Devon care home changes: safeguarding services

BACKGROUND

Devon County Council decided in 2004 to follow most other social services authorities in ceasing direct provision of services, and instead to commission them under contract from the private sector. The council was administered at the time by an all-party coalition, and the social services lead member was a Conservative - but the policy was supported by all the major parties.

Having offered all its residential care homes to the private sector to tender, and having received no viable bids, the council has for the past 18 months been negotiating a 30 year block contract with a leading private sector operator - Shaw Healthcare - to take over all the homes in the county. The contract being worked up will provide for comprehensive redevelopment of most of the sites, largely to provide new "extra care" flats where residents will live semi-independently, with increasing levels of care offered as they progress into older age.

While most people understand at least part of the rationale for these proposals for the future, the big concern is how this plan will impact on families who rely on current facilities. Nick has stressed to the county council the need to handle change sensitively, as disruption to elderly residents is generally disastrous. However, slipping timescales in this economic climate may mean that careful pre-planning can ensure minimal upheaval.

The other great concern is the future of day centres, which are currently provided on many care home sites. Devon anticipates many of these continuing to operate on future redeveloped sites, but clearly they would need re-locating temporarily during construction.

While recognising the need to embrace change, and acknowledging that many of the care homes are ageing and will need major works in the foreseeable future, the objective was to ensure that current users suffer minimum disruption, and that future users of social services should have at least as much choice in care provision as current users have.

PROGRESS TO DATE

Nick has taken up the concerns of many families whose relatives currently use the four facilities in North Devon: Beech House in South Molton, Burrow House in Ilfracombe, Lydiate Lodge in Lynton and Oakwell in Bickington.

In South Molton, a strong campaign led by councillors David Worden and Sue Sewell among others, and a large petition, emphasised the shortage of residential care provision in the locality and the dangers of this service being lost from Beech House. Nick, David and Sue went to Exeter and met county officers and leaders to stress this point. The meeting was very constructive, and Devon is now discussing with Shaw modifications to the plans which would see residential care sustained alongside extra care in a rebuilt (and probably relocated) new Beech House.

In Ilfracombe, big concerns surround the excellent day centre at Burrow House, and the need to avoid uprooting residents during redevelopment. A huge petition organised by Terry Marriott and the Burrow House clients demonstrated overwhelming community support for its work. Nick and councillor Geoff Fowler have conveyed this to Devon, which has guaranteed the day centre will be sustained for the future: it will have to be temporarily relocated during a redevelopment, but will then be found a permanent home. This will almost certainly be in the redeveloped Burrow House, which is however going to offer "extra care" rather than traditional residential care, because there is plenty of that in Ilfracombe in the private sector. But good planning ahead should minimise, and perhaps eliminate entirely, the need to disrupt residents.

Oakwell is in some ways the least disrupted of the four: it is due to be redeveloped along similar lines to its existing service, with expanded capacity and a greater range of services on offer in future.

The most difficult of the four is Lydiate Lodge, which Shaw has so far declined to take on as a going concern because it can't see an "economically viable business model". So an alternative plan to move the doctors' surgery into the building emerged. The town council organised a public meeting, with a staggering attendance of almost 300 people, which left Devon leaders and officials in no doubt about the community's desire to see care beds continue at Lydiate Lodge and the doctors' surgery remain in its current central location. Nick subsequently attended a meeting with health/care agencies, which discussed Lydiate providing "intermediate care" beds (like Oakwell) with the surgery rebuilt on its current site. Devon is now forming a working party to look at this and other ideas.

Devon County Council was unable to conclude a contract with Shaw Healthcare, which having examined its other commitments chose to drop out of the project. The staus quo was maintained and this has been considered a successful campaign by all those involved.

FURTHER INFORMATION

DCC's 'Proposed changes to the way we deliver residential care services'

DCC report: Adult & Community Services Modernisation Programme for Older People's Services' 29 July 2008