South Lanarkshire Integration Joint Board – HSCP18 External Care Home Placements - Manage Demand and HSCP19 External Care Home Placements - Existing
| Title | South Lanarkshire Integration Joint Board – HSCP18 External Care Home Placements - Manage Demand and HSCP19 External Care Home Placements - Existing |
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| Council Resource | Social Work |
| Aims and Objectives | The aim of this proposal is to review and reduce the number of externally purchased care home placements. Historically, South Lanarkshire has generally had a higher number of care homes placements when compared to similar sized or neighbouring local authorities and sits just above the Scottish average. Care Home Census for Adults in Scotland - statistics for 2012 - 2022 Public Health Scotland. The approach to date has been to fund an additional 5 nursing care home placements per month to reflect annual demographic growth. It is proposed to manage the demand in 2024/2025 and not make an additional 5 placements per month. The full year effect of the saving is £0.796m. It is also proposed to reduce the nursing care home budget by £1.592m. This would be achieved by reducing available capacity by 10 placements per month. This proposal reflects the increased range of services in the community that are available to allow more people to be able to stay at home independently for longer as from engagement and consultation activity the majority of people (where their needs permit), would wish to remain at home longer. The full year effect of both of these proposals is therefore £2.388m and would support the IJB to achieve its statutory responsibility to set a balanced budget in 2024/25. |
| Conclusion | Potentially the impact of this proposal will affect adult and older people, but in particular those aged 75+, given the higher proportions of this age group currently living in a care home setting. A range of consultation has been undertaken, including extended sessions with IJB members and IJB voting members. https://www.southlanarkshire.gov.uk/slhscp/info/2/integration_joint_board The South Lanarkshire Health and Social Care Forum has also contributed to the overall process, representing the views of the public on health and social care matters. This proposal to reduce care home placements could have an adverse impact in relation to the protected characteristics of age and disability with people requiring to wait longer to move to a care home placement following assessment possibly being delayed in hospital or in the community receiving care at home until such times that a place becomes available. There has however been significant investment in a range of services to support people with social care needs - and an increasing range of health needs - in their own homes. The Home First approach provides multi-agency teams supporting individuals with the identification of assessed needs being met through the provision of rehabilitative care and support at home to promote independence. Progressing full implementation of the Home First approach to care at home is pivotal to the success in supporting people to remain in their own home for as long as possible and thereby reducing the demand for care home placements. Until such time as the Home First approach is fully embedded, there may be additional waits for access to care at home services which would impact equally on those awaiting discharge from hospital as well as those waiting for care in their own homes. Work is also ongoing with acute colleagues as part of Operation Flow to improve the flow for patients in hospital and reduce the current levels of demand for services, provide more planned dates of discharge where support for discharge is required and thereafter, to avoid on the day cancellations. As well as reducing demand on care at home, this would also improve flow across the system. This will continue to be monitored through support plan reviews. Following the extensive consultation process undertaken to shape the IJB SCP 2022-25, communities and stakeholders confirmed that enabling and maintaining independent living in peoples own homes wherever appropriate was a key priority. The aim of this proposal is to review and reduce the number of externally purchased care home placements. It is envisaged that an increased focus on enabling people to live in their own homes for longer with additional community support, such as intermediate care at Blantyre LIFE and integrated reablement by Home First teams across South Lanarkshire, will offset some of the future demand for care home placements and waiting times will be managed. It is anticipated that consistent and equitable application of Self-directed Support will also mitigate the effects of the proposal by identifying tailored services that meet the needs and capabilities of individuals with critical and substantial needs. The IJB and the SLC partner are working together to deliver more support and interventions at home alongside the building of and adapting of flexible and connected homes for the future, reflective of a progressive housing approach. Agreed by the South Lanarkshire Integration Joint Board on 26th March 2024. |
| Completion date | March 2024 |
| Contact Email address | equalities@southlanarkshire.gov.uk |