Agenda item

The Cabinet Member with Responsibility for Adult Social Care and the Director of Adult Services had been invited to the meeting to update the Board on the 18 October 2018 Cabinet decision in respect of the Future Use of The Grange, Kidderminster.

By way of introduction, the following main points were made:

·       In February Cabinet made a decision about the future use of The Grange and agreed to re-purpose the building as a long-term dementia unit.  At this point decision makers did not have all relevant information in place and, in particular, a feasibility study on the future use of the building was not available.  When the feasibility study was produced it was clear that the business case for the development of the dementia unit was not practical.  Given the new information, the revised proposal was to close the facility.

·       There continued to be a need for a wide spectrum of dementia care and further work needed to be done to establish the range of need across the county.  This need might be met through direct provision or by stimulating the market.

·       The options appraisal made it clear that the capital cost of necessary refurbishment would outweigh any financial benefit of re-purposing the building.  It was acknowledged that The Grange was valued in Kidderminster but the building had now reached the end of the road.

Members were given the opportunity to ask questions and the following main points were raised:

·       It was disappointing that the February Cabinet report had not recognised that there would be major problems with the use of The Grange as a dementia unit.  The building was in clear need of updating and there appeared to have been neglect of a capital asset.

·       Of greater concern was the lack of provision for dementia care in the area.  Dementia patients often had elderly partners and local provision was important.  The loss of local dementia beds was a major concern.

·       The Director of Adult Services agreed that there was a need across the county for specialist units.  Everyone should have a choice of good quality care with reasonable costs.  She suggested that the county was at a tipping point in relation to older people with many more over 75s in the population.  She was pleased that the public recognised the quality of local authority provision but pointed out that there were also some very good private providers.

·       The clarity of paragraph 25 of the Cabinet report in giving details of the actual savings to be generated by the closure was welcomed.  A question was asked about whether the current forecast of £1.230m cost reduction would be used to mitigate cost pressures in Adult Services and what capital receipt might be achieved by the sale of the site.  In response, the Director informed the Board that she would certainly make the case for the forecast saving and any capital receipt to be used to support budgets in adult social care.

·       It was suggested that there was a need to be clear about what provision there currently was across the county.  In response, the CMR confirmed that work was ongoing on a market position statement which would be discussed by Cabinet in November.

·       The Vice Chairman summarised views expressed by suggesting that Members supported the direction of travel of the proposal and agreed that it was not appropriate to design a service around an asset.  All Board Members would wish to see a better dementia service for residents.  The Cabinet Member reminded the Board that the Adult Care and Well-being Overview and Scrutiny Panel would be looking at dementia care as part of its consideration of the market position statement.  It was confirmed that this would be added to the scrutiny work programme for the Panel.

·       It was confirmed that the building was not suitable for a dementia unit and would have meant a compromise in the care provided.  The market position statement was a statutory document that the Council had to produce.  With reference to dementia care, there was currently a gap in the market.  It was confirmed that the Council used both private and not-for-profit providers.  Once the Council talked to the market, it would be possible to move quickly on this.  The Cabinet Member suggested that if additional Council-run provision was needed, it could take 3 or more years to build a new facility from scratch.

·       Although The Grange was not an appropriate building for a dementia unit, the site itself may be useful.  There were currently 3 unused Council sites in Kidderminster and concern was expressed that the Council should not 'sit on' the site but should make use of it.  The Cabinet Member confirmed that he would pass on concerns to the Cabinet Member with Responsibility for Transformation and Commissioning.

·       It was confirmed that there were currently in the region of 40 fte staff working at The Grange.  Existing service users would be moved to new facilities from mid-January.  The Director of Adult Services reminded Members that she had joined the Council in February 2018 and had not been involved in the original decision.  At the time, the enthusiasm of staff had led to a position where officers were not thinking strategically, but were attempting to design a service around an asset.  Members were assured that lessons from this had been learnt.

The Board agreed that it would wish to make the following comments to the Cabinet Member with Responsibility for Adult Social Care:

·       In principle the Board supported the direction of travel.

·       It noted the lesson learned that it was not appropriate to design a service around an asset.

·       Members would wish to see a better service across the county for people with dementia.

·       The Board noted that the market position statement would be considered at a future meeting of the Adult Care and Well-being Overview and Scrutiny Panel.