South Lanarkshire Integration Joint Board - Proposed re-provisioning of care currently being provided from Dewar House and McClymont House Residential Care Homes.
| Title | South Lanarkshire Integration Joint Board - Proposed re-provisioning of care currently being provided from Dewar House and McClymont House Residential Care Homes. |
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| Service Area | Residential Care |
| Aims and Objectives | This EQIA aligns with the IJB paper entitled “Proposed re- provisioning of care currently being provided from Dewar House and McClymont House Residential Care Homes” and the IJB Financial Plan 2024/25, presented to IJB members in March 2024. In order to secure recurring financial sustainability in the context of significant pressures on public sector funding, the IJB approved the adoption of a Sustainability and Value Programme in September 2023 with the aim of achieving savings while maintaining statutory services and public protection. This programme includes a proposal to repurpose part of the residential care service. It is proposed that the IJB will recommend to the SLC partner that the saving achieved from reduced commissioning of residential care beds should be applied to McClymont House and Dewar House Care Homes, which would result in the closure of the two homes, care being provided for current residents in alternative settings and redeployment of staff to other posts. This strategy is in line with the vision and ambitions set out in the South Lanarkshire Integration Joint Board (IJB) Strategic Commissioning Plan (SCP) 2022–2025 as well as previous SCPs. Currently, long term 24/7 care in South Lanarkshire is provided through a mix of residential and nursing care. People who are currently supported in residential care have a lower level of need and tend to have fewer complex needs than those supported in nursing care. As a result of investment in community-based services and support, many people can now access alternatives to residential care allowing them to stay at home for longer. When a service user cannot continue to be supported to continue to live at home, their care needs are now generally more complex and they tend to require nursing care. This has resulted in a corresponding reduction in demand for residential care home beds (care homes with no nurses employed on site). The number of registered care home services has declined with 6% fewer in 2022 compared to 2018. https://www.careinspectorate.com/images/documents/7276/Care%20Home%20report%202020-22%20(%20final%2005.09.2023).pdf |
| Conclusion | Consultation has been undertaken between November 2023 and February 2024 with groups of people likely to be affected by the policy. Individual meetings were held with the families of residents of Dewar House and McClymont House and included residents themselves where they wished to participate. Some families engaged an advocacy organisation to support residents to share their views. Focus groups were held with staff within both Dewar House and McClymont House and public and community group meetings were held in the Hamilton and Clydesdale localities to allow any other interested people to give their views. A dedicated email address was also created to allow written submissions to the consultation. An Independent Advisory Panel was convened to provide oversight of the process. The full consultation report has been published on the South Lanarkshire HSCP website. The consultation findings indicate a high level of concern from participants about the potential impact of closure on residents, their families, care home staff and the wider communities in which the homes are situated. Wider engagement has also been undertaken every three years in line with South Lanarkshire IJB’s strategic commissioning cycle to inform the development of its successive Strategic Commissioning Plans and commissioning intentions. Transformation of our residential care model and a shift towards community-based services has been a feature of the IJB’s commissioning intentions: “reduce reliance on nursing and residential care through the development of proposals to remodel a proportion of residential care beds to focus on transitional support and the “home for life” principle.” (SCP 2016-19 / 2019-22) “support older people and those with particular needs to live independently within the community in a suitable and sustainable home, reducing the requirement for institutional care and risks of homelessness.” (SCP 2022-25) The assessment identified potential negative impacts related to age, disability, sex/gender, marriage/civil partnership and socio-economic status and inequalities. Where a negative impact has been identified, mitigating actions have also been identified. Residents will continue to access appropriate support in a setting which meets their needs. Assessment of each resident’s needs would identify people who would be best cared for in a nursing home so their increased level of need would be met. South Lanarkshire IJB has already overseen the successful decommissioning of three care homes – Kirkton, MacWhirter and Canderavon House - while effectively supporting service users, relatives and staff through the transition while minimising disruption. Social work staff therefore have experience of decommissioning of care homes and a process would be followed to identify suitable care to meet each individual person’s needs and maximise residents’ and families’ choice over their care. An undertaking has been given to families that care would be given to finding appropriate placements for each person. Staff would work with care home managers internally and externally to source placements and support residents and families through a move to minimise distress and anxiety. Ongoing review throughout the process will assist in determining the impact of the policy, whether other protected characteristics are also impacted and whether further mitigations are required. The need for institutional care has shifted, given the trends of reduced demand for bed-based services. Given the current financial position of South Lanarkshire IJB, if this policy is not approved then savings would require to be found from alternative areas which would also have potential for negative impacts and may affect a larger number of service users. Any impact of this policy will be monitored through regular internal review of outcomes for individuals and through regular inspection by the Care Inspectorate. Progress of the policy will be reported through the IJB, Social Work Resources Committee and the senior management team. It is recommended that the policy be implemented with a modification to allow the closure to go ahead over a longer time period than initially expected to alleviate the negative impacts identified and ensure that the mitigating actions outlined are able to be undertaken. Agreed by the South Lanarkshire Integration Joint Board on 26th March 2024. |
| Completion date | March 2024 |
| Contact Email address | equalities@southlanarkshire.gov.uk |