APPENDIX A
Consultation on proposals for care services in Allerdale and Distington areas
November 2011 – February 2012 Report by Fran Branfield & Jenny Willis
On behalf of Cumbria County Council
Consultation report on proposals for care services in Allerdale and Distington areas 1
Contents Page Acknowledgements 3 Overall Summary 4 1. Introduction and background 6 2. Responses to public questionnaire 9 3. Conversations with residents 42 4. Responses by letter and email 56 Park Lodge 57 Richmond Park 69 Woodlands 74 General letters 77 5. Public Meetings 80 6. Drop in session feedback 90 7. Staff views 100 Appendix 1: Copies of full responses from: Age UK 106 Alzheimer’s UK 108 Copeland Borough Council 113 Allerdale Borough Council 115 Cumbria LINKS 121 122 Adult Social Care comments on LINk response to consultation 148 Appendix 2: Petitions about Park Lodge and Richmond Park 161 Appendix 3: Public questionnaire 162 Appendix 4: Public meeting/drop in questionnaires 167
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Acknowledgements
We would like to thank all the residents of the homes we visited who shared their thoughts about where they live and on the Councils plans for their future, as well as relatives, staff and members of the public who took the time to contribute to the consultation.
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Overall summary
This report by Cairn Community Partnerships is based on the views and opinions of people living in the Allerdale and Distington areas of West Cumbria. This includes present residents of three Cumbria Care homes which have been proposed for closure in the consultation document, Park lodge (Aspatria), Richmond Park (Workington) and Woodlands (Distington); the voices of relatives and friends and of other community stakeholders, as well as staff and people attending ‘drop-ins’ and public meetings run by the Council.
Views in favour of the proposals Most people recognised that the council’s proposals were positive and welcomed aspects of them. In particular respondents recognised: That many people wanted to live in their own homes for as long as possible. That extra care schemes, if properly staffed, were a positive step for many older people. That assistive technology, if used alongside traditional care, could be helpful and constructive to the health and well-being of older people.
Concerns about the proposals There was a remarkable degree of consistency and agreements in what people told us were their concerns. These centred on: The health and wellbeing of present residents in the lead up to closure if it goes ahead. That there is felt to be a real need for local residential homes. That older people frequently feel isolated and/or lonely and that the Council’s proposals do not adequately address this major issue, and may actually increase isolation and loneliness. Fears that there will be a shortage of suitably qualified and experienced local staff for Home Care services. That whilst recognising staying at home seems the best solution and what people want, it is not always practical or appropriate for the support needs of all older people. That whilst assistive technology might have a place to play it could not replace human care and the ‘personal touch’. That technology could be frightening and confusing for older people. Home closures would have a negative impact on the whole community.
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Home closures would have a negative impact on respite care and day care services. The responses also indicated that: Many felt that residential care is the safest option for older people who are unable to care for themselves. The majority of people living in the communities where the Council are proposing to close three care homes strongly disagree with the proposed home closures. This was particularly true in Aspatria. That people living in areas where the local home was to be improved e.g. Wigton were much more supportive of the Council’s proposals. That homes be accessible and on good bus routes. Financial concerns.
Although there was broad support for the Council’s proposals to support people to stay at home as long as possible, there were fears that home closures were not appropriate before other options were in place. Equally people wanted evidence of good home care provision for people with high level needs as at present this did not reflect respondents’ experiences. This is summed up below with a quote from a letter in response to this consultation by Age UK: Age UK West Cumbria remains concerned regarding the provision of personal care and supported care within the community and would seek reassurance that the needs of people are being met with sufficient choice and affordability. Ideas for improvements to the proposals Respondents had many ideas to improve the proposals. People living in the communities where the council propose to close the homes suggested that the homes remain open. Other people suggested the need for: More information about the proposals, including more definite plans for new services. Look at alternative providers to run the care homes. Look at the wider picture the closures will have, for example on employment and sense of community.
Other general findings Several respondents suggested the Council adopt a more person centred approach to the closure of some homes and listen to what the service users want.
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The responses signalled that there was concern over domiciliary care services. This focused on High turn-over of staff Limited time staff spent with older person and subsequent risk of loneliness and isolation Quality of care and support provided
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1. Introduction and background
Service users now play an increasingly important role in efforts to improve social care services. As older people are the largest group of users of adult services, it is important that they are involved in all decision making that impacts on their lives.
Cumbria Council recognises this and the rising numbers of older people in its area. The Council also acknowledges: the rising expectations of service users in the future, government priorities and current gaps in services in the Allendale and Distington areas. (CCC Consultation document Nov. 2011) In response to this need for changes in service delivery to older people Cumbria Council has developed proposals which have resulted in this consultation.
This consultation took place between 14th November 2011 and 14th February 2012. 1200 consultation documents with questionnaires were produced by the County Council and sent directly to staff, residents of Woodlands, Richmond Park and Park Lodge residential care homes and family members of the care home residents. Questionnaires were distributed to public buildings across Allerdale including libraries, GP Surgeries and County Council and Allerdale Borough Council public offices. The consultation document was also available via the County Council’s website.
Public consultation events were held at Distington, Workington and Aspatria along with eight public drop-ins which were promoted locally and advertised in the local press. Stakeholders including NHS Cumbria, Allerdale Borough Council, Housing Associations, independent sector care providers and the voluntary sector including Age UK, The Alzheimer’s Society and Cumbria CVS were sent an electronic copy of the consultation document and asked for a response or to share widely with their networks.
11 consultation information meetings were held with residents and family members at each home over four days and evenings at the start of the consultation.
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Three staff meetings were held at the start of the consultation at the three homes followed by three staff drop-ins at Distington, Workington and Aspatria. Home Care teams were also asked for their views on the proposals.
The County Council’s local Area Support Team advised on the consultation arrangements and Area Engagement Officers supported the public information events and public drop-ins.
Over 620 people took part in the consultation by attending meetings and/or submitting responses, in addition to the organisations whose responses are included in Appendix one. A further 9868 signed petitions – see Appendix 2 for details.
The structure of this report This Report is divided into seven main sections. This, the first section, details why and how this consultation took place. Sections 2-5 report on the views, concerns and suggestions offered by residents, relatives, community members, staff and other respondents to the questionnaire in the public consultation document, in face-to-face conversations with the researchers, in letters and as a result of questionnaires filled in at public meetings. Sections 6 and 7 reflect the views, recorded by Cumbria Council staff, at ‘drop-ins’ with the public and staff working in care homes affected by the proposals and in home care teams.
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2. Responses to the public questionnaire This section of the report analyses the sixty eight completed questionnaires which were submitted by people who received the full consultation document.
Profile of those who responded: (This totals more than 68 because it includes those who identify in more than one category)
Category Number of people identifying in that category Service Users or on behalf of a service user in one of 6 the homes affected by the proposal Carer and/or family member with a relative or friend 23 in one of the care homes Staff member from one of the three homes 7 Other staff member 4 Member of the public 23 Stakeholder 6 Other 10 Did not answer 7
Responses to Questions: The majority of respondents who did not provide an answer to the yes/no/don’t know questions in the questionnaire were very concerned about the home closure proposals and some indicated specifically that they had not answered the questions on the advice of Tony Cunningham M.P.
Summary: There were common concerns expressed by the majority of respondents to all the questions. These concerns were: That the council proposes to close three of its homes. There is a lot of concern for the health and wellbeing of present residents in the lead up to closure if it goes ahead. That older people frequently feel isolated and/or lonely and a feeling that (due to lack of faith in level and quality of home care services now and in future) the council’s proposals do not adequately address this major issue, and may actually increase isolation and loneliness. That there will be a shortage of suitably qualified and experienced local staff. Consultation report on proposals for care services in Allerdale and Distington areas 9
That whilst recognising staying at home seems the best solution and what people want, it is not always practical or appropriate for the support needs of all older people. That people recognised assistive technology might have a place to play but there was a concern that it would replace human care and the ‘personal touch’. That technology could be frightening and confusing for older people
The responses also indicated that: Many felt that residential care is the safest option for older people who are unable to care for themselves. The majority of people living in the communities where the council are proposing to close three care homes strongly disagree with the proposed home closures. This was particularly true in Aspatria. Although there was broad support for the Council’s proposals to support people to stay at home as long as possible, there were fears that home closures were not appropriate at this stage before other options were in place and when evidence of home care provision for people with high level needs did not seem to be proven by respondents’ experiences.
What people said To accurately reflect the respondents’ thoughts, feelings and experiences the remainder of this section presents what people said under each question in turn. It is only in this way that we can illustrate the richness of the responses. There is a certain amount of repetition but again this reflects the consistent nature of what people said.
1) Do you agree with the Council’s overall plan to focus investment to help people to stay at home as long as possible?
Yes No Don’t Did not answer – see Know note on page 9 26 11 7 24
In support of proposals
Many people were in general agreement with the council’s proposals. However, there were only a very few comments that did not include a caveat:
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Keeping people in their own homes for as long as possible is always the right option with the correct amount of help and support.
Agree with ‘Closer to Home’ agenda.
This is definitely the way forward.
Whilst I recognise the important part that residential care has played in providing services to the most vulnerable of people I genuinely believe that the public as a whole wants to remain at home for as long as possible and that with modern technologies and new means of providing care (such as Extra Care Housing), we could successfully help people to stay at home for longer. If we can develop sufficient Extra Care Housing options in sufficient numbers it may ultimately be possible to do away with most residential care beds as people tend to move to Nursing Care from Extra Care if they require 24 hour care at all.
Yes, Allerdale Borough Council agrees with the County Council’s overall Plan to focus investment to help people stay at home as long as possible, as many older adults prefer to stay at home as they get older. Retired people take pride in retaining their independence and leading a life of their own. Staying at home provides this independence, and enabling people to remain in the area where they have often lived for many years and are known to local people, enables people to remain a part of the local community.
Concerns about the proposals
In answering this question respondents had some clear concerns. These fell into four main categories: Concerns over present residents Issues of isolation and loneliness Training and support for staff Appropriateness of alternative care proposals
Concerns over present residents Respondents were clearly worried and concerned for the well-being of the present residents of the care homes that the council are proposing to close. These comments mirror what many people said:
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I can see many of the benefits but remain concerned for current clients and residents.
It does seem a good idea but I worry about the residents who are there now. The change for them could be terrible.
People living in the homes at the present moment are upset at the possibility of losing their homes. They cannot be forgotten in this.
Isolation and loneliness Respondents said that many people choose to live in residential homes because they feel isolated and lonely living on their own. This problem, people said, would not be resolved by the Council’s proposals, and that it could be made worse. The following comments highlight this concern and express what many people said:
Isolation is a big problem for older people - they need to be with ones they know of similar age to share life's experiences.
Once elderly people are housebound they become very lonely, and families come under a lot of pressure to spend time with them constantly, whereas in residential care they have company and things going on around to keep them stimulated.
Giving good support at home is OK provided there is enough help. People can be left very lonely.
Right help and support Whilst some people recognised that being able to stay in your own home for as long as possible was a positive step, it was clear that people were worried that there would not be a suitably qualified workforce available to meet the needs of older people remaining in their own home. These comments below are typical of what many respondents wrote:
I am deeply concerned that there will be problems recruiting sufficient carers especially in rural areas of the district and also that the level of care (i.e. contact time) will be inadequate to meet the needs of the elderly for social interaction - fleeting visits and long hours in bed or waiting to be helped to the toilet is not satisfactory. Consultation report on proposals for care services in Allerdale and Distington areas 12
It would be better for people to stay in their own home providing the level of care was really good. How would this be monitored on a daily basis to prevent abuse of the system?
Keeping people in their own homes for as long as possible is always the right option with the correct amount of help and support. That means money and training.
People don't choose to go into a home on their own. Nine out of ten people have no choice. As almost all residents in Park Lodge would not be able to stay in their own home, unless 24 hr care would be provided, which won't happen.
Appropriateness of alternative care proposals The majority of respondents said that the idea of being able to stay in your own home sounded very appealing but in practice this was not appropriate to meet the care needs of a large proportion of older people. As these people put it:
Only in the cases where it's appropriate or possible, not for those who would not be able to cope, then it’s only giving them false hope. Most relatives do not put people into care homes lightly, it's usually a last resort and if this is removed the freedom of choice is removed.
We don't agree because elderly people are very vulnerable, especially if they have dementia, i.e. loneliness, stress, could be prone to accidents, likely to be victims of bogus callers or such.
It is a laudable aim but the plans do not have adequate provision for those who cannot stay at home.
Sounds well and good but this won't happen in Aspatria. What happens when they can no longer manage at home? Why should they have to move away from their home town?
I agree that people are living longer; but their family are also growing old. They are often unable to look after ageing Parents themself. No matter how much care you offer at home, families will still need to give 24hr care. This will affect their health. Consultation report on proposals for care services in Allerdale and Distington areas 13
My father, now 93, was in sheltered accommodation. After many assessments by social services they recommended a place at Richmond Park (at his own request).
I agree with keeping people in their own homes as long as possible. But not all people are the same and need to go into residential home because of their illness and are not safe to be on their own.
Objections to closures Some respondents said they did not agree with the proposals and expressed concern about the consultation:
I feel that the questions are biased and I very much object to the closure of Park Lodge care home. It really is needed in Aspatria.
I object to the closure of Park Lodge care home. It is needed very much.
All these questions are staged so that you get the answers you require.
Other people criticised the Council’s proposals:
Smaller homes work better. They are more homely and friendly and the council are not looking at the overall picture.
They are not looking at the overall picture.
Care homes in rural communities are vitally important.
Ideas for improving the proposals
People suggested that there would always be a demand for residential care, particularly for those seeking respite care. People said that this needed to be addressed in the proposals:
We still need the care homes to give families a rest or if any of us are poorly and can’t look after our loved ones.
There is no mention of respite care. This needs to be thought about. It is very important provision for carers. Consultation report on proposals for care services in Allerdale and Distington areas 14
Other people wanted to see proposals that were:
…flexible enough to respond quickly to changes of circumstances, and with proper ‘joined up thinking’ between all the agencies involved.
Choice, people need to have proper choices, choices that are explained and proper information given to the older person and their families.
2) The rehabilitation (re-ablement) service is helping people develop or regain the skills and confidence to do things for themselves. It is a free service for a period of up to six weeks. What are you views regarding this service?
Approve Disapprove Don’t Know Did not answer – see note on page 9 26 8 5 29
In support of proposals
The respondents to this question generally thought that the rehabilitation program was a good service:
This is a good idea. Is this available to all ages?
I am pleased it is free and do hope the resources will make it widely available and without a long wait.
Very useful, would be good to link to tele-health where appropriate.
In order to maintain people in their own homes for as long as possible it is important that we maintain their skills and abilities. This short term involvement will enable them to remain self sufficient for longer which in turn will allow the Local Authority to focus higher level services on those that need them most.
Very helpful. Have had experience twice due to two major operations and the six weeks certainly gave me confidence to improve my mobility with the carers' help.
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A very good scheme and invaluable for the individual affected.
Concerns about the proposals
However people also expressed concern. The areas of concern are that this service is: Not appropriate for everyone Limited by time
As we saw in the responses to Question 1, here most of the respondents expressed concern for those people for whom this would not be an appropriate service:
This would only work for people who are not physically frail or people with dementia. I feel that it is leaving vulnerable people lonely at a risk.
People need 24 hour care as they deteriorate and the best will in the world this won't happen. It never has and never will. Who sits in an office and decides these things.
The majority of people have already had reablement in hospital which hasn't been successful. If a patient isn't going to improve at hospital, the majority is not going to benefit by this.
This sounds good for younger people who have been ill, but my experience of my 90 year old mother is that once she has lost skills, she never regains it, and I get very stressed trying to stimulate her.
When you get to 90 years rehabilitation to regain skills is an almost impossible task people who are very frail will not respond. They just want care and attention which is what they get in Richmond Park.
Once again only if appropriate, for those people who would not benefit they need a safe environment in their own area where friends and relatives can visit with ease. If the rehabilitation takes longer than six weeks who pays and how much will it cost?
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This may be possible in a very small number of cases. I am not convinced it works for the majority of people.
A free service for a fixed term does not meet the needs of every elderly person. Some people will require support for a longer period than 6 weeks. What are the alternatives for them if support is required for more than the allotted period?
This takes a different time with each person. A person who is compos mentis and able bodied with support from professionals/family and friends would benefit (possibly more than 6 weeks). Others might find this infringing and not like anyone in their personal space. My father would have found this very intrusive. Other support would have to be put into place as everyone is different!
She has vascular dementia and cannot do any cooking; even using the microwave is not possible for her. Trying to teach her skills would be a waste of time.
Limited by time Those people who generally were more positive about the rehabilitation programme were concerned over the fact that it runs for six weeks regardless of progress of patient. They said:
What happens after 6 weeks?
If it works great but this will be for a short time, it sounds like a lot of money for a limited service.
Approve in principle but what if six weeks is not enough.
But it should be provided for as long as necessary to enable people to develop or regain their confidence other than being subject to an arbitrary time limit.
I agree with this as my nana has had this after her stroke and it helped her a lot. But then what will happen after the six weeks this is what I would like to know?
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Each case would have to be taken on its own merit as already stated, we do not put relatives in to care without a thought, it's usually a last resort because they can no longer do everyday things for themselves and it wouldn't matter how many weeks rehabilitation they had it wouldn't help, so they need to be in a safe environment in their own area to make the transition as easy as possible e.g. care home.
Ideas for improving the proposals
People felt that this proposal could be improved by embedding it within a longer term care plan. These people explain:
This is good for people, as long as a long term plan is in place before the end of the six week period.
Needs to be intensive help, with carers present for substantial blocks of time; patient must be able to copy before this extra help is withdrawn.
We agree but what happens when the six week period is over? Is there any follow-up service?
Sounds very familiar to successful STINT programme. The vital aspect is that people are enabled, and not abandoned at the end of the 6 weeks.
One person suggested how it could be financed:
It is nice to have an option which undoubtedly has value for some people, e.g. stroke victims, those returning home after a period of prolonged illness in hospital. Pooled budgets with health and a contribution from users or their families might be a way of subsidising such a service. Third sector organisations may be able to draw down money to assist in delivery that may not necessarily be an option for public private sector?
Some people said that there needed to be more communication between different services in order to make them more efficient. These comments are typical:
The reablement service matches what is provided by the very successful and innovative community short term intervention teams without the therapy input that they have. It sounds to me to be quite un-joined up Consultation report on proposals for care services in Allerdale and Distington areas 18
thinking for the county council to provide a similar service that competes for clients/patients.
This service should be integrated with existing services and should have qualified AHPs overseeing this service.
You need to think how you can integrate with the community short term intervention teams, not compete with them. Many people require far longer support than six weeks as you are well aware.
3) High level home care services provide people living at home with the combined traditional home care and basic nursing care services. Do you support our proposal to expand high level home care services from a night time only service to a 24 hours, 7 days a week service, to support more people to stay at home?
Yes No Don’t Know Did not answer* see note on page 9 29 9 5 25
In support of proposals
It might work if the proposed carers are fully trained and competent in their work, in all aspects of care for the elderly needs. Also provided they are, and the system and agencies are fully approved and monitored regularly.
If a careline facility is in place and any more vulnerable people have the extra add ons, fall monitor, etc. etc. as required.
The frail elderly often need input over the 24 hour period, this is to be welcomed.
Concerns about the proposals
Similar issues are raised in response to this question as they were to the earlier ones. That is: Issues of isolation and loneliness
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Appropriateness of service for everyone Training and support for staff Money
Issues of isolation and loneliness The main concern that people expressed was that this form of care could lead people to be very lonely and isolated. As respondents said:
It would be better to take them to a home - Park Lodge for day care, where they would have company of ones who could talk to them and enjoy quality time together with ones they know.
People need 24 hours of care, not just 'pop in' visits.
They will be very isolated at home and families will be very stressed.
Clients are in Park Lodge for company as well as care.
Appropriateness of care at home for everyone People expressed concern that the Council’s proposals would not suit everybody:
Yes but people who do not want to stay in their own house should not be pressurised to do so.
If people need this level of care, isn't it easier to provide it in one location? And more economical?
People would be better cared for in a residential environment that they live in now.
My mother could not possibly live at home.
If you need this care, would it not be more practical and financially viable to use a care home? Those provided a good service.
Question does not allow respondent to reflect support but not at the cost of closing high end dementia units.
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With the reservation stated elsewhere - this is not the solution for everyone.
I do not, because I feel that you are proposing to develop this kind of service at the expense of residential care services, especially in parts of Allerdale. In my opinion, again this type of facility might suit mild to medium dementia sufferers, but many sufferers need residential care and the numbers are on the increase.
Patients need to be able to call on help quickly when a crisis occurs. Not everyone has family and friends close by who can come to help quickly in the middle of the night. People also need the confidence to call for help and not wait until morning.
Family do what they can to look after parents at home, it then becomes so difficult you have to seek help. In my case the doctor advised residential care.
Staff and training Again there was concern among the respondents around recruiting and training the workforce. People said:
Where are all these people coming from, they won't have the training like Park Lodge staff. Carers cannot be there 24-7. People cannot pee to order!!?
Keep the care homes open. Home care is only 0.5hrs here and there, you don't get the same staff, often you don't get a hot meal. The staff do not have time to do this, or don't want to.
This depends on the people providing the care. It must be carefully monitored.
Home care services are fraught with difficulties and on balance I would have to say that it can never fully guarantee the level of security offered by domiciliary care. It doesn't stop isolation and loneliness and doesn't enable control of medication and is just as intrusive and at risk of undermining dignity as CCC alleges is the situation in the care homes they propose to close - which I refute as incorrect, untrue and misleading.
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Money People wanted to know where the money would come from for such a service:
Will this ever happen. Many elderly getting care now cannot afford the monthly bill for an hour a day so they would have to be very wealthy to get 24hr care. How much out of your budget will it cost for travel expenses for carers travelling lots of miles daily?
It makes sense economically to put people with high support needs all in one place. And it makes sense in other ways too. They will get better care and full time care.
Ideas for improving the proposals
A small number of respondents stressed the importance of such a service and suggested ways in which it could be utilised by other service users:
I feel it is important that a high level service is available long term 24 hours per day to those who need it e.g. those that require turning or repositioning throughout the day and night, in order to remain in the community long term. There are others for whom a high level of service is required short term to facilitate early (but appropriate) discharges from hospitals and in order to avoid unnecessary admissions. Such services may also assist to provide a respite for a carer whilst the customer remains in their own home.
This needs to be integrated with other services. It is already confusing for individuals having so many different people coming into their homes. Clinical skills will need carefully monitored - who by? It needs to be accessible to all, not just those who live in certain areas.
4. Sensors and alarm based technology can assist families and care staff in supporting people living in their own home. Do you support the proposal to increase the use of sensors and alarm based technology?
Yes No Don’t Know Did not answer * see note on page 9 27 7 10 24
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In support of proposals
A small number of respondents were very enthusiastic about this proposal:
Absolutely.
I fully support the proposal to increase the use of all assistive technologies as they can provide a crucial component of care - Peace of Mind. This is often peace of mind for the carer or relative as they know that if something were to happen the customer would have the ability to raise an alarm and get the help they need. On the other hand assistive technologies also provide peace of mind for the customer. Either way having the safety net of assistive technologies available 24 hours a day can reduce people's anxieties and reduce admissions to residential care for 'safety reasons' as currently customers and carers often say that it is the gaps between care visits which causes them the concerns about whether the customer should stay in the community.
They are a good thing. My husband fell out of his chair two years ago. He was leaning with his good arm on the table when his strap came off. I couldn’t pick him up as he is a dead weight. I phoned ‘care-line’ and right away they got me help. It’s great to know they are there to help. We feel safe with them being there for us.
Concerns about the proposals
There were many concerns expressed around the use of sensors and alarm based technology. These mainly fell into three categories:
A cheap alternative to ‘real’ care Fear and distrust of technology Peace of mind
A cheap alternative to ‘real’ care These comments reflect what many people expressed:
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Where is the love and care in a sensor? You're not thinking of the person, only saving money. People like hands on and a friendly face not a battery operated machine.
As long as it isn't seen as a substitute for human contact.
No, because there is no substitute for actual hands on care by professionally trained people with experience and families who understand each sufferer's personal needs and habits. Sensors/alarms do not understand people, but may help in a minor capacity.
You cannot replace people – especially those dealing with the old and often confused people – with gadgets.
No amount of technology can replace human contact. Alarms cannot cater for the full physical needs of a person and they definitely cannot provide company and comfort to a lonely person. How long is the response time after an alarm is activated?
Fear and distrust of technology Others pointed out that older people are often unhappy with technology. As these people illustrate:
My grandma wouldn't use her buzzer as she didn't want to 'bother them'. Luckily we lived close enough to check on her regular.
Technology scares a lot of old people and they end up not using it properly. My mother has a care alarm, but, sometimes she is at one end of the house and the alarm is on a table at the other.
Other people expressed concerns over reliability of technology:
They can break down, won't replace the reassurance and smile, hug of the staff they have known for several years and are part of a family.
They don't always work, so people are at risk.
Too many people will be put at risk.
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What happens if they breakdown? People need people.
Peace of mind In addition people said that residential homes ‘give peace of mind’ to relatives of elderly people that they do not get from alarm and other assistive technology
Care line is a good thing, but when you are constantly being called at all times day and night, it is very nerve wracking. This is why places like Richmond Park must remain open.
Because the service would call us to gain access to him. This is from past experience when my father lived on his own. He was admitted to hospital on a regular basis. This does not happen now I am in my seventies.
Ideas for improving the proposals
The majority of responses agree with the following quotes:
On the whole the idea is not bad, but unless someone is sitting outside the residence when someone has a fall, the possibility of getting there before serious damage is done is minute.
We fully support the proposals to increase the use of sensors and alarm based technology, as the use of this technology helps people to feel safer and more secure and importantly enables action to be taken quickly and appropriately, should a problem occur for an elderly person living in their own home. We would though welcome more details on how and to what degree it is proposed to make better use of this technology, as the proposals included within the consultation are not sufficiently detailed to allow us to understand how the use of this technology is proposed to assist people directly, and where the funding will be provided to enable sensors and alarms to be fitted and monitored within the homes of those who are supported.
Whilst I can understand that alarms and technology have their uses I think we need more information about how they would be used as I think a lot of people think it is going to be used instead of people. So please give us more information. Consultation report on proposals for care services in Allerdale and Distington areas 25
5) Improvements to the design of residential care home can reduce the affect dementia has on a person’s ability to live with a level of independence and a high level of contentment. Do you support the Council’s proposal to invest in improvements to the environment and in staff training at Inglewood and Parkside?
Yes No Don’t Know Did not answer * see note on page 9 22 9 10 27
In support of proposals
A few people were clear in their support for the proposals to improve design and staff training at Inglewood and Parkside for people with dementia:
I fully support the proposals. I have visited the Stirling University Dementia Centre and feel all residential establishments should aspire to achieve their standards.
Wholeheartedly support this. Not just for the two homes in question.
Concerns about the proposals
The responses to this question reflect the number of responses that we received from people who lived in and around the areas where it is proposed that two residential homes be closed. As with previous responses, many people agreed with the proposals but all added qualifications:
Of course I support improvements in care and in staff training, but this should be across the board, not just selected sites and it should certainly not be to the detriment of other areas.
Is it not possible to do this without the closing of other care homes?
I think the training could be spread out better, e.g. Park Lodge, so it could benefit people in the local area of Aspatria and surrounding villages. The
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residents don't want to move away from the area where they grew up and why should they when the facility is already in place?
At Park Lodge they have people there who are in various stages of dementia. The staff are trained to deal with this terrible condition. I support Park Lodge fully.
I think these 'improvements are great - but some folk from the South of Workington will think that Parkside is a long way away.
Any improvements to people's quality of life must be beneficial, but not at the expense of other facilities in other towns.
Wouldn't it be better to build new homes with better facilities? Inglewood has small rooms without en suites.
Why not at Park Lodge? These other two homes are no better in any shape or form. These other two areas also have alternative residential homes. Aspatria has nothing.
Why Inglewood and Parkside? Park Lodge has land in front of the building where an extension could be built. Everything goes to Wigton and Maryport. Why? Aspatria gets nothing. Would Maryport and Wigton people like to be moved, to an area where they don't know any of the residents? I don’t think so.
We need a residential care home in Aspatria.
I don't care about Inglewood and Parkside. But I do care about Richmond Park because that is where my mother is, that is not to say I don't care about the people in those homes.
The home Richmond Park has the same qualified personnel and accommodation as the above mentioned. It would cost less to extend the home to bring it to those higher standards. There is ample room at the rear to make them.
Why only Inglewood and Parkside? Why not Richmond Park which already has a good environment and staff seem quite capable.
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Richmond Park is larger than Maryport, Parkside, has more en suites, larger corridors. The council is only spending money on fixtures and fittings. Why not Richmond Park? This is about money and where Richmond is sited. The care homes (private) nearby are and never have been a threat. We are dementia friendly at Richmond.
Ideas for improving the proposals
As we have seen, the majority of respondents said they did not want any of the homes to close and that they would like the council to carry on providing a quality service with highly trained staff. This quote appositely sums up what so many people said.
All of the council run homes have a high level of training in dementia and so all should be kept open. These facilities will be much needed and used in the future due to modern day living (Drink/Drugs/Stress) and because we live longer. The Council run these homes with strict guidelines and have won awards at the highest level throughout the West and whole country. Bring all of the homes into line and show that you care for the public. If it's not broken - Don't try to fix it. Just alter it to make it work better.
6) Extra Care housing schemes provide people with their own self contained homes with the benefit of care staff on site. What are your views on the Council’s proposal to develop an Extra Care housing scheme in the Workington area as an alternative to residential care?
Yes No Don’t Know Did not answer* see note on page 9 20 6 9 33
In support of proposals
A limited number of respondents thought this was a good idea without reservations:
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Very good idea – again to looking ahead. It accommodates peoples’ physical and mental problems at an appropriate stage of their well- being.
Anything that gives a measure of independence and purpose is essential to Quality of Life.
Seems a good idea if that is what people want.
Concerns about the proposals
Many people said that in principle this was a good idea. However, similar concerns to those that have already been noted in response to previous questions were expressed here: Loneliness and isolation Appropriateness of service proposal Location
Loneliness and isolation On paper sounds good. How many staff to how many clients? Isolation comes to mind. I feel they are going to be in a goldfish bowl being watched (big brother comes to mind).
It might be good but it would be important to have a shared space with things going on so people can choose if they want to mix with others or not.
Appropriateness of service proposal Whilst the majority of people said that they liked the idea of extra care housing all added a warning that this should not mean that residential homes are no longer required. These comments reflect the majority opinion:
Excellent idea. Being able to keep more of your belongings with you is more comforting. It can be such a wrench to leave behind your entire house contents. Care needs to be taken, however, that people do not retreat into their own flatlet and sit alone because they do not have the confidence to mix with others - who could be strangers to them.
Extra Care housing is a scheme in its own right, it is a brilliant concept and
Consultation report on proposals for care services in Allerdale and Distington areas 29
has been proven to be beneficial. But I do not believe it should replace residential care as there will still be many individuals whose needs are such that they need more than extra care housing.
These are good for people who are able but the majority of people in Park Lodge would not benefit from this. Probably this would be the case in many of these homes. People are there because they could not live on their own.
My mother had a home *…+ we gave it up, for her to go into residential care. I did everything for 5 years. Bathing, cleaning, shopping and everything else. My mother is not capable of being on her own.
This should not be as an alternative but in addition too. Do you not think that people would rather just pay one bill and have all their needs cared for? Why would you want to buy or rent another home when you get to the age of 85? My parents have made their choice already they want to stay at Richmond Park Residential Home. If my Dad was well enough to live in extra care housing he would rely too much on my Mum instead of asking for help from the carers. There is no continuity of staff in these new extra Care housing schemes, especially when the council is only giving care providers three-year contacts. Richmond Park has less that 2% turnover in their staff; there is continuity there. I am afraid that these would start with Care Staff on site and it would gradually be changed to bells, buzzers and sensors.
There is real concern for the well being of people with high support needs:
What will happen to people that can't stay alone - they are more at risk?
What will happen to people that can't stay in these homes?
The comment below captures what a few people said about Cumbria Council:
The council are not going to run this extra care village. We still need council run care homes. These are the best. A number of private homes in the area have been getting bad publicity. People trust the council homes. You can only live in extra care if you are of sound body and mind. People with dementia are getting younger.
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Location There were many comments about the location of Extra Care Housing:
But will one facility be sufficient? How accessible will it be for elderly family and friends to visit regularly from other areas of the district (e.g. Keswick?)
It is important for people to be able to access services in their own locality
This is too far away for the people of Aspatria. We have an ageing population, we need a local care home. Park Lodge must be retained
Ideal for Workington people but no one else.
Why Workington? The small towns lost out to the big towns. There is still the need for these schemes in smaller communities. Has any study taken place to establish the amount of elderly people in each district or town that need this kind of accommodation or is it based on projections?
Ideas for improving the proposals
Don’t close any residential homes they are used and we need them!
There is nothing wrong with residential care homes - they just need an update.
The case for the development of Extra Care Housing Schemes is well made and subject to the required planning approvals, and identified need, we support investment into this type of scheme. We would wish to explore a needs based approach to be adopted to explore the opportunities for other areas in Allerdale to be considered for new Extra Care Housing Schemes.
7) The Council would like to invest the money currently spent on existing residential care homes in a new extra care scheme and in more services to help people stay at home. With this in mind, do you support the proposals to close three Cumbria Care residential care homes?
Consultation report on proposals for care services in Allerdale and Distington areas 31
Yes No Don’t Know Did not answer* see note on page 9 8 29 9 22
Of those who answered no to this question, 11 people referred specifically to Park Lodge, 12 referred to Richmond Park and 3 referred to Woodlands.
In support of proposals
Only one respondent agreed with this aspect of the proposals without any caveats:
With modern technologies and Extra Care Housing we could successfully help people to stay at home for longer. If we can develop Extra Care Housing options in sufficient numbers it may ultimately be possible to do away with residential care beds as people tend to move to Nursing care from Extra Care if they require 24 hour care at all.
Concerns about the proposals
People concerns were mainly around two major issues A need for residential services Present residents
A need for residential services Respondents said that there was a real need for residential homes:
Closing Park Lodge would leave Aspatria with no facilities for elderly who need 24 hour care, and those who love to go to day care there for company.
In my experience some people with dementia cannot live on their own. Even with support from carers. Aspatria is only a small town but the population needs Park Lodge for those who cannot manage due to the ageing population. Friends and family who have people in care are not as mobile either and they would struggle to visit or support, loved ones moved from their home.
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I do not support the proposals to close any homes. We should be investing in them. Improvements can certainly be made, bedrooms added. I think this is to save money, maybe we need to look at keeping them open
Definitely not. There will always be a need for residential care. Have any of the suit and tie staff who make these decisions ever worked in care? Do they really know what these poor people need? I don't think so. At the consultation in Aspatria they all just repeated themselves. Park Lodge has a very high quality of staff in dementia.
No I do not. These are people's homes. Many been in for a lot of years. Why Aspatria?
Richmond Park is an excellent care home, the staff are wonderful. There are quite a lot of en suite bathrooms surely things could be altered to accommodate your requirements.
I know all the rooms in Richmond Park are not en suite and three service users use one toilet. It is a good home and we have good staff and all the service users and their families will say the same. But it doesn't matter what we do to try and save Richmond Park you have already decided to close Richmond Park and the other two homes.
My concern is that a local facility is being taken away, and local people will have to move to another town, leaving their relatives to travel to visit them.
Park Lodge in Aspatria - I cannot understand the logic of closing something that is clearly working and throwing the lives of the residents and their families in to total disarray. It's ok to sit in an office and come up with these proposals, but you really have to put lives before money. Don't try and find excuses as to why you're doing this e.g. lack of en suite, the residents are happy the way things are.
Think this may be less beneficial in Aspatria where there is a great deal of community involvement in the care home there. E.g. school children regularly visit and maintain relationships there.
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I am very concerned about the proposal to close Park Lodge - the only residential home in Aspatria - and Aspatria has no nursing homes. Park Lodge provides care for the very infirm elderly from the Aspatria area in a place that families can access easily. The rooms are small but functional and residents who need en suite facilities have them. Residents who are in rooms without those, need support when using the bathroom. That requires a larger room which is available. The home is very well run and already has a closer to home emphasis with admissions from Park Lodge to hospital being very few. Care plans are in place agreed with Aspatria Medical Group and these are working well. Communication is excellent between staff and the surgery. Moving these residents to Maryport or Wigton and insisting all future R Home admissions are to these places will mean residents will lose their local GP services and their PHCT.
Present residents My mother has respite care at Park Lodge. She loves it there and has made friends with other residents. It has a lovely welcoming feel when you go there, like walking into the homes of a family. This family you are about to break up. I visit a friend in Inglewood and his room is much smaller than the one my mother gets at Park Lodge and had has to go out into the corridor for the toilet. The trauma these old dears are going to have to go through to perhaps end up with a room no better, doesn't bear thinking about. Also for those who have lived around Aspatria all their lives, a move to Wigton or Maryport will be like going to the ends of the earth.
It depends whether the alternative care services are in place fully before closure and that guarantees are given that residents will not be moved away from friends and family.
Richmond Park. Because most residents are frail and vulnerable and don't take to major changes which I feel is very detrimental.
Ideas for improving the proposals
More info needed Do not know enough about the homes concerned to know if this is the right decision. I understand the ideas behind the plan, but do not have enough information to make a sound judgement.
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I am very anxious about these closures. More information about the newly developing provision would be helpful,
8) What is important to you in terms of the location of a new Extra Care scheme? (e.g. should it be near a town centre, on a bus route, in the countryside?
Community People thought it was very important that any care provision be located close to family and friends – in the community from where they came:
Since Richmond Park and Woodlands are ear-marked for closure in the south of Allerdale and North Copeland, I personally feel that an extra care scheme should be allocated to service that area and provide a visible sight of Cumbria County Council Social Services in that area.
I think the most important factor in this is close to home. The elderly should not be forced to move out of their community they have lived in all their lives, causing isolation, loneliness and depression. Have you thought of building Extra Care housing in Aspatria?
I feel that Aspatria Park Lodge is situated on a perfect route for buses. Without Parklodge I would have had a 30 mile trip to visit my Grandma, who I saw 3-4 times daily before we needed to opt for a care home
Countryside? Come on! The clients are going to be isolated enough. Bus routes are being cut. A visit to Park Lodge can be walking distance for some family members. Using transport could add another 3-4 hours. A lot of family members are also becoming frail.
Village life, small teams, family and friends close at hand to pop in and see.
Good transport links People thought that it was important that any care service be located on good bus routes:
It needs to be near bus routes to enable friends/family to visit and ideally near facilities like doctors, shops etc for benefit of residents. Perhaps, if
Consultation report on proposals for care services in Allerdale and Distington areas 35
one facility is to serve the whole of Allerdale, it should be central to the area rather than on the west coast - e.g. Cockermouth.
Easy access to shops and regular bus services.
It should be near a bus route because not everyone can drive and near to shops as well and have a nice view.
Should be on a bus route and readily accessible.
I feel Extra Care Housing needs to appeal to individuals as a nice place to live, as my view is that we should be encouraging people to move to places whilst they only have accommodation needs and no care needs. By doing this they would then be a future proofed in that, when they require care it would be available on site. As individuals are all different in respect of their tastes this can only be rectified by having a wide variety of schemes in different locations which will appeal to a range of people. Having suggested that the key factor is 'appeal', as we have to start somewhere, it would make sense to develop the first unit where there are significant group of possible residents e.g. centres of population such as Workington, Maryport, Wigton or Cockermouth.
9) If you were the Council and needed to support growing numbers of older people with less resources, what would do?
People had many suggestions for the council.
Person centred support People said that it was important for the Council to adopt a person centred approach:
Ask them [older people] what they want. They are the ones who have paid taxes all their working years. Ask how they would like to live their last years.
Care should be tailored to the individual. Some older people's wishes and needs are very different than others. A broad spectrum assessment cannot be used.
Listen to what the residents, families and carers are saying Consultation report on proposals for care services in Allerdale and Distington areas 36
It’s about really listening to what older vulnerable people say they want. Not about deciding for them
Go and visit the elderly people and their families and ask their views on the matter.
Resources People recognised that financial resources were a critical factor and suggested:
Campaign vociferously about the need for such services and argue the case to Parliament and local people for the corresponding tax revenue (local income tax).
I would move heaven and earth to find the resources. I would speak up in what I believe in not follow the top councillor's proposals. Look at the sheltered housing we have - they are all full.
I think it is a measure of our society as to how we look after those that are vulnerable. With that in mind resources that are available should be used wisely. If new builds are required then they should be as cost effective and appropriate to needs. However when upgrades are an option then that is surely a better use of resources!
Firstly ensure that early diagnosis of medical and social needs are made, together with suitable treatment. Then provide much better care at home (though this can be difficult to do - the ideal situation would be an allocated carer who liaises with relatives and gets to know each elderly person better,) Then I am afraid I feel residential care is the better option after this, as it is the only way to provide a totally safe environment.
Encourage and support charities to help – Age UK, Alzheimer’s, Parkinson’s etc. Support the wider family - many may know what help is available for their elderly relative. The GPs would help point families in the right direction. Provided FREQUENT enough support and more wide ranging support e.g. changing a light bulb - without it being a major operation.
Realistically some form of contribution would have to be levied.
Consultation report on proposals for care services in Allerdale and Distington areas 37
Look at County Council homes becoming a trust. Save money from the top - less managers. Lots of money is wasted by not having the facilities to buy food locally and being told where to purchase it from.
Stop wasting money - on unnecessary paperwork.
It is not up to me - it is your job to do this correctly.
I agree with supporting people in their own home for as long as possible but there is always going to be a need for residential care particularly for those individuals suffering from dementia. Perhaps the council cannot tackle this problem - increasing numbers of elderly people and reduced resources alone. Pilot schemes in some areas of the country (Somerset) are joining forces with Health to provide integrated teams of staff to encourage as much independent living as possible. Currently this would seem to centre care upon the individual and reduce hospital admissions, making substantial savings in the long term. Perhaps the development of Extra Care housing is tinkering at the edges of care delivery rather than grasping the nettle of services working together. A much bigger problem.
Reserve the best quality care you have and engage with those in the community who can work with you to offer viable alternatives. The wellbeing of existing clients/residents should be of paramount importance - as well as seeking to work in partnership for viable solutions for the future. Significant investments e.g. Extra Care should be evaluated over time before further investment.
Improvements Other people suggested the Council improve what it already has. These comments are typical of what many people said:
I would update the homes you have now that they have been there for years and put money into them to make bigger rooms.
Surely to build a complete new building will cost more, than to modernise the original one. Old people deserve help they were born in times that were very hard.
Put the money into existing homes / get the independent housing to put money into these buildings (partnership) as you did with Council houses Consultation report on proposals for care services in Allerdale and Distington areas 38
you provide the Care. They are good sound buildings that need a little money to update i.e. Woodlands has the land to expand and modernise as you said above – to 'support growing numbers of older people'. Even Mrs Thatcher has dementia - it can take anyone in its clutches. Save and protect what you have.
Use what we already have more effectively. Listen to communities - what works in the bigger towns does not necessarily work in more rural areas. Do more effective research. Don't spend money developing services which another agency already has up and running!
Look and assess at what you have got already, then try to improve what is there rather than major upheavals to the residents' quality of life.
Other people put the emphasis on helping to change attitudes and communities:
Look for ways to encourage families to take more responsibility for the care of their parents and grandparents.
Encourage and support communities and families to support their own vulnerable people. Work with third sector agencies.
Encourage healthy living so that the ageing population stays healthier for longer. Encourage development of future proof homes which will allow people to retain quality of life whilst remaining in their own home as they become less able. Encourage communities and individuals to be self-sufficient and mutually supportive.
Some respondents said the Council should:
Leave things alone
Why try to fix things when they aren’t broken
Cut out waste and work smarter
The two comments below reflect what many respondents said:
Consultation report on proposals for care services in Allerdale and Distington areas 39
The ideas you have put forward seem reasonable. However they rely on having the right staff and training and facilities, and full involvement of the public/ residents / patients. It also assumes that the lessening demand for residential places is real and will continue. The drive for care at home can sometimes force people into situations against their will - not all want it.
I would try and keep people in their own area when the home is clearly working. I would leave it alone. Look into an area where there are more homes and (if closure was unavoidable) so you could still keep people in their own area. After all it's people not money that counts.
10) Any other questions, comment or suggestions? In answer to this question respondents returned to their main concerns already reported. These included: Concerns over present residents Training and support for staff
Concerns over present residents. People are very worried over the effect that the council’s proposals will have on present residents of the care homes which might close. These comments reflect what a lot of people wrote:
Park Lodge is home from home to a lot of residents. They are all cared for as individuals and with dignity and respect. Aspatria needs this residential home for the residents of the town. If I were elderly I would move into this brilliant home with no problem. I wouldn't want to move to Maryport or Wigton.
If you move old people in different directions now they will probably die with the upheaval of stress and worry. They are happy and content with their care. At Richmond Park I am also happy with the level of care.
If the patients are satisfied with the care they receive now and being of an age and content in the environment, why in heaven's name close the home they are in.
Friends will be split up and that is terrible. Please keep groups of friends who live together, together it is so important.
Consultation report on proposals for care services in Allerdale and Distington areas 40
Training and support for staff People reiterated their concern that appropriate training and support will not be given to the care workforce. These two comments speak for concerns a lot of people expressed:
I cannot stress enough of my misgivings that the appropriate training is given to staff. A popular public conception is that anyone can care! From my experience and specialised training regarding older people, I do not adhere to that myth. A further danger is that properly qualified staff as well as supervisors will be overloaded with work and provide a hotchpotch service!
Care at home may be poorer if those receiving care get an ever changing succession of carers, continuity is vital. Adequate time must be allowed to give carers dignity. Training of carers must be adequate and appropriate. The location of the home must be tailored to the population.
The final quote in this chapter appositely reflects the feelings of many: Although I am responding as a member of Adult Social Care staff, my views are also expressed as a Council Tax payer in Cumbria, wanting value for money at no increase in cost. As a resident of Cumbria I, too, may become a customer. I would like to think that I could plan for my future needs and make use of a range of options and that when I am no longer able to plan and decide for myself there will be a range of high quality options to offer the best quality of life.
Consultation report on proposals for care services in Allerdale and Distington areas 41
3. Face to face conversations with residents
Over a period of six days in early December 2011 we visited three homes: Park Lodge in Aspatria, Richmond Park in Workington and Woodlands in Distington. We spoke with 26 residents; 5 men and 21 women. Most were individual conversations but some residents took part in small group discussions. We spoke with 6 relatives of residents alongside their relations, principally to enable them to support relatives with a degree of confusion or dementia.
Experienced advocates had spoken with all residents before these discussions to explain the consultation process and assess whether or not the residents wanted to take part in the consultation, and if they did what support they might need to participate.
Whilst we used the questionnaire as a guide to the conversations it was generally not appropriate or possible to adhere to the set questions. This was due in part to the dementia that some residents experienced and in part to the conversational style of the group discussions. At all times in the interviews, and in the initial advocacy visits, great care was taken to support the residents to give their views and discuss the proposals in a way that incurred as little upset as possible. Some residents said they were very pleased to have the chance to tell us what they thought. In other cases it was not possible for residents to understand the full context of the discussions so we spoke to them about their experience of living in the home and what they thought about it.
The direct voices of both the residents and their relatives are used extensively in this chapter. It is only by using direct quotes that the richness of thought and the depth of feeling in people’s responses can begin to be conveyed. To preserve anonymity the responses have been analysed together, but where relevant the particular home is identified.
Summary of what people told us: All the residents said they were contented. Many said they were very happy where they were and did not want the home to close. The residential homes were located within local communities. This was very important to residents and their relatives. Most residents were extremely worried that they might have to move. Everyone praised: Consultation report on proposals for care services in Allerdale and Distington areas 42
o the staff and care workers o the accommodation o the food o the sense of community o the fact that all responsibility was taken off them Some people said they did not want to live on their own because: o they were lonely o they felt unsafe o they did not want to be a worry to their relatives Some people had used alarm systems around their necks. This was not always successful and it was what most people understood by ‘assistive technology’. Extra care housing was not popular amongst the residents as they thought they would be lonely. Some people said they could not manage to live alone in extra care housing or with assistive technology as they thought they were too frail. Deciding to use Residential services can be a positive choice for many older people.
Detailed analysis of views:
What people said What follows is based purely upon what residents told us, and upon what their relatives said. We have clearly indicated whether it is a relative who is speaking. Everything else is the voices of people using residential services.
This chapter is divided into three main sections, the first two with subsections. Each section was generated by the voices of the residents and their relatives.
Contentment o Satisfied customers o Location o The Staff o Accommodation Alternative services o Care at home . Safety . Isolation and Loneliness o Extra care housing Consultation report on proposals for care services in Allerdale and Distington areas 43
o Assistive technology What we would like to say to the Council
Contentment In the homes we visited we heard high praise for the residential services in Allerdale. Most of the comments fell within four categories. We will look at each in turn.
Satisfied customers The vast majority of the residents we spoke with said they were extremely happy with where they now lived. As these two residents make clear:
I’m very happy!
Oh yes so am I.
I’ve been here 6 or 7 weeks – I’m happy.
Other residents agreed:
I like living here – I know most of the others. I’m from Workington. *...+ I’ve been here a while. I like it. Everyone’s very friendly – that’s what you want.
I’ve got a big family and they always visit. I’m very happy here. My daughter comes every day. I keep in touch with my grandsons. Nobody bothers me. I like it.
It’s home sweet home here. When I’m older I want to come here. You can see how good it is here. (Relative)
I am very happy here.
There’s a nice atmosphere, no smell. There’s no tidying up before you come, how you see it is how it is. It’s alive and everybody’s chatting and well looked after. (Relative)
The food is wonderful. They’re always doing extra little bits like making scones, making shortbread.
Consultation report on proposals for care services in Allerdale and Distington areas 44
We ice biscuits, fold napkins. It keeps us out of trouble alright!
I don’t just get my own visitors – I get everybody’s visitors and we all share them!
We don’t want it to close.
We’re happy here. We get lovely meals. Everything’s lovely and clean, you’ve got a clean bed. What else do you want?
You get a feeling don’t you? It’s the fact that you feel at home that makes you feel at home if you know what I mean. (Relative)
Some of the residents were clear that change is inevitable as you age and that they were content:
I have to have somewhere to live. When you get older things change. I am quite happy here... It’s filled a purpose for me.
Everybody has their nature, don’t they? If you come prepared to accept, things turn out right.
When you’re older things aren’t the same. Getting older brings changes in your life. I’m thankful to have somewhere to be when I’m older.
This is a respite room – I’m going to move in when they have a room. We’re living too long. I’m pleased to be moving in – there’s nothing better – I’m not a burden to anyone. My son in law says I’m more or less spoiling his retirement. I couldn’t really call my home, my own home. It’s my son in law’s home. I’m much happier here. I shall be sorry to go out of here. I hope it stays as it is…but things don’t stay as they are. It’s a luxury and I appreciate it. What’s the alternative – I can’t see how they can improve on this.
Location Where the homes were sited was of importance to both residents and their relations.
Consultation report on proposals for care services in Allerdale and Distington areas 45
My mother’s from a village nearby. People from the village come here and volunteer, so she still sees them. There’s also people from Chapel. (Relative)
There’s a difference of people between here *Aspatria+ and Wigton or Maryport. The young men from Aspatria and Wigton used to fight each other! (Relative)
This is where I’m from. I wouldn’t want to go anywhere else.
People here all know each other – you can have conversations with different people. People know each other’s relations, it all ties up. (Relative)
The residents all know each other. We have some laughs. We knew each other before we came in here in some cases.
We all talk away together.
My old doctor came to see me because he knew I was here. We are a good community and the home is part of the community.
It’s important to the people here now but it’s important to the community as a whole too. (Relative)
We wanted to get her in here because all the family are round here. (Relative)
I live away but once she came in here I realised how important it was for her to be in her own community. It feels like she’s still at home. I think it’s important for her to be with people she’s familiar with. (Relative)
I can’t drive. If she moved to Silloth, there’s no buses. If it was Wigton there’s a bus but there’s ½ mile walk to the bus stop. She sees one of us every day, we couldn’t do that if she wasn’t here. (Relative)
When she was very poorly we sat with her here for three days. We couldn’t do that if she was at Wigton or Maryport. (Relative)
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The staff In all the homes we heard nothing but praise for the staff and care workers.
These girls take over as our family – it’s such a lovely team of girls.
You can’t fault them – they’ll do anything for you.
It’s 12 months since I came in. I love it. The carers are marvellous.
I like it here; the staff are wonderful. I wouldn’t want to leave. If I need anything in the night I just press the buzzer and the staff are there straight away.
This home is so well run. We’re all so happy. No one seems to have any complaints.
Everybody’s so helpful. That one over there is teaching me the foxtrot even though I can’t stand on my own two feet!
*Possibility of Home’s closure+ – Ah no – it’ll break my heart. I love it in here. The staff are very good. They do your shopping for you – bring anything from town. Oh they’re good. I hope they won’t close it. I think it’s lovely and the staff are great – couldn’t be better.
They all love it in here. Staff don’t change either which says something too. We’ve never had empty beds – which is another thing. If you ask for anything – it’s brought for you if it’s humanly possible. Nothing’s a trouble. We’ve done all we can *to keep the home open+ and hope that Providence takes a hand.
They’re good staff and get you anything you need. I like it here. The girls are nice. We’re good friends.
Accommodation Residents were quite clear that they viewed the residential homes as their home and did not agree with the proposals for themselves. Everyone said they were happy with the standard of accommodation.
This is now my home. I wouldn’t go into yours and tell you that you had to move because the toilet was not in your bedroom! I like my room. Consultation report on proposals for care services in Allerdale and Distington areas 47
If the Powers want bigger rooms – all well and good but there is no point closing this – we’re full and happy. Why should this home be closed?
Why decide what we want. No one has been to look at our rooms. We have our own toilets. The bedrooms are quite adequate. This is as good as anywhere I’ve been. When they’re on TV they show Woodlands and a small room. That’s not fair.
My room? It’s big enough for all I need.
I’m not bothered *about having en suite facilities+. I’ve got a commode and I’m quite happy with that.
No I would not change anything, we’re quite happy as it is. I don’t want it to close.
That’s another point – they say the corridors are too narrow – but they’ve coped here with the lifting equipment. You can pass each other with frames without waiting. You can move in your room easily.
I’ve got all my photographs and a nice room.
Toilet’s just there. I’m content with my lot.
Other places might have big rooms and ensuites and all that but you’ll not get the personal touch you get here. (Relative)
If I went to a hotel I’d want an en suite bathroom, but when I’m old I’m more interested in being looked after and feeling at home in my own community. (Relative)
They’re on about en suites, but they can’t use them! They go on about corridors not being wide enough for wheelchairs, but they are. (Relative)
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Alternative services
Support at home Part of the Councils proposals for care services in Allerdale and Distington is to invest in 24 hour 7 days a week high level support at home. People had knowledge and experience of home care services and in the main people said they were not wholly positive.
People told us they did not want strangers in their homes. Moreover they were unhappy with the number of different care workers they had had. These people explain:
Mother had never had a stranger in the house, so the first time they came I said for them to wait for me before they went in. Then we could talk to her and explain how they’d come to help her. But when I got there the carer had already been in to my mother’s bedroom and woken her up! (Relative)
At home I didn’t like all the different people coming in. I know everyone here. I used to work just down the road.
They [carers] changed with the weather. No connection at all. (Relative)
It’s difficult to get the same carers after you’ve been in hospital.
I would have preferred more support but now I’ve been here I realise that the care is here. At home it is ‘hitty missy’. I experienced it for a week and they came in for about half an hour, and anyway I was better at coping then. Primarily though it’s unfair on my son to have the responsibility of my care. He can come here at any time – and he knows I’m in safe hands.
Life before here was much harder – Not a lazy bone in my body.
One reason to come in here was that mother didn’t want home care.
My carer came in at quarter past five in the morning. Then I was in bed in the middle of the afternoon.
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We heard from relatives that many people would not accept the help and/or care in their own homes but would in the residential homes.
They came to make her dinner but she’d try and do it before they came, whereas here she accepts the help. (Relative)
She had home care packages, but she sent them away! In the end it was family, friends and she had a paid cleaner. (Relative)
She would always try and tidy up and cook before the help arrived so it was all done when they got there. But she likes it here now. (Relative)
At home you’ve still got the responsibility. It’s warmer in here.
Safety Some people chose to live in a residential setting over their own homes as they recognised they were unsafe living on their own. This is what residents said about the benefits of living where they did:
There’s bells all over here. We can summon anyone here anytime.
I don’t want to spoil the boat by twining. I feel safe but there is no place like my home.
This is my home – I feel so safe.
Safety was a major factor influencing relatives of older people<
Eventually you come to the conclusion, with the steps and the fire, she should come to Park Lodge. (Relative)
She hasn’t had any falls since she’s been here, they’re always keeping an eye on her. (Relative)
Both relatives and residents said they had better health care in the residential homes than they did living alone;
She’s had more care from the doctor since being here, she wouldn’t call the doctor when she was at home. (Relative)
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The doctor comes regularly to see us all.
They cut our toe nails and keep us tidy.
We can go away and know that she’s in good hands. (Relative)
Isolation and loneliness For many residents living at home, particularly after the death of a spouse, led to loneliness and isolation. These people explain:
My husband came here before me and I couldn’t manage on my own… I wasn’t happy without him. I didn’t want more support to stay at home, I wanted to be with him.
People are wanting to come in here because they’re lonely. When visitors come in here they know everybody. (Relative)
I had two operations and I was not able to cope. It wasn’t fair on my family. I’ve been with my husband for 63 years and I did not want to be apart from him. It’s better to have separate rooms. My daughter worked here until last year. My other daughter researched the options before my husband came in. When he came in – he had the loveliest feeling. He’d been in a private one and he hated it. But in here – he took it as his own. He never said he wanted to come home. He’s been here for 12 months. That was a good sign. If it closes he will be most unhappy.
At home you’d be on your own all day, but here you’ve got company.
I used to spend a lot of time alone. I was on my own all the time.
I’m happy, there’s nothing else I want to do. There’s company in here.
If I were anywhere else I would be lonely.
I wanted to come in here. I didn’t want to be on my own. I’ve got a friend who lives not far away so she comes to visit which is nice.
I like company. I have bother with my nerves. I like to talk but I like it quiet as well. Consultation report on proposals for care services in Allerdale and Distington areas 51
I was very lonely when he came in here. When I took the key out of my door, I did not think of it again. Moving in here was moving in with him again. We’ve been so lucky…so you’ve got a lot to be thankful for and still happy and I don’t want that taken away.
When I was at home I was always on my own. They were always on at me to have someone in but I said no. I love being at home. But it’s a lot easier here – it’s very nice.
Extra care housing Residents did not think that extra care housing was for them People expressed strong views about this:
Extra care housing? No that would be no good for us. You can’t live on your own if you can’t get about.
It might be a good idea but not for me!
You could still be lonely. No one to talk to, no chat. All on your own until the carers come in and do what they have to do and then leave you on your own again.
Assistive technology The Council are proposing that there be investment in assistive technology packages that would allow people to either stay in their own homes or be part of a care package alongside extra care housing. One major problem that people identified was that for a rural community it might take too long for assistance to arrive.
These Assistive Technologies are all well and good but it takes time to come. At night you feel so safe – always somebody here. You press the bell and in 2 minutes they’re here. This safety is very important. *Living on your own+ It’s at night when you don’t feel safe in the night time – this is the biggest thing.
In theory this care in the home works but in practice we’re in a country village, how long is it going to take for someone to come if they’re called? (Relative)
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I don’t like the idea of it at all and how long will it take for someone to come round?
No, you would still be on your own, whereas here you have company. (in response to a question regarding assistive technology)
I don’t want monitors and people spying on me! It would drive me mad!
Many people had experience of wearing an alarm. It was not always a positive experience: I had an alarm round my neck when I fell but I forgot it was there, I was so busy trying to get off my back before they got in.
She had a care line in her home but she didn’t like wearing the thing round her neck. Lots of people don’t like the idea of strangers coming into their home. (Relative)
At home she had a care line but she used to take it off but then forget where she put it. (Relative)
She had an alarm which she laid on in the night by accident so the care people called the neighbour, she ended up with the neighbours in her bedroom in the middle of the night which was very scary for her. (Relative)
Not becoming a burden I was very very upset at leaving home. I came in in rather an odd way, I had two spells in hospital when my diabetes was too low. My son lives in High Harrington, he said I wasn’t really safe on my own at night. I was in hospital at the time and when I left, I went from there straight to here. It was the most traumatic thing I’ve ever done.
What we would like to say to the Council My prime suggestion is if they possibly could, to leave us alone. It’s fine to make alterations with other homes but can’t see point of lifting anyone out.
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And my son would agree with everything I’ve said. My eldest daughter has written…If we could just spend the rest of our days here in peace and quiet – without being thrown out.
Tell them to leave it along instead of meddling with it.
Why meddle when it’s good?
You worry when you hear about all these things that go on in private homes. This is my mam’s home now and they want to put her out. (Relative)
When they offered *person’s name+ a room with facilities – she did not want to move. They must understand that old people do not want all this. Not when they are happy.
It would be lovely if they could build something like this home for us.
I hope the council mind their own business. I’m happy here. There’s great staff – do ‘owt for you – anything. I do not want to go anywhere else. I only hope they don’t close it.
If it ain’t broken don’t try and fix it. Leave well alone. (Relative)
I do not want to say anything to the council because whatever they’re going to do is already cut and dried.
We’re going backwards – not progressing at all. Most vulnerable people are being affected. I’ve got family support but I don’t know the answer. It’s political. What are they going to do with these places? They’re marvellous places.
My mum couldn’t survive a move. She knows a lot of people in here. It’s so sad. (Relative)
My sister doesn’t want it to close, she wants to come in here.
They don’t want to come in here and close it – we’d chase them!
This is the only place for old people in Aspatria. Consultation report on proposals for care services in Allerdale and Distington areas 54
I wouldn’t go anywhere else. I would give up altogether if I had to leave here. That’s the truth, I wouldn’t want to go anywhere else. I’d finish my days and that would be that.
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4. Correspondence from the general public in response to the Consultation Document
Introduction The first three sections of this part of the report reflect responses received about the three homes that are considered for closure in this consultation. The final section reports on the letters that were received which did not relate to a specific home.
1. Part Lodge residential care home, Aspatria 2. Richmond Park residential care home, Workington 3. Woodlands residential care home, Distington 4. General responses
Numbers of letters and emails
Numbers of unique Number of group letters/emails responses and type Park Lodge 64 80 copies of standard letter Richmond Park 8 98 letters from students at St Joseph’s Catholic High School Woodlands 5 (1 of which written on behalf of the Woodlands Care and Support group) General 3
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Summary of views received:
1. Park Lodge, Aspatria
In support of proposals There were no letters or E mails that were in clear and unmitigated support of the proposals.
Concerns about the proposals Signatories expressed worry and concern over the proposals to close Park Lodge, Aspatria. The areas of concern were: Sense of community Location Present residents The need for residential care services Standard of alternative services
Ideas for improving the proposals The letters and e mails received did not outline any improvements to the proposals as outlined by the Council. People were motivated to write against such proposals and were very clear in the outcome they wanted – that is to keep Park Lodge open.
2. Richmond Park, Workington.
In support of proposals There were no letters or E mails that were in clear and unmitigated support of the proposals.
Concerns about the proposals The areas of concern were: Location especially for respite care Present residents The need for residential services/inappropriate alternative services
Ideas for improving the proposals The letters and e mails received did not outline any improvements to the proposals as outlined by the Council.
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In addition to the eight individual letters and emails which were sent to Cumbria County Council there were 98 further letters sent by students of St Joseph’s Catholic High School. The main themes in these letters were: High standards of care in the home Number of staff redundancies Extensive community ties which would be lost Opinion that current residents are happy where they are Fears about effect on residents if they have to move Highlighting the local petition
3. Woodlands, Distington One letter about Woodlands was on behalf of the Care and Support Group at the home and the others are from relatives of current or former residents. They are all opposed to the closure of Woodlands. Their main area of concern is that the specialist dementia care in terms of the staff and the environment at Woodlands is vital to keep residents safe.
Section 1: Park Lodge, Aspatria
The quotations below are extracts from the 64 individual letters and emails that were sent in protest against the proposed closure of Park Lodge, Aspatria.
They have been separated from a larger group of letters which are essentially based on the same text, see (8 for more details. The letters considered below included submissions from the following organisations: Allhallows Parish Council Benefice of Aspatria with Hayton and Gilcrux Park Lodge - the Future Support Group. Park Lodge Committee Aspatria Medical Group Aspatria Rural Partnership.
The majority of the letters have come from within Cumbria, but there are a small number from outside the county and one from New Zealand.
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In support of proposals No one who corresponded with the council over these proposals wholeheartedly supported them.
Concerns about the proposals People had many concerns over the proposals. The closure of Park Lodge was of particular concern to the residents of Aspatria as it was regarded as being of central importance to the community, and the fact there is no other residential provision in Aspatria. This section is subdivided into areas of concern: Sense of community Location Present residents The need for residential services Standard of services Accommodation Alternative services
Sense of community The care home in Aspatria, Park Lodge, is central to the idea of community and sense of place. The majority of the letters received clearly mention the close links the home has within the local community. These people explain what this means to them and/or their elderly relative:
This home has been part of Aspatria community for as long as I can remember. My own Grandmother and Father were both cared for in Park Lodge and everything was done by the team there to make their lives as comfortable as could be in their later years. I still visit the home and find it like going into someone's house not an institution. I feel very strongly about the proposed closure as it is the heart of the community... this is a rural community and people should not have to be moved out into other areas if they wish to remain near family and friends...
This home is part of the community, they have all sorts going on for them in there and visiting them isn't a problem...I would like to add that a lot of its furnishing and fittings have been provided by the community by fundraising and donations.
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I am 80 years old and in good health. However if it is necessary for me or my husband to go into a care home, I think it would be very important to me and friends and relations, that I was living in my own community and that they were able to visit easily...Imagine a bus ride to Wigton and then a long walk to the home and then the return journey in all weathers.
My mother is in Park Lodge. She is 87 years old and cannot walk more than a few steps. She agreed to a home but only wanted to be at Aspatria where she lived and worked at for most of her life.
This is the only Residential Home in the Aspatria area and has a waiting list. The Home is an integral part of the community and serves Aspatria and surrounding villages. It is a valuable asset to our residents who are in need of full time care and their local relatives. The nearest other homes are in excess of 8 miles away and difficult to access by those relatives who rely on public transport.
There are no plans for extra care housing in Aspatria; if Park Lodge were to close people in the community would be forced to move from their home town, from their friends and family to an unfamiliar town.
The closure of Park Lodge would be one more lost provision of community support at a time when there is a desperate need to reassess public provision of care for elderly people within their own localities. Why must the elderly of Aspatria be cared for outside their community?
I have been instructed to write on behalf of Allhallows Parish Council who strongly oppose the closure of the above residential home... The Home is an integral part of the community and serves Aspatria and surrounding villages. It is a valuable asset to our residents who are in need of full time care and their local relatives.
As a young resident of Aspatria I see nothing being planned for the future of the town. There's no income, no economy and jobs are few and far between. The proposed closure, would lead to a loss of jobs. In today's climate that is a grave prospect for those who work so hard in Park Lodge.
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We chose Park Lodge above all others for Mother because she is Aspatria born and bred. All of her family and friends visit her regularly as she is still in her home town. Her friends are elderly so unable to travel... As the majority of staff are local people they know many of the residents on a personal basis which all contributes to making Park Lodge a real home from home for our Mother and others.
I attended the meeting at Aspatria on Monday night regarding the possible closure of Park Lodge. I am very worried as this affects my Mother who is a resident there at the present. I am so impressed by the care Mam has received there, the carers are like family- utterly dedicated and I no longer have the terrible guilt I had initially. I haven't the facilities to have Mam at home, but because we live locally we are able to visit regularly. My mother is happy and contented in Park Lodge, she has met up with and sits with her childhood friend and they entertain each other (and everyone else!). She also has met four other ladies from Aspatria she hasn't seen for years but they reminisce about olden days. This wouldn't happen in a home that wasn't local.
Location Integral to the importance of community, and of older people remaining in their own neighbourhood, is the importance location makes in terms of enabling friends and relatives to visit. Here are some extracts to highlight what people have said about this:
Park Lodge is unique in lots of ways. It is very special to all the residents and their families...Park Lodge is the only care home in the town so to close it would mean you take away choice for locals to continue living in their own home town they have lived in all their lives. To move these residents to a different town would mean isolating them from their family and friends. My Grandma's friends are the same age as her and can't physically travel, but they walk along the street to call in to see her - as they do often in Park Lodge.
Unfortunately Park Lodge was closed for renovation in 1995 and my mother was moved to Longtown. Luckily I had a car and could visit her most days. But what time and cost compared to her being in Aspatria. My Mum never made it home.
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I am ten years old and my Great Grandma lives in Park Lodge...My Mum, my seven year old brother and I visit her at least twice a week and she loves to see us and hear our news. I was very sad to hear that it might be closing and I daren't tell my Grandma because Park Lodge is a lovely place and it would upset her a lot. If she had to be moved to Silloth or Workington we wouldn't be able to go and see her as often. This would make us all sad. Please could you think about keeping Park Lodge open so that all older people can stay near their families.
It is the only care home in the town of Aspatria... if [people] need one they should not have to move miles away from people they know.
In general the residents don't want to move and family members do not want this as their family member is happy where they are at Park Lodge which they feel is their home and in their home town where they have lived for many, many years.
I have lived in the town all my life and seen so many shops and amenities closed - why not upgrade Park Lodge? Aspatria really needs a home here so that families can keep in touch regularly.
Another correspondent asks how the proposals link with current plans: The proposals also do not address how the planned services would be actually delivered in localities or make potential links with current plans. For example the Aspatria Rural Partnership Community Action Plan speaks of an intention to increase new and affordable housing in Aspatria, promote village hall use, engage the community in the Aspatria Rural Partnership and specifically speaks of the need to support older people in accessing services and local networks. This would not seem to be properly achieved by removing a whole section of people from the local community and be reducing local access to a service which the document itself says will still be needed as part of the mix. Present residents Tied in to both community and location is a real sense of concern for the present residents of Park Lodge. These comments sum up what so many have written:
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My grandmother, like the majority of Park Lodge residents has lived in Aspatria all of her life and finds it a great comfort to still be in the centre of her community where she can receive regular visits from family and friends (many of a similar age and with no means of transport). To ship these people out to another town in the last years of their lives is completely unacceptable.
Local people have set up homes and made friends. Leaving your home to go into care I can only imagine must be stressful enough. Remove the option of staying in Aspatria the stress load could be intensified. You could be further away from family and friends, the vital support network that keeps an individual sane.
As nieces of an aged Aunt residing in the only rest home in Aspatria, please may we encourage you to ensure the present facility remains open. It must be appreciated how unsettling it would be to shift these elderly vulnerable patients
If Park Lodge were to close it would be a huge loss in lots of ways - to the town, for the staff and most of all the residents who would lose their home, their choice to live in their home town and be forced to go through the trauma of a huge move with the adverse effects that been proven to happen
As a friend of a resident of Park Lodge, I would find visiting her extremely difficult if she was moved out of town. This would be detrimental to her health and well being as the stimulation of visits are important. On my visits to Park Lodge I have found the staff extremely helpful and caring and an excellent standard of cleanliness in the building.
My Aunt is currently in residence there, so it is of great concern to me...I understand we all have to make cutbacks where we can, but a proposal to close a much needed facility here in Aspatria should not even be considered.
A few people also commented on their concern for their own future if Park Lodge were to close:
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My wife and I...may require the services of a residential care home in the future (as will others). [We] would not relish the thought of having to be moved out of our home town where it would be difficult to maintain contact with friends and family. This being due to no accessible bus routes or other forms of public transport. This would in fact place people in our position in complete isolation.
We have always said that when one of us goes the other will move into Park Lodge.
The loss of the home could possibly be a burden on my children should I or my wife need residential care in the future, as lifetime residents of Aspatria we would prefer Park Lodge to any other home, as our children would have a minimum of a fourteen mile round trip to visit us, should the home close. Bearing in mind the high cost of fuel and the diminishing bus service through Aspatria, I can picture visiting being sporadic. Also another item I feel is important; I have seen the residents of Park Lodge watching the local gala and seeing their grandchildren and in some cases great grandchildren in the gala. On a summer's day the smiles on their faces were something special
The need for residential services Whilst many respondents have commented upon the Councils proposals, one of the emerging issues is that residential services are considered essential for some people. Many people argue that it is the best care service and the most appropriate service for some older people:
I was born here, grew up here and for nearly forty years was a Doctor in Aspatria... I agree that in principle, it is desirable to keep elderly people in their own homes, but every GP knows that a proportion of elderly people require Park Lodge type accommodation which is help, supervision and proper nutrition, but not professional nursing. If the numbers of elderly are going to increase as expected, we will need more of these homes not fewer...
My mother in law was a resident in Park Lodge from December 2010- December 2011. She had a stroke before she went into PL... it would have been impossible for her to survive at home alone. Before she went in carers did visit several times a day and she had careline, however the
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simple act of going to the toilet would sometimes end in embarrassment when the carers did arrive.
No one chooses to go to a care home for fun, they do it through necessity because they need 24/7 care by trained professionals, providing comfort for their families too.
As the population ages...with a higher burden of chronic illness, the need for residential care will only rise, despite the best efforts of all to ensure safe care in people's own homes.
I am a family friend of [a] Park Lodge resident. [She] is happy living there and the level of care she receives is second to none. She is registered blind and is unable to care for herself and needs 24 hour care not carers coming a few times a day. I find your suggestion that more elderly people in Cumbria should live in their own homes bewildering.
My Grandma is a resident in Park Lodge and is extremely happy and settled. My Granda died some years ago and she lived on her own in the house and was very lonely. She is 95 and blind. She became a danger to herself - from falling, setting things on fire, forgetting to eat, eating mouldy out of date food and making herself sick,...the list goes on... The hard but necessary decision was made to move my Grandma into Park Lodge...Believe me that was very traumatic for my Grandma and all involved. Now Park Lodge is her home and with it being so small and homely it soon began to feel just like that. With my Grandma being blind she has now found her way around, it being a smaller building has helped her do this. If she was to move to a bigger home she wouldn't find her way around and would lose all dignity having to ask and be taken to the bathroom etc. All the carers are now Grandma's extended family. This is the case for all the residents in Park Lodge, so how dare anybody even propose to up root these elderly people from their home....moving elderly people causes serious health problems, physically and mentally and leads to death.
Standard of service Everybody from Aspatria who wrote to the Council about the proposals talked about the high level of care and support residents and relatives were offered:
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[Park Lodge] is a very special place...I'm sure you will appreciate what a difficult time it can be for family when a loved one has to go into a care...I know from firsthand experience that a care home such as Park Lodge can help families come to terms with it in the knowledge that their relative is being cared for in a homely atmosphere, with the added benefit of the expertise of the staff there.'
Park Lodge is a lovely little home where the residents are well looked after. It is also used by the residents of the bungalows on site. If they need assistance they just ring PL and someone can attend to them immediately
I have had some experience of visiting Park Lodge both privately and as part of a group which regularly goes from the Methodist Church to sing hymns and conduct a small service for the residents...it is easy to see that the people living there are comfortable and happy. They are well looked after and they enjoy the stimulation of company which the home of course provides... I hope and believe Cumbria County Council is a humanitarian body ready to put compassion above expediency and will not sacrifice a successful and much appreciated establishment.
Park Lodge is hugely valued by the people of Aspatria and the nearby villages, and it is a very caring community in itself as well as being a very important part of the wider community...I have never heard staff, residents or visitors complain about inadequate facilities. What I have heard is praise: for the quality of the care provided and the personal touch; for the fact that people visiting their relative also know other residents and spend time with them too; for the offer of respite care on the doorstep, enabling carers (who are often not young themselves) to be able to visit easily for the duration of the respite; and last for the willingness of staff to care lovingly round the clock for those who reach the end of life, enabling them to stay in what, for them, has become their home.
Park Lodge is the home of choice for our loved ones due to the fantastic care they receive in their own home town. The uniqueness of Park Lodge is its homely layout and no one is segregated into units and they feel they are part of a family...
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The turnover of staff for the last three years is 0% thus giving continuity of care and filling our families with a great sense of familiarity and belonging
In the six months to end October 2001, only 1 Park Lodge resident was admitted to hospital as an emergency, speaking volumes for the care provided by the staff.
I can truly praise the home with its friendly atmosphere and the pleasant manner of the members of staff, as my dear elderly Auntie, and some of my friends had to leave their own homes, and be cared for at Park Lodge, with tender loving care.
The care in this home is exceptional...My mother was a resident in Park Lodge for a good few years...and her care you couldn't have asked for better. I know myself if she had been moved from the community she wouldn't have lived as long as she did - she was 95.
I work for the NHS and visit Park Lodge regularly. This care home is amazing. All residents are treated as individuals and are cared for with respect and dignity, every resident is happy and content. The staff are considerate and care so much for each individual's needs...
Accommodation These people demonstrate how they can appreciate the buildings might need modernising but, for them the accommodation is secondary to the standard of care:
We are aware of the shortcomings of the building...but the most important criteria is the care delivered to them. After all the building is just bricks and mortar, the care is people.
We are told that the proposal is in the name of modernisation and that Park Lodge is not fit for purpose due to not all rooms being en-suite and with narrow corridors. However...if you have been to visit you would notice there are no corridors in Park Lodge...hoists have been used for the last ten years and no one has had to move out of Park Lodge due to their needs not being met
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Park Lodge is just like a home. Elderly people need the best possible care not the best looking state of the art building. They would be so isolated if they were moved to another town, that is, if they survived the move.
Alternative approaches to care services Some people wrote that their experience of assistive technology was that it was not adequate to meet the needs of their relative:
Having Care-line and other such facilities are not enough for the elderly to be safe in their own home. Are they only meant to need the toilet at the times the carers are in the house?
Our decision to put her in a home was because she was always falling and sometimes be on the floor until her carers came in or our neighbour.
Ideas for improving the proposals The letters and e mails received did not outline any improvements to the proposals as outlined by the Council. People were motivated to write against such proposals and were very clear in the outcome they wanted – that is to keep Park Lodge open.
In addition to the 64 individual letters and e mails which were sent to Cumbria Council there were a further 80 letters and/or emails based on the wording below:
I the undersigned write to declare my objection to the proposed closure of Park Lodge Residential Care Home in Aspatria. The grounds for our objection are that such an action would have a severe detrimental effect on the residents who have made PL their home, the community and surrounding area and would be the removal of yet another important amenity from the town of Aspatria. The proposed closure would also lead to a loss of local jobs.
These signatories include letters from the following organisations: Aspatria Town Council Allonby Parish Council Waverton Parish Council
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Section 2. Richmond Park, Workington
106 letters were received in all regarding Richmond Park, two written by and on behalf of staff at the home and 98 submitted by students at St Joseph’s School.
What people said
In agreement with proposals None of the letters were in total agreement with the proposals
Concerns about the proposals There were many concerns that the letter writers expressed. These generally fell into 8 categories:
The need for residential care Community links Concern for present residents Job losses among staff Why close a 3* rated home. Loss of Day Care and Respite Care facilities. Finances Signatories to a petition
The need for residential care The letter writers recognised a real need for good, council run residential care: There is no way my father in law could look after himself even with food being taken to the door three times per day. How is building self- contained flats with on-site catering facilities going to give these old people 24/7 care?
My mother managed in her own home with daily visits from my sister and mam wrote lots of reminder notes and lists. However she became increasingly frightened and paranoid about being burgled and told us tales of little girls pestering her, which we thought were imaginary, until one day I answered her front door to two little girls of about 9 years of age who asked, ‘Where’s the old lady - she gives us money’. One day she broke down and told us that she was so frightened she could no Consultation report on proposals for care services in Allerdale and Distington areas 69
longer live alone....Richmond Park was our favoured choice of care home. It was Council run...and we strongly believe the people should not make profit out of caring for old people. It was next to my niece’s and a mile from my sister’s. Apart from basic care the most important support mam needed was company and assurance when she felt anxious.
My mother is a resident of Richmond Park and has lived there happily for approximately 2 years - the care is personalised, effective and safe. Dementia sufferers are amongst the most vulnerable and often overlooked and it is essential that Adult Social Care represents their needs and ensures a balanced position as part of the consultation.
Community Links People recognised that having strong links to the community was important:
Many of the residents in the home are able to receive visits from family as the home is on a main bus route and just outside the town centre. If the home was closed many residents would not see their family as often. I hope they realise the home is an important part of the community and should be kept open.
Many of the families can see them on a daily basis, but if you move them they will have to travel a long way.
Present residents People expressed a lot of concern for the well-being of present residents:
My friend’s Granddad is really poorly and he lives in the care home - if you shut it down where will he go?
How would you like being thrown out of your home? What if it was your mother left feeling helpless, alone, confused and anxious? Terrible, terrible tragedy for the residents!
Both my parents are in Richmond Park...They are not fit enough to be in their own home, which has gone now anyway. This was their choice. My Dad went in last year... Mum moved in at the end of May this year. We looked at the quality of care and Richmond came out the best in our area. I dread to think what will happen to Dad if he has to move, I think Consultation report on proposals for care services in Allerdale and Distington areas 70
he would not cope. I don't think they would be assessed as having the same type of care so would probably be split up. The staff are wonderful and they are both treated with the respect and dignity that elderly people need...Elderly people need company and most of them need care 24/7 - not to have a button to press if they need some help and Carers in twice a day... We support keeping Richmond Park open.
There is a new Extra Care development to be built in Workington evidently, but no one can inform us when new build will take place...While this sounds wonderful and will be for a minority of people - what about Richmond Park residents, 75% who reside on an EMI unit and would not have the capacity to understand they needed to ring a call bell to summon help.
It has been proved that moving elderly people at their age can kill them...The amount of stress being placed upon them would negatively impact their lives immensely.
Moving these elderly people may affect their health. Do these fragile friendly folk really need this at their stage in life?
Loss of jobs People also expressed concern for the care workers at the home:
There are over 44 staff working at Richmond Park. Where will they work if the home is closed?
I talked to a husband of one of the 44 members of staff...he says ‘It’s sad to see them go.’ You know people are distraught - so why do that to your community?
Why close a 3* rated home People genuinely did not understand why it was proposed that Richmond Park be closed (this was particularly true of a number of respondents who thought (incorrectly) that Richmond Park was ‘the only 3 star rated home in Cumbria’):
It is one of the best care homes in Workington and got a three star excellent service award by the CQC and they left glowing remarks such as: ‘...The manager makes sure that people have a full assessment of their health and social care needs before they are admitted to the home. Consultation report on proposals for care services in Allerdale and Distington areas 71
People are able to visit the home and to have a look around and meet the staff and other residents before they move to Richmond Park. All of these things help to ensure that people live in a home that is suitable and able to meet their needs and expectations’.
The home is a perfect place for elderly people as it offers pet therapy, holistic therapy, palliative care, respite care and convalescent care.
Day care and respite care The home also has a day care centre, so if people’s families want to go for a day out, they can put an elderly relative in there.
We are dismayed by the recent press reports re the closure of Park Lodge in Aspatria, Woodlands in Distington and Richmond Park in Workington. We use Richmond Park for respite every 6-8 weeks for my father in law so that we can have a break from looking after him after him 24/7.
Every time we have taken my father in law in for respite, Richmond Park has been full. Facilities are more than adequate for him even if a little dated...He enjoys the time he spends in there and thinks the staff are all wonderful and that they do a great job...The respite is our lifeline that keeps us sane.
Finances It astonishes and dismays me to realise that homes that are running with empty beds and units closed are being modernised, with the little money left in the coffers, while Richmond Park, operating at just under 100% occupancy (one empty bed due to recent death), has been chosen to close its door.
We have spoken to a number of people we know who work in care homes...They are all telling us the same that there are beds available in private homes at up to £650 per week but few beds in the Council homes for permanent residency and respite. Will the County Council be picking up the cost of care in these private homes? This looks to be an easy way of cutting spending in future years by paying for late 80-90 year olds whilst they live, a few months, a couple of years by which time you will have closed the current 3 and maybe more besides leaving no
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Council places left. So what do people who can't afford private care do then?
Suggestions to improve the proposals.
Finances People had many financial suggestions:
Reduce the cost of Richmond Park by lowering the unit cost by expanding to make more beds available.
Review your paperwork systems and stop all non-essential communications to save money.
Save the Council money by cancelling all 1st class travel and all 'jollys' and non-essential training.
Suspend the use of any 'Consultants' the Council are using. From my experience they only regurgitate information from the answers they are given to the questions. The people who work for the Council are the experts in the fields.
While we agree the home needs to be modernised we feel Richmond Park is more than worth modernisation. We operate on 99% full occupancy and provide excellent care to all clients
I feel that a good home is being penalised for the close proximity to two private homes...Whatever the future brings there are always going to be people who require 100% care over a 24 hour period and assistance that families and independent living are unable to provide.
A different idea was suggested by one letter writer:
It would be worthwhile to investigate while Barrow are in their second home closure how the new build is functioning and proving successful.
Other people took different approaches:
At its meeting on 17th October 2011, concern was expressed by Seaton Parish Council at these proposals. The home is used by Seaton villagers Consultation report on proposals for care services in Allerdale and Distington areas 73
as a residential home and also as a place of employment. It is considered to be well run, providing a caring service, and employing staff who are held in high regard...The Parish asks the County Council to reconsider its options in this area and keep the Richmond Park Care home open.
I am writing to you for help regarding our elderly care homes. We desperately need these places.
The lack of any description as to how and where alternative care will be provided for her and the process by which this is to be achieved is currently causing my brother and I some concern. Clearly this needs to be done in such a way as to minimise any upset to my mother and to maintain the relationships of the staff at Richmond Park which are an important part in her quality of life. We are also concerned as to what choices we, her most frequent visitors and advocates, will have in any decision making.
3. Woodlands residential care home, Distington
There are five letters relating directly to the proposed closure of Woodlands. One is on behalf of the Care and Support Group at the home, one from Jamie Reed M.P., one from Copeland Borough Council and the others are from relatives of current or former residents. They are all opposed to the closure of Woodlands. Their main argument is that its specialist dementia care is vital to keep residents safe.
Woodlands at Distington, was specially built to house people with Dementia. My parents were both residents. We had previously tried two other homes, but my parents were able to walk out of them. Woodlands was able to deal with everything. They shared a room, and were well cared for. This home is on a bus route, and visitors could easily visit them. I can't fault the care they received....It would be tragic if this home closed.
We the families of the residents of Woodlands Care Home are expressing our concern and worries about the proposed closure of the home.
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You the council are saying that over the next 10 years you are trying to keep people at home longer by 24/7, 365 days per year care at home. This is not practical for dementia sufferers...Our loved ones are usually trying to return to their childhood home, at any time of day or night, they have no awareness of time or danger, and sadly on occasions they can become aggressive and violent in their quest to understand what is happening to them....We the families try our very best to care for them at home, but as the illness progresses we can no longer keep them safe.
It is very upsetting to put a loved one into care, but at Woodlands the care they receive is second to none, and feels like a family. The Staff are trained in caring for dementia patients, and a lot of money has been invested in their training. The staff at Woodlands are invaluable for the care of our loved ones and for any future patients suffering from dementia.
It has been said by the Council that facilities need to be improved. The last thing any dementia patient is access to water without supervision, so why would anyone think that an ensuite facility is required?
Woodlands has facilities for 40 residents, with a current occupancy of 25...[W]hat we would like to know is how many dementia patients have gone into care in Cumbria within the last two years, and if Woodlands was offered to the families. The equation of occupancy rates to capacity does not equate to an ageing population which therefore suggests that the Council have been planning the closure of the facility for some time.
There has been a lack of investment in Woodlands, which supports the view of a planned closure and the monies raised from the sale of land for the Distington by-pass has not been reinvested in the home. The home is neighbour to an ambulance station and has a doctors' practice nearby, so has good support services locally.
The home already has fully trained dementia staff. However the Council does not seem to value this resource and want to have specialist dementia services in Maryport and Wigton. It is commendable to have resources available in these areas, but the centre of excellence for dementia should be where the trained staff are... As a standalone EMI unit, Woodlands is the obvious choice.
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We are not naive to the economic climate and we the Woodlands Care and Support Group challenge you the Council to give us the figures on which you based your decision making for us to review.
The burden of care where it is not able to be fully provided causes just as much suffering and it is always a heart wrenching decision to hand over a loved one to others. This is where places like Woodlands come in; they don't just offer care, they provide a comfortable home for sufferers and the affection for residents is openly displayed by the staff.
Woodlands is large enough to ensure that it has a wealth of experience to draw on in dementia care but small enough to provide a homely atmosphere. Facilities are clean and welcoming but also provide a safe and secure environment which ensures that sufferers can come to no harm. The enhanced duty of care to the residents is evident and is obviously achieved.
In the case of my Mother care in the home is no longer a possibility...the decision to place her into care was taken as she was a danger to herself when alone. Despite all modifications suggested by Social Services being undertaken, my Mother was still able to place herself and others at risk, she would leave gas and electric appliances turned on...and she would frequently throw rubbish into the gas fire...It was impossible to administer medication effectively and my Mother lost a considerable amount of weight as she simply 'forgot' to eat and drink. Taking these factors...removing dementia sufferers from a safe comfortable and established environment such as Woodlands and returning them to a place which in all probability they cannot remember, will inevitably cause unnecessary anxiety and confusion as well as putting them in harm's way.
I am asking those who are making decisions to reconsider the decision to close Woodlands care home. This cannot be based on what appears to be a purely financial basis with no regard for human impact and basic duty of care.
The letter from Jamie Reed M.P., whose constituency includes Woodlands, also highlights concerns raised by staff and residents about private care provision: The relatives of Woodlands residents do not wish to place them in a Southern Cross style facility within the private sector. They wish for Consultation report on proposals for care services in Allerdale and Distington areas 76
residents to be cared for by and within the public sector where standards of care and not business considerations drive the model and type of care that their family members receive... I was recently involved in (successful) attempts to secure a new operator for a care home in Whitehaven which was abandoned by the Anchor Group. Had a new operator not come forward, the consequences for the residents there would have been dreadful.
Please also refer to Appendix one – letter from Copeland Borough Council regarding Woodlands.
Consultation Letters - General.
This section looks at letters sent that are not focused on any one care home in particular. They include a letter from UNISON and representations from Tony Cunningham MP.
Concerns over the proposals
Present residents It is beyond belief that in this day and age the council is trying to save money by hitting the most vulnerable. The residents of these homes have already had to give up so much and now you are requesting that they give up their community and social links and for some probably their willingness to live... It is worrying to think that this generation who have served and protected our country are being treated in this way.
It would appear that after months of conjecture the true practical implication of the cuts has reached its final destination amongst those in the community who are the weakest and least able to raise their concerns. We have to find alternative solutions to the proposed course of action.
High quality of care. The proposals to shift complex care to the community is an untested gamble; there is a danger that the economic imperative to cut services will impact on the vulnerable people's lives in a dramatic fashion.
The closure of the homes puts into question the availability of respite beds for families and clients many of whom are desperate to ensure that Consultation report on proposals for care services in Allerdale and Distington areas 77
breaks are a built in feature of the support they receive...It is not clear if the council intends to maintain respite care and if it does at what level.
The bigger picture We would ask that Cumbria County Council provide reassurances that staff will not be facing compulsory redundancy and that they won't be asked to relocate to distant parts of the county...Many of the carers in the homes are local to the homes, and many have relatives who are residents in the homes. The work they do in their localities helps cement the intergenerational social and communal bonds, and are central to the maintenance of social cohesion in areas of growing deprivation.
These care homes also pump money into deprived localities through wages, contract requirements, commissioned work from local trades people etc. The homes provide added value and cannot be solely evaluated from a strict profit/loss basis.
The homes provide a source of employment for predominantly female workers, this recession has had a dramatic affect on the number of women who are unemployed and closure can only lead to further increase in female unemployment. A number of staff are also young people, and are part of a generation that has seen its future prospects dwindle.
Many of my constituents are staff working at the above homes and they are extremely worried what the closure will mean to the present residents of the homes and their jobs which they can ill afford to lose.
Others are residents of Aspatria and they feel they do not have available to them the services and amenities of bigger towns and cities in this country receive. They believe that closing Park Lodge and offering no alternative locally (within the town of Aspatria) would take away the choice of where they would want to reside.
The local people have set up homes and made friends. Leaving your home to go into care we can only imagine must be stressful enough... Remove the option of staying in Aspatria, the stress load could be intensified. You could be further away from family and friends, the vital support network that keeps an individual sane. Consultation report on proposals for care services in Allerdale and Distington areas 78
Another constituent's concerns are around Richmond Park's closure and...why if it is running at virtually 100% occupancy...it is not being considered for modernisation instead of closure.
Please also see Appendix One for relevant comments from the Alzheimer’s Society and Age UK.
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5. Public Meetings
Three public meetings were held by the Council as information sharing events. The format was a range of stands demonstrating the different elements of the modernisation proposal. This included stands on high level home care/ assistive technology, extra care housing, dementia care as well as a number of stands featuring third sector services to support people in the community. A number of Council Officers were on hand to discuss the proposals and answer questions.
In the case of Aspatria an open question and answer session was requested by attendees and therefore a panel consisting of James Airey- portfolio holder for Adult Social Care, Richard Parry – Corporate Director Adults and Local Services and Mark Hastings – County Manager responded to questions from the audience.
135 people attended the public meetings altogether of these (62% Aspatria, 33% Workington, 5% Distington). Consultation documents were available at the meetings and an additional questionnaire was made available (see appendix 6). 36 people completed this questionnaire and the responses are analysed below. Age UK provided independent notes of each meeting and these too are included where appropriate. Meeting about Woodlands at Lakes College, Lillyhall Tuesday 23rd November 2011
Who attended Numbers Forms completed Public 3 Staff 3 Family 0 Independent Sector Provider 1 Total 7 -
Main themes (taken from Age UK West Cumbria notes of meeting): Concerns for current residents of Woodlands Impact on relatives/friends of existing residents if changes happened Impact on staff employment
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Meeting about Richmond Park at Bridge Church, Workington Tuesday 6th December 2011
Who attended Numbers Forms completed Public 26 Staff 10 Family 5 Independent Sector Provider 2 Allerdale BC Housing Dep 1 Total 44 20
Main themes: General approval of key proposals to increase support to enable people to stay at home and to build extra care housing. Strong disapproval of proposal to close Richmond Park. Key concern that local people needed residential care to be an option when support at home or in Extra Care Housing became insufficient to meet a person's needs, e.g. due to suffering from Dementia. Strong desire to keep Richmond Park open and improve/modernise it.
Meeting about Park Lodge at Aspatria Rugby Club Wednesday 7th December 2011
Who attended Numbers Forms completed Public 54 Staff 14 Family 14 Independent Sector Provider 2 Total 84 16
Main themes: Support for the idea of care at home and extra care housing but strong doubts that sufficient care could be delivered when required i.e. 24 hour care as in a residential home.
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Widespread fear that Extra Care provision would not be built locally, in Aspatria. Large majority in favour of keeping Park Lodge open. Widely seen as essential for an older person's wellbeing to remain in his or her local community to maintain connections and support.
Total from all three public meetings:
Who attended Numbers/% Forms completed Public 83 61% Staff 27 20% Family 19 14% Independent Sector 5 4% Provider Other 1 1% Total 135 100% 36
What people said
Support for the proposals Concerns about the proposals Suggestions to improve the proposals.
Support for the proposals
There was a lot of support for most aspects of the Councils’ proposals. However, it must be noted that very few people supported them unequivocally.
This sounds an excellent scheme. I think I thought such provision existed already. People will want to know more about this if they are to come to terms with the closure of the existing provision.
Extra Care at home would be ideal.
I think that this would be a good thing. We could have support from carers, but be together and company for each other. I have a ground Consultation report on proposals for care services in Allerdale and Distington areas 82
floor flat, but extra care would mean that my wife could come home, supported by carers and we could live together.
I would agree with this. If more support had been available, maybe my wife wouldn't have gone into residential care, and we could have stayed together.
As we have noted elsewhere, most respondents added caveats:
In principle the idea is good. There is not the money or the resources to be able to provide 24 hour care at home.
Staying in their own home is good but not everyone is able to do so. A range of accommodation is required.
Good idea provided people are able bodied and their minds are working.
Nothing wrong with the proposal. Does the council comprehend how these proposals will affect the town and businesses in Aspatria?
For some people this will be great news - they really want to stay in their own home, and have a good network and social life. However we must remember that some people are lonely in their own home and increased support on its own will not solve this.
In principle I would agree with this principle. Would there be sufficient resources to support a big elderly population?
It should be noted however that very few people agreed with the closure of the three residential homes. We will return to this.
Concerns about the proposals
Areas of concern that have been reported elsewhere were again highlighted by respondents. These include: Present residents Loneliness and isolation Appropriateness of service Respite and day care services
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Staff resources
Present residents Many people were concerned for the health and well-being of present residents:
I don't think this is an option for Aspatria. There is no other care provision in residential care. Relocation to other towns is not an option as this would be detrimental to other adult’s health.
Need a range of support from home care, sheltered housing and residential to meet all needs.
I would agree that improving quality is important. For the here and now the trauma of a movement may have dire consequences for my mother. My major concern is the potential transfer for a resident and how she will survive the trauma.
Loneliness and isolation People expressed concern that the closure of residential homes would mean that older people would become lonely and isolated:
People are left alone behind a door for long periods and it is a very lonely end.
People are isolated and loners become more isolated and stay in their own homes. No social groups.
What will happen to vulnerable adults living alone? 4 calls a day from several different home carers.
I would like to be with my wife all the time
People also expressed concern for those residents who would no longer have family and friends living nearby if they were moved:
My concerns would be that the home is not local and the isolation the move to a bigger home would cause to both service users and relatives.
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I'm concerned that if residential care is not available in Aspatria - how far will family and friends have to travel? When they are local to Aspatria there is a chance that they may know other residents. In a large residential home they will be completely lost.
Agree that there should be a high quality facility but that this should be local for people of Aspatria and surrounding communities, not concentrated in Cockermouth and Wigton/ Carlisle
Appropriateness of service Relatives and friends of present residents feel that the only appropriate service for some people with some conditions, most notably dementia, is residential care:
The service users at Park Lodge would not benefit from this whatsoever, they need People (carers) with them at all times, for support, for personal, emotional, nutritional, mobility and social care needs
Not good. People are in residential care because that is what they need and they should have the choice of which one.
Some people can no longer manage in their own home.
Lack of adequate support at home. People get neglected at home. People choose to go in to residential care and are often happier there.
Extra Care would be good to have but not suited to everyone
The system you propose for keeping people in their own homes versus residential care worries me immensely because of health issues - hydration, nutrition (lack of it) leading to poor health and more hospital admissions. Gadgets and technology do not provide an alternative to the personal approach or touch.
Extra Care housing is not required in Aspatria as long as Park Lodge remains open. Aspatria has numerous bungalows for the elderly and when more care is required - people move into Park Lodge - for all their needs.
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Respite and day care services People were concerned that respite care and day care services were going to be reduced or relocated to an inaccessible environment:
To provide day care to relieve families and a safe secure environment centrally located for people with dementia.
More home carers, better phased respite, and choice for the individual.
Day care and respite care needs to be local. How will people get to day care if there is no local home?
Keep Park Lodge in Aspatria open. Other towns have alternative provision - we don't. Where do the day patients, clients go to?
What will happen to respite beds?
Staff resources The principle of staying in your own home is fine for people who are still sound in body and mind. The concerns are for the quality and timescale of 'visiting' carers based on an ability to pay. People will suffer from neglect and loneliness.
Where will all the carers come from? Older people don’t want a string of strangers waltzing through their houses. And who will pay for them? It will be more expensive.
Suggestions to improve the proposals
People had many suggestions as to how the Council could improve their proposals. These fell into 4 main categories:
Listen Do not close the local care homes Improve local care homes Look at the wider picture the closures will affect.
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Listen People suggested that the Council needed to listen to the residents, families and staff and take their lead from them:
What the residents think at the end of the day it's their home, not the council's.
What the residents want not what is better financially.
The views of residents and staff and families.
For the Council to actually listen.
Talk to more people and those in the homes.
Do not close the local care homes To keep Park Lodge open, to extend if needed and put money into Aspatria.
Good for people to have dementia friendly residential care.
I think we should provide elderly residential care in all towns. We have a predicted increase in the elderly generation, what are we going to do with the next generation?
Local services in local communities.
Allowing people to end their days where they are close to family and friends. Freedom to choose.
I would like Richmond Park to stay as it is, until there is a better alternative.
Keep and modernise Richmond Park and keep it open - fewer beds with better facilities.
Withdraw Park Lodge's proposals for closure.
Keep Park Lodge open as it supports a rural community.
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In 2008, following public consultation, the way forward in care for the elderly point to compact units (homes) in central locations and local to the point of need. This principle should be upheld. It is not the size of the rooms that matter, but the quality of care. People trust the council run homes, not the private sector.
Don't support the reduction of residential care. Strongly support better support for dementia.
Improve local care homes Extend Park Lodge as was originally planned to bring it up to standards.
Richmond Park is already specialist in dementia care and has an excellent unit.
Invest in Park Lodge and its community.
Upgrade Park Lodge there is enough land to build on.
Please try and build on the services we already have in Aspatria, not just abandon it.
Could the council consider utilising surrounding land to improve Richmond Park?
Take into considerations the right of choice of residents. Improve Park Lodge building. Not close it.
Keep Park Lodge open and build extra care housing.
Look at the wider picture the closures will affect Look at other resources in this area and Aspatria doesn't have any alternatives like Workington.
Remaining in their own community among family and friends. Supporting a lot of rural areas.
There needs to be a range of community services.
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Local residential care and other services provided by the county council, not the private sector.
What can they do for the people of Aspatria to help them live out their lives in their own home town or community?
How will closure affect the wider community - chemist - GPs, shops?
Other comments received on how the proposals could be improved. One respondent thought that if people were given better information then perhaps their concerns could be lessened:
The revamps of existing provision based on the Stirling University research look excellent. Many people are anxious about the closure of Woodlands because they think it is the best dementia environment available. Their concerns might be lessened if they were confident of radical improvement at other locations.
Others said:
Could a Housing Association take over Park Lodge?
Providing a range of services suited to everyone.
To provide care homes - should be more of them.
Couples should stay together for as long as possible.
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6. Drop in sessions
Drops ins were held in a variety of venues providing the opportunity for discussions with members of the public. Drop in questionnaires (see appendix four) were developed for the purposes of allowing a briefing on the proposals to be given and the views of participants captured by Council Officers from the discussions held with members of the public. Quotations included in this section of the report are as recorded by the Council Officers present. Broadly speaking there was more positive feedback at Drop ins than other elements of the consultation. This could be because fewer people attending Drop ins were directly affected by the home closure proposals. Feedback from each is detailed below.
Location and date Numbers Number of forms completed attending Distington 40 2 plus flip chart notes from group 6.1.12 discussion Maryport 0 8 forms completed on behalf of 12.1.12 members of the public in the library who were proactively approached and asked their views by CCC staff Wigton 2 13 forms completed on behalf of 19.1.12 members of the public in the library and Market Hall who were proactively approached and asked their views by CCC staff Workington 12 11 people gave their views 23.1.12 Aspatria 5 5 people gave their view on 31.1.12 summary sheets plus 1 Age UK group of people Silloth 0 8 forms completed on behalf of 2.2.12 members of the public in the library who were proactively approached and asked their views by CCC staff Distington 6 0 forms completed. Those who Consultation report on proposals for care services in Allerdale and Distington areas 90
3.2.12 attended were family members and Councillors (parish and district) who attended to express their views against the closure of Woodlands to Council Officers. Those who wished to had already submitted views via questionnaire or letters/emails. Workington 5 3 people gave their views via 7.2.12 summary sheets
Distington Drop In – 6th January 2012
Number attended: 40 Forms completed: 2 (Views were also recorded on a flip chart by Cumbria County Council staff)
In support: The forms indicated a positive response about the development of extra care if it could be built on the Woodlands site, and agreement with the intention to ensure people with dementia have high quality support.
Concerns: The main concern expressed was about loneliness and isolation for people remaining in their own homes and whether home care or extra care housing would be enough to prevent this from being a problem. There were also concerns recorded about training in private homes, the cost of care in private homes, concerns about the health of residents if they had to move, staff redeployment issues and the opinion that the decision to close the homes had already been taken. Other questions included: If there is expected to be demand for dementia care in the future why close Woodlands?
If it does close could the Woodlands site be used for an extra care housing development?
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Finally a point was made about the current provision at Woodlands being good due to being on all one level, easily accessible and on a bus route.
Maryport Drop In – 12 January 2012
Number attended: Nobody attended the drop in itself but Cumbria County Council staff approached members of the public in the library for their views. Forms completed: 8
In support: One person said they would like care to enable them to be supported to stay in their own home ‘but it would need to be good quality and not just ten minutes’. Others said they thought it was good to support people at home to help them to keep their independence and two respondents were positive about the fact that supporting people at home was less costly. The majority of respondents at this drop in were in favour of the concept of extra care housing: Good having own flat/apartment plus care team on hand if needed.
Concerns: To reduce the number of homes is of concern – will they pick up dementia clients? We need these places to stay open.
Care homes are needed and they need to suit the need/demands of patients. Concerned about the ageing population ... will there be enough provision if losing bed spaces?
Suggestions: Home care staff to be trained up in basic nursing duties More opportunities for assistive technology to be demonstrated to older people and training given so they are confident about using it Improvements in transport for older people e.g. to get to appointments - need a dedicated person on the bus as well as the driver so they can help people on and off The council should consider the effect of service changes on parents in relation to younger adults who require 24 hour care.
Wigton Drop In – 19 January 2012 Consultation report on proposals for care services in Allerdale and Distington areas 92
Number attended: 2 people attended the drop it itself but Cumbria County Council staff approached other members of the public in the Market Hall for their views. Forms completed: 13
In support: I think the 24 hour 7 day home care service would be good for those who need it – maybe people with dementia who get up in the night?
I think it is a fine idea to close the homes if it means improving the homes at Wigton and Maryport, although I do appreciate it is hard for the current residents and families.
My mother is 98 and receives care three times a day and wears a community alarm...My mother wanted her own space and did not want to go into a home. She is an independent old lady, I didn’t believe my mother would manage on her own but she has proved me wrong.
Good idea to have investment in dementia care. Happy for this to happen in the Wigton home.
My husband received home care and the service was excellent, they watched his dignity, although visits needed to be longer. What was wonderful was all the gadgets, we borrowed a chair, bath aids meant he could have a daily bath, this was vital.
On Extra Care housing: Own front door important, keeping spouses together, keeping independence.
My family would be happy with the proposals.
I am 85 years old and when the time comes I would like to stay at home. I do not want to move to residential care.
I agree with all the technology proposals, this must be a boon to anyone disabled or living alone.
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I’m all for the care at home element if it could be developed to a high standard – most people want to stay at home for as long as they can.
Concerns: Some respondents mentioned concerns about home care: Home care quality may not be what you would really want.
Home carers are only there for 10 minutes... dashing to get to the next one.
The concern would be that being at home would be used in inappropriate cases due to lack of alternative provision and responsibility and pressure would fall to family members. The quality and reliability of enhancements are key, particularly for those with no support networks. In home care services there needs to be consistency and continuity of carers. There needs to be adaptations in the person’s own home for home care to work.
There was also a concern about choice: People should still have a choice if they want to opt for residential care.
My mother in law has lived in Aspatria her whole life. She has always believed she would go in the Aspatria home when she was no longer able to cope at home, and won’t consider anywhere else. There is a generation who will have their care preference removed.
Concerns were expressed that the reduction in residential places would happen first before demand had reduced, then would be too late if needed.
I think it would be bad to close Park Lodge, I have heard that it’s important.
Concerns were expressed about the provision of home care in winter weather in a rural area.
Suggestions: A link direct to carers from the alarms for emergencies would be an improvement.
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Park Lodge should be modernised as residents get to stay within the local community. produce a dementia booklet for family members about adaptations, emotional support and medical support. My sister lives in America and lives in a complex that increases the care gradually, it even includes hospice type care. I think this is an excellent model.
Workington Drop In – 23 January 2012
Number attended: 12 Forms completed: 8
In support: This should happen – my experience was that my mother was able to leave hospital and return home with the help of a stair lift, oxygen tanks and a community alarm. She was happier being at home.
Agree [about people staying at home] as long as people have a choice and are not left isolated.
There were several positive comments about the proposals for Extra Care housing:
Brilliant idea. I would love this.
Seems to be a good idea – good to have communal facilities if people want to mix.
Concerns: I would not feel safe at extra care, I like staff to be close by. [current resident of care home]
The proposals for a younger generation are a good idea but not at the expense of others.
Not sure what I think about this [extra care proposals] especially because of the proposal to close care homes – this isn’t right.
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Not in favour of closing homes until all existing resident’s needs are met.
The building at Maryport is not as suitable as Richmond Park.
Older people are not as au fait with technology as younger generations... technology in some cases may prove to be detrimental. Technology will not always be able to trigger a human response quickly enough.
Suggestions: Aspatria - consider using the bungalows in the town for extra care housing – a group of properties together. Could another provider come in and run the homes If Richmond Park could be moved into Amethea, lock stock and barrel, then this would move the staff, care and residents as an entire entity. The building could close but the service and the integrity of the service could be maintained. Could a not for profit organisation take over the whole service?
Aspatria Drop In – 31 January 2012
Number attended: 5 plus small group attending Age UK event Forms completed: 6
Although generally respondents were in favour of proposals to support people staying at home, as in other areas of the consultation people expressed concerns that this wouldn’t be appropriate for everyone. Concerns were expressed about the possibility of isolation, and that people would want to stay in their own community if they needed residential care:
People would like to end their days in Aspatria.
In support: Agree with the idea of supporting people to stay at home.
Agree with the need to close old services to invest in new services.
My husband’s grandmother lived in sheltered accommodation until she was 94, and she lived there until the end of her life – this is an ideal solution.
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The best thing to do is to support people living in their own home.
Agree with the model of extra care but proposal to build in Workington would mean Aspatria community having to travel and visitors having to travel.
Concerns: Some older folk are too independent and would rather sit and suffer than ask for help.
Older people in the town visit the home [Park Lodge] for company and to visit.
Park Lodge has always been a part of the town – for the 40+ generation we expected that it would be there for us if we needed it.
Disagree with the argument about the facilities because people are not in their rooms all the time – the facilities do the job along with the staff.
Aspatria has lost its Police Station and other facilities – we don’t want to lose the Care Home.
Suggestions: Consider transport People should be supported where they grow up
Silloth Drop In – 2 February 2012
Number attended: Nobody attended the drop in itself but Cumbria County Council staff approached members of the public in the library for their views. Forms completed: 3 In support: All three respondents were supportive of services being geared towards supporting people in their own home, including adaptations to people’s houses. This is definitely a good idea, anything that prevents someone from going into residential care.
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There was a recognition that in order to release funds for this residential places would need to be reduced: I think this is a good idea, close them down, it is important to plan for the future. This is the way to go.
Concerns: Concern about long periods between visits [for those in their own homes.]
Need to ensure that the remaining homes cater for all parts of society.
Suggestions: Get school children into homes to serve meals and talk to residents. Home carers could bring newspapers with them. Suggestion that day trips should have a nominal fee to maintain the sense of pride of people going. Develop more befriending services to avoid isolation. Increase the number of people doing home visiting.
Distington Drop In – 3 February 2012
Number attended: 6 people attended the drop in to discuss the proposals Forms completed: 0 - Those who attended were family members and Councillors (parish and district) who attended to express their views against the closure of Woodlands to Council Officers. Those who wished to had already submitted views via questionnaire or letters/emails.
Workington Drop in - 7 February 2012
Number attended: 5 Forms completed: 3
In support: If I’d had a bit more support at home I would not have let my wife go into care.
Extra care housing sounds like a sensible option.
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Funds to make home alterations would be beneficial to help enable people to manage at home for longer.
Extra care in Allerdale would be a good idea... Maybe some teething troubles but that could be solved by good communication – encouraging people to talk and work things through.
Concerns: One person mentioned the difficulty of co-ordinating services - ‘have to tell SW/DACE/Independent Living Fund everything – it all goes round in circles’.
There is a need to invest in new services but understand the difficulties for people in homes now.
Look at the policies before making mind up about what to do – safety of service users should be a priority.
What is the future of the buildings – they and the land is still in the community.
Suggestions: Could do with more physio to keep people moving Housing organisations may be able to help e.g. Impact
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7. Staff views
Formal staff consultation on how any final decisions affect their employment arrangements will follow once decisions on the way to proceed are made. The staff however, as members of the public, were encouraged to participate fully in the consultation about the proposals.
Meetings were held with staff at the start of the consultation and staff were encouraged to complete consultation questionnaires. Special drops in sessions were also organised for staff and their views captured on flipcharts during the sessions. The notes from these flipcharts are included below.
Staff Drop In at Workington Library – 23rd January 2012 (6 staff attended)
Reablement/Homecare: Who provides homecare after the 6th week? Shouldn’t Cumbria Care homecare be increased Concerns over the quality of the private sector
Question 1 – Proposal to support more people at home Agreed that most people would want to stay at home but: - Not human contact with alarms (although alarms are good) - Isolation fears - What about people with dementia?
Have referrals been stopped to Richmond Park? Also respite referrals. ...concerns over this.
Concerned about Richmond Park residents having to move
Extra Care Good for some people (but not for those who need 24hr care or those with dementia) Different from what is provided at Richmond Park Could Richmond Park be upgraded instead of building extra care? Would the extra care scheme open before the care homes are closed? Who will provide the extra care scheme? Will Cumbria Care provide the care? (at the extra care scheme) Consultation report on proposals for care services in Allerdale and Distington areas 100
Why can’t Richmond Park be upgraded? Why Richmond Park over Maryport? (Parkside residential care home) Richmond Park dementia standards are good Richmond Park is being penalised for the vacancies in the independent sector
What will happen to the day care provision?
Fears over job losses
Staff Drop In at Aspatria Library – 31st January 2012 (3 members of staff attended)
Supporting People to Remain at Home Independent sector not trained properly Dignity – what if people need toilet when carers are not about? Worrying Times often don’t suit peoples’ needs Leaving people with dementia at home at risk Older people concerned about putting heating on Isolation – company/weather issues In a care home – 24hrs support People vulnerable to unprofessional carers Quality of home care
Build Extra Care Like extra care but would need to be Aspatria
Closing Existing Homes to Fund New Services Park Lodge is only home in the town/surrounding area Park Lodge rooms are bigger than those at Wigton and Maryport No parking at Maryport Unique – small, like a large house, feels like home Good food in care homes
Other Concerns about social work – managing cases/communication Concern about cost of support at home – adaptations/sensors/alarms Have to fight for reasonable support at home Consultation report on proposals for care services in Allerdale and Distington areas 101
Lack of public transport/transport links Taking everything from the town
Staff Drop In at Woodlands – 3rd February 2012 (6 staff attended)
Concerned that consultation (closure) is a ‘done deal’
Concerned about residents and future residents and where they will go
The layout of Woodlands is ideal for people with dementia – people can walk about (other homes have stairs)
Why can’t investment be made at Woodlands?
Already close to dementia standards Woodlands is in a good location - bus route - land to extend - outside space/garden - plenty of car parking
Extra cares looks great, but doubt it can meet the needs of people with high level dementia
Could site of Woodlands be used for a combined care/extra care scheme?
Concern about jobs
Some staff members live local and have no transport/can’t drive
Concern about quality of private homes
Closure of Woodlands is taking away choice
We have to change with the times and try new things (supporting people at home)
What has happened to the by-pass money?
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Summary of views of staff working in the Allerdale and Distington Community
Staff working in the home care service were consulted as although they are not directly affected by the proposals they have views and a special perspective around the support provided in peoples own homes which forms a key part of the proposals.
The presentation to staff included all elements of the proposals and underlined that investment in high level home care services would not bring more work to Cumbria Care given the Cumbria Care shift from home care to reablement.
Aspatria and Wigton Home Care Team – 25 January 2012 (18 staff members)
General Comments: Where will the residents go? Isn’t Woodlands just for dementia? Park Lodge is like a ‘home’ – it is homely, especially compared to larger homes which can be more institutional Why is there a focus on dementia? Aspatria home – unfair to expect people to move to other areas
Question 1 – Proposal to support more people at home Most people receiving home care have alarms but some people are reluctant to use Some older people fear technology – (reablement should help with this) Fantastic idea – but who will provide? What about daycare? Could be expensive if people have to travel The day care proposals sound like a good idea Most members of staff attending the meeting (12) agreed that supporting more people at home is a good idea, some have reservations.
Question 2 – Proposal to develop Extra Care Could they be built on the sites of the current homes? People need to see them being built Those residents who want to could then move in Who will provide the care? Cumbria Care staff are well trained/high quality etc
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Most members of staff attending the meeting (15) agreed with the proposal to develop extra care housing.
Question 3 – Proposal to reduce residential care/home closures Good for the future Understanding of why We need to prepare for the future Raw for those in the homes Concern about colleagues’ jobs Concern about the buildings Are we taking choice away in Aspatria?
Cockermouth Home Care Team - Tuesday 14th February (11 staff members)
1. Reablement is good if you have back up (physios etc) Choice of Cumbria Care home care is important A team of homecare and a team of reablement is best way A lot of people are using technology People need to know what technology is available – carers need to know too
2. Extra Care Is a good idea Like a mix of sheltered and resi Can Cumbria Care be the provider?
3. Park Lodge: This is the only home in Aspatria Small home, some people like this People can visit/transport Staff live local Needed because it is full
Richmond Park: Could staff transfer with residents to help the transition (or permanently) Consultation report on proposals for care services in Allerdale and Distington areas 104
Concerned about residents There seems to be plenty of homes in the area
Woodlands: Could this be specialised/centre of excellence for dementia? – especially if the number is increasing Could it be modernised?
4. View of residents need to be taken into account Consider other care homes in the local vicinity
Why not consider Parkside instead? Of the 3 homes, the closure of Richmond Park would have less impact – money can be spent in other areas
There needs to be continuity of care
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Appendix One
Age UK West Cumbria response to consultation
Closure of any care home is always an emotive issue and there is a need to realise the impact this will have on residents, carers, friends and the community. Despite the current economic situation, it is essential that the true impact is realised and every effort made to minimalize the negative effects.
Age UK West Cumbria supports the concept that people should be able to remain in their own home or move to suitable accommodation such as sheltered or Extra Care housing and be proactively supported to remain independent. In order for this to be a realistic option there needs to be considerable investment in personal care support and suitable housing solutions. It is clear that in this current economic climate this cannot be achieved without re-engineering current provision. There is also a need to plan not only for the short term but also for the medium and long term as the number of older people requiring support will continue to grow. Many older people will also require support for their physical and mental health and well- being and consideration needs to be given to the prevention agenda.
Age UK has studied the information provided and has undertaken its own analysis of what people want now and in the future in terms of support in later life. Extra Care housing is very much top of that list, both as rented and privately owned accommodation. They also tell us that they want a much more open approach to building retirement complexes where people can move to and then be supported as needs arise. Age UK would seek reassurance that the planning authority really does listen to need and not just the few that object to such development.
Age UK West Cumbria remains concerned regarding the provision of personal care and supported care within the community and would seek reassurance that the needs of people are being met with sufficient choice and affordability.
Age UK West Cumbria also seeks reassurance, whilst recognising there is more than enough residential bed capacity in West Cumbria, that this is of a high standard. By this we mean fit for purpose in terms of accommodation to meet both physical and dementia requirements, are meeting and hopefully exceeding CQC standards with additional awards such as the Daisy Mark.
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As regards the individual care homes:
Age UK West Cumbria would expect Adult Social Care to observe best practice at all times when changing personal provision and this is particularly important in terms of residential home closure. We feel that no one should be placed in these homes until the future of the home is decided. This will avoid unnecessary disruption to frail older people’s care
Woodlands – we support the closure of this and would ask that as far as possible all the residents, if it is their wish, are moved together. This not only supports them but also the people that visit and have formed support networks. We would hope that accommodation can be found as close to Woodlands as possible. We understand that there may be an expansion of a local home with a purpose built dementia unit and would ask that some consideration is given to supporting staff who wish to move with the clients as this certainly aids transition both for residents and their carers.
Richmond House – we support the closure of this as we feel there is more suitable accommodation within the town. In fact this home was cited as one that should be considered for closure when the last consultation occurred 3 years ago. Again we would ask that as far as possible all the residents, if it is their wish, are moved together. This not only supports them but also the people that visit and have formed support networks. We would ask that some consideration is given to supporting staff who wish to move with the clients as this certainly aids transition both for residents and their carers.
Richmond House currently supports a day care centre and it is crucial that thought is given to this day care element ensuring people are dealt with fairly and not just placed in inappropriate settings. The current day care tendering process will facilitate this.
A priority for CCC should be to lead and facilitate the development of Extra Care housing in both Workington and in fact the whole of Allerdale
Park Lodge, Aspatria - This is a slightly more complex issue. We do not feel the current accommodation is suitable in the medium term for older people who will be referred for residential care. The need in the future will be for higher level care and the accommodation is not suitable for this and modification would make places unaffordable. However we do understand the concerns of Consultation report on proposals for care services in Allerdale and Distington areas 107
the local people both in terms of care and the impact on their community. We have worked with them to support consideration of viable solutions, although have not been party to any of the options developed. We would be concerned if these were not realistic or viable and the CCC supported them as a quick fix solution. Our preference would be that no one else was referred to Park Lodge. This would prevent anyone having to make a later move. We would like to see the community services for personal support developed in Aspatria as a priority before the home is closed. During this period there will be a natural decline in numbers, making the final closure far more manageable. Service development in this way will also address the concerns of employment and community engagement.
We also consider that there should be immediate proactive moves to develop an Extra Care scheme in Aspatria. This could be a private or housing association development, providing some consideration is given to the allocation of current housing stock suitable for older people. It would be ideal if this build facilitated the closure as it would give Aspatria residents the reassurance they need.
Development of Parkside and Inglewood for Dementia Care – we fully support this and would ask that this is progressed as quickly as possible as the need for this type of accommodation is increasing. Cumbria Care has developed expertise in this area and it is to be welcomed that they wish to lead the way and support the independent sector with examples of good practice.
Alzheimer’s Society Response to Consultation on proposals for Care Services in the Allerdale and Distington areas
It was good to meet with Mark Hastings and have opportunity to learn more about the proposals .
We have not used the comments pages in the document as we felt the way they were worded did not allow us to fully give our views. We would not argue with your aims which are to focus on allowing more people to stay at home for as long as possible. This is a desirable outcome that most people would aspire to.
These comments are therefore around how you can do this, but at the same time ensure continuity of care for those who need residential support and Consultation report on proposals for care services in Allerdale and Distington areas 108
ensuring those needing such care in the future can still have their needs met. Our response is focussed on the needs of people with dementia, although we appreciate you are looking at the full range of care needs.
People with dementia are much less likely than others to be able to benefit from extra care-housing schemes. We acknowledge that in some cases this may keep them out of residential care for a period of time, but residential care will still be needed for people in later stages of the disease.
We would question that there will be less need for residential care in the future in relation to people with dementia. Even if more people stay at home for longer through extra care - housing and assistive technology investments, as the numbers of people with dementia are set to soar, (which you recognise) the numbers of people with dementia who can benefit from these new developments are likely to be much smaller than the increase in prevalence. We would appreciate knowing more about any studies that have been done to come to this conclusion.
One of the benefits stated as being able to support people via rehabilitation and expand high level home care may help some people, but will not be of great of benefit to people with dementia.
During the consultation period we have been contacted by carers who are extremely distressed at the thought of the residential homes closing. They have told us that the care their relatives are receiving at present is excellent and understandably do not wish to see this change. Moving home is highly stressful for anyone of any age, but for elderly people this is even more difficult. When you look purely at people with dementia the effect is even more pronounced as the change of environment i.e. moving to unfamiliar place can actually worsen their symptoms. This can happen even when they go on holiday – on numerous occasions carers have told that during a family holiday the person with dementia became even more confused and often this new stage of the dementia journey then remained permanent.
From discussions with Mark and from the document it is clear that the quality of care at the homes proposed for closure is not a factor in the proposed decision. There is therefore no need for us to comment on this apart from to state the requirement that should a decision be made to move people with dementia the council must ensure that the quality of care must be to the same standard in any new care setting. Consultation report on proposals for care services in Allerdale and Distington areas 109
It was also made clear that finance is not the driving force in the proposed changes; instead it is the desire to see more people remain at home and to enable care home environments to be more dementia friendly. This fact has though been contradicted by a councillor who had attended a public meeting and said that it is purely financial reasons. Understandably people are confused; we would like the correct reasoning behind the changes clarified and to ask why if the original information given out was incorrect why Cumbria Councillors are not fully aware of the facts?
Mark did state though that care in Cumbria Care homes is more expensive due to the level of salaries and pension benefits awarded to staff. It was surprising to learn that there is £100 a week difference compared with other authorities. We would add that well trained staff are the greatest resource in ensuring a quality service - more so even than the very desirable dementia friendly environments. We would suggest that the private sector homes would wish to give their staff the same benefits as Cumbria Care do, but will be restrained by the price the Council will pay? We appreciate that budgets are important and the public purse is not endless, but caring for vulnerable people with dementia must be recognised as a specialist skill and paid appropriately.
We have seen many examples in the news of the independent sector closing homes due to lack of finance. Even if the council cannot increase fees to private providers we would question if it is sound finance planning to close council run homes, giving people no alternative but to use private care and thereby putting more people at risk if these homes then close. We are advised that there are 120 vacant beds at present across Allerdale. If, as we expect, many of these are in private homes how sure is the Council that these homes will stay viable in the future?
From conversations with Mark it is clear that a great deal of time and effort has gone into thinking about what is a suitable environment for people with dementia and we were pleased that Stirling University has been used to influence this thinking.
Whilst we also welcome the £1million plans to invest in dementia homes and training from the dementia strategy money and understand the need to support the private sector to incentivise improving their environments and improve staff training in dementia skills; we would suggest that delaying the closure of the existing homes until this investment has taken place would be Consultation report on proposals for care services in Allerdale and Distington areas 110
preferable for people with dementia, so that when transfers into new facilities take place they will be moving into care settings that have been improved and that are run by skilled dementia care expert staff.
We are advised that the only way investment can be made into extra care- housing, assistive technology etc is through saving money by closing homes. Although such new developments are desirable, every effort needs to be made to ensure that this is not to the detriment of people currently using the residential care places at the homes proposed for closure.
It has been stated by the Council that families are currently not choosing homes such as Woodlands due to there not being the modern facilities such as en-suite etc. Although this may be the case, it could also be true that people are not choosing these homes because there is uncertainty around their future. Can the Council confirm that social workers are giving families details of these homes which would illustrate that people are in reality making a positive decision not to go there?
Also it is not clear from the consultation why Woodlands and Richmond Park have been selected for closure both being in the same vicinity. One of the issues carers have raised with Alzheimer’s Society is the difficulties they face visiting as many are elderly and do not drive. We would like to question therefore why have these homes been ear-marked for closure and others further away for investment in dementia wings?
We are told that since there are 120 vacant beds there will be opportunity for people to be moved to a home either nearby or, as many people don’t actually come from the area where the homes are located, will be able to be placed somewhere near their families. It has also been stated that no homes will be closed until everything is in place. Can the council confirm that no-one will be moved further away from relatives making these transport issues even more difficult for carers?
Receiving regular visitors is important for anyone in care. Those caring for people with dementia express serious feelings of guilt when their relatives go into care (wrongly) and not being able to visit as frequently as they would like, will just add to this guilt. Can the Council commit to providing some sort of transport to the new facilities for carers who neither drive nor can easily access public transport?
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There is mention made in the consultation of building a new purpose built dementia home. Would it not make financial sense for the Council to invest this money in improvements to existing homes like Woodlands?
These are proposals we would like to see implemented as part of the process if closure does go ahead:
The suggestion made by Mark Hastings that beds would begin to be reserved ahead of any move following closure. so that groups of people could move together. We feel this will help to alleviate the distress of a move, so would ask that no one is moved unless their groups of friends can be accommodated together. We are advised that there is no time scale and that the process can take as long as necessary. This for us would be a minimum requirement.
Equally Mark’s suggestion that staff from the homes would move with residents so remain as ‘familiar faces’ is something we would wish to see implemented. When and who would decide if the familiar staff could cease going? Presumably this would be based on how well the people have settled?
The thorough assessment of every individual’s needs and desirable outcomes before any move takes place and the risks noted is paramount. I was pleased to hear again from Mark, that people will be able to move on a trial basis to begin with – staying overnight etc. What will happen though if they do not settle or are unhappy?
All the above i.e. placing groups together, staff moving with them and overnight trials are good suggestions to make the moves less stressful. However as these are not noted in the consultation document we welcome confirmation that these processes will definitely form part of the strategy.
To summarise, we recognise that developing extra – care housing is the way forward in keeping people at home for longer and out of residential care. However this development will not benefit people with dementia as much as other elderly people and may just delay the move (a second one) into residential care.
If the only way to fund such investment is to close some care homes, recognition has to be given to the fact that those people with dementia
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currently living in these homes (who are well settled and have relatives happy with their care) are going to be distressed by a move to a new home in order for the new facilities to be developed for others. The families will naturally be unhappy about this, so as much support as possible must be given to them by putting in place the suggestions identified above.
By closing Council run homes, and in turn investing in the private sector, which is subject to national economic factors, this is increasing the risk of being unable to accommodate people if some homes do go to the wall in the future.
The expected massive time bomb of increased numbers of people with dementia will mean more residential accommodation will be needed. If the private sector has declined due to financial restraints and council run homes have closed, will people then perhaps have to move out of the district or even the county to find care for family members?
We would also ask if the ’added value’ of these homes been considered. Could they become a community facility, enabling residents to feel part of a community by other groups meeting there etc?
To conclude we do welcome the fact that the Council is embracing modern thinking on dementia care. However this cannot be at the detriment to the people with dementia currently using services.
We realise that this consultation is just the first stage of a process and would welcome remaining involved in the process. As leading experts in dementia care Alzheimer’s Society believes that we can make a helpful and positive contribution to future discussions.
Copeland Borough Council – response to consultation on proposals for care services in the Allerdale and Distington areas – Woodlands
I welcome the opportunity to respond to the above consultation on behalf of the External Overview and Scrutiny Committee (OSC) at Copeland Borough Council and would like to thank you for meeting with the Task and Finish Group (TFG) on 23 January 2012. Members appreciated the opportunity to
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discuss the proposals and some of the concerns around them given that Woodlands specialises in dementia care.
Firstly, Members are well aware of the budgetary pressures faced by the County Council and welcomed your assurances that the proposals are not based on cutting costs. Furthermore it is recognised that older people needing care want the choice to be able to receive it in their own homes and demand for residential care is reducing at the current time.
The TFG understand that District by District reviews of care services are being undertaken for management reasons. Members were therefore concerned that Woodlands at Distington had been placed within the Allerdale district review given the position of this care home and the potential impact its services and closure could have on a significant part of Copeland. I am pleased that you are going to consider the wider implications of this.
The reasons for the proposed closure of Woodlands include low occupancy, poor location and its need of refurbishment. We therefore welcome the position that refurbishment of this care home could be a feasible option and could be explored further given its position as a Gold Standard holder. You will recall we also discussed social care referrals to Woodlands and you advised you would look into this further.
Members feel strongly that the distress such proposals cause for residents and their families should not be underestimated and need careful management. Members recently met with the Woodlands Care and Support Group and there appears to be significant fear around the proposals and what they mean for their loved ones.
These include access issues for visiting and receiving visitors including transport, travel costs and time and distance. There is also concern around the upheaval and unsettlement caused by a move for vulnerable residents. The group advised that the County Council had not been clear about how this would be managed and where vulnerable residents would move to. You stated in our meeting that there would be a twelve month ‘transition’ period. Please
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be aware that this will be a difficult and uncertain time for residents and their families. How will vulnerable residents be supported at this time? Finally, we are all aware of the demands dementia puts on our social care services nationally and especially in Cumbria which has an aging population. We trust that the proposals are put forward in the longer term context of the needs of people with dementia.
I look forward to seeing the outcome of the consultation.
Kind regards.
Yours sincerely,
Councillor John Kane Chair of the External Overview and Scrutiny Committee
Allerdale Borough Council – response to consultation on proposals for care services in the Allerdale and Distington areas.Consultation on Proposals for Care Services in Allerdale and Distington
1. Do you agree with the Council‟s overall Plan to focus investment to help people stay at home as long as possible?
Yes √ No Don‟t Know
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Please tell us what you think.
Yes, Allerdale Borough Council agrees with the County Council‟s overall Plan to focus investment to help people stay at home as long as possible, as many older adults prefer to stay at home as they get older. Retired people take pride in retaining their independence and leading a life of their own. Staying at home provides this independence, and enabling people to remain in the area where they have often lived for many years and are known to local people, enables people to remain a part of the local community.
2. The rehabilitation (reablement) service is about helping people develop or regain the skills and confidence to do things for themselves. It is a free service for a period of up to 6 weeks. What are your views regarding this service?
Approve √ Disapprove Don‟t Know
Please tell us your views
Allerdale welcomes the introduction of the rehabilitation service. In our experience the vast majority of people want to live in their own home for as long as they can, and the reablement steps proposed help to make this more likely. There is evidence to suggest that people who access „preventative‟ services (such as reablement) have a reduced need for long term care and live independently for longer. We believe that this must be a good thing in terms of future provision of care in Allerdale.
3. High level home care services provide people living at home with the combined traditional home care and basic nursing care services. Do you support our proposal to expand high level home care services from a night time only service to a 24 hours, 7 days a week service, to support more people to stay at home?
Yes √ No Don‟t Know
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If not, please tell us why, or tell us your ideas on the types of services you would like to see provided in the community.
The provision of High Level Home Care Services for 24 hours day 7 days a week is an improvement on the current service providing home care and nursing at night, and is therefore supported by Allerdale Borough Council. The need for this type of care is very often not limited to the night-time and this development of the service should allow for more people to remain at home for a longer period.
4. Sensors and alarm based technology can assist families and care staff in supporting people living in their own home. Do you support the proposal to increase the use of sensors and alarm based technology?
Yes √ No Don‟t Know
We fully support the proposals to increase the use of sensors and alarm based If not, please tell us why. technology, as the use of this technology helps people to feel safer and more secure and importantly enables action to be taken quickly and appropriately, should a problem occur for an elderly person living in their own home.
We would though welcome more details on how and to what degree it is proposed to
make better use of this technology, as the proposals included within the consultation are not sufficiently detailed to allow us to understand how the use of this technology is proposed to assist people directly, and where the funding will be provided to enable sensors and alarms to be fitted and monitored within the homes of those who are supported.
5. Improvements to the design of residential care homes can reduce the affect dementia has on a persons ability to live with a level of independence and a high level of contentment. Do you support the Council‟s proposal to invest in improvements to the environment and in staff training at Inglewood and Parkside?
Yes √ No Don‟t Know Consultation report on proposals for care services in Allerdale and Distington areas 117
Please tell us your views
The proposals outlined in section 3 of the consultation, to invest in better signage and floor coverings, including the best use of colours, tones and textures to minimise confusion and help people find their way around the home, are relatively low cost proposals and should, we would suggest, be adopted as best practice in all County Council managed residential care homes as appropriate. As such, we question the rationale of including this question in your consultation. Similarly works to provide for large bedrooms with en suite bathrooms would seem a sensible approach and it is difficult to find fault in this approach. No details as to the extent and costs of the proposed works are outlined, and therefore it is not possible to compare, this level of investment alongside other proposals.
6. Extra Care housing schemes provide people with their own self contained homes with the benefit of care staff on site. What are your views on the Council‟s proposal to develop an Extra Care housing scheme in the Workington area as an alternative to residential care?
Please tell us your views
The case for the development of Extra Care Housing Schemes is well made and subject to the required planning approvals, and identified need, we support investment into this type of scheme. We would wish to explore a needs based approach to be adopted to explore the opportunities for other areas in Allerdale to be considered for new Extra Care Housing Schemes.
7. The Council would like to invest the money currently spent on existing residential care homes in a new extra care scheme and in more services to help people stay at home. With this in mind, do you support the proposals to close three Cumbria Care residential care homes?
Yes √ No Don‟t Know
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Please tell us your views (if you have ticked „No‟ to this question, please tell us the name of the care home if your concern is for any particular care home)
We are sympathetic to the views of people who wish to see the 3 residential care homes in Allerdale remain open. The 3 homes provide local care and residence for some 83 places. There will inevitably be disruption to the families and residence of the people who occupy these homes, if they are to shut, as moving people is likely to be distressing to those concerned and it is likely that they will be relocated to facilities that further away from their families. However, we also acknowledge the reducing resources available to the County Council and the need to plan for the future to ensure that the level of care provision meets the needs of the people of Allerdale in the future. We also acknowledge that the need for residential care home places is reducing as, through the support they receive, people are living longer in their own homes, and generally have a preference for the greater degree of independence that living at home or living in an Extra Care Scheme brings.
We wish to put particular emphasis upon the need for the additional rehabilitation service and the provision of Extra Care Schemes to be in place before the closure of the 3 care homes.
8 . What is important to you in terms of the location of a new Extra Care scheme? (e.g. should it be near a town centre, on a bus route, in the countryside?)
Please tell us your views: In terms of planning, ideally, extra care homes should be located in a sustainable location - close to shops, services and community facilities. This follows the principles of planning set out in Planning Policy Statement 1(PPS1). However case law has determined that such development may be located in suburban/fringe locations, if (a) the development has appropriate on site facilities and (b) special transport arrangements are provided (i.e. mini buses into town etc.), on the basis that the need for off-site trips is limited. The other considerations are (a) local need and (b) the existing level of provision in the area. Residential units within extra care homes constitutes a C2 use class, it is not regarded as a 'domestic dwelling' in the customary sense (which is C3 use class) and therefore, they cannot be subject to occupancy conditions. Extra care homes be shown to meet local needs and therefore we consider that (a) and (b) must be considered carefully when assessing application for residential care homes - to avoid 'overprovision' in the high demand areas.
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9. If you were the Council and needed to support growing numbers of older people with less resources, what would you do?
Please tell us your views:
The approach suggested by the County Council is similar to the approaches taken in other areas of the United Kingdom, underpinned by a change in lifestyle and demographics. It is important that work to progress the development of Extra Care Schemes is aligned with the future need for these facilities, and that should residential care homes close, this resource is invested into Extra Care Schemes in a timely and cost effective manner to make the best use of the resources that are available.
The Borough welcomes the early consultation and engagement with stakeholders, residents and users of the service and encourages the County Council to continue to with this approach, and that following the consultation, the findings and future decisions affecting care provision is fully communicated in a timely manner.
Please tell us if you are responding to this consultation mainly as a:
Service user, or on behalf of a service user, in one of the residential homes affected by the proposals;
Carer/or family member, with a relative or friend in one of the care homes;
Staff member employed in one of the care homes detailed in this document;
Staff member – other;
Member of the public;
√ Stakeholder – e.g. Town/Parish Council, Voluntary group;
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Cumbria LINk
Response to the Proposals for the modernisation of Social Care Services in the Allerdale and Distington areas
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February 2012
Contents
Executive Summary Page 3
Introduction Page 6
Comments on the Process Page 7
Comments on Proposals Page 8
Residents, Carers, Staff and others comments:
Park Lodge Care Home, Aspatria Page 11
Richmond Park Care Home, Workington Page 14
Woodlands Care Home, Distington Page 19
Conclusions Page 24
Recommendations Page 26
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Executive Summary
Cumbria LINk’s response to the proposals for the modernisation of Social Care Services in Allerdale and Distington
Cumbria LINk has considered the proposals presented by Cumbria County Council on the modernisation of social care in Allerdale and Distington. We have also spoken to current residents, their families and carers of the three care homes affected by the proposals.
Our comments fall into three categories;
The consultation The options The current residents/closure of Care Homes
The Consultation Plans to modernise care in Allerdale began long before this public consultation and we understand that referrals to the care homes had been stopped well in advance so that the true picture of occupancy has been affected by these moves.
Engagement in the development of the proposals, particularly those directly affected did not take place. We consider that allowing local communities to be part of the development process would have achieved better outcomes and had the potential to identify alternative opportunities.
Our response raises many fundamental questions that we hope have been discussed at length but are not dealt with in the Consultation Document. We have therefore felt it necessary to raise these in our response.
People we spoke to were reluctant to tick the yes/no boxes in the consultation response fearing that their views could not be accurately expressed in this way.
Those directly affected by the proposals feel that this is something that is being done to them rather than feeling empowered by the process.
We agree that good advocacy should be part of the consultation process; however two residents had been extremely distressed by the sessions with the independent advocates.
The Consultation Questions 1 Most people would agree this as an ideal but life is not always so. Some individuals may, for example because of rural isolation or living on their own, feel safer in a residential home setting. Any such plans need to take account of such variation in choices. Cumbria LINk Governing Body is concerned that people will no longer have the option of choice
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2 Generally we approve of rehabilitation (reablement) service but are concerned about the time limitation it should be more flexible to allow a little extra time where it‟s needed rather than pull the plug at the 6 week period. What happens if someone needs extended services, who pays, is it means tested. We understand this is intended to be a short tem intervention but some flexibility is needed.
3 The consultation document does not inform us what has been done to make sure this option is safe. Cumbria LINk Governing Body is extremely concerned that not enough has been done to assess the potential risks of providing care at home. We fear that there will be increased risk of hospital admission, due to falls and ill health due to poor living conditions, poor diet and fuel poverty. We are aware that older people are feeling the impact of the current and ongoing financial crisis, national news reports talk of older people have to choose between eating or heating.
We feel that not enough has been done to consider the impact of social isolation for those being cared for in their own homes. There is a wealth of evidence that indicate social isolation has a negative effect on wellbeing.
We have major concerns that the options for care presented in the consultation may in fact only offer a short term solution and act merely to delay residential care. As more care homes are forced to close because of reduced referrals, how can Cumbria County Council be certain that places will still be available when needed? There has been no economic impact assessment to consider this.
We are extremely anxious that there be robust monitoring of any care provided at home. We need to know that all those cared for at home have all necessary safeguards in place to prevent abuse or inferior care.
4 We have concerns about the rural nature of the area and the response times to be able to give care when it is needed. This is a huge and sparsely populated area, how will a rapid response service work in this area?
We understand that the current contract has appointed one telecare provider for the whole of Cumbria, who is based in Liverpool, has this arrangement been proven to be safe and reliable?
We agree in principal but more information is needed to be fully informed
5 We have talked to organisations that provide services for older people during recent work to refresh the JSNA. They lead us to question the statistics used as a basis for your proposals. What the JSNA does not describe is the picture in terms of people living beyond 85. We are concerned that planning is based on limited available facts and that as people live beyond 85 the number of people living with long term conditions, dementia and disabilities will rise, increasing the populations care needs. Has the council fully considered the actual need for dementia residential care demands for the future?
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We agree with the improvements to the design of residential care homes but feel this and training should be introduced at other homes too
6 There is not enough information in the consultation document to allow us to make an informed decision. We need to know how much accommodation will be available, we also don‟t know why the Workington area was selected and who was involved in that selection.
Whist we agree with the notion of Extra Care Housing we don‟t know enough to be able to give a concrete response.
Should the Council decide to close any or all of the care homes we would hope and expect that this would not happen before Extra Care accommodation is available as a real option.
7 Current residents and their families together with well supported on line petitions tell us that they do not support the closure of any of the care homes.
Cumbria LINk Authorised members visited all three care homes and spoke to residents, staff and relatives, who raised a number of concerns and questions with us, we would ask that these be considered fully and be responded to. A full account of our visits can be seen at page 11
We are concerned about the current residents of all three care homes and the negative impact on them should they be moved. From those that we spoke to they are not „on board‟ with the closure and there is research that shows this to lead to an even worse outcome for those involved.
Current residents are not concerned about the size of rooms or the lack of en suite facilities. We found on our visits and in conversations with residents and their families that they very happy with the quality of care they received
8 The decision on where it is should be open to public consultation which should consider public transport, and the needs of people who will potentially live there.
9 Involve people at the beginning of planning. There is growing evidence that engagement helps to save £100,000s per year. Build on existing assets with communities „Look at the strengths of older people not just at their needs‟. „Growing Older in the English Countryside‟. Over the Hill Report
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Introduction Cumbria LINK recognises the need to make sure that appropriate and adequate care is provided throughout Cumbria that takes into account the challenges now and for the future as the number of people living longer increases.
The Cumbria JSNA 2009 informs us that by 2015 there will be 5,000 more people with diabetes, 6,000 more people over the age of 65, 6,000 more people over the age of 65 unable to manage at least one domestic task, 1,600 people over the age of 65 with a moderate to severe visual impairment, 1,200 more people with dementia and 2,500 more over the age of 65 with learning disabilities.
What the JSNA does not describe is the picture in terms of people living beyond 85. We are concerned that planning is based on limited available facts and that as people live beyond 85 the number of people living with long term conditions and disabilities will rise, increasing the populations care needs. What the JSNA does not describe is the picture in terms of people living beyond 85. We are concerned that planning is based on limited available facts and that as people live beyond 85 the number of people living with long term conditions and disabilities will rise, increasing the populations care needs. Consideration also needs to be given to the fact that the more elderly people get, the more elderly their relatives get, and the additional complications that brings. Because of these factors, the number of people who will be able to be cared for in the community will decrease.
In response to the present consultation around the proposed changes in social care in Allerdale, there are three active on line community campaigns against the closure of the care homes, demonstrating the extremely high level of opposition to this element of the consultation.
We understand that the cost of providing care in a residential care home is greater than the options described in the consultation document but these costs do not represent equivalent care. We would point out that quality and appropriateness of care should be the overall goal and not the cost.
We appreciate that the closure of residential care homes is part of a national target that Cumbria County Council needs to achieve in order to meet the national personal budget targets. We are aware that there is considerable national debate and concern around the closure of residential care homes and the future of funding of social care services, therefore we questions the likelihood of local voices influencing and successfully opposing any proposals for change that sit under a wider Government agenda
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Comments on the Process There have been public meetings held in each area where the proposals have been outlined to the local communities, and they have been encouraged to respond using the consultation documents.
We have been informed that staff heard about these proposed closures only days before it was announced publicly.
We have been told that many people will not respond using the consultation document because they consider it to be flawed in the way the questions are worded and the way people are expected to answer, because of the „Yes, No, Don‟t know‟ nature of the available answers/check boxes. It was felt that that the questionnaire is intended to gather support for the proposals rather than get a real sense of how people who currently use services, their friends, families and the wider supporting communities feel about the proposed changes.
Feedback suggests that people felt the public meetings were a means of Cumbria County Council „transmitting information‟ with very little scope for „receiving information‟ and listening to the concerns and suggestions of the public.
The consultation process has been criticised due to the lack of openness and honesty.
Consideration of Alternative Solutions/Working with Communities We are not aware of other options that were considered other than those presented in the consultation document. For example what engagement took place with communities to explore other possibilities, did Cumbria County Council learn from the Ravensfield Care Home closure in Keswick, where communities were keen to present innovative and cost effective solutions?
The consultation presents us with no alternative options other than the closure of these residential care homes. Prior to the consultation, were the views of residents who live in and use these facilities on a day to day basis sought, and have they been asked what changes would improve their level of care?
The consultation/proposals suggest the care homes will be replaced with Telecare, home care or extra care housing - services that are not presently existing, appropriate or available to residents. The use of existing private care homes is not mentioned in the consultation document, yet for many residents is the only real alternative. There are many reports outlining the effect that loneliness and isolation can have on older people for example the „Loneliness and isolation Evidence review‟ (Age UK). The evidence gathered supports the need of those already in residential care for both company and support, hence the choice of residential care in preference to staying in their own homes.
It is clear that the consultation follows the advice of „Change Agents‟ appointed to bring about change in the provision of care homes. The document quotes commonly used phrases like; “because this is what people want‟, “the homes are not fit for purpose”, “the rooms are not large enough for hoisting equipment” for example. (Care Home Closures - the law and the implications, Yvonne Hossack, 2006) Consultation report on proposals for care services in Allerdale and Distington areas 127
Comments on the Proposals
Expansion of high level home care services We have major concerns about this service, these include:
Quality assurance Actual time spent giving care Social isolation Depression Appropriateness of client‟s home Abuse by carers/relatives
There have been a number of stories nationally about poor quality of care provided in people‟s own home that do little to reassure those receiving care for, or their families, that abuse does not happen. The consultation document does not inform people about how quality of care will be monitored; competences of carers and how these issues such as safeguarding will be dealt with.
People working as home carers say that they have little time left to provide care as considerable amounts of time are lost travelling, to and from clients homes; this is especially true in rural areas.
Social interaction is key to the wellbeing of older people, and identify that loneliness and isolation can cause depression, and have a negative impact on wellbeing (Loneliness and Isolation Evidence review, Age UK). Home care offers no opportunity for social interaction other than that provided by the attendance of the carer. This is especially pertinent given the closure of day care services.
Cumbria County Council‟s Equality Impact Assessment has not considered the issue of rural isolation and its impact on wellbeing.
The responsibility of up keep, maintenance and general safety of the home rests with the client. Their home environment therefore may not provide suitable levels of safety, warmth and comfort.
Sensors and alarms The benefits outlined in the consultation document are dependant on the ability of the individual to be able to operate and understand them. The initial assessment and ongoing review of peoples needs should be thorough and ongoing; this is not discussed in your document.
The two options above (high level home care and sensors and alarms) may offer a solution in the short term, or to people at the very beginning of their „care pathway‟ but we feel that for many it may only defer a move to residential care, and will have a negative impact on those currently in residential care, that do not wish to leave (involuntary transfer).
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Extra Care Housing This offers a real alternative to residential care for some elderly people, but it does not currently exist. This option was offered in Keswick as an alternative to residential care and is still not available. At this time this is not a realistic option. There is very little information provided about where this may be located or when it will be available. We would also like to see how you arrived at a decision to provide Extra Care Housing in the Workington area.
We also question how people how people can make informed choices regarding the proposals when so little detail is available in the consultation process.
Closure of the Care Homes As stated previously there is considerable public opposition to this proposal. Some of the arguments used to support the idea of closure in the document are not issues for the current residents (see feedback from residents and carers). It is important to consider where the respite services would be provided in the Workington area if Richmond Park is to close
Impact of Change on Residents We are aware that at least one of the residents that will be affected by the proposed Care Home closure has already been moved from the care home in Keswick that was closed, for that individual this proposed closure and a further move is unacceptable. There is considerable research and evidence that finds the mortality rate increases following the closure of care homes. The trauma of „involuntary transfer‟ has been recognised and is known as „relocation stress‟ (Haggerty v‟s St Helens Council, 2003)
Community Assets It is considered best practice to plan using an asset approach rather than a deficit approach. There seems to be no consideration given to the potential and real assets the residential care homes can offer the community, neither has there been an opportunity for the local community to consider any other services the home could provide, and how the community could support the care homes.
Choice We understand that in the future people will be offered a range of care packages that include re-enablement, home care, alarms and assistive technology or extra care housing (when and if it is available). We also understand that unless there is a need for dementia care there will be no option for people to choose for residential care (other than to pay privately).
There needs to be an awareness of the impact the general reduction of funding is having on the residential homes in the private sector as many are closing their doors as they are no longer viable businesses. Cumbria County Council also needs to consider those services provided by the 3rd Sector for older people and their support in the community, particularly those that have been withdrawn due to changes in contracts and lack of independent funding.
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There is a need for residential care homes in the final stages of a „progression of care‟ structure.
Economic Impact The impact financially on relatives who may have to travel out of the local area to visit will be considerable, and will lead to reduction in visits, and all the implications from that for both visitors and residents.
The impact on other providers of services such as private care, and the voluntary sector should be considered, as they are presently under financial pressures, and are withdrawing services to this group of vulnerable people throughout Cumbria.
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Park Lodge, Outgang Road, Aspatria, Wigton, CA7 3HP
Cumbria LINk carried out a meeting with members of the Save Park Lodge group at 7pm in the Chapel Café, Aspatria
Those members of the LINk Governing Body who attended the meeting were: Ailsa Benson John Baillie Jane Thompson Supported by: Kay McGregor
Important to note: We were contacted by a member of the family of one resident at Park Lodge who expressed concern at our intended visit. She asked us to consider not speaking to residents because her Mother in Law had been very distressed following the visit by the independent Advocates. Subsequently a second family contacted us and also told us that their family member had also been distressed by the Advocates visit. Out of respect for the 2 families we did not speak to residents at Park Lodge. We did not seek any other views on the experience of the advocates of residents or their families at any of the care homes. Our decision not to speak to residents of Park Lodge was in response to the 2 concerns we had received.
Meeting report: We were informed that they had gathered 3,500 signatures from local people against the proposed closure of Park Lodge which had been presented to the full Council. They had also sent standard and many personal letters to Cumbria County Council for consideration in the Consultation, and had produced leaflets and posters which were displayed locally raising the profile of the proposal to close Park Lodge.
We had feedback from 2 families of an insensitive approach by the appointed Advocates who‟s visit had caused distress to 2 residents. One relative exampled how upset her Mother in Law had been and still was about the thought of having to move from her „home‟. She had cried for the whole of the rest of the day after the Advocates departure.
We were told that it is not only a place for residents, but that many local people felt they had a stake in Park Lodge as it played a part in their own future plans of how they want to be cared for in future. It is the „hub‟ for care for a lot of local villages, and the rurality of this area needs to be considered.
If Park Lodge is closed it leaves a geographical gap in local provision of Residential Care, and relatives having to travel miles to visit. It is considered a local Asset, and as such, can be developed and improved as well as continuing to provide extremely high quality Home care for the more vulnerable in this Community.
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This group and others have given thought to other services Park Lodge could provide to support older people in their local Community, but to do this it needs to exist. There could be some income generating ideas to pursue if it is to survive. At present the home provides Day Care for 2 people but has the capacity for more. They have been instructed not to provide this service for any more local people.
There were grave concerns expressed about the lack of local alternative care provision for the present residents, and the extreme concern around the impact of moving such elderly and frail people. No matter how long the process takes, and how supportive the process, it will still have a big impact on them, and may shorten their lives as research has proven major change in later life can do. For those local people who have lived in their homes „for as long as possible‟ and may need the services of a care home in the near future, extra care housing would not be an option and actually does not exist locally for them. It was considered that they would finish up in hospital as there would be no other safe place for them to be placed. Wigton hospital would see an increase in emergency admissions from hospital as there would be no safe place to discharge elderly frail people.
The local GP attending the meeting made the point that there is a false assumption that Dementia is going to be more prevalent in the future, therefore are relevant decisions being made around planning appropriate care for the future? They also told us that people moving out of the area would lose that important connection with their local GP that may have existed for many years and is extremely important at this stage, especially when discussions around choices for end of life care need to take place. These conversations are easier face to face with all concerned in the care home environment.
We were told, and this has been supported by many others, that the plans to incorporate en- suite bathrooms for all are not always essential, as many older people who are frail prefer supported baths. There is research that shows actually having baths and showers in en-suite facilities need to be risk assessed as they can be „falls risks‟ for those who are frail or have limited capacity. We were told that actually many of the now residents have not expressed a need or want for en-suite facilities.
One main point we were told that is very important from relatives and friends is the ease with which they can visit. Many local people visit this home very regularly. They may have other commitments but because of the Home‟s present locality they do not have to travel long distances or rely on public transport to get to see their loved ones. The rurality issue raises its head once again, as any move out of Aspatria is not going to be to somewhere local as it does not exist. This has implications for relatives of long journeys, and relying on buses to visit.
The age of present residents is around eighty to ninety, and very importantly, this means their relatives are in their sixties and seventies, so the prospect of long distance visiting is daunting, and would mean a reduction in family involvement.
It came across very strongly that the Community feels as if it has „ownership of the home‟ and in turn the Home is very much part of the Community.
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There was fear expressed at the possibility of replacing 24 hours a day care with nine and a half hours a week. The present residents are there because they need twenty four hours a day care. An example we were given was of one lady who was receiving home care, had developed pressure sores and was underweight as she was never given a proper meal. Since being admitted she now has no sores, is eating well and her „well-being‟ has improved immensely.
There was an awareness of the crisis situation being presently experienced by the Voluntary Sector who are withdrawing some of the local support services suggested to support people to live in their own homes. This needs serious consideration.
Once this home is closed, they will not get it back and with the ageing population, is it wise to remove a proven service, valued highly by those who use it and locals who want to use it in the future.
The question was asked „If Park Lodge closes, what are the plans for the building?‟
If Park Lodge were to close, and there is no more Residential provision locally, what will really happen if an elderly person living in an isolated village or location cannot be accessed because of weather conditions, or even ill health of appointed carer?
Those present residents of Park Lodge now would all „choose‟ residential care, why will that choice no longer exist if that is the „choice‟ of those who are now using it?
Finally, we were told that this suggested closure makes a mockery of „Closer to Home‟ for those residents now if they all have to be moved. Can Cumbria County Council guarantee that if they have to be moved, they will be listened to and included in the „decision making process‟. Ideally all the staff and residents should move together as a family, but if this is not possible, they should be placed in equally excellent accommodation and not just where there is a place available.
The question was asked „what is the integrated social and health care pathway for the elderly across all areas of Cumbria and what are the cost implications?‟
Will there be a pot of money available to support family and friends to travel to visit their relative regularly if they are moved out of the area?
Some relevant quotes from people at the meeting: “Park Lodge is a proper ‘home’” “If Park Lodge were closed then it would be very difficult for family and friends to visit”. “The health of the residents is bound to be affected and that of their carers due to increased anxiety and stress”. “The home would be an even bigger asset if current day care provision was increased”.
Dignity and Respect, Human Rights and Disability Rights must all take high priority when considering the very serious action of removing people from their home without their consent
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or against their will. These residents need to be treated with Dignity and Respect and their Human Rights respected. Any of them who are frail or without mental capacity have rights under many Acts, and these must be carefully taken into consideration when decision making processes about their futures and where they will, and where they choose to live out their final days are made.
Cumbria LINk will be watching the progress of the Consultation with interest and will maintain contact with key people throughout.
We were asked at this meeting that each report be considered independently.
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Richmond Park, High Street, Workington CA 14 4ES
Cumbria LINk carried out a visit to Richmond Park on Thursday 2nd February 2012 at 10.30am
Those members of the LINk Visiting team were: Alan Alexander Ella Cullen Evelyn Bitcon Supported by: Kay McGregor
This particular report relates to a visit to Richmond Park by members of the LINk Visiting team where discussions took place with residents, relatives and some members of staff.
They were told about the difficulties one very frail resident experienced when they lived at home because of deafness and nervousness dating back to their experiences in the war. Relatives related that he was cared for at home but this was unsatisfactory and actually a bad experience, as he was left unwashed and there was great difficulty with him not taking medication. The GP could not get access to the home on one occasion so a relative had to break in. He is now very well cared for in Richmond Park and all problems he had when living at home alone have been corrected. Their relative was absolutely certain this was the only form of care suitable for them.
Another resident is able to be near to her husband as they were no longer capable of being the carer at home. When he lived at home, he did not want carers in the home as the intermittent care made him uncomfortable. He has regained confidence whilst in Residential Care. She was very lonely at home on her own, and really appreciates the company of others she now has every day. She feels part of a family, and told us she would be really upset if the home was closed. She has disabilities so needs 24 hour care and is very appreciative of it. She is able to go to the Day Care centre and meet other people and get involved with some activities. She has local family who visit every day.
She wanted LINk to emphasise the loneliness of living in her own home and receiving various visiting carers and how isolating this can be.
We were told by another resident that she has family locally who visit her every day. She was very concerned that the home might close and said she was far too old to move again. The staff „go the extra mile‟ for her and when family bring in food, they make it into sandwiches for her in the evenings, or bring shopping in for her. She says she is very happy in this home and did not want to be „forced‟ to go somewhere else.
One lady told us that she wants to die in Richmond Park. She likes her own company but has the option of mixing with others when she chooses. She is surrounded by her own memories, photos and furniture. She enjoys having an assisted bath and couldn‟t cope with
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this on her own. She has regular visitors here, and does not want the home to close. What will become of her if it does close, a big worry for her?
We were told on many occasions about how happy residents are there. They have privacy if they want it, but can choose to mix with others if they wish. Some of the residents are very elderly and frail but told us how happy they are living there. If they ring the bell for assistance they never have to wait for someone to come, they are there straight away.
We were told that „good people‟ work in this home. This lady was born in Workington and has lived there all her life and this home is her choice. ‘Please fight to keep this place up and running as I only have happy memories of living here’.
One resident, whose health is deteriorating, is frightened for her future and had been asking her family in a distressed and tearful state ‘Where are they going to put me!‟ This lady feels she has no choice, and it is felt that this is not a respectful or dignified way to treat her.
Staff: General comments from staff have been that they have not been told why these three specific homes have been earmarked for consideration for closure.
We were told that the staff think that the Council consider that this home is not fit for purpose, however, they have spent money on Maryport Park Side home which is in the same group as Richmond Park. The Council need to remember that this is also a well used day care centre, whereas Maryport is not.
This home is always full, very popular place with a good reputation. It has a good bus route for visitors.
The training for staff here is first class, which in turn, supports them to provide an excellent standard of care. The staff told us they have great job satisfaction, low turn over as they don‟t want to leave, and enjoy working in this lovely friendly home.
Relatives: A meeting was held with some of the relatives who were visiting on that day, including some who had come in specifically to meet with the LINk Visiting team members. It was a very emotional and very moving meeting, with many relatives in tears as they tried to tell us about how they felt about the proposed major changes to their loved ones care. They were all behind saving Richmond Park from closure, and told us they have the backing of the local MP, Tony Cunningham.
These Relatives thanked LINk for giving them the opportunity to speak about their concerns around the suggested closure. Many of them showed signs of being back at that stage when they had to make the decision to admit their relative to care because it was at a critical stage and they could no longer cope. All the good work of the staff at the home reassuring them and providing above average care for their family members after admission, and letting them experience trusting somewhere to do the caring, so that they can be daughters and sons
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again is being destroyed by this process. A grave concern was the worry that their loved ones would die from broken hearts if they have to be moved, very powerful statements.
Comments, questions and concerns raised by relatives: Why did Cumbria County Council allow people to come in to Richmond Park and settle if they knew there was even a possibility of it closing? Why have Social Workers been discouraging people recently from coming here telling them it is going to close? Why have relatives and carers been left out of any discussions around the decision making when considering closing Richmond Park? Where are the other „respite services‟ in Workington? „Amathea‟ and „Newlands‟ (local private care homes) offer residential care but they are independent, and they have no proven track record of excellent care like Richmond Park so would not be a natural choice for those who have relatives in Richmond. If Richmond Park closes what will the choices be locally that have equal care standards, as this is not clear in the consultation? They told us from their first hand experience that in their experience Care in the Community does not work now, and they felt strongly that it will leave more older people at risk of abuse from stressed, over-tired relatives struggling with the 24/7 responsibility for those who actually „need‟ full time residential care. If Cumbria County Council are no longer offering Residential Care as an option, will this mean that the private sector will no longer have a cap on their charges and will be able to charge what they like? Richmond Park has such high standards and does not allow under 18 year olds to bath residents, they make sure they receive good support and training before they are allowed to support residents with tasks like bathing etc, private homes allow 16 year olds to carry out these tasks. As Richmond Park has excellent Care Quality Commission ratings could it be used as a training centre, example of good practice for those that do not achieve so highly? Surely Cumbria County Council should be proud of the service they provide at Richmond Park, surely there are services that do not get such high praise that could be considered in the push to save money? Relatives told us that they believe the way the Consultation has been presented is flawed. We were told that some of them have not even filled the Consultation papers in as they feel the questions are slanted, the offering of a Yes – No response with comments below allows a summary that may be slanted if the comments are not taken into consideration. Some of the options offered do not exist and would not be suitable for the residents presently in Richmond Park. A very important point was raised about the stress this will cause those residents who will have to be moved, no matter what is put in place to support the move. There is strong irrefutable evidence that clearly indicates that moving elderly frail people who either have Dementia or even have capacity has a major impact on their health and many die from the stress this change causes, and this is well documented. It is very disappointing that there is an expectation that Cumbria County Council will disregard this evidence and quote from research carried out that states it has no impact. There is a real sadness that relatives feel that the massive impacts this move would have on both the residents and on themselves, will not be considered, as emotive issues have no „clout‟. However, they all are showing signs of deep concern and stress, equitable with when they had to make that difficult decision originally to place their loved ones in care.
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The way Richmond Park has a wonderfully supportive natural progression route through Day Services, then respite care to full residency is special and has proved an incredibly smooth way for residents and their carers to experience a smooth transition into permanent residential care . It is very important to take into account that many of these residents are in their 80‟s and 90‟s and their relatives are therefore in their 60‟s and 70‟s, and have health problems themselves. A quote from one relative “Retirement for me has been completely about working even harder as a full time carer, and I was completely exhausted before a place in here became available” They told us that they had seen the plans to extend Stainburn School, and were concerned that Richmond Park, as a building, was nowhere to be seen on those plans. They told us that the allotment owners behind Richmond Park have received notification that they may have to quit their sites. Suspicions are running high that Cumbria County Council have already earmarked the building for demolition and the land around it to be used for other things as it is in a prime location. Relatives expressed their concerns about those people who can no longer afford to use the day care services due to the rise in the cost of that and the rise in travel costs. This needs to be taken into account. Cumbria County Council may well say that the need for Day Care services has reduced at Richmond Park as people aren‟t using it, but they need to honestly look at, and investigate why, before taking that service away. There are some heartbreaking comments from residents, such as „I‟m not moving again, this is my home‟. “I‟m going to tie myself to the railings”. Some of the group stated they have already seen some deterioration in some resident due to the stress of uncertainty. Some relatives told us that they felt strongly that Park Lodge would survive and both homes in Workington would close, „Park Lodge had been thrown in as a red herring‟. They felt this has not been a fair process, and that they believe closure is a „done deal‟. The serious emotional turmoil these relatives are feeling can‟t be emphasised enough around having to travel distances if relatives are moved Some relatives have other dependants at home that they are caring for (example of lady with another relative with cancer at home), and the thought of relying on public transport, fills them with anxiety. Their relatives in Richmond now would be visited far less, if not at all. We were asked if these residents no longer have any Human Rights? Have Cumbria County Council seriously considered that the Private Care Sector and the Voluntary Sector are also in desperate need of finances and are withdrawing services? Have Cumbria County Council consulted with the other providers around where the provision of care will come from? What will happen to those members of local communities who need residential care in the future if that provision is no longer available to those who can‟t afford it? Will they rely on the NHS to care for these people and is this appropriate? The Consultation document talks about the inappropriateness of Richmond, but it would seem totally appropriate for the present residents. It would seem that those residents who have limited mobility do not need bigger rooms, and the argument around not enough room for hoists can be dealt with easily and safely with the introduction of overhead hoists.
Finally, there was not one relative who had anything even slightly negative to say about Richmond Park, they are completely happy with the care they get here for their
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relatives, it is one big family, pretty unique. Those residents who live here now would „choose‟ to continue to live the rest of their lives here.
Cumbria LINk will be watching the progress of the Consultation with interest and will maintain contact with key people throughout.
We were asked at this meeting that each report be considered independently.
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Woodland Care Home, Toll Bar. Distington CA14 4PH
Cumbria Link carried out a visit to Woodlands Care Home on the 8th February at 10.30am
Those members of the LINk Visiting team who carried out the Visit were: David Stringer Ailsa Benson Neil Hughes Evelyn Bitcon Ella Cullen
Supported by: Kay McGregor
Woodlands is on the border of Copeland and Allerdale districts, and has recently had major road works carried out around it. However, it remains in a good position, with plenty of parking and no noise interference from the traffic. There is an ambulance station very near to hand.
There is also a save Woodlands campaign and Cumbria County Council will be presented with signatures from local people who want the home to stay open. Unfortunately, they were not in time to submit this petition to Cumbria County Council prior to the Consultation closing date, but will be submitting it later in March to the County Council cabinet.
We were told that part of the land that belonged to Woodlands was sold by Council to the Highways Agency to enable them to carry out the required work for the Lillyhall Improvement Scheme. The money Cumbria County Council received in payment from this could have been used to update the building to required standards. There seems to be confirmation that the Highways Agency paid Council, but some confusion around where this money has gone within Cumbria County Council budget.
Although Woodlands is at present exempt from having to comply with having en-suite bathrooms and rooms of a minimum of 12 foot, they are at present 9 foot, no money has been spent on it for some time. There is however, evidence that en suite bathrooms for residents who have Dementia can be dangerous as they do not recognise the bath or the shower and can attempt to get in to them, leading to slips, scalds etc.
The residents at Woodlands range in age from 67 to 93, and all of them have some form of Dementia, meaning some have very complex needs. Some have lived here for around 12 years so it is very much their home. All the staff are very well trained, and the Cook and the cleaning staff have Dementia training and are considered to be very valuable members of the team.
They have looked at and compared the training offered in the private care homes locally, and told us that e-learning is used rather than the excellent training they receive. The staff
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from the private homes could be offered training by Woodlands to the standards they have achieved.
The provision of care at Woodlands appears to be excellent, the staff are very dedicated, well trained and genuinely worried about the futures of their residents. The staff were seen to be providing gentle, patient support to their residents, many who have very complex needs and are mentally unwell. The Visiting Team members all reported the calm, homely, relaxed feel of the place, and the friendliness and openness of the staff. It was evident that the staff know their residents, they are respectful, tactile with them, and treat them as individuals.
There is a calm air of acceptance by residents, this is where they are now and they accept it.
We were told with great pride that they had just had a Care Quality Commission visit and they have been classified as excellent. With everything that is going on the staff are maintaining those high levels of care, and being professional around their residents.
One of the Visiting team commented that it was an honour to experience and witness such high quality care being delivered, and seeing the positive impact that had on the residents, making them happy and calm, it was a delight!!
The cook was very proud to tell us about the food she provides, and each residents likes and dislikes, even those who have diabetes, or coeliac, or those who have to have soft diets. She, like many other staff here go the extra mile for their residents.
Cumbria Care should be very proud of the service they provide at Woodlands, and this was recognised by the fact that they won the West Coast, then the National award for „Nutrition and Hydration‟. This can be a very big issue, especially for people with Dementia, and to be recognised nationally for good practice is something to be very proud of. Kate Bowman from Cumbria County Council accompanied some of the staff to London to receive this award.
The Visiting Team witnessed the staff‟s patience with residents around this issue, encouraging residents to drink and eat, and spending time with them to ensure they got enough, and recording it, so others knew.
All policies were clearly presented around the home, and staff were very aware that, especially around Dignity and Respect, it was sometimes difficult to adhere to the letter of the guidance, but that they worked as near as possible to it.
The staff told us they have serious concerns about the future for their residents, especially those who have no relatives. They told us about the impact moving people like their residents who are very vulnerable due to the severity of their Dementia could have on them. They told us that one relative had told them that she hoped her Mother died before she had to be moved! Even for those people who die in Woodlands it is a well supported and sensitive time, staff offering support to relatives and caring for the resident who is dying.
The staff are presently having to support relatives who are numbed and distressed about this threat of closure, along with the worry about losing their own jobs. Many of them have been Consultation report on proposals for care services in Allerdale and Distington areas 141
working here for many years, and they feel this is another positive consistency for the residents. The hairdresser talked to one of the Visiting team and told them how she loves working at Woodlands as it is like a real home. She works with people in their own rooms, whereas she has to work in the corridors of some other homes.
Age Concern come into the home once a week to do activities with the residents.
Those residents the team talked to were all very happy, relaxed, well cared for and clean. They did tell us they have friends there, they like being there, it is their home. There is no sense that any of them are aware of the plans for their future, the staff are maintaining a calm, homely environment for them. Residents who like to walk can do very safely at Woodlands as the corridors are ideal.
The staff all seemed very grateful for the opportunity to talk about their deep concerns and fears for their residents, as they feel they are like a family. We were told that the first the staff knew about the Consultation was when they were summoned to a meeting at Inglewood Care Home for a meeting. They were told that the news of which 3 homes proposed to close would be announced the next day. They feel distanced and shut out from the process, and think the decisions have already been made, and that this consultation is merely an exercise that needs to take place.
Their experience of the public meetings was that Cumbria County Council were „transmitting‟ information with no „receiving‟ mechanism for information they should consider.
Some relatives and staff told us that they have not filled out the Consultation document as it is flawed, and the questions are Yes or No answers with a box for Comments, and they feel the comments will be ignored,
Although this is a forty roomed home they presently have twenty residents. We were told that there could be many reasons for this. Social Workers are not referring new residents to Woodlands, only referring to the private care homes. The gradual run down of numbers does not mean people did not want to use Woodlands, Cumbria County Council are no longer paying for people to go into Residential Care, so the occupancy figures do not reflect the true picture, but could be misconstrued and used as inappropriate evidence.
We were told of an example of a local lady, known to the staff, who had specifically asked to go into Woodlands, but had been told it was no longer a choice.
Recently the staff have asked why they were not getting any referrals, and suddenly they had three new residents. This is creating a feeling of mistrust towards Cumbria County Council as they feel they are not being honest with them about what is happening, and they are aware of Government pressure to make changes.
We were told that they used to provide a good respite service, but that they were told to withdraw that service. This service could be resumed and would be well used by the local community providing care Closer to Home. Consultation report on proposals for care services in Allerdale and Distington areas 142
We were told that Woodlands used to work very closely and very well with the Dementia service at the hospital. Once this was stopped, Dementia care locally fell apart, and it also triggered their loss of day care services, another service they were told to withdraw.
There was a doctor present who is very concerned about the possible closure of Woodlands, they used to work at the hospital and has valuable experience in Dementia. They shared that they have serious concerns for those people in the Community now with Dementia. If Woodlands closes, they will be left in the community, „their own home is a dangerous place!‟
We were told that bathrooms can be very dangerous places for people with dementia as they no longer recognise the toilet for what it is, and can try to get into baths themselves, or slip on the floors of showers, or scald themselves and there are statistics to support this.
We were told that Eddie Martin has told them that it is cheaper to provide care in the private sector. The staff at Woodlands work with the most vulnerable of people who can not speak for themselves, therefore they have great concerns that „you get what you pay for‟ and that quality of care will suffer if staff are paid less and are not as well trained. Experienced, well trained staff who understand and know their residents, and care about them as well as for them, will be replaced by poorly paid staff who do a job.
An example of the difference in delivery of care was given as16 year olds being allowed to carry out tasks such as bathing residents on their own, and that they would not be allowed to do this if working for Cumbria Care until they were 18 and trained appropriately.
If these residents are moved they need reassurance that they will receive at the very least equal quality of care, continuity is very important. There are severe concerns about the repercussions of moving some of these late stage dementia residents, as research has shown this can cause death shortly after a big disruption.
Another thing to consider is the fact that many relatives come from local deprived areas and are not well off. They are fearful of the cost implications of any move making it impossible for them to visit as regularly.
We were shown a letter sent by Eddie Martin promising that if the closures go ahead it will be done very sensitively and take as long as it needs. The staff would like to think that this will be in their opinion, not that of the County Council. Concerns were raised about the reliance of the County Council on the private sector and the 3rd Sector, but they are both having financial difficulties and closing or withdrawing services.
We were told that one of the private homes nearby has applied for permission to build a 20 bed special care unit. Because suspicions are running high, thoughts are that this is in preparation for the closure of Woodlands. The thought of the group were that the land where Woodlands is now will be sold and the money raised will pay for extra care housing, but that that would be totally unsuitable for the residents they have now.
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The staff feel that Woodlands has many positive opportunities and relevant experience to offer: Providing meals for those with early Dementia in their own homes Specialist day services Respite Step down from hospitals for those with Dementia Training for others End of life care
Cumbria LINk will be watching the progress of the Consultation with interest and will maintain contact with key people throughout.
We were asked at this meeting that each report be considered independently.
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Conclusions
Referring to the document „Care Homes closure, the Law, it‟s practice and implications (2003)‟ commissioned by RAGE national it would appear that the proposed closures of these homes shows the classic signs of how County Councils plan the process for some time before it actually happens. Cumbria Link is concerned that due process has not been followed.
We are concerned that planning for changes began well before and did not involve local people or residents in the formulative stage of decision making.
The Questions were worded in such a way that it was difficult to disagree with the Councils recommendations. People told us that they thought questions were open to misinterpretation.
Many people told us they felt the consultation was flawed as no existing alternatives were offered, and no option, other than the closure of the three residential care homes, is given.
Many of the proposals are welcomed as a long term future vision. However none of the options offer the kind of care residents of these homes need. There is great concern about the removal of the care home provision that is so obviously needed as the „final stage of care‟ for the most vulnerable elderly in Cumbria.
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Cumbria Links Recommendations in response to the Consultation:
That the evidence presented in this document gathered directly from residents and their relatives is properly considered as a response to the consultation
Notice should be given to the recent publicity about the major concerns around „Pensioners being passed like parcels by Care Agencies‟ article in the Daily Telegraph, Wednesday 28th February 2012, and the comparisons to this particular process.
That the homes in question be re -considered as Local Assets (Asset Based Community Development) and their true viability be considered if they were „allowed‟ to work at their full potential delivering a variety of other services to local people.
Residents and their relatives are included and well informed at the earliest stages around any decision making processes around any changes after this consultation finishes.
We have been told to point out that this consultation process is seen to be flawed, as the questions were thought to be open to misinterpretation, and relevant choices were not made available for consideration.
Those questions included in this response are answered by Cumbria County Council, and appropriate replies sent to Cumbria LINk within the required time limit
What the Council considers fit for purpose does not match what residents have told us they want, for example en suite facilities and small bathrooms.
That the Council take this into account and allow flexibility to allow for personal choice and suitability.
Full economic impact assessment be undertaken that considers closures of private care homes and reduced funding to Voluntary Sector who support this area of work
Cumbria LINk is extremely concerned about the long term future of the present residents of these homes and would ask for re-assurances that if any of them have to move, great care is taken to place them in a home: 1. Of equal standard (CQC rating) 2. A home that is not going to be considered for closure in the near future, as some residents have already been moved once and this is extremely distressing 3. Moved with present staff
We are disappointed to hear that „emotive issues‟ are regarded as having no weight and will not be considered as valuable contributions to this consultation. Much of this report is emotive and full of very valuable information from those who will be directly affected by these proposed changes. We recommend that their opinions are taken into account. Consultation report on proposals for care services in Allerdale and Distington areas 146
That those residents of Richmond Park, if moved, are not just moved into Amathea or Newlands as relatives have told us that they have strong feelings and objections to this as they are not considered equal quality of care, merely „convenient‟ locally. Relatives are rightly concerned that a member of staff from Amathea has recently been imprisoned for abusing residents.
Staff should be treated with respect and given truthful information about the long term plans for the homes where they work, and be allowed to contribute freely.
It is felt essential to have new facilities, including technology and extra Care housing in place before closing down any homes.
The council review the provision of respite services in the area to support the additional burden on carers.
That the Council take notice of the vast amount of research around „Loneliness and isolation for elderly people who are kept in their homes, for example (Loneliness and Isolation Review - Age UK) that examples the detrimental effects isolation can have on older people.
That the Council make clear the criteria and the Care Pathway that will be used for each individual showing the level of care, the nature of the assessment and the timeframe envisaged to support any proposed changes.
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Adult Social Care comments on LINk response to consultation
Clarification of information contained within the LINk report
Page 3 – LINk report states “….we understand that referrals to the care homes had been stopped well in advance so the true picture of occupancy has been affected by these moves”.
Adult Social Care clarification: There was no such block on admissions to the homes affected by the proposals. Both Park Lodge and Richmond Park had full occupancy when the consultation commenced. Woodlands has had low occupancy for sometime attributed to the new by-pass running close to the home and clients exercising choice in terms of their preferred locations.
Page 3 – LINk report states “..allowing local communities to be part of the development process would have achieved better outcomes and had the potential to identify alternative opportunities”.
Adult Social Care clarification: The proposals were developed based on a District Working Group chaired independently and involving local stakeholders. The proposals on which we have consulted invited views on the proposals and invited ideas for improving the proposals.
Page 3 - LINk report states “…good advocacy should be part of the consultation process: however two residents had been extremely upset by the sessions with the independent advocates”.
Adult Social Care clarification: The advocates supported 29 residents to take part in the consultation and are highly trained and skilled in helping vulnerable people express their views. Individual pre-meetings were held to find out which residents wanted to participate and family members were given opportunities to be present. It is clearly a process that can understandably cause upset but the advocates worked hard, supported by staff at the homes, to ensure the sessions were sensitively undertaken.
Throughout the LINk report a number of questions have been posed and the Adult Social Care response to these questions is included as an annex to this response to the Link recommendations.
Cumbria Links recommendations in response to the Consultation:
That the evidence presented in this document gathered directly from residents and their relatives is properly considered as a response to the consultation
Adult Social Care response:
The consultation feedback from Cumbria LINk will be considered by Cabinet when making their decision on the proposals.
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Notice should be given to the recent publicity about the major concerns around ‘Pensioners being passed like parcels by Care Agencies’ article in the Daily Telegraph, Wednesday 28th February 2012, and the comparisons to this particular process.
Adult Social Care response:
Ensuring services are available for a local population that is getting older is challenging. People are living longer and expectations of the social care services required in later life are changing. We need to modernise services to meet these changes and be more able to support older people to stay at home.
We are not saying that residential care is not needed but we do need to re balance the mix of services to provide high quality 24/7 care at home, embrace new models of care such as extra care housing (own flat with on site care) and ensure residential is fit for purpose and able to support people with needs that cannot be supported in their own homes particularly dementia.
That the homes in question be re -considered as Local Assets (Asset Based Community Development) and their true viability be considered if they were ‘allowed’ to work at their full potential delivering a variety of other services to local people.
Adult Social Care response:
The three month consultation has been an opportunity for people to provide their views on the proposals and to put forward suggestions as to how the Council can support the growing numbers of older people in Allerdale. Several respondents have suggested alternative uses for the care homes.
Residents and their relatives are included and well informed at the earliest stages around any decision making processes around any changes after this consultation finishes.
Adult Social Care response:
The Council will ensure that residents, family members and staff are well informed at every stage of the decision making process.
We have been told to point out that this consultation process is seen to be flawed, as the questions were thought to be open to misinterpretation, and relevant choices were not made available for consideration.
Adult Social Care response:
The aim of the consultation was to hear views on specific proposals put forward by the County Council with the rationale as set out in the consultation document. People were encouraged to provide their views or put forward alternative proposals in any format they wished. Page 22 of the consultation document clearly describes a variety of ways for Consultation report on proposals for care services in Allerdale and Distington areas 149
people to provide views. Narratives boxes were provided for every question in the questionnaire for people to provide their wider views. The actual responses to the consultation have come in a variety of formats.
Those questions included in this response are answered by Cumbria County Council, and appropriate replies sent to Cumbria LINk within the required time limit
Adult Social Care response:
Annex A responds to the detailed questions asked by Cumbria LINk.
What the Council considers fit for purpose does not match what residents have told us they want, for example en suite facilities and small bathrooms.
Adult Social Care response:
The Council appreciates that the current residents are settled and largely content. However, the proposals aim to develop services that meet the needs of people into the future. This includes providing accommodation that is large enough to support those that use wheelchairs or require hoisting. It aims to have accommodation that is of sufficient size to allow personal items of furniture in rooms and offer privacy for residents when families and friends visit. The shared bathrooms and toilets of the current homes are generally small and not well designed to meet the needs. It is very difficult for staff to give the help needed in such small space in a dignified way. En suite facilities are becoming more important to people and are an essential element of meeting modern day dignity expectations.
That the Council take this into account and allow flexibility to allow for personal choice and suitability.
Adult Social Care response:
If the proposals to close care homes are agreed Social workers will work with each resident / family members to look at their individual needs and preferences. This will be done sensitively and we have a track record of achieving smooth transitions to new accommodation.
Full economic impact assessment be undertaken that considers closures of private care homes and reduced funding to Voluntary Sector who support this area of work
Adult Social Care response:
The County Council is not aware of any recent or pending closures of any independent sector care home in Allerdale or Distington. The Council pays a set price for a residential care placement in an independent sector home. Prior to the recent tender exercise, the Council carried out an analysis of care costs and benchmarked the hourly
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rates offered against other similar authorities. This process has ensured that the new pricing structure will continue to enable the provision of high quality services whilst delivering value for money for service users and the local authority.
Cumbria LINk is extremely concerned about the long term future of the present residents of these homes and would ask for re-assurances that if any of them have to move, great care is taken to place them in a home: 1. Of equal standard (CQC rating) 2. A home that is not going to be considered for closure in the near future, as some residents have already been moved once and this is extremely distressing 3. Moved with present staff
Adult Social Care response:
If the homes do close we will support residents and families and we will follow good practice, set out in a protocol, to ensure a smooth transition for current residents to their new location. Social Workers will work with each resident to look at his or her individual needs, preferences and alternative accommodation options and ensure that moves are carefully and sensitively handled.
The good practice protocol that we work to includes an aim of moving groups of friends together, and if a decision to close the homes is made, we will reserve beds in other homes to enable this to happen.
Viewings or short stays will be arranged to support residents decision making and family members will be involved with the process at every stage. We will ensure that each resident‟s individual needs are met and this will include familiar staff moving with them during a transition period where this is of benefit.
We are disappointed to hear that ‘emotive issues’ are regarded as having no weight and will not be considered as valuable contributions to this consultation. Much of this report is emotive and full of very valuable information from those who will be directly affected by these proposed changes. We recommend that their opinions are taken into account.
Adult Social Care response:
This assertion is simply not correct. No officer or Council member has suggested that the views of people are not relevant to this consultation. There has been a considerable amount of qualitative information that has provided a richness of feedback. All of this has been included in the consultation feedback report and will be considered by Cabinet when weighing the issues and arriving at their decision.
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That those residents of Richmond Park, if moved, are not just moved into Amathea or Newlands as relatives have told us that they have strong feelings and objections to this as they are not considered equal quality of care, merely ‘convenient’ locally. Relatives are rightly concerned that a member of staff from Amathea has recently been imprisoned for abusing residents.
Adult Social Care response:
If the proposals to close care homes are agreed, we will work with each resident to look at his or her individual needs and preferences. The vast majority of people in residential care in Cumbria are living in an independent sector home and the vast majority are rated good or excellent by the Care Quality Commission. All care providers, including Cumbria Care, occasionally find that a very small minority of staff have not behaved appropriately but most have arrangements in place to identify, discipline and if appropriate prosecute offenders.
Staff should be treated with respect and given truthful information about the long term plans for the homes where they work, and be allowed to contribute freely.
Adult Social Care response:
We pride ourselves on being open with staff and have been keeping all staff in the three homes affected by these proposals informed at every stage during what we know can be a difficult time. We have encouraged them to participate in the public consultation and they will be consulted fully on the implementation of any decisions made. The Council values its staff and recognises that staff affected by these proposals do an excellent job. The proposals affecting the homes are a reflection on the accommodation standards and not the quality of work delivered by hard working staff.
It is felt essential to have new facilities, including technology and extra Care housing in place before closing down any homes.
Adult Social Care response:
The implementation of any service developments and home closures will be carefully planned to ensure there is no detrimental affect on service provision in the area.
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The council review the provision of respite services in the area to support the additional burden on carers.
Adult Social Care response:
The Council recognises the support that families provide to service users living in the community. The 2009 to 2012 Strategy is currently being reviewed and will include actions for supporting carers. The total budget on Carers services by Adult and Local services for 2012/13 is £869,000. Respite care will continue to be available across Cumbria Care and independent sector homes in the district.
That the Council take notice of the vast amount of research around loneliness and isolation for elderly people who are kept in their homes, for example (Loneliness and Isolation Review - Age UK) that examples the detrimental effects isolation can have on older people.
Adult Social Care response:
The Council recognises that many older people, regardless of care needs, can be isolated and lonely. However, admission to residential care is based on an assessment of need; people cannot choose to move to residential care because they are lonely. A day care tender is underway which will provide further opportunities for flexible day time activities and the Third Sector are active in encouraging communities to support older people - befriending/reading groups etc.
That the Council make clear the criteria and the Care Pathway that will be used for each individual showing the level of care, the nature of the assessment and the timeframe envisaged to support any proposed changes.
Adult Social Care response:
If homes do close we will support residents and families and we will follow good practice, set out in a protocol, to ensure a smooth transition for current residents to their new location. Social Workers will work with each resident to look at his or her individual needs, preferences and alternative accommodation options and ensure that moves are carefully and sensitively handled. We have a track record of doing this successfully elsewhere in the County; two Cumbria Care homes in Furness closed last year and the moves went very well for residents, many of whom were people with dementia.
If the homes were to close, there is no set timescale at present. It is unlikely that any homes would close before 2013.
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Annex A
Responses to specific questions raised by Cumbria LINk
Is there any flexibility to the 6 week period of free enablement services and if so would that be charged to the client?
Experience has shown that most reablement interventions secure the desired outcomes within 4 weeks. Some require the full 6 weeks and in exceptional cases this can be extended if it is assessed that further benefit can be secured. There is a weekly review and a more formal review at 4 weeks which helps to identify progress. The service is free as would be any exceptional extensions.
What has been done to assess the safety of care provided at home in terms of safeguarding clients and safety of the home?
The Government‟s Fair Access to Care Services guidance sets out the criteria which all local authorities must follow when assessing new and existing service users aged 18 and over. Eligibility criteria are used to establish the level of risk to independence in these four areas:
Health, safety and freedom from harm, abuse and neglect. Autonomy and freedom to make choices. The ability to manage personal and other daily routines. Involvement in family and wider community life, including hobbies, leisure, unpaid and paid work, learning and volunteering.
We will also take into account:
Help available from carers and other agencies. Any assistive equipment which may support independence. Risks faced by others such as family carers. Which risks are acceptable to individuals which are a natural part of independent living.
What has been done to assess the risk of falls, reduced wellbeing, fuel poverty and effects of isolation for those people who are cared for at home?
Social Workers assess a person‟s needs which take these issues into account (see question above). The County Council works closely with NHS Cumbria to raise awareness and prevention measures. With regards to fall prevention there is a Falls Prevention Strategy in place. In Cumbria, much has been done to inform householders about fuel poverty. Road shows have been held, grants arranged and Age Concern has played a leading role in disseminating information to older people. At a strategic level, Cumbria County Council has recently represented the issues of fuel poverty in Cumbria to central government. Any isolation issues will be picked up by the Social Worker during the assessment and referrals to day opportunity services or other activity options made accordingly. A day care tender is currently underway which will provide further opportunities for flexible daytime activities to meet individual needs. The Third Sector are active in encouraging communities to support older people - befriending/reading groups etc.
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Can the Local Authority be sure that there will be adequate care home places for the future?
An independent report by an organisation called Planning4Care used research methodology approved by the Department of Health to estimate demand for residential care in Cumbria which has been taken into account when putting forward the proposals for care services in Allerdale. The trend over the last few years has been a reduction in the number of people moving to residential care as new types of services are being provided that help support people at home. Improvements in home support services, health and housing means that many people with high level needs are now able to stay at home until such a time as they may require nursing care with residential care being missed out altogether. Consequently, the average age of a person moving to residential care has increased and the length of stay reduced over the years. Additionally, the choice of residential care options has been greatly increased by the development of several new care homes in Allerdale and the supply of beds is far in excess of demand.
Has the services of the Telecare provider been adequately tested to be sure that response times are adequate?
The telecare provider, VNC, works within the standards set out by the Telecare Service Association. There are a number of service standards that they are expected to meet within this framework. Response times to emergency calls are one of the many service standards.
Has the Local Authority fully considered the actual need for dementia residential care demands for the future?
An independent report by an organisation called Planning4Care used research methodology approved by the Department of Health to estimate demand for residential care in Cumbria. This report takes into account the estimated number of people with very high care needs, including those with cognitive impairments. Our expectation is that the demand for residential care in the future is likely to come from people with dementia who are no longer able to stay at home. We are increasingly seeing the independent sector embrace this change and we are working with providers across the sector to help them reshape their provision to this more specialist area.
How much and what type of Extra Care Housing is planned?
The proposal to build an extra care housing scheme in the Workington area is subject to consultation and subsequent decision by Cabinet. The detail behind the scheme will not be developed until after a decision is made on the proposals. However, most extra care schemes have between 40 to 60 units.
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Why was Workington chosen as the site for Extra Care Housing?
Workington is the main service and population centre in Allerdale and the proposal to build extra care housing in Workington is based on District Working Group recommendations from 2007. The groups were chaired by Age UK and included a wide stakeholder group from within the District. Allerdale is currently the only district in Cumbria that does not provide the option of extra care housing. The need for extra care housing in Workington is recognised in the Cumbria Housing Strategy and is supported by Allerdale Borough Council. Our aspiration is to develop further extra care solutions in future.
Questions from Relatives and Friends of Residents of Park Lodge
10 people attended a special meeting including resident’s relatives, local people, staff, a union rep and councillors.
What is the integrated social and health care pathway for the elderly across all areas of Cumbria and what are the cost implications?’
When people are assessed by Adult Social Care, we use a set of eligibility criteria to define who is able to receive community care services. These criteria are set out in national guidelines from the Department of Health called 'Fair Access to Care Services'. The Government‟s Fair Access to Care Services guidance sets out the criteria which all local authorities must follow when assessing new and existing service users aged 18 and over. This helps us to ensure that those in greatest need and at the highest risk receive services, and that everyone who requests a service is dealt with fairly. For further information and the cost implications for service users, please visit our website: http://www.cumbria.gov.uk/adultsocialcare/default.asp
There is a false assumption that Dementia is going to be more prevalent in the future, therefore are relevant decisions being made around planning appropriate care for the future?
Numbers of people with dementia in Cumbria are expected to rise substantially from about 7,000 in 2010 to nearly 13,000 in 2030 as our population ages (Cumbria Dementia Strategy, 2011). Cumbria County Council and NHS Cumbria are jointly charged with leading the implementation of the dementia strategy and have responsibility for ensuring that particular services are available.
If Park Lodge closes, what are the plans for the building?
The County Council owns Park Lodge. It is premature to be considering any future use of the sites at this stage. There are no plans in place.
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If Park Lodge were to close, and there is no more Residential provision locally, what will really happen if an elderly person living in an isolated village or location cannot be accessed because of weather conditions, or even ill health of appointed carer?
Adult Social Care, through its contract processes, will continue to ensure providers of services have contingency plans in place. Home care providers in Allerdale have excellent experience of implementing contingency plans; the track record of delivering services in very challenging situations is strong.
Those present residents of Park Lodge now would all ‘choose’ residential care, why will that choice no longer exist if that is the ‘choice’ of those who are now using it?
People who are assessed as requiring residential care would still have access to it at Maryport, Wigton or Silloth. However, admission to Park Lodge is based on an assessment of need; people cannot choose to move to residential care. In the past many people had no choice but to move to residential care, the expansion of community support services will mean that many older people in Aspatria can be supported at home and will not require residential care.
Can Cumbria County Council guarantee that if they have to be moved, they will be listened to and included in the ‘decision making process’.
If the any of the homes do close we will involve and support residents and families in decision making processes. We will follow good practice to ensure a smooth transition for current residents to their new location.
Will there be a pot of money available to support family and friends to travel to visit their relative regularly if they are moved out of the area?
Many family members and visitors to Park Lodge live in a variety of areas across Allerdale and further afield so Maryport, Wigton or Silloth may be closer to where they live than Aspatria. There is a good public transport system to the nearby towns of Maryport and Wigton. The Stagecoach 300 bus runs every hour from Aspatria collecting from a number of bus stops to Wigton and Maryport. The bus from Aspatria to Wigton takes around 16 minutes with a fare of around £3.60 for a return journey. The bus from Aspatria to Maryport also runs every hour with a journey time of around 17 minutes costing around £2.90 return. People who have a disability and older people will receive free travel on bus journeys after 9:30am who have a NOW card. There is also a train station at Aspatria linking to Wigton and Maryport, with trains running frequently with a cost of around £2.40 for any day return.
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Questions from Richmond Park Residents and Families
We spoke to 8 residents, and around 20 relatives who came especially to talk to LINk, plus 4 members of staff
Why did Cumbria County Council allow people to come in to Richmond Park and settle if they knew there was even a possibility of it closing?
The proposal to close Richmond Park is subject to consultation and subsequent decision making. Until a decision is made on the future of Richmond Park, Social Work teams were briefed that it was “business as usual”. All potential/new residents were informed of the consultation proposals so they were aware before making their care home decision.
Why have Social Workers been discouraging people recently from coming here telling them it is going to close?
Social Work teams were clearly briefed that it was “business as usual” during the consultation period and until decisions are made. The district leads responsible for Allerdale and Copeland have confirmed that there has been no change to this policy in terms of local implementation. However, we know that the uncertainty around the future of the homes is bound to have an impact on people choosing to move to the homes.
Why have relatives and carers been left out of any discussions around the decision making when considering closing Richmond Park?
The proposal to close Richmond Park has been through a three month consultation. This consultation was about securing views on the Council‟s proposals and inviting alternative ideas and several meetings for family members were held at Richmond Park. Family members were also free to attend public meetings and drop in‟s.
Where are the other ‘respite services’ in Workington?
Respite services are available at most of the care homes in Workington. However, respite care can also be provided in other ways such as using our voucher system. This enables support to be provided within a persons own home supported by carers. Vouchers are a way of providing services such as short-term breaks to carers.
‘Amathea’ and ‘Newlands’ (local private care homes) offer residential care but they are independent, and they have no proven track record of excellent care like Richmond Park so would not be a natural choice for those who have relatives in Richmond. If Richmond Park closes what will the choices be locally that have equal care standards, as this is not clear in the consultation?
The independent sector currently provides 824 beds in 27 care homes and Cumbria Care provides 184 beds across five homes across Allerdale and Distington. Most of the people in residential care in the district are living in an independent sector home. The majority of the independent sector homes are rated excellent or good by the Care Quality Commission. If Richmond Park closes, Social Workers will work with families and service users on their alternative care home options.
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If Cumbria County Council are no longer offering Residential Care as an option, will this mean that the private sector will no longer have a cap on their charges and will be able to charge what they like?
Cumbria Care will continue to operate two residential care homes in Allerdale, Parkside at Maryport and Inglewood at Wigton in addition to 28 other Cumbria Care homes across Cumbria. The County Council has a set price that it pays to residential care providers across Cumbria.
As Richmond Park has excellent Care Quality Commission ratings could it be used as a training centre, example of good practice for those that do not achieve so highly?
The majority of the care homes in Allerdale are rated excellent or good by the Care Quality Commission. Good practice is shared within the care sector.
Surely Cumbria County Council should be proud of the service they provide at Richmond Park, surely there are services that do not get such high praise that could be considered in the push to save money?
Richmond Park has served the community well over the years and the quality of the care is not in dispute. However, the accommodation is struggling to meet the needs of increasingly dependent residents who often need wheelchairs, mobility aids and use of hoisting equipment. The choice of residential care options in Workington has been greatly increased by the development of several new care homes by the independent sector who are providing modern design as standard, such as en-suite bathrooms and large wheelchair accessible rooms.
We were asked if these residents no longer have any Human Rights?
The proposals are motivated by a desire to provide modern social care services to meet peoples needs and aspirations into the future. We know we can provide high quality alternative accommodation for existing residents and build high quality services for the future. This will truly treat our older people in a way that they deserve. Preserving models of care that place older people into small rooms with shared bathrooms is not the Councils aspiration for delivering quality care into the future.
Have Cumbria County Council seriously considered that the Private Care Sector and the Voluntary Sector are also in desperate need of finances and are withdrawing services? Have Cumbria County Council consulted with the other providers around where the provision of care will come from?
The County Council will continue to ensure that care services are available for people who require it. The Council would like to provide more options for people who require care and support and who do not wish to move to residential care and our proposals are a response to this. Currently the supply of beds is far in excess of demand and there are high numbers of vacancies across Cumbria Care and the independent sector homes, at any one time. The Council has regular communications with providers and providers have been asked for their views on the consultation.
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What will happen to those members of local communities who need residential care in the future if that provision is no longer available to those who can’t afford it? Will they rely on the NHS to care for these people and is this appropriate?
The County Council already purchases 66% of residential and nursing care for older people from the independent sector. People who are funded by the County Council do not have to move to a Cumbria Care home; people can choose a home in the independent sector. Cumbria Care homes are not free to those who live there. Everyone is assessed for financial contributions towards the cost of residential care, regardless of who provides it.
Questions from Woodland Care Home Residents and Families
We spoke to about 8 residents, many, not all, have Dementia and are very well settled, 4 relatives, 1 retired doctor who used to recommend Woodlands as a place of excellence to people looking for care for a relative and provide mental health support to the home, and 6 members of staff. 2 relatives who are not local sent information via post and email
Many of the relatives come from deprived areas and asked if relatives could be moved to homes close by so that they could continue to visit?
If the homes do close we will support residents and families and we will follow good practice, set out in a protocol, to ensure a smooth transition for current residents to their new location. There are a range of options in Allerdale but also in Copeland where many of the Woodlands residents originate from and still have family. Who decides how long the move would take, should the home close?
If decisions are taken to close homes it is unlikely that this would happen before 2013. Detailed plans will be developed to deliver any decisions made and these plans will be shared with families. We will work with each resident / family members to look at needs and preferences and develop a transition plan.
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Appendix 2 – Petitions
Park Lodge Residential Care Home – Aspatria
The wording of the petition is as follows: “We the below are signing in protest to the proposed closure of Park Lodge Residential Home in Aspatria.” The petition contains 3,579 signatures.
Richmond Park Residential Care Home, Workington
The wording of the petition is as follows: “Please help to save our home! Richmond Park residential care home, High Street, Workington from closure and sign our petition”
The petition contains 6,289 signatures.
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Appendix 3 Questionnaire from public consultation document
Consultation on Proposals for Care Services in Allerdale Consultation meetings are taking place separately with residents and family members of the care homes affected by these proposals. Sensitive discussions regarding the possible impact on individual residents will take place and all residents will be offered the support of independent advocacy to represent their views during the consultation process. This questionnaire is aimed at the wider public and we recognise that there will be separate questions that are equally pertinent to residents.
This form is for you to make comments or ask questions about what you have read in this document. (Please use additional sheets if required).
1. Do you agree with the Council‟s overall Plan to focus investment to help people stay at home as long as possible?
Yes No Don‟t Know
Please tell us what you think.
Larger box was provided in consultation document questionnaire
2. The rehabilitation (reablement) service is about helping people develop or regain the skills and confidence to do things for themselves. It is a free service for a period of up to 6 weeks. What are your views regarding this service?
Approve Disapprove Don‟t Know
Please tell us your views
Larger box was provided in consultation document questionnaire
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3. High level home care services provide people living at home with the combined traditional home care and basic nursing care services. Do you support our proposal to expand high level home care services from a night time only service to a 24 hours, 7 days a week service, to support more people to stay at home?
Yes No Don‟t Know
If not, please tell us why, or tell us your ideas on the types of services you would like to see provided in the community.
Larger box was provided in consultation document questionnaire
4. Sensors and alarm based technology can assist families and care staff in supporting people living in their own home. Do you support the proposal to increase the use of sensors and alarm based technology?
Yes No Don‟t Know
If not, please tell us why.
Larger box was provided in consultation document questionnaire
5. Improvements to the design of residential care homes can reduce the affect dementia has on a persons ability to live with a level of independence and a high level of contentment. Do you support the Council‟s proposal to invest in improvements to the environment and in staff training at Inglewood and Parkside?
Yes No Don‟t Know
Please tell us your views
Larger box was provided in consultation document questionnaire
6. Extra Care housing schemes provide people with their own self contained homes with the benefit of care staff on site. What are your Consultation report on proposals for care services in Allerdale and Distington areas 163
views on the Council‟s proposal to develop an Extra Care housing scheme in the Workington area as an alternative to residential care?
Yes No Don‟t Know
Please tell us your views
Larger box was provided in consultation document questionnaire
7. The Council would like to invest the money currently spent on existing residential care homes in a new extra care scheme and in more services to help people stay at home. With this in mind, do you support the proposals to close three Cumbria Care residential care homes?
Yes No Don‟t Know
Please tell us your views (if you have ticked „No‟ to this question, please tell us the name of the care home if your concern is for any particular care home)
Larger box was provided in consultation document questionnaire
8. What is important to you in terms of the location of a new Extra Care scheme? (e.g. should it be near a town centre, on a bus route, in the countryside?)
Please tell us your views:
Larger box was provided in consultation document questionnaire
9. If you were the Council and needed to support growing numbers of older people with less resources, what would you do?
Please tell us your views: Consultation report on proposals for care services in Allerdale and Distington areas 164
Larger box was provided in consultation document questionnaire
Please tell us if you are responding to this consultation mainly as a:
Service user, or on behalf of a service user, in one of the residential homes affected by the proposals;
Carer/or family member, with a relative or friend in one of the care homes;
Staff member employed in one of the care homes detailed in this document;
Staff member – other;
Member of the public;
Stakeholder – e.g. Town/Parish Council, Voluntary group;
Other: please define:
Please use this space for any other questions, comments or suggestions.
Larger box was provided in consultation document questionnaire
Thank you for taking the time to give us your comments.
Please provide contact details below so that we can understand a bit about who has responded and if follow up is needed on any issues that you raise.
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You can request further information on any aspect of our plans from the modernisation team on Tel: (01228) 221553 or [email protected]
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Appendix 4 Wording of questions/prompt sheet used at public meetings and drop in events Used at public meetings: MODERNISING SOCIAL CARE SERVICES IN ALLERDALE / DISINGTON A key proposal is to increase support to allow people to stay in their own homes. What do you think is good about this and what concerns would you have?
A key proposal is to build extra care housing (own flat with on site care). What do you think is good about this and what concerns would you have?
A key proposal is to reduce residential care places and make sure that remaining residential care is of high quality and able to support those with dementia. What do you think is good about this and what concerns would you have?
What do you think the community priorities are in meeting the future needs of older people?
What do you think the council should consider when examining the outcomes of the consultation?
What do you think we should do to improve the proposals made by the Council?
Thank you for your comments & contribution
Used at drop in events: MODERNISING SOCIAL CARE SERVICES IN ALLERDALE / DISTINGTON – prompt sheet for drop ins
People are increasingly asking us to provide services that better support them to remain in their own homes.
Question 1.
A key proposal is to increase the support to allow people to stay in their own homes – high level home care, alarms and sensors and rapid response arrangements. What do you think is good about this and what concerns would you have?
Question 2.
Our current Cumbria Care homes have small bedrooms and many residents have to share toilets with several other residents. We have introduced in other parts of the County a new model of Care called extra care housing (own flat/apartment in a building with an on site care team). This suits many people who would otherwise go into residential care.
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As people are better supported at home and in extra care housing we expect the numbers requiring residential care places to fall.
Question 3
A key proposal is to reduce residential care places and make sure that remaining residential care is of high quality and able to support those with dementia. What do you think is good about this and what concerns would you have?
We would like to bring extra care to Allerdale where there are currently none. What do you think is good about this and what concerns would you have about this type of care?
Question 4
What do you think we should do to improve the proposals made by the Council?
Question 5
Is there anything else you would wish the council to take account of when considering this consultation and deciding what best to do?
Consultation report on proposals for care services in Allerdale and Distington areas 168