Decision details

Transforming NNC Adult Social Care Provider Services - Strategy and Case for Change

Decision Maker: Executive

Decision status: Recommendations Approved

Is Key decision?: Yes

Is subject to call in?: Yes

Decision:

RESOLVED

 

KEY DECISIONS

 

That the Executive:

 

a)     Considered the strategy and case for change and approve the proposal recommended option 3 (set out in section 3.3 of this report), to consult withregular users of NNC CQC regulated provider services on the futureproposed strategy and implications

 

b)     Approved the request to engage with Unions and staff affected on thestrategy, case for change and the four proposed phases of transformation

 

c)     Delegated final decision making, following consultation, to the ExecutiveMember for Adults, Health and Wellbeing, in Consultation with Executive Director for Adults, Communities and Wellbeing, to conclude the statutory consultation with people that use those services

 

d)     Delegated the final decision, to the Executive Member for Adults, Health and Wellbeing, in Consultation with the Executive Director for Adults,Communities and Wellbeing, as to whether to implement the strategy and phased proposals and after that decision to enter into formal consultation with unions and affected staff

 

e)     Noted that as part of phase 1 proposals that due diligence is being undertaken to consider and make recommendations to the Executive on the business case for running a Specialist Care Centre. It is anticipated that final proposals will be brought to the Executive for consideration at its meeting on 10thNovember 2022

 

 

Reason for recommendations:

a)    The main physical buildings involved in delivering two of the services weretransferred to the council on vesting day having had insufficient investmentnecessary to develop the sites for the future.

 

b)     Investing in newer facilities will enable us to provide the environments for ourstaff to deliver better quality services & the right environments to maximiseassessment, re-ablement, enablement and opportunities for independentliving for people that use the services

 

c)      The current facilities are in poor condition and require significant investmentto return them to an acceptable level of quality, and even if that decision were made the buildings would need to be vacated for significant periods of timeto enable the level of works required to be completed and would still struggle to achieve the desired outcomes for the services due to limitations within both sites

 

d)      Our own staff had experienced impacts on their pay and reward growth overthe last decade, and their training and development has been minimal within previous organisations

 

e)     We have a finite budget within which to work with, which will require a phasedapproach to transforming ASC Provider Services over the coming threeyears and will focus initially on those Care Quality Commission (CQC) regulated services.

 

f)     There is a role for the local authority in delivering services that we struggleto get from the independent sector, or that with more direct control over there is the opportunity to significantly improve outcomes.

 

g)    It is beneficial for the local authority to retain some services to enable it to bea provider of last resort should that ever be required e.g., following provider failure.

 

h)    The people that use the services will get a clear understanding of theintended vision and strategy to invest in these services for the future and intended benefits to different stakeholders are explored in this report and the strategy and case for change.

 

i)     With a clear strategy, strong leadership, improved environments andinvestment in care and support staff, there should be a marked improvement in recruitment and retention. There should also be a demonstrable impact in areas of improvement required as identified in recent CQC inspection reports.

 

Alternative Options Considered:

 

Option 1 – Invest in existing services to make them fit for purpose and address

all building issues to maximise capacity.

All options considered require significant, prohibitive investment

There is an inability to pay our staff the market rates, as we have a finite

budget within which to work with

We have difficulty in competing with other sectors

There is also retention and recruitment difficulties in ASC Provider Services

Residents that live in Beech Close or use Pine Lodge would have to vacate

the buildings for the entire period of refurbishment

Whilst improving the environment this would not achieve the optimum

building environment for either of the building-based services due to

constraints on working within the existing footprints and building designs

For example, an options appraisal commissioned in March 2022 for the

Beech Close site explored the following potential options, costs and

timescales:

 

Option

Scope of works

Rooms/ units

Estimated project costs*

Duration

Current provision (do nothing)

42 Bedded residential care home (currently only 21 beds are used due to works required in other areas)

21 current

42 maximum

N/A

N/A

1a

Invest in existing property to make fit for purpose and address all existing building issues, reduce number of beds to provide en-suite facilities

24 ensuite

£6,070,000

33 months

1b

Invest in existing property to make fit for purpose, but with elements of new build to maximise the number of beds

33 ensuite

£7,480,000

35 months

2

Rebuild new residential home fit for purpose with en-suite facilities, and focused delivery for acute dementia beds

41 ensuite

£8,455,000

40 months

3

Rebuild Extra Care provision with individual flats on existing site

20 apartments

£7,515,000

40 months

4

Demolish the existing building to enable the sale of the site

0

£410,000

12 months

 

 

*Estimated project costs for each of the proposed option include Professional and Design fees, Planning costs and Employer Risk Allowances

 

Option Scope of works Rooms/

 

Option 2 – Continue as currently (do nothing)

This option is not recommended, as this will:

Continue to compound recruitment and retention issues experienced by

the service

Continued undesirable inspection outcomes of Regulated Services and

possible closure

Poor working conditions for our staff

Poor outcomes for our users

Poor quality of support

Increasing building repair costs, including critical failure of certain

aspects of the building-based services including hot water and heating.

Uncertainty for staff

Inability to control reablement delivery and outcomes

 

 

 

Option 3 – Consult on a new strategy for our in-house services and phased

approach to transformation

This is the recommended option as it will:

Ensure that there is a clear, strategy and vision for our in-house provider

services that is clear to people that use those services and to staff that work in

them.

Fulfils a gap in the market and places our own services at the heart of

maximising independence for people in North Northamptonshire

Provides a generational change and investment in the direction of travel for our provider services, creating a fit for purpose offer with clear ambitions.

Improve working conditions for our provider services staff

Create strong foundations on which to evolve our provider services

 

Publication date: 13/10/2022

Date of decision: 13/10/2022

Decided at meeting: 13/10/2022 - Executive

Effective from: 21/10/2022

Accompanying Documents: