To consider any requests received in accordance with Standing Orders.
Minutes:
Deputation 1 – Unison – Chris Taylor
Mr Taylor spoke, on behalf of Unison, in opposition to the closure of Osborne Grove Nursing Home. Mr Taylor expressed that management were using the earliest opportunity, following the CQC [Care Quality Commission] “requires improvement” rating, to close Osborne Grove Nursing Home and to re - provide the nursing facility with an external provider. The new staff would be employed on lower wages and lower working conditions. Mr Taylor expressed that to close Osborne Grove Nursing Home would leave staff, who were mainly women and from a BAME background, without employment. Furthermore, the closure would lead to vulnerable residents having to be moved, causing undue distress and disruption to their daily lives. Mr Taylor expressed that this action was not needed, if the residential nursing home was likely to be to be re-opened, providing nursing care beds.
Mr Taylor contended that the CQC had not required the Council to close Osborne Grove Nursing Home and there had been significant improvements made, since the earlier CQC inspection findings. In Mr Taylor’s view, the CQC findings on the failings of the home, were related to senior management and governance failures. Mr Taylor, on behalf of Unison, contended that the issues with staff at the home had been exaggerated.
Mr Taylor referred to the CQC report from February 2017 where the only standard at the home rated as “good” was for caring. This was the standard that related mostly to the actions of the front line staff in the Nursing Home. He spoke favourably of staff interactions with clients and carers. He felt that there was no reason why the Nursing Home could not remain open, continuing to take forward the improvements made.
Mr Taylor further questioned how meaningful the consultation had been, given that only one option of closure had been put forward.
The decision to close Osborne Grove would consequently make staff redundant and this action conflicted with employment law, including TUPE. Mr Taylor called for Cabinet, to not close Osborne Grove. He appealed for this Nursing Home to be either run by the Council or be managed in partnership with the NHS, keeping vulnerable residents living in the Home whilst continuing improvements.
Mr Taylor further reflected that, if an elderly resident was living in a house that was not good, the Council would work to improve this. Therefore, Mr Taylor felt that the same principle should apply to Osborne Grove.
The Leader sought Mr Taylor’s view on the current overspend of £1m on the home, in light of the care quality issues and the pressing financial issues. Mr Taylor questioned whether this money was well spent as there were basic failures identified in the home which, in his view, were compounded by lack of management oversight and inconsistent audits. Mr Taylor contended that with improved processes and proper management oversight, issues at the home could have been resolved without the high level of financial investment. Also the cost of the home had increased recently because of the overdue need to invest in improved equipment to assist carers in the home with clients. The increased cost of moving people from the Nursing Home and re-providing care, needed to be compared to the potential re-opening the Nursing Home in the future. There was also a potential legal issue, if the Council re-provide the Nursing Home and have made staff redundant.
Councillor Vanier, Cabinet Member for Adult Social care and Culture responded to the deputation. The fact that the CQC did not require the Osborne Grove to close was not disputed. However, the current rating of Osborne Grove “requires improvement” also needed to be considerably factored. There had been three out of four warning notices assessed as being complied with but the Nursing Home, which had been taken out of special measures, still “required improvement” and this fell short of required standards put forward by the Council to other providers which were to be “good” or “outstanding”.
The Cabinet Member asserted that senior management roles and responsibilities in relation to the Nursing Home had been working. The Care Quality Commission, Clinical Commissioning Group and corporate management of the council had provided support to make these improvements. It was important to note, that the embargo on the Nursing Home had been in place since August 2016 and the Council had been working throughout this time to improve the quality of care. The CQC had acknowledged these improvements, in July, but there were still further improvements needed.
In respect of providing alternative provision, 90% of nursing care commissioned externally was categorised as “good or outstanding.”
The Cabinet Member thanked Unison for their deputation and the tabled response to the consultation would also be noted.
Deputation 2 – Gordon Peters representing Haringey over 50’s forum, Haringey Older People’s Reference Group and Hornsey Pensioners action group
Mr Peters, spoke in opposition to the closure of Osborne Grove Nursing Home. He expressed that Osborne Grove was the last remaining full time residential home, caring for residents with frailty and complex needs. Mr Peters felt that the value of the provision was recognised by the Council and was regarded a valuable and well placed site to provide nursing care.
Mr Peters referred to a previous Council led options appraisal exercise concerning Osborne Grove, in late 2015, which explored continuation of nursing bed provision alongside provision of respite care and rehabilitation services.
Mr Peters welcomed the Council’s effort to improve the care provided at Osborne Grove, following a decline in CQC [Care Quality Commission] ratings. He attributed the current high costs of the Nursing Home to the Council’s own admissions embargo, leading to low occupancy levels and higher staffing costs. Although the current position was unsustainable, Mr Peters contended that closure was the wrong option.
Mr Peters asserted that there was already a lack of nursing care beds in the borough and questioned the timing of this closure now. Mr Peters claimed that 41% of care beds in the borough were poor or “requires improvements”. All lives mattered, and Mr Peters expressed that Cabinet take account of legal and reputational issues that will arise following closure of this Nursing Home
An options appraisal for the Osborne Grove site was due to be considered at the January Cabinet meeting and Mr Peters questioned why the decision on closure was being considered before the options appraisal. Audits of referrals to the home, further indicated there was good potential to provide mixed use nursing beds.
Mr Peters urged Cabinet to listen to the consultation responders, and for social care provision be seen as a contributor to the local economy rather than a drain on resources.
Mr Peters concluded by asking Cabinet, to act on carers concerns and bring forward options for continuing the services at Osborne Grove; fully costed with the NHS or a social enterprise before closure is considered.
The Leader highlighted the previous work of the Council to avert closure of the home in November 2015, when there were discussions with Whittington Health on providing step down accommodation. This demonstrated the Council’s willingness to find solutions for the Nursing Home. Mr Peters repeated his assertion that the Council should be working with the CCG to provide a better future for this Nursing Home. Mr Peters, further expressed that the options appraisal with financial projections and guarantees for nursing beds, should come forward to Cabinet for consideration before closure is considered.
The Cabinet Member responded to the issues highlighted by Mr Peters in his deputation. The Cabinet Member explained that the options appraisal had begun last year but the quality of care issues then took precedent over this additional provision, and Whittington Health had stepped back from these negotiations.
The Cabinet Member outlined the gravity of the situation with Osborne Grove subjected to a statutory local authority led establishment concerns process. This was put in place to manage the number of essential improvements required under quality of care and was completed with the support of multi-agency co-operation, local providers of care, and having an embargo in place.
Improvement plans had been in place since 2016 to improve the quality and safety of care. The Cabinet Member re-iterated the standard of care expected for all care providers in the borough and this also applied to Council providers of care. It was important to note, that despite improvements there were still key issues that remained. For example, the embedding of improvements needed to be seen as established and the care quality assurance system still needed improvement, in terms of having evidence of care. The knowledge, skills and competency of staff at the Nursing Home was still of concern. This was in spite of input from senior management, corporate resource additions and working with CCG.
The Cabinet Member concluded, by re-iterating the commitment to explore alternative models of nursing care on the Osborne Grove site.
The Cabinet Member thanked the deputation for their views.
Following the completion of the deputations, the Leader varied the agenda, to allow consideration of item 10 [minute number 125] outcome of the consultation and decision on the proposal relating to Osborne Grove Nursing Home.