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ITEM EX9

EXECUTIVE - 10 DECEMBER 2002

HOMES FOR OLDER PEOPLE REDEVELOPMENT PROGRAMME

Report by Director of Social & Health Care

Introduction

  1. The Executive in October considered proposals for the redevelopment of 5 of the homes for older people that were transferred to the Oxfordshire Care Partnership, and an option appraisal process for 3 homes that were not identified for redevelopment. This paper reports back on the consultations that have been taking place on these proposals, and on the financial and other evaluations that officers have been undertaking on the redevelopment proposals.

  2. The objectives for the transfer are, in summary, to ensure that the there is not a reduction in the number of beds available to people in Oxfordshire, that there is an increase in the proportion of beds that can meet the needs for nursing and high dependency care, and that there is redistribution of places to the south of the county to have a more equitable spread of provision. The redevelopment programme is integral to how these objectives are reached.

  3. Annex 1 sets out these objectives in more detail, and identifies the key issues that lie behind them for the Social & Health Care Directorate and the directorate’s NHS partners in the pooled budget arrangements for the purchase of residential and nursing home care.

    4. Consultation Process

  4. There has been a substantial programme of consultation this Autumn. This has comprised the following.

  5. Sixteen public meetings: These comprised eight meetings in care homes and eight public meetings at local community venues such as town and village halls. Attendance has varied, with public interest greater in the three homes recommended for further option appraisal. The table in Annex 2 shows the approximate attendance (including presenters) at each meeting. In total 250 people attended meetings in homes and 400 attended public meetings.

  6. All comments at the 16 meetings have been recorded and written summaries of each have been sent to the relevant care home, town/parish council and local county councillor. West Oxfordshire District Council have also been sent copies. Copies have also been made available in the Members’ Resource Centre.

  7. At each meeting County Council and Order of St John (OSJ) officers gave presentations with slides; written copies of the presentations (in large print) were circulated.

  8. Written information posted out: A consultation pamphlet, list of meeting dates, summary of proposals for each home and the 1 October Executive Report were sent in different combinations to over 500 addresses. These included: All OSJ care homes (with the eight most effected passing on information to all residents and staff); all district, town and parish councils; G.P surgeries in all effected areas; PCTs and other NHS Trusts; local voluntary organisations concerning older people.

  9. Written comments received: There has been a steady flow of correspondence with over 150 letters and emails sent (to date) to dedicated OCC freepost and email addresses. All are being acknowledged with a personal reply. Over half the correspondence are letters opposing any suggestion to close Langston House.

  10. Invitations to address specific meetings: This option was offered to a number of key organisations. However few have pursued this, as most appear to have favoured written replies or attendance at public meetings.

  11. Media coverage: The County Council has issued various press releases and letters to local media and newspapers in order to publicise the consultation programme. Officers of both OCC and OSJ have given various TV and radio broadcasts.

  12. Advocacy Service: The independent Age Concern Advocacy service within each home has provided useful comment on consultation methods. They have also attended most public meetings and have worked closely with residents in recording their views. A composite report from the Advocacy Manager was presented to the member/officer Homes for Older People working group. This report praised the consultation process and recommended that residents should continue to be kept informed.

  13. This report can only provide a broad summary of responses. However, it is clear that the consultation response has fallen into two groups: those involving the three West Oxfordshire ‘option appraisal’ homes, the other being the five ‘replacement’ homes. Each group is considered below.

    14. Consultation Responses

    Homes recommended for further ‘Option Appraisal’, at Chipping Norton, Milton Under Wychwood and Woodstock:

  14. General Comments:

    • There was strong opposition to the potential threat of closure from all groups.

    • Residents and relatives were very concerned about possibly having to move to an alternative home

    • Why have West Oxfordshire and rural/small town areas been ‘singled out’?

    • There was widespread support and motivation from the local community to engage in the option appraisal process and to find creative ways to "save our homes".

    • If the homes should close, where would local people go? Other independent homes are not affordable and the redeveloped Witan House, Witney will be too small.

    • Will the homes be ‘blighted’ by this uncertainty?

    • Some independent care home operators pointed out that they too had funding shortages and that the County Council should maintain a ‘level playing field’ between them and OSJ.

    • Whilst both OCC and OSJ officers were thanked for genuine and sincere presentations, and their limited resources better understood, they would be ‘judged by their actions’ during the option appraisal process.

  1. There has been continuing debate about who should be involved in the actual option appraisal process. The HOPS member/officer working group considered all views and agreed that the process should encompass three broad groupings:

    • An elected members steering group involving both County and West Oxfordshire District councillors

    • A strategic group of senior officers from OCC,OSJ, housing and health care providers to appraise options across all three homes, and

    • A local stakeholders group representing a wide cross-section of each specific community which would help generate proposals and respond to options.

  1. A number of specific comments were recorded and these are summarised in Annex 2.

    2. Homes recommended for replacement at Witney, Oxford (Rose Hill and Sandford on Thames), Bicester and Thame:

  2. General Comments;

    • There was general support for the new homes and the improved physical environment they will offer.

    • Most resident/relative questions concerned points of detail and reassurance (given at meetings) about ‘what it means for me’,

    • The removal of shared rooms and the inclusion of en-suite facilities were particularly welcomed.

    • There were a lot of site specific questions. Where will the new homes be and what will happen to the old sites?

    • Where is the money coming from and the additional staff/nurse recruitment?

    • Will the new homes be sufficient to meet demographic demands?

    • Will the bigger, 60 bed plus homes be too large and impersonal?

  1. There were further specific comments that are summarised in Annex 2.

    2. Overall Conclusions

  2. The overall conclusions from the consultation process are:

    • There is general support for the redevelopment of the four new homes to replace the five existing homes. Many residents and relatives showed real enthusiasm for the proposed improvements to accommodation. The interest of the general public (excluding relatives) has not been great, possibly because the majority accept this as ‘good news’ and have no further comment. There is a need however for OCP and the Orders of St John to continue providing information and reassurance to residents, relatives and staff as the new homes and locations develop.

    • In the three homes recommended for option appraisal there is a strong commitment to ‘save the homes’ amongst the local community, plus a high expectation that the option appraisal process will be real, comprehensive and transparent. The local community in each area is very keen to participate in the option appraisal process.

Key Development Issues

  1. The acquisition of appropriate sites is a critical component of the redevelopment programme. Work continues on the acquisition of sites in Bicester and Thame. The site for the redevelopments in Oxford City, on the Donnington Middle School site, was agreed at Council County in December 2001, and officers from the Social & Health Care Directorate and the Education Department are working on the area of the site that would be required for the home and the very sheltered housing development.

  2. A site for the Witney home, to replace Witan House, has also been identified in the Madley Park redevelopment. The Oxfordshire Care Partnership (OCP) are proposing that they acquire the use of this site through a long lease from the current freeholder, not from the County Council, as was the original model. This is to the Council’s financial advantage because it reduces the impact on the Capital Programme for Social & Health Care, but it does mean that the Council would not retain any freehold interest in a replacement home. This is not considered to be a fundamental problem. The consultation process has not given rise to objections to this site, but concerns have been expressed about transport links once the whole of the site is developed. There is not another site in Witney that would be available within the timeframe for the redevelopment programme, and no objections regarding the site have been raised by WS Atkins or Environmental Services. It is therefore proposed that agreement is given now to this redevelopment proposal for the Witney area.

    3. Financial Implications

  3. The agreement with OCP was based on a financial model that established that the services and the redevelopment programme that the contract requires are affordable and within the Council’s financial resources. The proposed redevlopment programme that has been consulted on differs in some significant respects from the ‘model’ redevelopment programme that was used in the financial model. This has meant that the financial model has had to be re-evaluated to allow the same level of assurance to be given as to the affordability of the redevelopment programme. This re-evaluation has been done, and the proposed redevelopment programme would appear to be fully affordable in terms of the financial model supporting the contract. The final evaluation of this will be reported to the Executive.

  4. The differences between the redevelopment programme and the assumptions that were made in support of the financial model also have implications for the Social & Health Care Capital Programme, and more work is required before a final evaluation of this aspect can be given to the Executive.

    5. Conclusions

  5. The redevelopment programme that has been proposed has been extensively consulted on. The redevelopments have been welcomed, and for the 3 homes for which there are to be option appraisals, a process has been put in place. Very considerable concern has been expressed in all 3 localities over the possibility that any of these homes will close. The option appraisal process will be directed at finding and evaluating all the possible ways that there could be for ensuring the continuation of services for older people in the localities in question.

  6. However, the evaluation of the financial issues is complex and still continuing. The final outcome of this work will be reported to the Executive, but at the time of writing it is proposed that the Executive agrees to the redevelopment programme, subject to the final financial evaluation being considered and agreed with the Executive Members for Community Care & Health and Children & Young People.

  7. Because of the leasehold arrangements that are being proposed for the acquisition of the replacement site in Witney, it is proposed that agreement is given to that development proceeding now.

    Supplement

    8. RECOMMENDATIONS

  8. The Executive is RECOMMENDED to

          1. authorise the Director of Social & Health Care to proceed with the redevelopment programme proposed for homes recommended for replacement at Oxford (Rose Hill and Sandford on Thames), Bicester and Thame, subject to the Executive Members for Community Care & Health and Children & Young People being satisfied as to the final financial evaluations on the affordability of the programme;

          2. agree the arrangements set out in the report for implementation of the proposed replacement for the home in Witney;

          3. note that a further report will be presented to a future meeting on the outcome of the option apparaisals for the homes at Chipping Norton, Milton under Wychwood and Woodstock.

CHARLES WADDICOR
Director of Social & Health Care

Background papers: Responses to Consultation

Contact Officers: Nicholas Welch, Assistant Director 01865 81 5714

Nigel Holmes, Service Manager 01865 854480

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