Agenda item

Context:

To provide an updated position with regard to the development of the new build care home that will replace Severn View Residential Home. 

Key Issues:

·         This project seeks to replace and re-provide services currently provided at Severn View Residential Home in Chepstow. Previous reports to Adults Select Committee and Cabinet established the background to the proposals. 

·         The current facilities and environment at Severn View place restrictions on the Authority’s ability to deliver the range and extent of services that enable people living with dementia to live well and a life that matters. 

·         The home is on two floors and restricts free and spontaneous access to outside spaces.  Access to outside spaces is integral to people’s well-being; not only does it improve sleep and reduce stress, it supports people to develop a sense of self and of place.

·         The home is severely limited by not having en-suite bathrooms.  Shared bathrooms are increasingly untenable in providing care in the 21st Century and the Authority runs the risk of future problems with registration as a result.

·         The layout of the building does not support orientation and a sense of home.  The layout is one of a number of long corridors which is seen as poor practice in care home design; particularly in respect of people living with dementia due to difficulties in orientation and feelings of restriction.

·         Care practice has developed significantly over the last few years following significant investment by the Council in support and training to deliver a relationship based approach to holistic care.  The environment does not prevent care teams from adopting this approach but it limits the effectiveness and does not enhance the Authority’s ability to support this holistic approach.

·         The current model of staffing does not create the ratios that sufficiently allow the team members to practice as they would wish.  An amalgamated household support worker model is required that creates better staffing ratios.

·         It is well established and recognised the importance of integrating our care facilities with the surrounding community.  The current infrastructure and location of Severn View limits the opportunities for community integration.  A more radical approach is required to ensure that moving into permanent care does not mean isolation from your local community. 

·         South Monmouthshire currently has two rehabilitation beds at Severn View.  This represents an under provision when compared to Monmouth and Abergavenny.  There is a need to increase the number of rehabilitation beds in the south of the County to enhance our ability to facilitate hospital discharge and to prevent admission.

Member Scrutiny:

·         The proposal is for a 32 bed unit.  However, it was considered that there was an opportunity to take this a step further and investigate whether it would be feasible to create a 48 bed unit, and explore the options available with other organisations with a view to enhancing the proposal.

·         Revenue funding is available for the re-provision of Severn View Residential Home for a staffing model around 32 beds. However, the opportunity exists, whilst going through the planning phases, to consider a further 16 beds in addition to the proposal. Conversations regarding this matter are beginning and preliminary meetings will be held with potential partners, going forward.

·         Two planning applications for detailed planning consent are being pursued with a view to keeping the options open for as long as possible.

·         The capital funding is a challenge but not as great as establishing the revenue funding.  Securing the revenue funding will be the main issue.

·         With regard to the valuation in the sum of £700,000 for the Severn View Residential Home site, officers have been prudent in costings and budget planning and have therefore gone to the lower end of the valuation.  A further valuation will be undertaken shortly and then a final valuation at the point of sale.

·         Conversations have been held locally and with the Integrated Service Partnership Board, mainly about concept.  The opportunity to have some flexible use of beds is being discussed such as end of life care.

·         It was considered that it was unpractical not to allow in the design for car parking spaces as the care home needs to be integrated within the local community.  The proposal is designed on the basis of the manual of streets which means that the roads are not wide enough to allow vehicles to park on either side of the road and for vehicles to pass by, which creates parking and traffic flow difficulties.

·         Concern was expressed regarding public transport issues. The Severn View Care Home is close to the centre of Chepstow and is accessible without having to travel by car.  The proposed site is located within the centre of the development.  However, concern was expressed that buses might not be able to access the care home easily on a manual of streets design. Currently, a bus route does not exist.  Bus stops are to be located on either side on a main road next to a grass verge which could be dangerous for elderly people slipping on the verge. 

·         A Select Committee Member expressed concern that the whole issue of public transport, car parking and getting people to and from the site has not been properly considered. It was felt that the site was inaccessible with parking and access difficulties.

·         In response, the Head of Planning, Housing and Place Shaping informed the Select Committee that Planning Committee has only considered the outline planning consent for this planning application.  The detailed stage is yet to be presented to Planning Committee.  The bus stops are to be located on the ‘B’ road so the bus will not be travelling through the site.

·         In response to the issues regarding public transport, it was noted that these matters are relevant to staff and residents’ families. As the planning phases are processed it was acknowledged that transport is critical and will be a key consideration. With regard to the car park, there are 22 parking spaces allocated.  In terms of developing an innovative design, every car parking space is an area that cannot be given to the residents.  The aim is to try to maximise the communal recreational spaces for the residents. Minimum car parking requirements, as established, have to be met (one place for three non-resident staff, one place for resident staff and one place for every four residents for visitors). There will be up to 20 staff on site with eight places for visitors and one resident member of staff, the proposal falls within the minimum car parking requirements but it is acknowledged that the parking at Severn View Care Home has more spaces and there is likely to be some tension under the new proposal with regard to parking spaces.  The maximisation of spaces for residents need to be explored as well as exploring car sharing and park and ride options.

·         Pets are important and currently feature in the Severn View Care Home.

·         That we will not place any limitations on visiting hours to ensure that families / friends are involved in all aspects of the life of the home.

·         The Integrated Care Fund (ICF) is with the Minister with a recommendation for it to be signed and it is anticipated that this will be signed off imminently.  ICF has to be spent in year.  Therefore, funding for the land purchase has to be spent by 31^st March 2019.

·         The Crick Road Business Case is an innovative model. The staffing model is co-produced allowing for staff involvement in its development. When the model has been agreed, early training for staff will be provided. When Ministerial sign off has been received a staff forum will be established allowing the team to look at all aspects of the proposal.

·         It is anticipated that at least one double room will feature within the design.

·         Between 10.00pm and 7.00am there are four waking night staff based at the care home and there is also the Team Leader who sleeps in.  The households are designed to be interdependent with the central corridor being opened up at night allowing movement between the households. This information should be added to the report that will be received by full Council.

·         The pavilion has two purposes. One being a sense of destination allowing purposeful movement by residents. The pavilion is a multifunctional space. It is primarily a space for the residents of the households but will also be accessible by the local community as a shared space.

·         Monmouthshire County Council wants to remain a provider in the care home market and the authority can work in partnership with other providers across the sector. It would be beneficial if the proposed model could be replicated in other areas of the County either via the local Authority or via other providers taking a lead from the proposed model for Crick Road.

·         Recommendations 2.1 and 2.3 of the report are not recommendations.  Recommendation 2.2 is potentially a recommendation.  It was considered that the recommendation for the report should be ‘that Members consider the various options outlined in the report and come to a conclusion’.

·         Add to the recommendations – Further consideration be given to the car parking issues, access to the site and public transport.