Agenda item

To consider the results of the analysis undertaken with respect to potential for future provision of the services at the Awelon site in Ruthin.

 

9.35am – 10.20am

Councillor Win Mullen-James, Chair of the Task and Finish Group who had been tasked with reviewing the Council’s in-house social care provision, in introducing the Group’s findings with respect to the future use of Awelon paid tribute to late Councillor Raymond Bartley, who had been a dedicated member of the Task and Finish Group and the Committee.  Councillor Bartley had worked tirelessly to safeguard the rights and welfare of the elderly and vulnerable in the county throughout his career, and would be greatly missed.

 

In her introduction the Chair of the Task and Finish Group informed the Committee that the Group was of the view that the recommendation contained in the report (previously circulated) would meet the demand for both care and support in the preferred Extra Care arrangements as well as support community activities for residents and the wider community within the new community facilities.  The Task and Finish Group was also of the view that the entire project would benefit from being managed by the 3 current users of the site – the Council, Grŵp Cynefin and the Committee of Canolfan Awelon - coming to a mutually beneficial agreement.  Hence the reason why the Group was recommending that they work together to implement the best configuration for the site based on Options 2a, 2b and 3a in the report.  By adopting this approach individuals currently living in the residential part of the site would be able to remain there for as long as their needs could still be met.

The Chair welcomed Rhys Dafis, Grŵp Cynefin’s Regeneration Services Director, to the meeting for the discussion on the proposals and feasibility study.

 

The Corporate Director:  Communities and the Head of Community Support Services detailed the feasibility study undertaken by Grŵp Cynefin, which respected the spirit of the Cabinet resolution in May 2016, and outlined the conclusions drawn at the end of the study. 

 

Responding to the Committee’s questions the Corporate Director:  Communities, Head of Community Support Services, Lead Member for Social Care (Adults and Children’s Services), Chair of the Task and Finish Group and Grŵp Cynefin’s Regeneration Services Director:

 

·         confirmed that Option 3 put forward by Cabinet in May 2016, relating to engaging with the Betsi Cadwaladr University Health Board (BCUHB) to investigate the feasibility of developing additional nursing care capacity in Ruthin, was still being pursued.  However, the schools site, adjacent to the present hospital in the town would not become vacant for some time.  The proposals for consideration at the current meeting related to the Awelon site, which was a separate entity.  Any future proposals which may be put forward, either separately or in conjunction with BCUHB for the former schools site, could potentially further enhance health and social care provision in the Ruthin area;

·         explained the Council and the Regulators roles in inspecting and monitoring care and support both in care establishments and in people’s own homes. This was a multi-layered approach, the quality of care and support provided was closely monitored as were safeguarding arrangements.  Contracts for the provision of care were regularly monitored to ensure that all contract specifications were being met.  A quarterly report on quality monitoring of external care services was provided to the Scrutiny Chairs and Vice-Chairs Group (SCVCG);

·         advised that, with a view to enhancing the Council’s contract monitoring capacity, a recruitment exercise would be undertaken in the new financial year for an additional contract management post within the Council’s Contracts Management and Review Team;

·         confirmed that the majority of the Council’s arranged social care placements were within the independent sector in the county;

·         emphasised that the proposals being put forward for the future provision of social care services in Denbighshire were not being driven by the need to realise budget savings.  The primary driver was meeting legislative requirements and providing services which were in line with residents’ needs and choices and which improved outcomes for the individual concerned.  Whilst budget pressures had become more of a factor in recent years, the approach of supporting independence and supporting people in their own homes was a long-term aim of the Council.  The Extra Care complex approach enabled individuals to have a level of independence and couples to stay together when one or both needed care or different intensity of care, in an environment that they could regard as their ‘own home’, thus improving their quality of life;

·         advised that the Council had a duty to utilise public money effectively and efficiently.  The intention of the proposals contained within the report was to improve outcomes for individuals whilst meeting their identified needs.  The proposals under consideration for Awelon specifically stated that no current resident would be expected to move to another establishment for as long as their needs could be safely met at Awelon;

·         confirmed that the proposed £7m investment proposed for Awelon was an investment by Grŵp Cynefin, the Council’s contribution would be to transfer the site to Grŵp Cynefin, who already operated the Llys Awelon Extra Care housing complex on site;

·         explained that with respect to Options 2a, 2b and 3a the eight temporary residential care bedrooms was a guide to how many would be needed whilst the remodelling and refurbishment work was taking place.  As and when work was due to commence this number could be increased or decreased to meet the demand at that time from residents who wished to remain at Awelon.  ‘Temporary’ units would continue to be available for as long as they were required, they would not be subject to time constraints. To ensure the development can be progressed in as timely and smooth a way as possible, no new 'residential' residents would be admitted to Awelon;

·         confirmed that needs defined currently as ‘residential needs’ could be met within extra-care facilities, and were actually met in extra-care facilities that were currently in existence.  The advantage of the extra-care facilities was that when residents’ needs increased they did not have to move out, instead their care packages were changed to meet their increased needs.  Whilst the Council was not, by law, permitted to provide nursing care in its establishments the development of extra-care facilities would result in less upheaval and disruption to vulnerable people’s lives when their care needs increased;

·         confirmed that the Council and Grŵp Cynefin were looking to work closely with the Committee of Canolfan Awelon with a view to identifying their requirements and incorporating them into the final plans for the complex.  The ultimate aim would be to enhance the offer available at the community centre for the local community;

·         advised that from Grŵp Cynefin’s perspective they would be looking towards developing an integrated facility to benefit residents and the wider community which would deliver the Group’s core vision of improving residents’ quality of life.  This was similar to their approach for developing extra care housing in Denbigh, those plans were currently being consulted upon;

·         advised that for Grŵp Cynefin from a value for money perspective Option 2a would be the most cost effective.  However, they were willing to work with the other two partners to develop any of the three preferred options.  It may be at the conclusion of this exercise that the final option may contain an element of all three preferred options;

·         explained the reason why Option 1 had been deemed unviable.  This was because of the risk involved with adapting an old, inefficient energy usage building that would not in the long-term deliver a sustainable solution for providing modern social care services.  The proposed new extra-care facility would provide at least the same level of residential care as at present, but aspired to provide a much more holistic living and care package that would supplement and enhance each individual resident’s well-being;

·         advised that if Option 1 was to be recommended the Council would need to find a new partner to deliver the development and would need to invest circa £2m in refurbishing the current building;

·         emphasised that the main consideration in relation to the proposals was the model of care that should be delivered in future.  The Council was expected to commission/deliver services which improved outcomes for residents and which were sustainable in the long term having regard to the demographic changes which lay ahead.  By developing bespoke extra care facilities, similar to those proposed for the Awelon site, better outcomes could be delivered for residents as there would be a wider range of choices available to them in future;

·         reassured members that the health, safety and welfare of residents during the remodelling work would be of paramount importance to all partners and every effort would be made to support and reassure them and their family members/carers before the work commenced, as well as during and after its completion;

·         advised that if approval for the proposals development were given Grŵp Cynefin would form a Partnership Group, as it had done with similar developments elsewhere, to engage with residents, families, carers and stakeholders with a view to alleviating fears and misconceptions and finding solutions to identified problems etc.  Grŵp Cynefin had also in the past revisited residents, stakeholders and Partnership Group members twelve months following the completion of the project to undertake an evaluation of the project and the impact on their lives.  The same approach was likely to be adopted for this project;

·         the design for the extra-care facility at the Awelon site would be ‘dementia friendly’ throughout, similar to the design being proposed for Grŵp Cynefin’s Denbigh extra-care facility;

·         the facility would also have an apartment for visiting family members/friends to use;

·         proposals for the majority of apartments being two-bedroomed units were based on service-users preferences, these were also practical for residents who would require overnight carers;

·         advised that Grŵp Cynefin would not be responsible for delivering care services at the new facility, these would be commissioned from an independent provider following a tendering exercise.  Consequently, not all current staff at Awelon would be transferred over.  Some staff were likely to be offered to transfer to Grŵp Cynefin i.e. canteen staff.  Nevertheless, Council officers had already had discussions with staff regarding the potential implications for them of the proposals under consideration.  All of the care staff were highly skilled and therefore their skills would be in great demand in health and social care establishments.  The Council, via its HR Department, would make every effort to support staff to find alternative employment

 

The Lead Member read a message she had recently received from relatives of a former resident of the extra-care facility at Rhyl, in which they thanked the facility’s staff for the devoted care they had given their relative throughout her time there, and in particular the dignified care they had given her and them during her final days.  In the Lead Member’s view this epitomised the whole concept of extra-care.  The Task and Finish Group’s Chair also gave an example of how the extra-care facility had enriched a resident’s life and improved his/her general health now that he/she was no longer socially isolated.

Grŵp Cynefin’s Regeneration Services Director extended a welcome to councillors to visit any of their extra care schemes to see the facilities on offer and speak to residents.

 

Prior to the conclusion of the discussion the Committee Chair permitted a member of the public present to address the Committee.  In her address she asked the Committee to consider in detail the actual floor space size of the proposed new Canolfan Awelon.  She was of the view that it should not be of a smaller floor space size than the current facility. She also asked the Committee to consider who should be charged with managing the community facility in future.  In her view there would always be a need for some level of ‘residential care’ going forward or otherwise local hospitals would continue to be full to capacity.

 

Committee members emphasised the need for the new Canolfan Awelon to be designed in a way that met residents and the wider community’s needs.  The current Canolfan Awelon was widely used by the local community, as had been illustrated by members at the meeting.  It would therefore be important that any future design could accommodate a wide range of users whilst meeting residents’ needs at the same time, and that public access to the community centre would not impinge on residents’ privacy.  Members also requested that the Council make every effort to support community groups to find alternative suitable accommodation to conduct their events whilst the remodelling work was being undertaken.

 

The Chair thanked everyone involved for the production of a very detailed feasibility study and for their work in bringing the proposals forward for the Committee’s consideration.  He also thanked everyone present for diligently scrutinising the proposals. 

 

A minor amendment to the recommendation put forward by the Task and Finish Group (as detailed in the report) was proposed and seconded.  On being voted upon the Committee, by a majority:

 

RESOLVED: having had regard to the observations made at the meeting and the conclusions of the Well-being Assessment, to recommend to Cabinet that it:

 

a)    should take account of the Well-being Impact Assessment as part of its considerations;      

b)    agrees with the Committee that Options 1 and 3b of Grŵp Cynefin’s Feasibility Study are not viable options for the reasons stated in appendices 1 and 5 of the report respectively; and

c)    authorises discussions to commence between local Members, officers, Grŵp Cynefin and the committee of Canolfan Awelon to work through Options 2a, 2b & 3a to take forward the best configuration for the site that meets all parties’ needs and provides least disruption for existing residents/tenants, and that these discussions include floor space requirements for the Canolfan Awelon Community Centre

 

(At a suitable point, this would enable the remaining Awelon Site to be cleared and for work to begin on the extension. The task and finish group were of the view that maximising the number of Extra Care units developed  (as set out in Option 2a) would  deliver the optimum arrangements for providing Extra Care Housing with Community Facilities on the Awelon site. However, it was acknowledged that further discussions need to take place with the committee for Canolfan Awelon to ensure the final scheme can deliver the community activities they already provide.

 

This meets the preferred option of Cabinet following discussion in May 2016 and will secure up to 35 additional Extra Care apartments on the site whilst enabling those residents who are currently receiving residential care services to remain on site through the development if that is their wish, as well as continuing to provide community facilities to promote independence and reduce social isolation.)

The original recommendation, as outlined in the report, was then proposed, seconded and voted upon.  As the majority of the Committee abstained from voting on the original recommendation the amended recommendation as detailed above will be submitted to Cabinet for approval.  Members also asked that the report to Cabinet states clearly why Option 1 is not considered a viable option.