Decision Maker: Executive

Outcome: Recommendations Approved

Is Key Decision?: Yes

Is Callable In?: Yes

Date of Decision: February 13, 2025

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.