Agenda item

Report for Decision

ORDERED the Executive:

 

1.    Approve the provision of health respite services at Levick Court, subject to the closure of the Most Suitable Provider (MSP) process being conducted by the Integrated Care Board (ICB).

2.    Approve the revised fees and charges schedule for Adult Social Care, as outlined in Appendix one of the report.

 

 

The Executive Member for Adult Social Care submitted a report for Executive’s consideration. The purpose of the report sought Executive approval to reprofile Levick Court that would ensure that a high-quality respite/short breaks service would be provided for residents and would ensure sustainability within the workplace.

 

In 2010, discussions began with the Tees, Esk and Wear Valley Mental Health Trust (TEWV) and the Levick Trust regarding the relocation of existing respite services from the Council’s provision at 4 St. Paul’s Road and TEWV’s Bankfields Court, Eston, to a new site of the former Levick House Care Home on land owned by the Levick Trust.

 

Construction commenced in 2011 to develop a 16-bed respite unit for adults aged 18 - 64, alongside 20 Older Person’s Housing apartments. These apartments, intended to replace the previous care home on the site, were designed to meet the housing needs of older people in Middlesbrough. North Star Housing took on responsibility for managing the apartments as well as the building’s repairs and maintenance.

 

However, in 2012, as the site neared completion, TEWV withdrew from the project, citing concerns about the ongoing revenue funding required to operate their element of the service. Their withdrawal also resulted in the loss of a £500,000 capital contribution, even though the building had been designed to meet clinical standards in line with their requirements. Following TEWV’s withdrawal, the Council proceeded to move its respite service from St. Paul’s Road and repurposed the remaining capacity at Levick Court to provide residential care. This facilitated the relocation of permanent residents from St. Paul’s Road, and the service opened later in 2012.

 

Levick Court, operated directly by Middlesbrough Council, offered both residential and respite facilities for adults with learning disabilities aged 18 to 65. Historically the unit comprised of eight residential and eight respite beds. It had been operational for over a decade. During that time, the age profile of residents had increased, with the average age being around 60 years and some residents nearing 65. The facility was originally developed for a younger, working-age group, with a staffing model based on residents spending much of the day accessing community services. Staffing was therefore modelled on staff presence in mornings and evenings. As such the staffing model had not been able to accommodate individuals with increased daytime needs.

 

Respite care was vital for adults with learning disabilities and their families. It provided essential breaks, reduced carer stress, and improved the wellbeing of both carers and those receiving care. Respite services could help maintain family relationships, promote independence, and reduced the likelihood of long-term or permanent care placements.

 

However, demand for the service had declined in recent years, and the unit currently operated at around 37% occupancy. In some cases, Continuing Health Care (CHC) funding had supported the service to sustain capacity for individuals with complex needs, ensuring that appropriate placements remained available when required.

 

During the COVID-19 pandemic, the service was temporarily closed, leading to a loss of income from both user contributions and CHC-funded placements. Since reopening, revenue had only partially recovered, and a significant service redesign had been undertaken. Social care demand projections indicated that only eight respite beds would be required to meet future needs. Given the current low occupancy levels and high unit costs, Levick Court had been identified as a service in need of substantial transformation.

 

To meet the objectives of the transformation programme, alternative delivery models were considered, and included:

 

An option appraisal was undertaken to determine the future of Levick Court. Currently, on average 20 clients access respite services at Levick Court on a regular basis, with support ranging from 20 to 88 nights per year. Four of these clients received some level of health funding toward their care. The service currently employs 22.4 full-time equivalent (FTE) staff, including 3.09 FTE vacancies.

 

·         Developing an all-age short breaks provision, potentially merging with children’s respite services.

·         Creating an integrated health and social care respite service.

·         Full closure of Levick Court.

 

The Mayor stated he was pleased Levick court was to remain open. He also stated that when the Council had sufficient financial capacity it could achieve positive outcomes. The Mayor expressed his thanks to all those involved in the creation of the report.

 

OPTIONS

 

A number of options were explored before considering engagement with the Integrated Care Board which included:

 

·         Remaining as is, however, was not financially viable.

·         Work with children’s services to explore respite – this was not viable to the capital investment required to modify the building due to the requirements around CQC and OFSTED.

·         Working with a private organisation to deliver services – this was not financially viable.

 

ORDERED the Executive:

 

1.    Approve the provision of health respite services at Levick Court, subject to the closure of the Most Suitable Provider (MSP) process being conducted by the Integrated Care Board (ICB).

2.    Approve the revised fees and charges schedule for Adult Social Care, as outlined in Appendix one of the report.

 

REASONS

 

The proposed revised model would deliver the efficiencies identified within the Adult Social Care Transformation Programme and would make best use of an existing asset. More importantly, it would ensure the ongoing delivery of short breaks and respite care at a local level, while fostering greater collaboration between health and social care partners. This approach aimed to deliver improved outcomes for residents and their families.