Agenda item

To receive and consider the reports of the Head of Scrutiny and Member Development and the Director of Adult Social Services to facilitate the Adult Social Care Scrutiny Board Inquiry into the Future if Residential Care Provision for Older People in Leeds

The reports of the Head of Scrutiny and Member Development and Director of Adult Services introduced the Board’s Inquiry into the Future of Residential Care Provision for Older People in Leeds.  The reports outlined the timetable for the Inquiry and submission of evidence. 

The Chair welcomed Sandie Keene, Director of Adult Services and Dennis Holmes, Deputy Director, Commissioning to the Meeting.

It was reported that the Residential Care strategy was one of the key issues for adult social care in Leeds over the next 5 to 10 years and there was a need to create a service that was fit for future needs.  In response to concerns regarding the use of percentages in the report it was advised that the accompanying presentation to the report would show projected figures.  Members were also advised to inform the Director of Adult Social Services with any ongoing cases where problems had occurred with the provision of residential care.

The Board was given a presentation on long term residential care for older people in Leeds.  The first part of the presentation focussed on the following areas:

• The National Social Care Context – personalised approach,, support in own home, control of own care, work with NHS colleagues, financial and demographic pressures, how to shape services
• Current Policy Context – What can be offered in future? Choice and control for individuals needing care
• Demography – Projected Population Growth and Dependency, there would be an estimated 33% increase in the older population of Leeds by 2029
• Benchmarking Comparisons – Leeds had an average demand in comparison to other Yorkshire and Humber authorities which was also reflected on a national basis
• Demand for Housing Options and Services to Maintain Independence – Fewer people were requiring residential care due to differing options available such as lifetime housing and extra care housing; promotion of independent living; personalisation and the use of direct payments.
• The Local Picture and Expected Numbers of Beds for Future Services – It was reported that there was currently a large number of void beds which equated to the total of 1.5 care homes.  It was predicted that the number of local authority commissioned residential care beds would fall from 2,500 to 850 by 2029.
• Facilities and Supply of Residential Care in Leeds – Members attention was drawn to maps which showed the locations of residential care homes across the city.
• Implications for Local Authority Residential Care – expected changes to patterns of use, market competition, more demand for personalisation and people being cared for at home

In response to Members comments and questions, the following issues were discussed:

• The forecast reduction in provision of residential care in contrast to the increasing elderly population.
• Provision of end of life and palliative care.
• Respite care and facilities for carers to support their families whilst in respite care – it was reported that new provision would enable carers to stay with relatives during respite care.
• Sheltered housing – provision of wardens and activities for residents.
• Those who received care from families and friends and were not accounted for by the care system.
• Concern that respite care was used as an alternative to long term residential care – it was reported that respite care was used to enable people to remain independent and in their own homes for as long as possible.

The Board was given a further presentation, this focussed on financial frameworks, the following issues were highlighted:

·  Rising financial requirements of existing public sector residential homes – staffing costs, registration and regulation issues, need for capital investment.

·  Cost of void beds

·  Lack of opportunity for capital investment in public sector residential properties.

·  Unit cost comparisons with the private sector.

In response to Members comments and questions, the following issues were discussed:

• It was felt that current arrangements for public sector residential care would not remain sustainable in the long term, particularly in the light of significant budget reductions and reduced future demand.
• Support was available for those who would be placed into private sector residential care.  Financial assessments were the same whether people went into public or independent sector care.
• Fire prevention works at existing homes would be carried out within the current capital programme.
• It had not been proposed to close any of the existing residential homes.  There was a need to review future provision and alternative arrangements.
• Quality of care – this was overseen by the Care Quality Commission (CQC) and it was reported that good quality care was provided by both the public and independent sectors in Leeds.
• Independent sector homes had more modern facilities and required less updating and were therefore able to provide a cheaper unit cost for services.
• Provision of intermediate care.
• Partnership working with the NHS.
• The reduction of people requesting permanent residential care was due to the success of alternative care packages that had allowed people to remain in their own homes longer and other housing options such as sheltered and extra care housing.
• Geographical issues – these would be considered as part of the residential care strategy and take account of the demographic information and predicted requirements.
• The need for Elected Members to be involved in consultation.

The Chair thanked Sandie Keene and Dennis Holmes for their attendance,

RESOLVED – That the report and discussion be noted in line with the Inquiry into the Future of Residential Care Provision for Older People.