Closing credit

Three years ago, Lancashire Council embarked on an ambitious and controversial programme to transform residential care services. Despite initial concerns, clients are now beginning to reap the rewards. Derren Hayes reports

Lancashire Council’s decision, in 2003, to close nearly threequarters of its residential care homes was unpopular.

“There was lots of negative publicity at the time,” remembers Joe Slater, project manager at the council. “There was a lot of pressure on councillors to reverse their decision and a judicial  review was threatened.”

A High Court judge eventually ordered negotiations between the various parties and after agreeing to involve clinicians in assessing residents’ health before being moved, the council pushed ahead with the plans. Three years later, as the closure programme approaches its final stages, just 13 of the original 49 care homes remain open across the county.

Slater explains that taking such a radical step was necessary if the quality of care homes was to improve.

“It was not about saving money but using it differently. We were driven by the desire to help people stay in their own homes but at the same time bring some care homes up to a higher  standard,” he says.

The 13 homes that remained open were refurbished and expanded with specialist wings for dementia and intermediate care developed. None of the residents had to move while the work was done. One new home is to be built. The whole project represents a £20m investment.

Residents who moved as a result of home closures were monitored and there was found to be no significantly adverse impact on their health. And Slater says the council had been able to  keep its assurance that people would only have to move a maximum of five miles away.

“People are territorial and have a sense of place. But it’s important to consult them and their families and talk to them about the changes. When there were transfers, ensuring nothing got lost  in transit was difficult. Medication and belongings were there when they arrived – everyone had a key worker to ensure their move went well,” he adds.

Despite the upheaval residents are happier in the new homes, claims Slater. “Most say standards they are now living in are much higher and it’s important that is recognised.

“We’re offering an environment that has up-to-date facilities: there are wandering areas for residents with dementia, bathrooms have been upgraded and a number of homes have day centres attached.”

Margaret Horner, care manager at Dolphinlee House in Lancaster, one of the homes refurbished under the programme, says the new home is “a pleasure to live and work in”.

“In the past, attention wasn’t always given to decor but just because you’re elderly doesn’t mean you don’t appreciate nice things,” explains Horner, who has worked in the home for 24 years. “If you live in a nice environment you’re going to feel valued.”

The closures meant 100 staff took voluntary redundancy while others retrained or moved from providing residential to day or domiciliary care.

Horner says the training opportunities the programme has offered staff have also pushed the standard of care up.

“Nineteen of my staff have NVQ 2, and seven have NVQ 3 qualifications. They have a better understanding of what the clients’ needs are and feel better about themselves. I still go on training courses such as the safe handling of medicines,” she adds.

Horner says that the closure of homes was upsetting for people but feels it has given residents and staff more choices. And it would have been impossible to bring all the homes up to the  current standard “without a huge injection of money”, she adds.

“We have to be realistic and say we can provide this to the best standard if we do it this way. It wasn’t a nice situation but something that had to be done. No one wants to give up their own home but if they are going somewhere better then it is easier to get through that period,” Horner says.