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ITEM EX15

EXECUTIVE - 18 MARCH 2003

PROPOSALS FOR THE REPROVISION OF STOWFORD HOUSE HOSTEL FOR PEOPLE WITH LEARNING DISABILITIES

Report by Director of Social & Health Care

1. A report was presented to the Executive on 26 November 2002, outlining the progress that had been made in moving residents from the hostels managed by Oxfordshire County Council into ordinary housing in the community. It was agreed that Marywood House would close. This happened in December, with the residents moving smoothly into houses, where they are settling down into a new way of living. The residents have all confirmed they are very happy and would not want to return to Marywood. No one has indicated that they want to return to the hostel.
2. In that report, Members’ attention was drawn to the need to consider plans for the future of Stowford House, the last remaining hostel.
3. The purpose of this report is to outline the options for the future of Stowford House and its current residents, with costs and timescales. A way forward is proposed taking into consideration a wide range of issues. This will enable residents and their families to make their choices over a period of time, and within a cost efficient framework for the Council.

Current Position

4. The Stowford House service consists of three elements – Stowford House itself, three small houses on the same site and Fettiplace Road consisting of two houses joined together in Marcham about three miles away.
5. Fettiplace Road has been run as a small registered unit with 6 places. It was originally two houses, made into one, and managed as a satellite of Stowford House. At present work is underway to convert this back into two separate houses, which will then be sold to Oxford Citizens Housing Association under arrangements similar to other properties across the country. The Council gains 50 year nomination rights, and the residents become tenants in their own home, attracting Supporting People funding. This work will be completed by the end of March and there will be provision for 7 people in these two houses.
6. At the front of the Stowford site are three, separate, small houses, where 9 people currently live. These will be sold to Vale Housing under the arrangements outlined above. They will then refurbish them so they become ordinary homes in the Community. The residents will become tenants and attract Supporting People funding. Care will continue to be provided from the Stowford House staff team. All these arrangements have been made on the basis of care planning with residents and their relatives.
7. The Stowford House main hostel has 23 places, with 1 of these in a self-contained flat. At present the Fettiplace residents are staying there during the refurbishment, but when they leave, there will be 17 residents remaining. Of these, 8 people are around 60 years or older, and some have always lived in an institutional setting. Care planning work has taken place with all residents and their relatives. The current position is that 9 residents want to move, 8 are uncertain and have not yet made a definite decision either way. It must be recognised that these people probably want to remain in Stowford, as it is, rather than any hostel environment. As other residents want to move on, this will not be possible, so the way forward must balance the needs and wishes of both these groups of residents.
8. Currently there are 2 housing opportunities in Abingdon which will be allocated to us. They are new buildings and will be eligible for Supporting People funding. There are 5 places (plus 1 staff sleep in) in separate flats, and a house for 3 people (plus 1 staff sleep in). These will be available early 2004. When all the moves have taken place, this leaves the 8 residents who currently want to remain at Stowford.

Stowford House Property Issues

9. A feasibility study was conducted on Stowford House, taking into account National Care Standards. This indicated we would need to spend £200,000 to £250,000 to provide 12 places which are up to this standard. However, new guidance was issued in February which has been checked with the local NCS Area Manager. As the total average combined bedroom and communal living space is above 14.1 sq. metre per resident, it would be possible to continue to run Stowford without any additional Capital expenditure, other than Health and Safety requirements.
10. There are immediate Health and Safety issues to be addressed. These are:

1. Installation of low temperature radiators
2. Water temperatures
3. Kitchen
4. Driveway
5. Electrical circuits

11. It is difficult to estimate the exact revenue cost implications of developing Supported Living due to the additional income generated from Supporting People funding. It is possible to apply for further funding for 2003/04 under Pipeline Schemes, where the new provision has been planned but not implemented. The gross unit costs of Supported Living places is greater than gross hostel unit costs, but the additional income from Supporting People funding and Independent Living funding makes this a more cost effective solution overall.
12. The current gross unit cost of Stowford is £21,400 and the estimated unit cost of running a 12 place hostel is £33,550 with no possibility of additional income via Supporting People. The long term revenue costs of running a small hostel therefore need to be considered, rather than capital costs, if we were to continue to run Stowford in the long term as a small hostel.

Other Issues to be Considered

13. Information from Care Management indicates that over the last five years, no person coming new into the Department’s accommodation services has requested a hostel placement.
14. Currently when an emergency arises, arrangements are made with Adult Family Placement, a hostel vacancy with an existing provider, including the internal service, or emergency places in respite units. Care Management have identified the need for further planning to meet emergency needs, and will need to include this in future budget planning.
15. The current strategy for older people with a learning disability is to support them in their own home, in their own locality. Should the need for residential care arise, then arrangements will be the same as for other older people, with additional support.
16. If we were to move towards an accommodation service that is completely Supported Living, concerns have been expressed about the management of vacancies. Care Management hold a central vacancy list, and arrange for vacancies to be taken up as they arise. This has worked well for the internal services and vacancies are notified and filled. However, changes may arise due to further National Care Standard registration. From 1 April 2003, all domiciliary services, including Supported Living, will be registered under a new set of Regulatory Standards. As vacancies arise, which are for tenancies of the Housing Association, there will need to be further work to clarify the agreement between the Housing Provider and the registered Care Provider, as to how those are filled. If there are any implications arising from this, they will be considered as part of budget planning for learning disability services.
17. This report has been shown to the Chairman of the Friends of Stowford who has discussed it with the relatives. They are pleased to have been involved and that residents will be able to choose. They have concerns about the services for older people and emergencies, and these will be discussed further with them.

Proposal

18. In arriving at a proposal for the way forward, the above issues have been considered, together with the needs, present and future, of individuals, Registration Issues, efficient costs, all within the national strategy direction of Valuing People.
19. At present there are some uncertainties in relation to emergencies, and the implications of the new NCS Registration for Supported Living Schemes. There are capital costs associated with Health & Safety, and loss of income from running a hostel rather than community based services
20. However, at present there are eight residents who want to move and another eight who either do not want to move or have not yet made the decision. Therefore it is proposed that we take a step by step approach, recognising that the final solution is not clear at this time, and depends on the needs and wishes of the remaining eight residents, and their families, which must be respected.
21. It is proposed therefore that:

1. Arrangements for Fettiplace, the three houses, and the new accommodation are completed over the next year.
2. The Health & Safety work is prioritised and a bid made for capital funding to do any immediate work to remove Health & Safety hazards.
3. Care Management review the longer term strategy for emergencies and vacancy management with a view to ensuring efficient and cost effective arrangements are in place.
4. Care Management continue work to support the remaining eight residents, including the appointment of an independent advocate.
5. No decision is made at this time on whether Stowford continues to run at 23 places, or less. This will be kept under review, as needs for emergencies, respite care etc. are reviewed, and as some of current residents move on, and care plans change, early in 2004.
   
   

Financial and Staff Implications

22. This proposal does require some additional capital expenditure on Stowford House, in the short term, to deal with immediate Health & Safety issues. This will need to be considered and prioritised as part of the overall Capital Programme. However this programme of hostel closure has already produced a Net Capital gain to the Council of £1.4 million. In addition the receipts for Marywood, Fettiplace and the three houses have yet to be realised.
23. The revenue consequences are more difficult to evaluate. However Supported Living placements will, in the immediate future at least, attract Supporting People Funding. The detailed Unit Costs for a twelve place hostel will need to be taken into account in the final decision on the future of Stowford.
24. The staff currently employed in the hostel will work with people in Supported Living placements. This transition has been difficult for some staff but once they have gained skills and confidence experience has shown that most prefer to work in Supported Living.

RECOMMENDATIONS

25. The Executive is RECOMMENDED to approve the proposals as set out in this report for the redevelopment of services provided at Stowford House.

CHARLES WADDICOR
Director of Social and Health Care

Background papers: nil

Contact Officer: Jean Carr, Assistant Director, Tel – 01865 815565, Alan Sinclair, Operations Manager, Specialist Services, Tel - 01865 854481

March 2003

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