Proposals to exit from the provision of mainstream dementia long stay residential beds
Case ID: IIA-532222868
Date of assessment: 23/01/2024 11:02:08
Lead officer: Julie Uttley
Strategic directorate: Adults & Health
Directorate: Learning Disabilities & Mental Health
Service: In-House Provision
What is being assessed: Removal of a service
Outline of the proposal and the overall aims/purposes:The closure of Castle Grange and Claremont House dementia residential units, subject to formal staff, service user, family and Trade Union consultation and to provide alternative placements in the private sector through reassessment of existing residents. The council to then agree the future of both empty properties. This proposal will contribute to the adult social care revised budget targets.
Who does this proposal impact upon: Employees and residents
Does this proposal concern health care, education or housing: no
What wards will be affected by this proposal: All
Index of multiple deprivation,Kirklees area profiles,Kirklees joint strategic assessment,Other https://www.gov.uk/government/statistics/dementia-profile-updates https://digital.nhs.uk/data-and-information/publications/statistical/recorded-dementia-diagnoses/ https://fingertips.phe.org.uk/search/dementia Care home capacity tracker National and international research on the impact of relocating older people with dementia from one residential home to another (e.g. https://academic.oup.com/ageing/article/40/5/534/46619#Introduction) Ageing and Society, Involuntary relocation and safe transfer of care home residents: a model of risks and opportunities in residents’ experiencesComments in relation to intelligence and insight considered:
Consideration to dementia prevalence and population trends, impact on wider social care market through exit of the Council as a provider of long term residential care. Understanding care home capacity and quality across the wider market. Identifying potential impacts on residents and their families (both short and long term) and consideration of evidence based mitigating actions
To what extent were Public Sector Equality Duty (PSED) aims considered: Fully
Comments in relation to how PSED aims were considered:Through completing this IIA
Does the proposal include residents/service users accessing information or a service from the council: yes
Details why residents/service users access has not been considered:Does this project involve making a planning application: No
Did this proposal require an Environmental Impact Assessment (EIA) completing: No
Were any groups consulted: yes
Details of consultation:Full and meaningful consultation (non-statutory) process, for a minimum 12 weeks to ensure a wide range of views are captured. Methodology involves: online survey, hard copy survey, advocacy sessions (where needed), specific consultation sessions/focus groups with families and carers, ward councillor consultation. Relevant information to be shared throughout the consultation period to ensure stakeholder needs are satisfiedSummary of action plan including how negative impacts were mitigated:
in progress
Equality, diversity and inclusion - Protected characteristics
Type of impact: Neutral
No impact, although a high proportion of staff are 'older' employees who may struggle to find alternative employment
Level of impact: High
Type of impact: Negative
All residents are elderly and moving accommodation/relocation could be considered detrimental to resident wellbeing both in the short and long term (see Consultation section for national and international research in this area). This risk/potential impact will be managed sensitively with residents, families/carers, staff at the care homes and with social work assessors to ensure any plans around relocation are safe and effective
Type of impact: Neutral
Staff and residents are from a wide diverse background
Type of impact: Neutral
Service users are from a wide and diverse communities across Kirklees, the current residents are predominantly from a white british background
Type of impact: Neutral
No impact
Level of impact: High
Type of impact: Negative
All service users have dementia and transferring them to alternative accommodation will require detailed assessments. Also research shows that moving accommodation is a traumatic experience for care home residents and their families. A literature review of the impact of moving care homes has been carried out by a member of the Public Health team, the findings of this are summarised below, • The evidence within the past 10 years is limited - evidence from the past 10 years reveals a paucity of research into the impact of care home closures and relocation on dementia residents. • The understanding of impact is mixed - the health effects of any relocation of older adults suffering from dementia were negative. The research highlights a decline in physical, mental, behavioural, and functional well-being. It is important to note that the research also examines how relocations can be managed in order to reduce the negative impact on residents. This includes involvement of patients, careful planning and preparation and creating a similar environment for the resident in their new home. These factors are present within the Kirklees Care Homes Closure Protocol • The way in which the process of relocation is managed is important - studies show that the way in which a relocation process is managed for residents, staff and family can have a significant impact on the outcomes for care home residents. The research suggests care home closures may be a “tale of two halves”, with inevitable distress during the closure but, if done well, with scope for improved outcomes for some people in the longer term.
Type of impact: Neutral
No impact envisaged
Type of impact: Neutral
No impact envisaged
Type of impact: Neutral
No impact
Type of impact: Neutral
No impact
Level of impact: High
Type of impact: Negative
The vast majority of employees are female and at risk
Type of impact: Neutral
no impact
Level of impact: High
Type of impact: Negative
The majority of staff affected are low paid workers who may be the only source of income in their household
Type of impact: Neutral
Unknown at this stage
Type of impact: Neutral
No impact
Type of impact: Neutral
No impact
Type of impact: Neutral
No impact
Type of impact: Neutral
No impact
Type of impact: Neutral
Unknown if any employees are currently pregnant, many are female employees
Type of impact: Neutral
No service users are affected
Type of impact: Neutral
No impact
Type of impact: Neutral
Faith/cultural needs of each resident will be considered as part of a social work reassessment and in accordance with the Equality Act 2010 and the Health and Social Care Act 2008 (Regulated Activities (Regs 2014)). We are not aware of any existing resident that actively practices a faith/religion however, we have some residents who enjoy bible studies and the services have links with local churches and other faith groups to support religious and/or cultural needs. Individual service user preferences and their religious / cultural needs will be considered as part of the social work reassessment as per the above
Type of impact: Neutral
No impact
Level of impact: High
Type of impact: Negative
Relatives, although not direct unpaid carers, will be adversely affected with the trauma of the move and reassessment process and possible increased transport costs when visiting their relative. Relatives/carers/families inform us that they are more confident about the quality of Council run provision as opposed to the Private Sector, Social Work Assessors will work closely with families and residents to identify the most appropriate provision. Possible change of setting may also impact on how frequently families/relatives can visit their loved one (including grand children) which impacts on familiar routines
Access to services
Level of impact: High
Type of impact: Negative
All service users have dementia and the majority, if not all will not have the capacity to understand this process. Many will have legal representatives through Power of Attorney to act on their behalf.
Type of impact: Neutral
Families acting on behalf of residents will liaise directly with the care home and with social work assessors
Type of impact: Neutral
not applicable, these are long term residents already receiving a service. Staff at the Front Door/Gateway to Care have been briefed on the proposals to enable them to support families/carers with the consultation process.
Environment
Type of impact: Neutral
When the building is closed there will be no emissions
Does this proposal affect an Air Quality Management Area (AQMA): No
Type of impact: Neutral
no impact
Does this proposal include changes to a location within a Site of Special Scientific Interest (SSSI), local wildlife sites or green belt: No
Will the proposal be impacted by climate change: No
Type of impact: Neutral
no impact
Type of impact: Neutral
none when buildings closed
Type of impact: Neutral
no impact
Type of impact: Neutral
no impact
Type of impact: Neutral
no impact
To what extent was reducing the amount of waste created in the first place been considered: Not at all
Details, information or evidence in relation to waste reduction: no impact
Type of impact: Neutral
not applicable
Does this proposal involve the installation or use of a private water supply: No
Type of impact: Neutral
no impact