Agenda item - Knoll House Resource Centre: Future Use
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Knoll House Resource Centre: Future Use
- Meeting of Health Overview & Scrutiny Committee, Wednesday, 16th October, 2019 4.00pm (Item 18.)
- View the background to item 18.
Report of the Executive Director, Health & Adult Social Care (copy attached)
18.1 This item was introduced by Rob Persey, Executive Director Health & Adult Social Care (HASC).
18.2 Mr Persey told members that the post-hospital care model has changed considerably in recent years. In part, this is because services now try to support discharge direct to patients’ homes wherever possible. In part, as the population ages, we have more very frail people who no longer need to be in acute care beds, but who do require some quite intensive nursing support in community beds. These factors mean that the profile of patients using community beds at Knoll House (KH) and Craven Vale (CV) has changed, with a much greater acuity of nursing need. Nursing care at KH and CV was being provided by Sussex Community Foundation NHS Trust (SCFT), but SCFT recently announced that it was unable to continue to provide nursing support due to the higher than anticipated levels of care required. The suitability of KH and CV for higher needs nursing care has also been a concern, and NHS commissioners have now sourced beds in more clinically appropriate settings. Since people with lower levels of need are now being discharged directly to their homes and the people with highest needs are being placed in the beds that the CCG has commissioned, this has left the council with a surplus of beds at KH and CV. In consequence, a decision was made to focus services at CV for people with care needs, with KH to be used for other purposes.
18.3 In response to a question from Cllr Barnett on the potential use of KH for people with mental health needs, Mr Persey told members that a business case for the future use of KH was being developed, but that no decision has yet been made. One possibility is that KH is used to support people with mental health issues as part of their recovery journey. These would not be people whose primary health/care needs relate to substance misuse, although it is not possible to guarantee that no one placed at KH would have substance misuse issues. Mr Persey has already met with local residents to discuss the future uses of KH and has committed to further engagement as the preferred options become clearer.
18.4 In answer to a question from Colin Vincent on the number of community beds commissioned by the CCG, Mr Persey informed members that around 174 beds have been commissioned for Brighton & Hove residents. This is an interim position, as the whole of local step up and step down services are currently being reviewed. There has been no decrease in local beds: more are being commissioned now than previously and funding has not reduced. Not all of these beds are in Brighton & Hove, although Mr Persey stressed that these are short term beds, with an average stay of around 20 days.
18.5 In response to a question from Fran McCabe on the possible use of KH as step-down accommodation as part of the mental health supported housing pathway, Mr Persey told members that KH was not being considered for this purpose. The council is actively sourcing this type of accommodation via the Strategic Accommodation Board.
18.6 In answer to a question from Cllr Powell on the impact of changes on staff and patients, Mr Persey informed the committee that there will be no direct impact on patients as these are short-term beds, so no one has had to be transferred from one care setting to another. This has been a very anxious time for staff. The changes to KH and CV have been progressed swiftly in large part because the recent expansion of facilities at Ireland Lodge has created opportunities for staff transfer. This would not have been possible on a slower timeline – i.e. the council would have had to recruit to Ireland Lodge and would then have faced the problem of having excess staff once all community bed services were transferred to Craven Vale. The process has been managed without any compulsory redundancies, but this has meant that it has not been possible to involve members in decisions at an early stage.
18.7 In response to a query from Cllr Powell on whether there is pressure on the council to place people into long-term nursing care, Mr Persey told members that the Royal Sussex County Hospital is under extreme pressure and needs to ensure timely discharge of patients. However, the health and care system works together via the Operational Command Group to ensure that everyone is discharged into the accommodation that best fits their needs.
18.8 In answer to a question from Cllr Druitt on therapy, Mr Persey told members that both nursing care and therapy has been commissioned by the CCG. There has been no reduction in the amount or the quality of therapy offered to patients discharged into community beds. Some of the beds commissioned are at dedicated rehab facilities such as Newhaven Downs. In other instances the CCG has bought short-term beds from nursing homes. These beds are separate from long-term beds and specifically include elements of rehab/therapy. Cllr Barnett noted that she was sceptical about these arrangements.
18.9 Cllr McNair asked a question about the public consultation over opening a hostel in Hollingbury. Mr Persey responded that he was not able to answer this question at the meeting, but would be happy to provide a written response.
18.10 RESOLVED – that the report be noted.
- Knoll House Resource Centre: Future Use, item 18. PDF 393 KB View as HTML (18./1) 42 KB
- Knoll House Resource Centre: Future Use APX. n 1, item 18. PDF 155 KB View as HTML (18./2) 15 KB