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ITEM EX9 - ANNEX 1

EXECUTIVE - 10 DECEMBER 2002

HOMES FOR OLDER PEOPLE REDEVELOPMENT PROGRAMME

Report by Director of Social & Health Care

 

OBJECTIVES AND KEY ISSUES

  1. We need to maintain, or increase, the supply (capacity) of care homes.

    • Oxfordshire has 92.4 beds for every person aged 75+, but the national average is 123 per thousand aged 75+. This leaves Oxfordshire approximately 1,166 beds below the national average.

    • Oxfordshire has about 3,636 registered beds (2,023 residential, 1,613 nursing) of which 1,578 (43%) are purchased by social service/pooled budget. Most of the 57% of beds not purchased by the state are at "unaffordable" fee levels.

    • The relative shortage of capacity leads to higher fee levels, longer waiting lists and, in some cases, more hospital "bed blocking".

    • If more independent homes close the above pressures get worse. Therefore, our strategy is to "build capacity" and secure it by block contract agreements.

    • Population projections suggest we require a further 1,344 beds by 2021 just to maintain the current per capita supply.

  1. Residents requiring care homes now have more extensive needs and/or nursing needs. Care homes therefore need to be "fit for purpose".

    • More older people are helped to live at home for longer periods, therefore have greater needs when they enter care.

    • Larger, preferably en-suite rooms, are required to care for residents in wheelchairs, who need hoisting or nursing care. Approximately 200 OCP rooms are too small (below 9.3sqm) for these purposes and the National care Standards Commission have indicated they cannot be used for Band 2 and 3 residents. We are therefore buying beds (average £440 per week) which do not meet our strategic needs now or in the future.

    • There is a shortage of nursing beds in Oxfordshire and nearly all are privately operated. The City and South have particular shortages. This has a direct impact on hospital discharge waiting times and the possibility of future "fines" for bed blocking.

  1. We need to reduce double/shared rooms.

    • Oxfordshire Social Services purchase more shared rooms than most other local authorities. This hinders our ‘star ratings’ and performance assessment. Double rooms are generally unpopular and difficult to fill.

    • Most of our double rooms (172) are with OCP. By 2007 the redevelopment programme will have removed this problem.

  1. We need more beds for residents with serious mental health needs and "challenging behaviour".

    • Our strategy requires 60 to 100 more of these beds. Many patients waiting in hospital have these needs, but there is limited provision.

    • OCP are assessing the service needs of these residents. The redevelopment programme gives us the opportunity to plan for such services in new "fit for purpose" buildings.

  1. We need to look at alternatives to residential care and provide rehabilitation for those who can return home from hospital.

    • Our strategy plans for 180 very sheltered housing units by 2005. These are seen as a popular alternative to "low level" residential care. The OCP redevelopment will provide one third of our requirement.

    • Intermediate Care aims to provide a means of helping people move from hospital to home quicker. We are piloting 12 of these beds with OCP and could add to this as new homes are developed in detail.

  1. We need detailed data on demand and supply to plan our strategy.

  • The redevelopment working group has produced ‘purchasing grids’ which map the local population, care home supply and price availability. These grids have also been subject to local testing with care managers. The redevelopment proposals have been based on these local analyses.

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