Thornwood - county cabinet swings axe

Tuesday's meeting accepted the recommendations of director of adult social care Keith Hinkley to swap funds to community care.

But non-cabinet members, meeting last Friday had opportunity to put their points to cabinet.

Bexhill King Offa Division member Cllr Graham Gubby said he was pleased that cabinet had taken on board points he had raised about the importance of respite care.

Tuesday's meeting accepted the recommendations to:

*Negotiate with Rother Homes and Hastings and Rother PCT to terminate contractual arrangements for intermediate treatment services at Thornwood with a view to discontinuing the service

*Delegate authority for this to the director of adult social care and approve investment in community-based support

Cabinet members were told the move would release 772,000 a year, leaving 110,000 in the pooled budget at the county council's contribution to the community collaborative rehabilitation team.

The director said: "There is a twelve month notice period on the contract with Rother Homes, so the timing of the discontinuance of the intermediate treatment service is dependent upon detailed negotiations with Rother Homes and the PCT but it is not anticipated that full year savings will be realised until 2008-2009."

The proposal is for the funding to be to be invested in ongoing day services including:

*72,000 in ongoing day service provision

*250,000 into the extra care housing scheme at Ticehurst

*450,000 into the community care budget

The Thornwood intermediate care scheme was established in February 2004 through the sale of the county council 16-bed residential care home and integrated 16-place day care unit to Rother Homes to provide a jointly-commissioned intermediate care service.

The service is commissioned through a pooled budget with Hastings and Rother PCT with the county finding the entire 772,000 value of the contract with Rother Homes.

Thornwood consists of a sheltered housing complex, a 16-place day centre and a 16-place registered care home, all operated by Rother Homes.

"A recent review of PCT beds indicated that, whilst in overall terms there is a shortage of bed-based resources, there is an over-provision of residential intermediate care in the east of the county.

"The room sizes at Thornwood prevent the admission of more dependent patients who require hoisting therefore limit the alternative uses.

"Whilst the service is of a high quality and is clearly valued by those who have used it, from an adult social care perspective, the TICS service is not meeting core objectives as referrals are primarily from acute settings and lengths of stay are longer than anticipated."

A further expansion of bed provision is anticipated in the east of the county including AgeWell private finance initiatives for the replacement of Mount Denys and the establishment of a new facility in rural Rother.

"The funding released through the withdrawal from the contract and the discontinuance of the intermediate treatment service at Thornwood will be used to provide more community-based rehabilitation and support services, which will enable service users to remain at homes and live independently...."

Cabinet members were told that the primary care trust is supportive of the proposed change and that Rother Homes, as the service provider was willing to work cooperatively with county and PCT.

The director of adult care says both day and residential service users are placed on a short-term basis and the services would run down naturally as referrals ceased.

He concludes: "The county council and the PCT are committed to increasing their investment in community based services. Disinvestment from this contract and the discontinuance of the intermediate treatment service at Thornwood is an opportunity to adjust the balance of provision from residential to community services, whilst maintaining the overall level of service provision."

Stuart Prince, director of care services for Rother Homes, has told the county: "We have been very proud to provide the Thornwood Intermediate Care Service, whilst the partnership with the PCT and Adult Social Care has provided wider benefits of increasing all our understandings of care needs within the Rother community.

"Although the proposal to close the centre is supported by statistics that show a longer length of stay than anticipated, as well as an overly-medical model of service from the perspective of adult social care, it nevertheless remains that Thornwood has offered an excellent service to the users that have received care there.

"This is borne out by the inspection results and comments of the Commission for Social Care Inspection, as well as by countless numbers of comments and compliments paid by Service Users to management at the centre.

"We are aware of the proposals and are keen to maintain the positive working relationship between Rother Homes, the county council and the PCT. As such we will work co-operatively with the organisations to achieve the objectives."

The terms of the contract do require either party to give 12 months' notice of termination, although given the good on-going relationship between Rother Homes and adult social care and the possibility of further collaboration in other areas, this could be waived.

He says that before agreeing to waive the contractual notice period, Rother Homes would need to discuss and agree with the county an action plan covering redeployment and redundancy for current Thornwood staff including the potential transfer of some staff to the Newington Court Extra Care Scheme at Ticehurst and the relocation of day service users and the phased running down of the intermediate care facility.