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Update on the Care Unit Developments

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Update on the Care Unit Developments JOINT SERVICES COMMITTEE 11 DECEMBER 2009 POLICY AND RESOURCES COMMITTEE 17 DECEMBER 2009 UPDATE ON THE CARE UNIT DEVELOPMENTS Report by Director of Social and Community Services PURPOSE OF REPORT To provide Members with a report on the progress made in relation to the transfer of usage of the Care Units. COMPETENCE 1.1 The legal and financial aspects of the report are detailed within the body of the report. SUMMARY 2.1 The report provides an update on the transfer of usage at Carloway, Garrabost, Iochdar and Uig to 24 hour area units. It details the outcome of consultation with the Care Commission regarding registration of the new service, in particular the practical and financial implications registering the Area Care Units as Care Homes. 2.2 The Report provides a summary of the Charging Policy which is to be implemented for the residents at Carloway, Garrabost, Iochdar and Uig Area Care Units. 2.3 The Report provides an update on the transfer of usage at Bernera, Gravir and Scalpay to tenanted accommodation and puts forward suggestions for the surplus Care Units at Back, South Dell and Tigh Celidh buildings. RECOMMENDATIONS 3.1 It is recommended that: a) the Care Units at Carloway, Crowlista, Iochdar and Garrabost commence as 24 hour Area Units from 1 January 2010; b) the said care units retain a dual registration of Care at Home and Housing Support with the Care Commission to reflect the service provision; c) the level of charging for the 24 hour area Care Units be approved at £680 and become effective from 1 January 2010; d) the Committee consider the accommodation at Iochdar Care Unit support Adults with Learning Disabilities for long stay and respite care; e) the Comhairle approve the rental charge for the 3 tenanted properties at Bernera, Gravir and Scalpay be set at £50.81; and f) the Care Units at Back and South Dell and the surplus tigh celidhs adjacent to the care units be disposed off in accordance with Comhairle procedure. Contact Officer: Ella MacBain Post: Interim Service Manager, Community Care Tel No: 01870 603346 BACKGROUND 4.1 The Comhairle at the February 2009 series of Committee meetings approved the following decision: • Garrabost, Carloway, Crowlista and Iochdar care units should be a 24 hour staffed care unit service through out the Western Isles. Iochdar unit to remain open for a further 12 months and a report on this unit to be submitted following consultation to the February 2010 committee series; • the level of weekly charge for a 24 hour staffed Care Unit placement be considered from year to year along side Comhairle Residential Care Homes and be at a rate equal to that set by the Comhairle for a placement in a Comhairle Residential Care Home and that the statutory regime applicable to assessing a Residential Care Home resident’s ability to meet the cost of their care (including the ability to place a security upon heritable assets owned by the resident to secure payment of the charges set), be adopted and applied in relation to assessing the means of a Care Unit resident’s ability to meet the cost of their care and determining the level of charges they should pay; and • The care units at Bernera, Gravir and Scalpay cease as care unit facilities and become tenanted accommodation for the current residents – a shared tenancy in Bernera (2) and single tenancies in Gravir and Scalpay. STAFFING 5.1 There will be an increase in staffing at the 24 hour area care units to allow for morning, afternoon, evening and sleep over cover. A Senior Care Worker will have overall responsibility for day to day management of the unit. Duties will include managing staff rotas, documentation, ensuring compliance with National Care Standards as well as liaison with residents, families, health and social care professionals to ensure the unit is run efficiently and a high standard of care provided. MANAGERIAL RESPONSIBILITY 6.1 The 24 area units will sit within Adult Services. This will ensure policies and procedures within the 24 hour units are in line with other supported accommodation operated by the Comhairle and it will ensure that the care units are considered in any future developments with in adult care services. 6.2 An appraisal in adult care services is currently underway in Uist and Iochdar Care Unit is being included in discussions. The option appraisal for Ardseilleach Care Home/Respite service will undertake a revision of Current Housing Support and Care at Home Services CARE COMMISSION REQUIREMENTS 7.1 The Area Care Units cannot be registered with the Care Commission as residential care home facilities due to the regulations that exist for Care Homes including: “Each bedroom will have at least 12.5 square metres of usable floor space, not including en-suite facilities. Each person will have their own en-suite toilet, sink and bath or shower facilities which will be no smaller than 3.5 square metres. Communal space within the care home will be at least 3.9 square metres for every resident not including corridors. The building will have capacity to install modern equipment such as hoist tracking, environmental control equipment, signage (taking account of individual needs such as sight and hearing difficulties, learning disabilities and dementia) and grab rails. There will be appropriate procedures for control of infection and the management of clinical waste.” 7.2 Regulation 12 of the National Care Standards for Care Home states: “Providers of a care home service shall, having regard to (a) size of the service, (b) the statement of aims and objectives and (c) the number of service users”: • provide adequate facilities for service users to prepare their own food and ensure that such facilities are fit for use by the service user; and • ensure that there are provided at appropriate places in the premises the service provider provides sufficient numbers of lavatories, and of wash basins, baths and showers fitted with a hot and cold water supply. 7.3 The current space provision in the care unit is limited and therefore would require major renovations to be carried out to comply with Care Commission standards for a Care Home. 7.4 Staffing levels and skill mix would require to be reviewed and a staffing schedule agreed between the Care Commission and the Comhairle. 7.5 The Care Commission is satisfied the existing registration requirements for Generic Housing Support and Generic Care at Home will remain. There will be no additional cost for a variation. The North Uist residential Care at Home and housing Support Service are applying for a variation to their conditions of registration to include Iochdar Car Unit. The certificate of registration for Carloway, Garrabost and Uig will reflect the change of manager. WORKS 8.1 A schedule of works was identified following Health and Safety and Fire Safety inspections and the properties have undergone repair and maintenance works in recent weeks. These works included new kitchens at Uig and Garrabost, new bunded oil tanks, fire door upgrades, provision of sheds for storage and paintwork to the properties. This has resulted in improved internal environments for residents and staff. Surplus furniture and items that were in good condition in the closed units at Back and South Dell have been utilised at Carloway, Garrabost and Uig. TELECARE PROVISION 9.1 A successful bid to Telecare secured funding for tunstall control equipment. Items including fall detector, carbon monoxide detector, flood detector, chair occupancy alarm, Wandaguard and enuresis sensors were purchased for each of the 24 area units. CHARGING 10.1 The level of charging for the area 24 hour units has been revised to £680 per bed per week. This is based on costs based on all four care units on the 2009/10 budget and increased staffing provision. 10.2 Free personal care at £153 is available for all residents over 65 years. 10.3 The respite charge is to be £107.85 - the same as Local Authority Care Home charge. Currently there are 9 permanent residents affected by the increase in charges. Financial assessments are carried out as part of the assessment process and residents are informed of their assessed charge. 10.4 The residents affected by these changes will be informed of the increase and will be given the opportunity to discuss their options to ensure their interests are safeguarded. Occupancy agreements have been drawn up for the permanent residents. DATE OF TRANSFER 11.1 It is anticipated that the date of transfer of usage for the 24hr care units will be 1 January 2010. This will allow a visit to the 9 permanent residents to explain the contents of the Occupancy Agreements and the process of recruitment for additional staff. PUBLICITY 12.1 An up to date leaflet will be made available to promote the Area Care Units in each locality and it is hoped the units will be considered by the community as a respite facility, depending on availability. Such a facility will be welcome by informal carers who can consider a care unit as an option for respite instead of a Care Home in Stornoway. BERNERA, GRAVIR AND SCALPAY TENANCIES 13.1 In February 2009 the Committee agreed that Bernera, Gravir and Scalpay cease as Care Unit facilities and become supported tenanted accommodation to enable the current residents to remain. The Bernera care unit (occupied by 2 residents) will become a shared tenancy and single tenancy arrangements for Gravir and Scalpay will be put in place. 13.2 Works There were some minor works to be carried out to improve the standard of accommodation, ie paintwork, electrics and these were included in the works programme approved for all the care units.
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