Council Sets out Modernising Agenda for Care for Older People
The Highland Council held a public meeting at Caol Community Centre, Fort William, on Monday night to outline its plans for modernising care for older people. More than 150 people attended to listen to presentations from representatives of the Council and NHS Highland and have their say.
Mr Arthur McCourt, Chief Executive of The Highland Council, told the meeting a strategic review of community care services for older people in Highland in 2001 highlighted the need to modernise services to meet the aspirations of older people, and to comply with the requirements of the National Care Standards and the Disability Discrimination Act 1995. Without significant change and major capital investment, many Council care homes would not be viable into the future.
It was estimated that the number of people in Highland aged 75+ would increase by 80% by 2024 with a projected increase in frail older people.
He said there was a pressing need to develop more community-based services, and for these services to be more intensive, such as home care at evenings and weekends. At present, largely because the Council has a greater part of its budget committed to residential provision than other Councils in Scotland, home care provision was less well provided for.
The Council provided 343 home care clients per 1,000 people over 65 compared to the Scottish average of 561 clients per 1,000 people over 65. Releasing £1 million from residential care for example, would provide an additional 1,700 hours of home care per week.
He also highlighted that independent sector care costs £405 per week per resident. The average cost of Council care is £754 per week per resident – a difference of £18,000 per annum per resident.
The Council provided for 1,471 care home places for older people. 80% of these places (1,185) are commissioned from the independent sector.
He said: “When people do come into residential care, we believe that they should be supported as far as possible in the same establishment, even when their needs change. People should not have to move home simply because they have an increased need for nursing care. This continuity cannot be achieved in residential care that is managed by the local authority. All possible contingency options have been examined. These include the Council building new homes, and operating refurbished care homes of the current size, or the larger size envisaged in this exercise.”
The Highland Council had embarked on a procurement initiative to identify independent partners to provide care home and nursing care services in Fort William, Grantown, Inverness, Muir of Ord and Tain.
The proposals for providing care home places are as follows: -
At Kingussie, the Wade Centre will be refurbished to become linked to housing with support for older people in Kingussie. Day care will continue to be provided at the Wade Centre for people who are assessed to need personal care to remain at home.
Mr McCourt said the cost of the Council continuing to provide these services through new buildings in the five locations would be £21.3 million in capital, and revenue costs of £5.8 million including loan charges of £1.5 million. Refurbishment and extension of the existing buildings, even if possible, would cost £15.4 million and revenue costs would be higher by a further £3 million, mostly because of decant costs. Refurbishment without extension would cost around £7.4 million in capital, with only minimal change to the revenue projections.
The procurement route has been identified as the only option that would meet the required standards, providing funding for capital costs, delivering higher intensity and nursing services, and releasing the necessary resources to invest in home care.
Looking at the timescale progressing the procurement initiative, he reported that the Council intended long-listing bidders before the end of the year. The shortlist to three bidders was programmed for early in the new year and by the end of the year the new provider would be chosen.
Bill Alexander, Acting Director of Social Work, said Invernevis House was designed as a single large unit, and for a different sort of client group to the people who are in residential care today, or who will require care services in the future.
The Council was aware that service users speak positively of the service they receive there, and that the home was held in high regard within the community. However, the home did not meet the necessary standards for:
These standards could not be met by the building in its current form. Without action to address this, Invernevis House would have to close.
Because of this, in May 2004, the Council agreed to refurbish Invernevis House, and included it in the capital programme, with work scheduled to take place by the end of 2006. However, the necessary options appraisal exercise found that no decant options were available for residents in the Fort William area, thus making the refurbishment impossible without forcing people to move a considerable distance away. Hence in November 2005, the Council agreed to the inclusion of Invernevis in the established procurement process.
He said the Council had made clear in the procurement process, that the preferred option for Fort William is a new, purpose built home. This would fully meet care practice, regulatory, fire and disability requirements.
“The residents will not move from Invernevis House until the new home is ready, ensuring we avoid the significant disruption to the lives of residents and families that arise from decant arrangements. We will take all steps to ensure consistency in staffing and care provision, by ensuring that any new provider honours the terms and conditions of the staff who transfer.
“We will commission 30 residential and nursing places in the home for at least the next 15 years. We will require that the service meets all care standards, and that it will be fit to cater for people with dementia in line with recognised good practice.”
Residents would move to a modern, purpose-built facility, with:
The Council would intend to continue the day care provision, but also, seek to release funds that would allow the development of enhanced and intensive home care provision in Fort William, to support people better and for longer in their own homes and communities.
He concluded: “The new home will give residents the quality of environment that they deserve in their later years, and will provide staff with the modern facilities that they want, to enable them to provide the highest possible standard of care to Lochaber’s older people.”