Purpose

To seek approval on the proposals for Short
Breaks Transformation for Working Age Adults, in particular around
the services provided from Pine Lodge

Content

RESOLVED
 
KEY DECISION
 
That the Executive:
 

a)   
Approved that a consultation be commenced with
people receiving care and support at Pine Lodge to identify
alternative care provision that can meet their assessed needs in an
alternative setting.
 

b)   
Approved the commencement of a repurposing of Pine
Lodge for short breaks.
 

c)   
Approved the development of a business case and
development plans to support the transformation of Pine Lodge to a
setting that can be utilised to provide temporary accommodation led
by the Council’s Housing Team.
 

d)   
Noted that it is intended that the delivery of short
breaks and transitions will move from an in-house service model to
an externally commissioned service model.  This will be through support at home, Shared
Lives, supported holidays and bed based short breaks via contracted
care providers within the independent care sector.
 

e)   
Approved the development of a full business case and
options appraisal to develop an in-house service that can function
as a ‘provider of last resort’, provide short breaks
for any individual where the external market is unable to provide
bed-based short breaks and to provide an intensive enablement
service to reduce longer term care costs.
 

f)     
Delegated authority to the Executive Director of
Adults, Health Partnerships and Housing in consultation with the
Executive Member for Adults, Health and Wellbeing to take any
further decisions and / or actions required to support the
recommended proposals including commissioning and investing in
alternative settings via current contract call off arrangements and
mini competition.
 
 
Reasons for Recommendation:
 

·      
The independent market has a willingness to create
capacity in residential services, which could be repurposed in more
modern purpose-built settings. The utilisation at Pine Lodge has
decreased consistently over the last three years as people choose
alternative settings and more innovative options for their short
breaks. Pine Lodge has serviced the people in North
Northamptonshire well, but it is now 60 years old and the needs of
people who use the service have changed significantly.

·      
The care market has also improved significantly as a
result of the Council’s partnership approach to working with
contracted care providers and investment to ensure a high quality
and sustainable choice of service is available for people living in
North Northamptonshire.

·      
It is recognised that any change in service
provision can be a time of anxiety for people, their families and
local communities. However, we are committed to working with people
and their circle of support to explore more personalised options
for short breaks such as Shared Lives, supported holidays and other
day or weekend opportunities that represent more
‘enabling’ forms of short breaks.

·      
Reimagining the short breaks offer for Working Age
Adults means that there is an opportunity to review the services
provided at Pine Lodge, implement a phased reprovision of the
service over the next 12 months and to focus on the business case
for the development of an alternative bed-based enablement service
that can act as a ‘provider of last resort’ and may
still provide some form of short breaks.

·      
The assessment and transition function at Pine Lodge
is valued and if operated in a different and smaller setting with a
focus on enablement, it will provide excellent outcomes for people
and support North Northamptonshire Council in managing demand for
longer term care and support. This will also provide capacity for
the Council to act as a ‘provider of last resort’ as
well as essential capacity for Short Breaks for the small number of
individuals where the external market may not be able to meet their
needs.  By provider of last resort, it
means a Short Breaks service that can be used in the event of an
unplanned provider failure to support people, so it would be part
of a contingency planning / response.

·      
This transformation also enables the Council to
review how Pine Lodge is used and to develop plans to use the
building to provide temporary accommodation within North
Northamptonshire at a site where support for people who are
homeless can be well coordinated.
 
Alternative Options Considered
 

·      
Reconfigure the existing site at Pine Lodge - the
building is in need of significant
maintenance and improvement, which is not economically
viable.  The building is also larger
than is required and spans two floors and is not fully accessible
to people with physical care needs and therefore, the effective
unit costs because of running costs are prohibitive. The size and
design of the building also contradicts best practice guidance for
services supporting people with a Learning Disability
(“Registering the Right Support” Care & Quality
Commission (CQC) June 2017 and “Building the Right
Support” by NHS England, the Local Government Association
(LGA) and the Association of Directors of Adult Social Services
(ADASS) as part of the Transforming Care Programme, 2015) and
therefore does not represent the Council’s vision to provide
modern public services.

·      
Move Pine Lodge to a different site – The
Council’s Provider Services Transformation Strategy outlined
its ambition to focus on providing services that the independent
sector was unable to do so at an equivalent cost. The
Council’s market engagement suggests that independent
providers are able to support people more flexibly in local
communities and at a lower unit cost. The Council should also be
ambitious for the outcomes and services that it supports people to
use; the Council has an opportunity through its Shared Lives Scheme
and the provision of support at home and supported holidays to
offer better options for short breaks. To recreate Pine Lodge at
another site following the same service model is not a recommended
option.

·      
Using Pine Lodge or other sites to co-locate
services to make better use of facilities was also ruled out as the
cost to refurbish Pine Lodge is prohibitive, as would most likely
be the cost of refurbishing or rebuilding on other
sites.