Decision details

To consider the report of the Cabinet Member for Adult Care seeking a decision as to whether three Learning Disability registered residential care homes remain as residential care homes or those homes deregister and become supported living homes.

(i)  To delegate authority to the Executive Director of Communities, Culture and Homes that following consultation with the Executive Director, Finance & Commercialisation and pending successful agreement with NHS England (NHSE) and Clarion Housing Group the three homes transfer to the Housing Revenue Account (HRA).

(ii)  To delegate authority to the Director of Quality and Integration following consultation with the Executive Director Wellbeing – Health and Adults to work with relevant partners and stakeholders to deregister the three homes to Supported Living pending the outcome of recommendation (i).

(iii)  To note the consultation summary and Equality Safety Impact Assessment (ESIA) both of which are appendices to this report.

1.  National and local policy in relation to support and accommodation for adults with learning disabilities encourages a move away from ‘unsettled’ forms of accommodation such as residential care and towards the development of more ‘ordinary housing’ within people’s local communities. This includes a wide range of ‘settled’ options for people with the primary option being supported living in which people have their own tenancy, flexibility to choose their own support provider and access to a wider range of benefits (dependent on individual circumstances).

2.  There are 59 supported living properties in and around Southampton already with around 170 people living in them. They range from one person bungalows, to shared houses for seven people, to complexes of flats for 8-10 people. The Integrated Commissioning Unit (ICU) in partnership with Adult Social Care have been working for several years to increase the number of supported living properties in the City. This is achieved partially through new property developments but also through deregistration of existing residential homes for adults with learning disabilities to become supported living. Deregistration means that the homes themselves are no longer directly registered with the Care Quality Commission (CQC) however the support provider which delivers the support is registered with the CQC. Deregistration doesn’t mean that less support is provided to those living there but it does mean that there is more flexibility to personalise the support for each individual.  Over the past five years, there have been five local deregistrations of residential homes; two homes in Shirley ward, one each in Bassett and Coxford wards and the final home was in Hedge End. Based on contract monitoring by commissioners as well as feedback from social care assessments of those living there, these homes have all made a successful transition to supported living.

3.  The three residential homes in question have a total of 17 individual bedrooms for residents of which 15 are currently occupied by adults with learning disabilities. There are currently two bedrooms vacant. The age range of the residents is from 47 to 74 years, their disabilities include Learning Disabilities, physical disabilities, and autism. Support within the homes is delivered throughout the day and night, this will not change as a result of the deregistration. The CQC registered provider for the three homes is Dimensions UK Ltd. They are also the largest provider of support to individuals in supported living in the city so have extensive experience and have been directly involved in two previous deregistrations in Southampton in 2016. Dimensions will continue as the care provider following deregistration with the support delivered under the home care framework and regular contract monitoring by commissioners in the ICU. The homes are owned by Clarion Housing Group however NHS England hold a legal charge over the properties as the funding for the properties originally came from the NHS in the late 1990s. NHS England have indicated that they will require ongoing protections from the Council in respect of the grant funding which they initially provided for the properties and a satisfactory resolution of that will need to be negotiated once this proposal to deregister has been agreed in principle.

4.  A formal consultation was held between November 2019 and February 2020 to obtain the views of those living at the three homes as well as their family members and/or advocates about the proposal to deregister.In total 23 people submitted a response to the consultation. When asked what option they preferred 9 people chose supported living compared to 3 people who chose residential care. A further 11 people did not express a preference but nonetheless gave feedback about their views. Full details of the consultation responses are given later in this report as well as the accompanying appendices.

5.  The current CQC registered provider for the three homes, Dimensions, have been consulted and are supportive of the proposal to deregister. The current owner of the properties, Clarion Housing Group, are not supportive of the proposal to deregister, as this does not fit with their strategic objectives. Clarion are however, willing to relinquish their ownership to the Council.

1.  The three homes could continue to operate as registered care homes. This will necessitate commencement of a tender process in order to award a new contract. This option is not recommended, as it is not in line with local and national policy objectives and does not increase the options for further independence and flexibility for residents. In addition, the homes remaining as residential care leaves the risk that in the future Clarion could decide to sell the homes or Dimensions decide to close them with the Council having limited influence to affect this.

2.  The three homes could be closed and the individuals supported to move to alternative accommodation/housing. This was rejected as most people have been living in the homes for many years and would not wish to move. The properties are deemed suitable for longer term use and this would not support a person centred approach to meet individual needs.