We will be using this blog to provide weekly updates on the Residential Services consultation which started on December 1st 2011 and will close 29th February 2012. You can find out more about the consultation and read related documents on our consultation finder database.
Bristol has around 140 residential care homes, 11 of these are run by Bristol City Council. Our residential care homes for older people were reviewed in 2008 with recommendations to close all council-run services and replace them with a smaller number of resource centres and specialist dementia units. Work on this plan was put on hold in 2010 due to falling property prices and rising staff costs.
This consultation looks again at how services can be improved by developing alternatives to long-term residential care and making best use of all care homes in the city, including the independent sector.
We are asking for the views of residents, their families, friends and staff on the future of residential services in Bristol. This will help us decide how we can continue to improve services within the difficult financial environment that now exists.
Residential Services Consultation information leaflet
Have you filled out our residential services consultation questionnaire?
We are speaking directly to residents, their families, groups and organisations representing older people, staff and trade unions to find out their views at a series of meetings over the next few weeks.
Residential Services Consultation Timetable of events
This week we have been meeting with staff, residents and families at:
- Coombe – a residential home in the North of the city specialising in the care of people with dementia.
- Greville – a residential home in the South of the city specialising in the care of people with dementia.
Comments and issues raised this week include:
- Concerns about people living in the community being isolated. Residential homes provide opportunities to make friends and socialise.
- Concerns about negative press reports on independent sector care homes and a lack of trust in monitoring and inspections.
- A comment that the quality of care in a residential home is more important than the physical environment.
We will keep you updated on the outcomes of the meetings on this page.
Please respond to the consultation using the questionnaire.
If you have comments or questions about the information in the weekly updates, please join the discussion.
Councillor Rogers
It would be easier to judge any new proposals if we could have some information on past actions. So could I have answers to the following.
How many service users were in the Bush Centre when it closed.
How many were offered personal care packages and how many accepted.
How was the level of remuneration calculated. What would it have been for the most severe cases of need.i.e. those who have to have 24 hour care.
I can understand that some clients who have only minor learning difficulties may be glad to cope with the complexities of administring a care folio, but my experience of the Bush is that many have extreme learning difficulties and would not be able to decide for themselves. How are these cases resolved.
James
Thanks James
I will ask officers to respond on the specific questions.
I understand that the needs assessment was updated for every person that attended the Bush before any changes were made to care arrangements.
The “care folio” / “care plan” would follow from that needs assessment, and involve service user input where possible. Additionally, families, carers and of course staff would have input into that care plan.
Finally, there would be a dialogue on how the plan would be managed. The majority are managed by the council still, or by the voluntary sector, but about 10% of service users or families manage their own budget (just over 600 when last I heard)
When the Bush closure was announced in September 2008 there were 107 service users. All services users were reviewed by a team of practitioners to determine their needs and interests and this was completed in May 2009. At this time the number of service users had reduced to 97. The reviews identified four groups of people:
* People who require a building base and specialist facilities for complex and significant personal care needs although this is not intended on the whole to be a buildings base for activities. (20)
* People who are able to lead relatively independent lives with minimal support and training (know as the Moving On Group) (16)
* People who require dedicated support to access community activities and to plan their day-to-day programme. (20)
* People who are in residential care and attended the Bush for day activities (37)
During the process four moved to alternative services
All service users received new care plans once alternative suitable services were identified to meet their needs. At the time none chose to take a direct payment but opted for a managed budget instead. The third group who access community activities have generally reported that they are very satisfied with their new service and many are reporting a greater range of community activities that are now accessible.
As to the amount of budget this will depend on their assessed individual eligible needs and therefore it is not possible to specify as it depends on a number of different factors.
Thanks Jon for some of the replies .
1.Barbara Janke the leader of the council announced that £50 million will be borrowed to support Bristol will Social care Adults get a % of this ?
2. Redfield lodge is a 40 bedded home for dementia services , a new dementia service is also been piloted in homecare .Why is Redfield lodge still running on agency staff since March 2010 even though Homecare staff have been relocated and the vacancies not filled . ( Should we not have a bank staff structure that we can use a pool of staff for both homecare , dementia and residential care like the NHS has .)
3. Why cant residents be funded from central government (ie income support )like the poeple in the community , to take the burden off local governments where each local government has different prioriies and the elderly are been targeted .yet again ?
4 Why cant all res homes, pwd’s and nursing facilities be non profit making and the standards not be compromised by profit hogging companies ?
1.Barbara Janke the leader of the council announced that £50 million will be borrowed to support Bristol will Social care Adults get a % of this ?
The £50m Capital investment in Bristol’s Future is one of the Liberal Democrat budget proposals. The budget debate is on 27th February.
12% (£6m ) is earmarked for investment in Extra Care Housing and Aids and Adaptations to support people in their own homes.
The remainder is for school places (£20m), improved transport and highways in Bristol (£16m), a new pool for East Bristol (£6m) and a recycling centre for South Bristol (£2m).
2. Redfield lodge is a 40 bedded home for dementia services , a new dementia service is also been piloted in homecare .Why is Redfield lodge still running on agency staff since March 2010 even though Homecare staff have been relocated and the vacancies not filled . ( Should we not have a bank staff structure that we can use a pool of staff for both homecare , dementia and residential care like the NHS has .)
My understanding is that the home care staff have not all been relocated.
Last I heard was the majority of the 250 staff have agreed next steps, but some have not. We are determined to offer all our excellent home care staff the opportunity to continue to work in our care services if possible. We don’t want to lose their skills, experience and expertise.
The review of day services and residential services may also lead to further changes, so it is possible that officers are trying to preserve further future flexibility.
This might be a good topic for direct discussions on details between officers and the trade union representatives.
To add to Councillor Rogers response to Q2 30/1/12 asked by Charmaine, the last few members of staff that are moving from the Continuing To Care (CTC) service are currently being dealt with, after which other vacancies can be looked at for recruitment. Vacancies at supervisory levels have already been advertised as transfers of staff from CTC at this level have all been completed.
3. Why cant residents be funded from central government (ie income support )like the poeple in the community , to take the burden off local governments where each local government has different prioriies and the elderly are been targeted .yet again ?
We are certainly not “targetting the elderly”. We are trying very hard to protect front line services, and indeed we are expecting to deliver more services this year than last year, and more services next year than this year.
We have a growing population of older people and we will need more services not less.
On the specifics about income support, I don’t know the rules around this. I will ask officers to respond.
To add to Councillor Rogers response to Q3 30/1/12 asked by Charmaine, currently residents in care homes who are funded by their local authority are financially assessed to make a contribution to the cost. National benefits, state pensions and any private income they receive are taken into account in this assessment.
The funding of long term care, is being considered by central government following the publication of the Dilnott Report.
4 Why cant all res homes, pwd’s and nursing facilities be non profit making and the standards not be compromised by profit hogging companies ?
I presume because people want choice.
They choose what services they want. There are many excellent “not for profit” care services, and also many excellent private providers as well.
To add to Councillor Rogers response to Q4 30/1/12 asked by Charmaine, the local authority officers and staff work within the mixed market that exists, which includes our own provision, private profit making businesses and not for profit organisations. The focus when arranging services for people is to ensure apropriate, quality services that are value for money
1.What saving will the council be making by closing one of the 11 council run facilities in Bristol ?
2.Why is adult care being used as a political football , at the 2008 residential futures we were told that the standards were not right ( but the economy took a dip and we fell into a receesion so the property market halted the sales of valuable property been sold !)?
3.Hollybrook was shut with very littloe notice to all concerned with immediate effect as to refurbish the building and sell off the other two homes ie GREVILLE and Maesnoll , why is Hollybrook standing as a white elephant now that could have brought in revenue of _+ £4million a year and that would be a earnings of £12 mill in the time that it has stood vacant ?
4 .How much has it cost in Senior management wages to run the residential futures projects since 2005 .Why do we need so many managers consulting on one project .
5.Who commissions the admissions to residential/PWD’s for Bristol City Council , why in the last few months whilst home -care staff were been redeployed were the vacancies not filled in the EPH’s ?Most homes were running on 60% capacity why was theer not a need to cut back on vacancies(agency staff then .
6.What is the breakdown that makes BCC £34 ph so much more expensive to run than the private sector £17 can we have a breakdown so that we can see where all the expenses are ?
7.Which of the homes that the council currently use are owned by the council and which are rented property?
8. What is the next 5 year strategy for the rest of the other homes that will be saved ?
9.What support is there in place for the public to access if they have problems with getting info about Care services besides CQC ?
We had drive about PUTTING PEOPLE first in BRISTOL but it obviously is now PUTTING money first then people after , because the vulnerable are been targeted first .
Thanks Charmaine. You raise a number of important issues.
Below are my own, off the cuff, answers.
I’ll answer the ones that I think I can, but will ask officers to respond to your more specific and technical questions 3. , 4. , 5. and 7..
You conclude by saying, “We had drive about PUTTING PEOPLE first in BRISTOL but it obviously is now PUTTING money first then people after , because the vulnerable are been targeted first .
I understand your concern, but we are definitely putting “people” before “money”. Not only is it the right thing to do, but is also required by law.
Some councils have tried to limit care to those with “critical” needs. Bristol has chosen not to do that.
In fact, we are putting money into prevention services, advice services, advocacy services and carers services as well as standard care services.
We recognise that tackling problems early can save money later on. As a recently retired GP, this is second nature to me!
Jon
1.What saving will the council be making by closing one of the 11 council run facilities in Bristol ?
That would vary from site to site. The condition of some of our buildings is poor, and may need new boilers, new windows, new rooves, redecoration etc. Also, not all are owned by the council, so there may be a rent charge.
Feedback so far seems to indicate that having a base is important for many users, families and carers, but it is the people that are most important.
People include regular, friendly, experienced, well trained staff, friendship groups, and open to carers and families.
To add to Councillor Rogers response to Q1 26/1/12 asked by Charmaine, the actual amount saved would also depend on other factors such as how many places the home provided, occupancy level, re-deployment of staff, saving from not needing to spend on refurbishment.
6.What is the breakdown that makes BCC £34 ph so much more expensive to run than the private sector £17 can we have a breakdown so that we can see where all the expenses are ?
The figures you refer to are the average costs of the discontinued Continuing To Care CTC in house/council run home care service (£34 per hour) compared to the average cost in the independent and voluntary sector.
The huge difference in cost has been repeatedly investigated over the last 5 years, most recently at the cross party Resource Scrutiny on 16th December 2011. The report is here… http://bit.ly/bccctc1
8. What is the next 5 year strategy for the rest of the other homes that will be saved ?
Council officers will produce a report on residential care in Bristol for the March 29th Cabinet meeting. That will include information on how residential services could change and make one or more recommendations for Cabinet decision.
I would expect those recommendations to cover all council run homes for at least 5 years. I would also expect some assessment of other current and future residential provision in the city, including Extra Care Housing ECH.
The Liberal Democrat proposed budget for 2012/13 was confirmed yesterday, and includes £5.5m for ECH housing, as well as an additional £500K for aids and adaptations.
The Full Council, with councillors from all four political parties, will vote on that budget on 28th February 2012. The Liberal Democrats do not have an overall majority although we are the largest party on the Council.
Adding to Councillor Rogers response to Q8 26/1/12 asked by Charmaine, in ensuring that the chosen strategy provides sufficient residential provision to meet people’s needs it will also take account of the level, type and cost of independent provision.
9.What support is there in place for the public to access if they have problems with getting info about Care services besides CQC ?
The best and easiest local source of help is Care Direct on 922 2700 or email adult.care@bristol.gov.uk
Happy to hear other comments and try and answer any other questions.
Jon
In response to your point 2, Charimaine: The strategy which was agreed through the Residential Futures project was designed to ensure the homes the Council ran would be of an acceptable standard and could be maintained as such. The decision to pause the work was made for financial reasons as the subsequent national financial crisis significantly reduced the value of the homes which were identified for closure and sale, in order to finance the refurbishment of the remaining homes. This meant the plan was no longer financially viable.
Response to point 3: The decision to close Hollybrook was taken in 30 July 2009 by Cabinet following a 3 month consultation. The home to close and reopen as a home for people with dementia, with residents from Greville moving there. However, the Residential Futures Programme was paused by Cabinet in June 2010 due to the economic downturn. A three year plan for residential services will return to Cabinet in March 2012 and this will include a decision on Hollybrook.
Response to point 4: Dedicated Council staff worked on the Residential Futures project for approximately 2 years; (approx cost £105k). Input from other senior managers occurred as part of their managerial role
The programme of consultation meetings that is currently taking place is intended to act as a briefing and explanation of the whole change programme that is underway as well as consulting specifically about residential services and day opportunities. This is a major programme which covers all aspects of Bristol’s social care system. The involvement of all senior managers reflects this and also indicates it’s importance and significance.
Response to point 5: It is social workers who make the placements.
Homes are encouraged to staff shifts according to the number of residents in place , however, an adequate number of staff is always needed. Bristol is working to reduce the number of agency staff employed.
I have been trying to attend as many of the consultation meetings as possible.
The meetings are happening right across the city concerning both residential care and day opportunities. The meetings have involved service users, families, carers, staff and interested residents and organisations. A number of ward councillors have also attended.
All seem to have been well attended, even the meeting at the Bristol 600 club on Saturday morning!
So far, I have had the pleasure of visiting Brentry House (9th), Bowmead (10th), Dovercourt Road (11th), Broomhill (12th), Coombe (16th), Hayleigh – ( 18th – wrong day, but shown around and met some staff and residents!), Bristol 600 on 21st and off to Maesknoll today.
Every one has been friendly and welcoming. Each have their own character. Each have strengths and weaknesses, and I am impressed at how open staff are to possibilities.
These reviews are looking at the total provision of care services across the city, not just our own council run services and officers will be bringing recommendations to Cabinet at end of March.
Jon