Information for families
Care home bed capacity and admissions
Claremont House and Castle Grange offer a mix of 30 long stay beds and 10 planned respite beds.
During the COVID-19 pandemic the respite beds offer was suspended in these homes in line with government guidance and to ensure the protection of residents and staff. The demand for these beds following the pandemic had reduced significantly and the council reconfigured the bed mix across all council-run care homes. The impact of this work on Castle Grange and Claremont House involved:
- Relocating service users at The Homestead into a wing at Castle Grange whilst capital development work was being undertaken for the new Homestead service in Almondbury. This mitigated short term cost pressures on the council in finding an alternative and temporary location for The Homestead service. This decision reduced the offer of the respite beds at Castle Grange.
- Making up to 10 dementia respite beds, in line with our understanding of demand for these beds at the time, available at Moorlands Grange.
- Expanding the council's long stay bed capacity provided through both care homes from 60 to 80, in line with our needs analysis and market analysis at the time.
Discussions took place within the council and with partners (NHS, Independent Sector).
In readiness for these changes the council also set aside capital monies for facilities work across Moorlands Grange, Castle Grange and Claremont House. Investments were also made in new IT solutions to support with electronic care records, electronic medication records and more sophisticated nurse call technologies.
Staffing pressures across social care services and in particular the two care homes impacted on our ability to move at speed with the above plan.
A wing of 10 beds at Claremont House has now been approved (as at 26/10/23) to reopen to provide respite on the proviso that social workers and families/residents are made aware that the council will not be in a position to support short term stays eventually converting to long term stays.
Care home occupancy
Each care home has capacity for 40 beds, however currently as the cabinet report indicates, there are 46 residents across all 80 beds. Reasons for this level of occupancy are:
- 10 beds at Castle Grange are being used as the temporary decant solution for The Homestead team pending completion of works at Knowl Park House in Mirfield
- 10 beds at Claremont House were retained as vacant capacity pending significant facilities management works to be undertaken during 2023/24
- Limited demand for short term respite beds following the pandemic - the service currently has capacity for up to 20 short term respite beds, this service offer has been under-used which led to the Council reviewing the bed mix across the homes
Should Cabinet decide to move to closure of Claremont House and Castle Grange, we will work with families, social work professionals, the team across each care home and with independent sector providers through the Kirklees Care Association to identify the service which best matches and meets the needs of residents. Each case will be assessed by a social work professional in collaboration with families and the care home team and considered on a case-by-case basis.
Impact on staff
Recruitment across the council is now being managed in a careful and considered way. Following the decision at Cabinet on 26 September, the council has taken the decision to pause any further substantive recruitment into these services pending formal cabinet decision, so as to not place any further staff at risk of potential service change.
There is an open and ongoing recruitment campaign to attract more people into social care, however, lack of workforce in the labour market is a strategic issue impacting on social care services across the country.
No discussions have taken place with staff about redeployment. The staff are not currently considered in a service change process nor are they at risk until a formal decision has been made about the future of each care home. Managers have met with teams and their trade unions to inform them of the council's financial pressures and to share information on all service reviews that are currently being undertaken. We continue to ensure we are engaging and listening to staff during this uncertain and difficult time.
Staffing levels
The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 18 in relation to staffing states that: 'Sufficient numbers of suitably qualified, competent, skilled and experienced persons must be deployed in order to meet the requirements of this Part.' In summary, this means that we must make sure that we deploy enough qualified, competent and experienced staff to enable them to meet all the other regulatory requirements. The legislation does not indicate what safe staffing levels are and there is no official tool for calculating appropriate staffing levels.
The CQC's guidance 'Guidance for providers on meeting the regulations' states that to meet the requirements of regulation 18, 'providers should have a systematic approach to determine the number of staff and range of skills required in order to meet the needs of people using the service.'' Providers should also consider, 'the different levels of skills and competence required to meet those needs, the registered professional and support workers needed, supervision needs and leadership requirements.'
Information on staffing levels can be found in the cabinet report.
Impact assessment
Please see updated Impact Assessment which has been strengthened in this area. Officers are also engaging with the Council's Dementia Strategic Lead and various academic experts in this field to continue to build on the assessment of impact based on national and international research.
The impact assessment can be found on the following link: Integrated Impact Assessment
Social Worker support for service users and families
We appreciate this is very stressful time. Should cabinet decide to approve proposals to close both care homes we would like to assure families that we have a tried and tested process to support residents and their families.
Private sector care homes
The Council is one provider out of many care homes providers in Kirklees providing residential (and nursing) care support to people with dementia.
NHS pressures
Castle Grange and Claremont House are residential care homes providing long term care and support placements in a residential setting.
The NHS can only provide funding to a care home where:
- There is provision of nursing care by a registered nurse for those assessed as eligible for NHS-funded nursing care
- Ongoing medical/health care needs provided alongside social care support for a temporary period (usually up to 4 weeks), usually following a stay in hospital, as part of intermediate care
Castle Grange and Claremont House do not fit the above criteria and therefore legally cannot be funded via the NHS in the way Ings Grove House and Moorlands Grange are.
To support with NHS pressures the Kirklees Health and Care Partnership is investing £400,000 in recovery beds at Moorlands Grange in Netherton. Up to 40 recovery beds will support the wider health and care system, relieving pressures on hospitals through dedicated care staff and wrap around therapy, nursing, medical and social work input to support patient outcomes to maximise independence.
Working with partners
We are engaged with a range of stakeholders and partners in respect of this consultation and this includes engagement with the University of Huddersfield in a number of areas.
We have good partnership relationships with the NHS, both the provider and commissioning arms of the NHS, as well as with the wider care home sector. We continue to explore opportunities to engage with the care home sector to explore different models of care and ways of working. We will be actively engaging with care home providers who express an interest in the Council's proposals.
In relation to the NHS, Castle Grange and Claremont House are residential care homes providing long term care and support placements in a residential setting. The NHS can only provide care to a care home where:
- There is provision of nursing care by a registered nurse for those assessed as eligible for NHS-funded nursing care.
- Ongoing medical/health care needs provided alongside social care support for a temporary period (usually up to 4 weeks), usually following a stay in hospital, as part of intermediate care
Castle Grange and Claremont House do not fit the above criteria and therefore legally cannot be funded via the NHS in the way Ings Grove and Moorlands Grange are.
Please see the following cabinet report about our work with Newtons: Cabinet Report Adults External Commission
Financial information
We are unable to provide a like for like service comparison of our homes with the private sector as each service offer is unique.
As per reference in cabinet report - Planned expenditure of 'Ring-fenced' £550,000. This was monies funded by the Council's Corporate Centre to cover the provision of new kitchens at Claremont and Castle Grange, and the works to the ensuites at Claremont.
As per reference in cabinet report - Asset Register Valuations of £8,346,000. These valuations are based on Existing Use Value from 2019, examination of individual properties is based on a 5-year cycle. A return on investment is difficult to quantify at this stage.
As per reference in cabinet report - Sale of surplus assets (or alternate use). In the current economic climate, it is difficult to confirm increases or decreases in asset values as assets can go both up and down. It should also be noted that these buildings will have defects list and maintenance issues particularly as the boilers and their main systems will now be over 20 years old.
A range of options have been explored, including demand management, strength-based approaches to care and investment in prevention and early intervention. Both care homes have also had investment over the last few years, for instance to support with the Wellbeing Pods enabling families to visit their loved ones during the Covid19 lockdown arrangements. Wider work also done with both services to identify ways in which the services can operate in a more efficient manner.
Whilst occupancy has an impact on unit cost it is not a factor in determining the overall financial position for these homes. As set out in the Cabinet report, should the homes operate at 100% occupancy, it would still remain value for money for the Council to support service users through maximising the capacity in the independent sector.
The council would need to follow the legislation relating to third party top up payments. The allocated Social Worker will support families with this. Generally, the council would try to support the family to find a care home that doesn't require a top up. If this is not possible or the family chooses a care home that charges a top up the council will advocate on behalf of the resident and their family.
Investment in new facilities
The council is investing £8m in new and modern dementia day care facilities which will open in 2024. Read further details about Knowl Park House.
The council is investing capital funding in a residential scheme in Golcar to support older people. We need to ensure we have the facilities that our ageing population will need in future years. This housing scheme will replace outdated accommodation and we are statutorily obliged by government to compensate current residents who will have to move whilst their current homes are demolished and rebuilt. Cabinet report Sycamore Grange Cabinet Report 17 October 2023.pdf (kirklees.gov.uk)
Financial analysis
There will be a dedicated session on finances with families as part of the consultation process.