APPENDIX EIGHT

Dear Colleague

Re: Bath and North East Somerset's EPH Re-Provision Strategy

You may have read in the press recently or heard from other sources that the council is in the process of consulting on how best to meet the new standards in relation to its Elderly Persons Homes required through the Care Standards Act 2000.

A report concerning the Council's response to the legislation was presented to the Councils Executive meeting on July 12^th 2002 with the following recommendations:

1. Decide on the preferred Model of Care for consultation.

2. Decide on the preferred range of sites for consultation.

3. Consult with residents, relatives and staff at Greenacres House EPH (Midsomer Norton) with a view to affecting an early closure.

4. Provide a report in October 2002 for decision-making on the overall EPH Re-Provision programme and the potential early closure of Greenacres House, Midsomer Norton.

5. The report be referred to the appropriate Overview and Scrutiny Committee to be discussed as part of the consultation process.

The decisions were as follows:

1. The preferred model of care upon which to consult was agreed as that set out on page 12 of the report in paragraphs 4.70, 4.71 and 4.72. The financial implications of this choice are set out on page 15 of the same report in paragraph 4.87.2 described as Option 2B. This option suggests that three EPH's replace the current eight. The model includes a mixture of Registered Care beds and Extracare units as part of a Sheltered-housing scheme built alongside the care Home. Under this option the total number of care support beds across the authority would be 180.

2. The preferred sites upon which to consult for the new developments were agreed as;

Keynsham Hawthorns House site.

Midsomer Norton Greenacres House site.

City of Bath Carrswood LD day centre site.

3. It was agreed that consultation concerning a possible early closure of Greenacres House should take place.

4. Officers were asked to provide a further report to the Executive in October 2002 in order that final decisions on the overall re-provision project and early closure of Greenacres House can be made

5. The report was referred immediately to the appropriate Overview and Scrutiny Committee.

The relevant extracts from the report are annexed to this letter to help you with your discussion. If you would like to read the full report please use the following address to access the Bath and North East Somerset Website:

Councillors, Democracy and Elections

Subsequent Events

On Tuesday July 23^rd 2002 The Secretary of State for Health, Mr Alan Milburn made an important announcement in the House of Commons that materially affected the EPH Re-Provision process in Bath and North East Somerset. Since that time the above report and the resulting decisions made by the Councils Executive have been reviewed to explore the local implications of the Ministers announcement taking into account the revised "Environmental Standards" for Registered Care Homes guidance issued by the government.

The Councils Executive has decided to remain committed to the decisions it made on July 12^th 2002 and has asked officers to re schedule the postponed consultation process as soon as possible. In other words the decision to ask officers to consult on the preferred model of care and locations for new build Registered Care Homes plus Extracare and Sheltered Housing in Keynsham, Bath and Midsomer Norton remains as set out earlier in this letter.

One further addition that has emerged since the July Executive meeting is the possibility that more than one site may be available in Midsomer Norton for the location of the new build complex. The council is in discussion with the Somer Housing Group to see if a joint development might be feasible utilising current sheltered housing sites in Midsomer Norton. Firm plans have yet to be developed and consequently no specific site has been studied from a feasibility point of view.

There now follows a period of consultation during which residents, resident's relatives, staff, trade unions and other stakeholders will be able to explore how the suggested changes might affect them in the light of the guidance from the Executive.

I am seeking the views of your organisation in order to include them in the consultation feedback. I would be grateful if you would complete the enclosed questionnaire. If you need either this letter or the questionnaire in a different or large print format please contact either Yvonne Case or David Smallacombe to arrange this. Please send your questionnaire and comments to me at the above address by October 11^th 2002 at the latest.

Your sincerely

David Smallacombe

Project Manager

Elderly Persons' Homes Re-Provision

ANNEX ONE

4.68 Model of Care

4.69 Under the arrangements set out in this report two models of care are possible. The first involves the council re-providing its eight current EPH's with four or three larger (up to 60 beds) Elderly Persons homes. This would offer the older people of Bath and North East Somerset either 240 or 180 Registered Care beds to use in a variety of ways. People who are very frail, physically heavily dependent, or who have EMI and/or nursing needs would be assessed and directed towards the appropriate type of bed to meet their needs. Respite and rehabilitation care could be offered from the new homes. Each of the homes would also offer up to 15-day care places per weekday.

4.70 The alternative model is one where a combination of 180 Registered and Extracare care support beds is developed across each of the three main population centres across Bath and North East Somerset. This model is based on the premise that some people who would have previously been admitted to an "old style" residential care bed will, in the future, take up residence in one of the Extracare units and be supported in a rented "home of their own". These people will be too frail and vulnerable to remain in their own community based homes. This form of care will help to maintain their level of independence, afford them full tenancy rights and provide a secure environment in which to receive a package of care appropriate to their assessed needs.

4.71 In this model the registered care beds will be reserved for those older people who are the most vulnerable in Bath & North East Somerset such as those with nursing/EMI/heavily dependent needs. This group of people is unlikely to be able to maintain themselves even with support in an Extracare setting. Therefore it is essential to retain a core of registered care beds to meet the full range of need of the older peoples' population in Bath & North East Somerset.

4.72 As in the previous model respite and rehabilitation care could be offered from the new homes and each of the homes would also offer up to 15-day care places per weekday.

4.73 Potential Locations for New Build Complexes

4.74 In October 2001 the Council specifically asked officers to explore whether three or four new 60 bed EPH's would be required to meet future demand and to research possible locations for them.

4.75 Officers from Social and Housing Services and Property Services considered all the current EPH sites and identified those which would be able to support the "footprint" of a new build 60 bed Registered Care Home. Only four were of a suitable size and none from the Bath City area. Subsequently officers trawled the Bath City Local Area Plan map and identified all sites in the councils ownership which would be able to support the "footprint" of a new build 60 bed Registered Care Home. From this exercise a further three sites were short-listed. All seven sites have been studied with the assistance of external property consultants and presented to the Councils Development Control Team for scrutiny.

4.76 In addition officers have explored the possibility of creating a different kind of care provision complex. The notion of supporting vulnerable people in an Extracare setting (referred to in paragraphs 4.45 and 4.70 above) where previously they may have taken up a place in a registered care home has led officers to consider whether this model of care could be developed as part of this re-provision programme.

4.77 Consequently where there was sufficient space within the current site each of the North East Somerset locations has been considered for either model. i.e. a 60 bed Registered Care Home or a 30 bed Registered Care Home with 30 sheltered housing units attached 15 (or more) of which could be designated as "Extracare" Units.

4.78 In the Bath City area however the sites have only been considered for a 60 or 45 bed registered care home as up to 45 Extracare units are already under development on sheltered housing sites in and around the city.

4.79 What follows is a brief description of the seven potential new build sites across Bath & North East Somerset. A summary of the opportunities and constraints attached to each site and site-specific capital implications is contained in Appendix Four. The external property consultant's' report which contains detailed information relating to each site is available in the Executive Members' room.

North East Somerset Sites

(See Appendix 5 for a map indicating the location of these sites)

4.80 HAWTHORN HOUSE, KEYNSHAM

4.81 SUNNYSIDE HOUSE, PEASEDOWN ST. JOHN

4.82 GREENACRES HOUSE, MIDSOMER NORTON.

Bath City sites

(See Appendix 5 for a map indicating the location of these sites)

4.83 TYNDALE HOUSE, BATHFORD

4.84 CARRSWOOD CENTRE, TWERTON, BATH.

4.85 ENGLISHCOMBE LANE, SOUTHDOWN, BATH

4.86 MEARE ROAD, COMBE DOWN, BATH (Land Off Meare Road/Axbridge Road)

4.87 Summary of Revenue implications (Details in appendix 2)

4.87.1 Option One

4.87.2 Option Two