Agenda item

The future of Direct Care Homes for Older People


The Council owned and ran 23 residential care homes for older people which made it one of the largest local authority providers of residential care in the country. There were 11 other residential care homes ran by local authorities across the East Midlands Region. Each service was individually registered with the Care Quality Commission and inspected by them to ensure the required standards were being met. In 2018, detailed property condition surveys were commissioned in relation to a number of these homes, focusing on general building condition and electrical systems in the older homes. These reports were commissioned in the context of concerns that the ageing buildings were no longer considered fit for purpose and a concern for the state of the buildings given their age and the ongoing need to ensure the safety and wellbeing of residents both now and in the future. The Director of Adult Social Services advised Cabinet Members that an appropriate and rapid course of action was needed to mitigate the concerns raised and thereby ensure the ongoing safety of residents.


Significant maintenance, renovation and refurbishment needs were identified which included the requirement for arrangements to be made for the homes to be rewired by September 2022 in addition to significant refurbishment works. To complete these major works Adult Care was advised that there would be significant disruption to residents including the potential requirement for people to move out of their home for up to 40 weeks whilst the work was undertaken.


As a result of the inspections and alongside implementing the urgent mitigation measures, a 12 week public consultation was undertaken early in 2020, following a report to Cabinet on 23 January 2020 regarding the proposed possible closure of the following 7 residential care homes as well as the refurbishment of several others. The consultation regarding the possible closure of the seven homes followed advice from the council’s Corporate Property Department that these homes required a full electrical rewire by September 2022 to meet current safety standards. On 4 June 2020, Cabinet made a decision following the report, the decisions had been outlined within the report.


          The Interim Market Position Statement for Older People’s Nursing, Residential, Extra Care and Homecare Services 2021 – 2022 (“IMPS”), which was published in June 2021 highlighted that people were continuing to choose to live at home for longer and that people were entering care homes later in life and with more acute needs, which had resulted in a reduction in the demand for long-term residential care and an increased demand for nursing care and homecare. The information contained within the IMPS was relied upon to support the recommendation to conduct a consultation exercise on the proposals regarding possible closure of the homes identified.


          It was proposed that the Council consulted on the three viable options from the five contained within the report. The relevant factors to be considered as part of any consultation of the viable options had also been outlined. It was proposed that formal public consultation would commence on 22 November 2021 and last for 12 weeks ending on 14 February 2022. A single consultation exercise would be carried out covering all seven homes.


            There was an extended debate about the detail of some works stated to be essential and the estimated costs thereof. Following this Councillor Kemp stated that he had extensive personal experience in Adult residential and nursing care home provision: as a public sector commissioner of services; as a public sector regulator; and as a private sector provider and contractor of services. Having examined the available information on the homes in question, the latest CQC reports and the building layouts he had reached his own opinion on the issue, especially having regard to such issues as moving and handling regulations, the problems posed by hospital acquired infections (HARS) and cross-infection generally – before even considering the present-day expectations of prospective residents. He posed a specific question to Mr Stevens; ‘If every single identified defect or shortfall in each building was addressed and rectified to the maximum possible degree and regardless of cost, would the buildings then be ‘fit for purpose’. Mr Stevens answered that they would not, and Cllr Kemp commented that this was precisely as he would expect from his own knowledge.


            Councillor Kemp then proposed a vote on the resolution detailed below, seconded by Councillor Taylor.


            Before the vote was taken Councillor George put forward the following amendment to the original motion, which was duly seconded:


            That the Committee should reserve a decision until it had received further documents containing key information not provided with the report before deciding to recommend the information provided within the resolution.


            The amendment was voted on and rejected, following which there was a vote on the original substantive motion which was approved.


            RESOLVED to advise Cabinet that as to carry out all of the necessary repairs and refurbishments would not make the seven homes fit for purpose in order to provide good and appropriate care for the residents of Derbyshire, it would seem inappropriate to undertake that work.


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