Adult Care and Health Cabinet Panel Thursday 10 September 2009 at 10.00Am Item 3 - Service

APPENDIX D

HERTFORDSHIRE COUNTY COUNCIL

ADULT CARE AND HEALTH CABINET PANEL THURSDAY 5 MARCH 2009 AT 9.00AM

ANNUAL ACCOMMODATION STATEMENT FOR ADULT CARE SERVICES

Report of the Director of Adult Care Services

Authors: Eileen Ziemer, Asset Manager (Strategy) Tel: 01992 556206

Sue Fox, Programme Manager, Accommodation Services for Older People Tel: 01438 844258

Executive Member: Sally Newton (Adult Care and Health)

1. Purpose of report

1.1 To provide members of the panel with an overview of service direction and objectives, and relevant property issues. These take into consideration emerging needs and the fitness for purpose and ability to sustain service delivery of existing property used by the service.

1.2 The Annual Accommodation Statement (AAS) summarises service strategic objectives that have property implications and forms part of the Asset Management system which links to the Service Property Priorities (SPP), and Capital Programme processes.

2. Summary

2.1 The AAS will be used to inform the Service Property Priorities, the Council’s Property Plan and the Capital Prioritisation Group. It will also be edited for publication in the County Council’s Property Performance Report.

2.2 A summary of all services AASs will be presented to the Policy and Resources Cabinet Panel.

2.3 The AAS enables services to inform stakeholders, Members, Hertfordshire Property, and others of their service needs. It enables Hertfordshire Property and partners to assist in achieving outcomes to support their future service needs by developing programmes, projects, cross-service and other authority schemes and effective bids for capital and other funding.

3. Recommendations

3.1 The Panel is invited to note and comment upon the report.

090305 Adult Care & Health Cabinet Panel Item 5 – Annual Accommodation Statement for Adult Care Services 1 APPENDIX D

4. Background

4.1 The services’ strategic property statement, called the Annual Accommodation Statement (AAS) contains an overview of the service and its service aims; service priorities and resulting property implications. The service AAS forms part of the Asset Management system which links to the Service Property Priorities (SPP), and Capital Programme processes, and is summarised in the body of this report.

5. Service Overview and Objectives

5.1 ACS is responsible for providing services to the following people:

 The elderly  People with a physical disability and/or sensory loss  People with learning disabilities  People with mental health problems  People who misuse drugs and alcohol  Gypsies and travellers  Carers  Other vulnerable adults  Crime and drug strategy unit

5.2 The 2006-9 ACS service plan is on the County Council’s website. There is currently a new plan in draft which will be available when it has been through the approval process.

5.3 The service supports the new council’s key priorities in all key areas; confident citizens, personalised services, catching problems early, stable and secure neighbourhoods, prosperous people, and maximising efficiencies. The many ways of achieving this are outlined in the new service plan.

6. Service Priorities

6.1 The property related priorities from the plan can be summarised as follows:

A) Physical disability/sensory loss i) Review provision of residential care and accommodation ii) Equipping peoples’ homes for independence

B) Elderly people i) Increase supply and use of extra care housing (rather than residential care) ii) Increase intermediate care provision in Herts in partnership with the health service iii) Review of day services iv) Increase supply of nursing beds v) Equipping peoples’ homes for independence vi) Ensure all accommodation is fit for purpose

C) Learning disability i) Develop housing and support places including shared ownership and keyring schemes ii) Progress day service modernisation programme iii) Progress campus reprovision programme

D) Mental Health I) Review day services and develop day opportunities ii) Review housing and support provision

E) Gypsies and travellers i) Manage and maintain gypsy sites

F) Carers i) Provide access to respite services

6.2 The general theme is to work with partners to provide accommodation for those most in need. This involves partnership with District Councils, and registered social landlords (RSLs) i.e. housing associations, to provide accommodation to meet specific needs and carry out adaptations to people’s own homes to enable them to continue to live independently.

6.3 An overarching aim is to increase the range of housing and support in Hertfordshire to all client groups and to provide services close to the family home.

7 Reasons for changes in provision

7.1 A key thrust of the service direction is to enable people to live as independently as possible and as fulfilling a life as possible.

7.2 Property needs have changed over time to reflect this, for example the move from large institutional hostels and shared housing to appropriate individual units of housing, and the move from large industrialised day centres to community based buildings.

7.3 Demographic evidence shows increases in some areas of the population, notably the elderly and people with learning disabilities.

7.4 Detailed strategies for each service user group are available.

7.5 Key strategic objectives include to make use of available government grant funding as available-for example, gypsies and travellers, older people, mental health, learning disability, and to maximise opportunities for contributions to partners for new build, - mainly housing associations, who can access funding and build some types of property more economically.

7.6 The introduction of Self directed support and individual budgets may have an effect on future service provision and property use.

8. Consultation

8.1 There are several streams of ongoing consultation for existing and future projects.

 A local board is held with key strategic partners in each district in respect of older people’s accommodation services

 Individual meetings are held specific to each development (e.g. Jupiter drive in Hemel Hempstead)

 The programme for day centre modernisation has regular meetings with key stakeholders

 Links with partners, i.e. districts and housing providers, are made regularly. Also strategic care provider partners lead on consultations affecting homes for older people (eg Newhaven in Stevenage)

 Extensive consultation events were held between September 2007 and January 2008 for people with physical disabilities and sensory loss which identified accommodation needs. A specific project (Castle project) in St Albans is being taken forward to meet some of the identified needs, and this will need to be expanded. A meeting with countywide housing providers was held on this issue in Nov 2008

 Reprovison of St Michaels (WGC) and review of Lavender fields (Hitchin) are underway with relevant stakeholder consultations

 The mental health accommodation strategy is currently being consulted on and an updated Learning disability one will follow

 There has been a respite carer’s event which covered accommodation issues

 Specific service user and carer meetings have been held about the future of existing learning disability houses (e.g. Little Bushey Lane, Spring Drive in Stevenage, Rye Road in Hoddesdon etc)

 Regular consultation with gypsies and travellers is undertaken

 The supporting people commissioning body is a consultative body and it has a service user reference group that meets regularly.

 Consultations were carried out with occupants of mental health group homes prior to transfer of management to a housing association.

All identified issues are currently accounted for in this statement.

9. Property Implications of future Service Priorities

9.1 The continuing move to personalise service delivery will lead to changes in accommodation needs. Properties may become surplus over the next 5 years as they are reprovided either to a more fit-for-purpose accommodation, or to a more appropriate modern type of service.

9.2 Most property-based services that have not been modernised or reviewed in this way will aim to be done within the next 5 years. If an alternative site is provided by a partner, rented or used from existing HCC resources then the current site will become surplus. This particularly is true for some homes for older people and day centre sites. It is also likely that several group homes used as shared housing could become surplus.

9.3 Due to demographic changes which impact on all care groups, an increase in access to certain types of accommodation will be required.

10. Adequacy of existing accommodation

This section can be divided into two key areas - identifying inadequate existing accommodation and the areas that must grow.

10.1 Inadequate existing accommodation

A) Registered care homes for older people

Some are inefficient and some do not meet (statutory) residential standards. A programme of remodelling is underway involving existing homes and growth is essential – additional capacity will mainly be provided through extra care with some existing residential capacity converted to meet more specialist needs e.g. dementia, nursing .

The suitability of 17 homes is being reviewed over a period of time with partners and plans will be developed. These include:

Ashwood Residential Care Home Beane River View Residential Care Home Bulwer Lytton House Residential Care Home Fourfields Residential Care Home (reprovision plans imminent) Freeman House Residential Care Home Hyde Valley House Residential Care Home (reprovison plans imminent) Jane Campbell House Residential Care Home OIC House and Staff Flat Margaret House Residential Care Home Minsden Residential Care Home Nevetts Residential Care Home and Staff Flats Newhaven Residential Care Home (new build on alternative site underway) Richard Cox House Residential Care Home Fairway Residential Care Home.

090305 Adult Care & Health Cabinet Panel Item 5 – Annual Accommodation Statement for Adult Care Services 5 APPENDIX D Planning applications to extend Belmont, Fosse house and Willow Court are all imminent.

B) Accommodation for people with learning disabilities

One hostel from the original four identified remains unsuitable and needs remodelling - Little Bushey Lane in Bushey. Two further hostels have been identified as in poor condition and unsuitable and plans for their remodelling will need to be progressed, Manor house in Bushey and Scarborough house in Stevenage.

C) Accommodation for people with mental health problems

There is an ongoing review of accommodation for these service users in partnership with Herts Partnership Foundation Trust (HPFT). Shared houses which comprise most of our stock are not a preferred model now.

D) Accommodation for people with a physical disability/sensory loss

St Michael’s Hostel does not meet service requirements and is subject to review.

E) Day Services

i) Learning disabilities - 8 day services to be modernised; 1 is practically complete (Balmoral in Watford) and 7 are underway, Hornbeams in Welwyn Garden City, Leydon House in Stevenage, Geddings in Hoddesdon, Butterwick in St Albans, Jarman in Hemel Hempstead, Baldock and Shepherds in Rickmansworth.

ii) Elderly and physical disability – review underway/ required at 6 sites, with resultant actions to follow. These are Greenhills (Hemel Hempstead) , Stevenage RS, Broxbourne DS, Kennedy gardens (Letchworth), Buntingford, Garden City DS (WGC)

iii) Mental health – day services review underway

iv) Multi-purpose day services - will be reviewed next year (4 sites- Borehamwood, Bishops Stortford, South Oxhey, Hitchin)

F) Vacant properties to be brought back into use

There are currently 2/3 (reduced from 5/6 last year) identified service properties to be brought back into service use following vacation, for people with learning disabilities: 24 a and b New Road Ware, and Oakview in Hydean Way Stevenage. Work on these is underway.

There is one property in the mental health portfolio - 74 Sandringham Road in Watford - that is currently vacant with future development plans being investigated.

G) Properties affected by corporate initiatives

Day Services at Greenhills and Kennedy Gardens are affected by The Way we Work project. Halfhyde Lane Gypsy site in Cheshunt may relocate due to a commercial opportunity.

Additionally the resource for manual handling and lifting training has been closed as part of the Way we Work project and no replacement facility provided. The designated area needs to be large enough to accommodate fixed equipment and strong enough structural for hoists.

Properties are used to their maximum capacity. The aim of residential accommodation is to minimise the number of voids. Other spaces are used as often as possible including sharing and hiring out, but within the confines of planning regulations.

10.2 Growth areas

10.2.1 The provision of buildings in some service areas is inadequate and needs to grow. There are a variety of means of achieving this, mostly working with partners. The following areas are particularly specified:

a) There is a need to increase accommodation spaces for older people as evidenced by demographics and market analysis. These indicate that the number of accommodation spaces needs to grow by over 600 places by 2010 and significant numbers beyond that date. This will be in a variety of solutions, but in particular more extra care housing is needed.

b) Learning disability, the agreed strategy indicates growth of at least 60 places per year. A further needs analysis is underway to confirm locations and mix.

c) Day services, the fulfilling lives strategy indicates a potential growth in the number of properties, although these will generally be smaller than the traditional day service.

d) Mental health, the strategy under current development is likely to indicate growth.

11 Work with partners

11.1 Much of the work in ACS is done in partnership with other organisations and this applies equally to property matters. An increasing amount of service provision is by indirect means through arrangements with partners, mostly medium to long term commitments. A significant amount of accommodation is now provided via nomination agreements. Monitoring these is a key area of work. Shared use of buildings is encouraged where appropriate and this is particularly relevant to day services/opportunities.

090305 Adult Care & Health Cabinet Panel Item 5 – Annual Accommodation Statement for Adult Care Services 7 APPENDIX D In conclusion, the service is aiming to increase the capacity and choice of accommodation available to all its service user groups. It is committed to continuing to build relationships and work co-operatively and in collaboration with partners.

Background Papers

2008 Service Annual Accommodation Statement (AAS) 2008 Service Property Priorities (SPP) 2009-2011 Draft ACS service plans

090305 Adult Care & Health Cabinet Panel Item 5 – Annual Accommodation Statement for Adult Care Services 8