care, in the right place and at the right time.
One of the key aspects of Transforming Your Care (TYC) was how we care for older people. People tell us that we should organise our services to enable them to stay at home as long as possible or to be cared for at home, and when they do need support then more choice and control over how their needs are met, is important to them. For some people, residential care remains the most appropriate choice but for others this may not be what they want. TYC is about providing a range of alternatives which will better meet people’s needs.
In October 2012, the Health and Social Care Board (HSCB) led the public consultation on Transforming Your Care: Vision to Action which set out the proposed service changes in response to the Review. This included a range of proposals for older people services to reflect people’s future needs and personal choices, including an increased emphasis on independence. We also wished to recognise the significant shift we have seen in the profile of residential care over the last five years with a fall in demand for residential care despite a rising elderly population.
John Compton, Chief Executive of the HSCB said: “The Board supports the trend towards independent living at home focussing on helping people remain at home for as long as possible or in supported living accommodation and offering more choice and control about the type of care available to older people.”
“In addition, many of our current statutory residential homes are in need of significant capital investment which we feel would be more appropriately directed to non-institutional, community based services to increase the range of alternatives for older people,” he said.
Alternatives would include supported living accommodation, re-ablement services, self-directed support, assistive technology, and domiciliary care packages. We are also investing in the promotion of health and wellbeing of older people, and the prevention of ill-health in the first place.
Mr Compton continued: “We are investing £3.2m in developing re-ablement services over the next three years, which provides a short period of intense help and support to help people build up the confidence and skills to do things for themselves after a period of ill health in their own home.
“We are investing in frontline community care, for example, the Northern Trust has invested an additional £3m in 2012/13 in their elderly services.
“Supported living accommodation or ‘housing with care’ options are already developing. Indeed, two of the homes which the Northern Trust is proposing to close are to allow for the development of supported living accommodation on the same site. We can see from supported living facilities, such as Cedar Court in Downpatrick how successful these can be in providing both support and independent living for residents.
“We need to move away from an institutional ‘bed based’ response to older people’s care needs toward one which gives people ‘their own front door’ and better reflects most people’s wish to live in a home setting. We expect that over the three years to 2015, over 450 supported living places will be developed across Northern Ireland,” said Mr Compton.
Residential Care will continue to be available for those who need it. The non-statutory sector is currently the largest provider of residential care in Northern Ireland, and across the region, there is currently 10% additional or unused capacity in this sector. The non-statutory sector is under the same quality standards and regulation framework led by the Regulation Quality and Improvement Authority.
It was proposed in Vision to Action that at least 50% of statutory residential care homes would close over the next 3 to 5 years. Following the consultation, the Minister for Health, Social Services and Public Safety, Edwin Poots MLA, made a statement to the Assembly on 19 March 2013 on the way forward for residential care. The proposals which were agreed at the Northern Trust Board today represent their plans to take forward this policy. Similarly, the other Trusts across the region will bring forward their plans in due course. It is important to recognise that this proposal relates only to statutory residential care provision, not to those facilities providing nursing care.
Speaking about the difference between residential care and nursing care homes Mr Compton explained: “There is no proposal to close any nursing homes. These are homes where residents require full time nursing care or support. In comparison, residential care homes accommodate those who need help with personal care due to old age, illness and/ or infirmity, or disablement.
“For those people who may be concerned about the potential financial impact if they are moved to an alternative residential home, the Minister has also confirmed, in his statement to the Assembly in March, that where a Trust is unable to secure a statutory residential care place at the core rate and uses a higher rate place in the independent sector as an alternative, then the Trust will pay the difference,” he said.
Mr Compton concluded: “It is extremely important that the current residents in all residential care homes are treated with dignity and respect with recognition that the residential home is their home. Any transition should be managed sensitively and with the full involvement of residents and their families, and we are committed to working with the Trusts to ensure this is achieved.”