than others; but that is not to be taken as permitting conduct that would otherwise be prohibited by or under this Act.