Recommendations
1) That Executive notes the options considered to address the escalating pressures on HAS budgets driven by the requirement to purchase increasing levels of specialist older people’s residential care in the independent care sector, alongside the risk and issues faced with the current EPH estate.
2) That Executive approves the recommended option to develop new Council-run Care & Support Hubs in place of existing Elderly Person’s Homes with delegated responsibility to the Corporate Director of Resources in consultation with the Corporate Director – Health and Adult Services, the Executive Member – Finance & Resources, and the Executive Member – Health & Adult Services to consider and approve individual strategic business cases on a locality basis.
3) That Executive approves delegation of responsibility for approval of individual site-specific Net Zero business cases to the Corporate Director of Resources in consultation with the Executive Member – Finance & Resources, Deputy Leader and Executive Member – Managing Environment.
4) That Executive approves inclusion of the proposal as part of the Capital Budget put forward to Executive on 21st January 2025
Minutes:
Considered – A report of the Corporate Director Health and Adult Services which provided an update on proposals to address the escalating pressures on HAS budgets driven by the requirement to purchase increasing levels of specialist older people’s residential care in the independent sector and the risks and issues faced as a result of the age and condition of the current elderly person’s homes which meant this provision was unable to meet need for specialist residential care.
Approval was sought for the development of new Council-run Care and Support Hubs in place of existing Elderly Person’s Homes with responsibility delegated as detailed in the resolution for approval of individual strategic business cases on a locality basis. Approval was also sought for decisions on site-specific net-zero business cases to be delegated as detailed below and for inclusion of the proposal as part of the Capital Budget to be brought to Executive on 21 January 2025.
The Executive Member for Health and Adult Services, Councillor Michael Harrison, presented the report and gave an overview of key points:
· the key drivers for the proposals were the increase in demand for specialist dementia services, increased demand for intermediate care to avoid the need for people to go into long term residential care, and issues around the property condition of existing elderly persons homes.
· The business case proposed the development of up to five new build care and support hubs across the county
· The proposals required a capital investment of up to £60m, but could potentially lead to savings of up to £14.8m per year once implemented
· It was proposed to build the first two hubs in Harrogate and Scarborough, and make further decisions on location over the next few years
Richard Webb, Corporate Director Health and Adult Services, reported that the hubs would provide a new generation of fit for purpose facilities for dementia care and should help to prevent hospitalisation and ensure people could leave hospital sooner. The Director thanked colleagues who had played a key role in developing the proposals including Finance and Property teams and the Provider Services Development Manager.
Members of the Executive welcomed the proposals which would provide a good quality modern service for vulnerable residents. In response to a question the Director confirmed that for inhouse care the Council was currently at 96% recruitment and he was confident that staff could be recruited and retained for the hubs.
Resolved (unanimously)
1) That the options considered to address the escalating pressures on HAS budgets driven by the requirement to purchase increasing levels of specialist older people’s residential care in the independent care sector, alongside the risk and issues faced with the current EPH estate be noted.
2) That approval be given for the recommended option to develop new Council-run Care and Support Hubs in place of existing Elderly Person’s Homes with delegated responsibility to the Corporate Director of Resources in consultation with the Corporate Director Health and Adult Services, the Executive Member Finance and Resources, and the Executive Member Health and Adult Services to consider and approve individual strategic business cases on a locality basis.
3) That approval be given for delegation of responsibility for approval of individual site-specific Net Zero business cases to the Corporate Director of Resources in consultation with the Executive Member for Finance and Resources, Deputy Leader and Executive Member for Managing our Environment.
4) That approval be given for inclusion of the proposal as part of the Capital Budget put forward to Executive on 21st January 2025
Reasons for Recommendations
A market management intervention is needed to address the escalating pressures on Health and Adult Services (HAS) budgets, one of the main drivers being the requirement to purchase increasing levels of high-cost specialist older people’s residential care in the independent care sector, due to a growing demand for the provision of dementia services and intermediate care.
An options appraisal has been undertaken, and the recommended option is to replace our current EPH provision, which consists of seven EPHs, with new build provision of five Care and Support Hubs, to be operated through our in-house Care Provider Services.
The proposed option delivers the optimum saving to the revenue budget of up to c£14.8m per annum in the HAS budget and the most cost-effective model for future provision of specialist residential care. This model is in line with the strategic vision for the transformation of Care Provider Services and demonstrates an ability to off-set current escalating costs in the independent sector.
Alternative Options Considered
An options appraisal has been undertaken to consider how the Council addresses these issues. The alternative options considered are as follows:
1. Do nothing - Continue to undertake responsive maintenance only & deliver existing EPH provision
2. Do something - Undertake essential remedial works to achieve minimal compliance & continue to deliver existing EPH provision
3. Close & Re-provide in Independent Sector
4. Reconfigure and refurbish existing EPH provision
5. Replacement new build provision – Recommended Option
Options 1 – 4 have been discounted due to failure to address the inability of current services and properties to meet the changing and emerging demand for more specialist residential care and intermediate care and associated costs of such provision in the independent sector.
The proposed option to replace the current EPHs with new build provision delivers the optimum revenue saving and financial benefit to the Council of up to £14.8m per annum. This is the ‘best case’ scenario saving. A number of other scenarios have been considered and are summarised in Appendix A. Scenarios considered include reduced occupancy, reduced market rates and other variables. This analysis still demonstrates that the investment will result in significant revenue benefits.
Supporting documents: