The Executive Director of Wellbeing, Care and Learning submitted a report that sought approval to proceed with the closure of 11a Sunningdale Road Mental Health Residential Home.
The closure of 11a Sunningdale Road was included in the Mayors savings for 2013/14, with a savings target of £125k in the first year and £256k full year savings in subsequent years. 11a Sunningdale Road was a residential service run by the Council, which provided up to 14 people with planned short stays, as part of an individuals care plan, for either respite or rehabilitation, and four people with emergency short stays when an individual was deemed to be in a mental health crisis.
Following the initial announcement of the 2013/14 savings proposals, a comprehensive consultation had been undertaken, which involved people who had used the service, commissioners of the service, staff and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV), a key partner of the Council in delivering the current service.
The respite service was provided to give carers of people with a mental health problem a break from their caring responsibilities. An analysis of usage of this service confirmed that demand for this service equated to one residential bed at any given time. The rehabilitation and recovery service was provided primarily to facilitate discharge from hospital and prepared people for a return to independent living in the community and had benefits for both Health and Adult Social Care Services. The consultation concluded that a residential facility was not the ideal setting for this to take place as opportunities to develop the necessary budgeting and independent living skills were limited. An analysis of usage of this service confirmed that up to ten places were required at any given time.
The crisis service was provided primarily to deal with an immediate crisis and prevent admission to hospital. The service received £89k per annum income from NHS Tees and TEWV towards this service, which equated to £428 per bed per week, against an actual unit cost of £821 per bed per week. TEWV had accepted that they were responsible for the ongoing provision of this service in full.
The report outlined that there were four options available:
Option one was to have continued to provide the existing service at 11a Sunningdale Road - this was not cost effective and did not provide an appropriate setting for rehabilitation and recovery. In addition, the identified savings would not be achieved.
Option two was to continue to provide the existing service at 11a Sunningdale Road, but negotiate an increased contribution from NHS Tees and TEWV towards the service - This may have achieved the savings target, but the fact that a residential setting was not appropriate for rehabilitation and recovery remained. Through the consultation process, NHS Tees and TEWV had ruled out any additional contribution to 11a Sunningdale Road.
Option three was to provide a respite service by commissioning one residential care bed per week from the independent sector at £26k per annum, and to have provided a rehabilitation and recovery service by commissioning up to ten residential beds from the independent sector at £260k per annum, with TEWV making alternative provision for the crisis service - This was not the ideal setting for a rehabilitation and recovery service to be provided, as opportunities to develop the necessary budgeting and independent living skills were limited.
Option four was to provide a respite service by commissioning one residential care bed per week from the independent sector at £26k per annum, and to have provided a rehabilitation and recovery service by commissioning a supported housing based service from a Registered Social Landlord, to have supported no more than ten people at any given time. This would have ensured that housing and care and support were separated, and that individuals could have claimed housing benefit to meet their accommodation costs. This service would have needed to be provided initially from temporary premises, potentially for up to two years duration, while work was carried out to identify a Registered Social Landlord willing to develop a building specifically to meet the ongoing requirements of the service. The cost of commissioning such a rehabilitation and recovery service was estimated at £260k per annum. As part of the commissioning process, negotiations would be entered into with South Tees CCG and TEWV to secure appropriate NHS funding towards this service. As with option two, TEWV would make alternative arrangements for the crisis service. Further information was outlined in detail within the report.
During the meeting is was discussed that the service users consulted as part of the initial consultation process should be asked for any comments in relation to the proposed new model for rehabilition and recovery and that any comments be fed back to the Executive Member for Adult Social Care and Public Health.
That option four be approved and further consultation with service users to take place in relation to the proposed new model for rehabilition and recovery and that any comments be fed back to the Executive Member for Adult Social Care and Public Health;
an initial supported housing based rehabilitation and recovery service was commissioned at no more than £153.8k per annum in the first instance; and
That negotiations with South Tees CCG and TEWV in order to secure a minimum of £106.2k per annum funding in order to take the longer term service forward as per option four are commenced; and
the closure of 11a Sunningdale Road on the 17 May 2013 be approved.
The decisions were supported by the following reasons:
In order to achieve the savings outlined in the Mayors 2013/14 budget statement.; and
In order to develop a more appropriate and cost effective rehabilitation and recovery service for Middlesbrough.