integrated commissioning unit - portsmouth d… · corben lodge is a residential care facility run...

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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014

Integrated Commissioning Unit

James Gagliardini Consultation and Engagement Officer

Contents

1. Purpose of the report p1.

2. Background & Context p1.

3. Summary of Resident and p1.

Relative Consultation

4. Summary of Day Service p.2

Consultation

5. Conclusion p3.

6. Residential Service User Feedback p.4

7. Day Service Feedback p.9

1. Purpose of the report

The key aim of this report is to ascertain the views

and experiences of people currently living fulltime

at Corben Lodge and their family members on the

potential proposed closure of the facility.

The report will also look at the impact a closure

would have on those accessing the day service,

which now operates from the facility since the

closure of The Vanguard.

This report will be split into two sections, one

covering the views of residential clients and their

families, the other those accessing the day service.

2. Background

Corben Lodge is a residential care facility run by

Portsmouth City Council for adults with physical

disabilities.

The Unit offers both long stay and short stay/respite for adults with a physical disability, providing 24 hour care. At the time of writing this report seven individuals are occupying the long stay beds. The views of individuals accessing Corben Lodge for short stay respite have not been included in this consultation

as the service they receive will not be affected by the potential closure.

As part of this review, the methodologies sought

to gain the views of service users and their families

were via questionnaires, one to one interviews and

focus groups.

All service users currently using the service were

given written notification of the intentions of the

consultation and offered the opportunity to meet

as part of a focus group or individually with myself.

Focus groups were organised at Corben Lodge and

facilitated by myself on behalf of the Integrated

Commissioning Unit and Adult Social Care.

SEAP Advocacy have been commissioned to offer

both residential and day service clients the

opportunity of additional support to air their

views.

3. Summary of resident and relative consultation

A. Loss of Social Networks

Social isolation appeared to be the one of the main areas of concern for both residents and relatives as individuals have built up networks in the area. It was felt that if residents moved from Corben Lodge this would be lost. Due to the length of time individuals have lived at the facility, relationships between residents were strong with this extending to the day service clients. For some there was great anxiety that they would not see the other residents again should they leave Corben Lodge. This was echoed when speaking about the locality and wider community, for example the use of the local church and pub which have become important social networks for the residents. There was concern that the local community accepted them and there is fear around not being accepted elsewhere.

B. Ability of residents

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There did not appear to be confidence in the physical and mental ability of some residents to move into more independent living accommodation. This was raised by some relatives and residents themselves when talking about completing day to day tasks such as preparing meals, paying bills as well as domiciliary care. Personal safety, risk of falls and the potential for individuals to be left unattended for long periods of time were raised as concerns.

C. Quality of Future Care

The possible change from onsite care 24/7 to a different package of support was a concern for both residents and their families. The potential change from having staff available at all times to a number of visits per day was not seen as a positive move and there was a feeling that this would create a risk to personal safety. Ensuring that any change to residents' placements would be tailored to their individual needs was raised as an issue; for many Corben Lodge was seen as the only option for them. The frequency of visits from agency staff within an extra care placement was a concern for relatives and service users; many expressed the importance of the relationships they had built with the current staff at Corben Lodge and relatives reported satisfaction with the level of care delivered at the unit.

D. Financial Savings

It is the perception of many residents and family members that the closure of Corben Lodge is only being considered in order to make financial savings for Portsmouth City Council and that the welfare of its residents is of no consequence.

E. "Decline Of Corben Lodge"

Whilst the physical and quality of care delivered by the staff at Corben Lodge was not in question, relatives did express that they felt there had been a distinct change in the running of the facility in the past few years. It was commented that activities

had ceased and that morale seemed low; in some cases this was attributed to the potential closure of Corben Lodge. A move to the use of more agency staff was also

seen as confirmation that the unit would be closing

and that the consultation was purely a paper

exercise.

From the feedback given by both residents and

relatives who took part in the consultation it is

clear that there is great concern about the future

for service users and the options are available to

them should Corben Lodge close.

It is important to state that not all residents and

families chose to take part in the wider

consultation, other than initial meetings. Only

three accepted the offer of one to one meetings to

discuss their individual concerns.

4. Summary of Day Service Consultation

A. Availability of Activities From the feedback given by users of the day service it appears that there is some dissatisfaction with the choice and availability of activities presently on offer at Corben Lodge. It was stated that in the past there had been regular trips organised for service users and activities such as horse riding and archery which have now ceased. There is also some confusion for day service clients around members of staff, i.e. who is working with residents and who works with those who only attend the day service. It was reported that this has an impact on what activities take place and what assistance they feel is on offer to them. It was suggested that a timetable of available activities would be useful as it appears that some clients are unaware of exactly what it is they can do at Corben Lodge.

B. The Vanguard

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Throughout the consultation comparisons between the service at Corben Lodge and The Vanguard were made, particularly around the facilities and range of activities previously available to service users at the old service. Activities such as cooking and growing vegetables were reported as having stopped since the move to Corben Lodge.

C. The Building Day service users focused more on keeping the building open, rather than looking at what the service actually offers individuals. It is seen as a good place to socialise and for many the only times they interact with their friends and others who have the same needs as themselves. However, it was recognised that the building itself did not lend itself to a day service with reports that the rooms were not sufficient size to carry out groups work and some activities. The main lounge was reported to be used for socialising, drinking tea and having lunch but not really utilised in any other way.

D. Independent Living and Community Support

Accessing facilities outside of the Corben Lodge

was something that the majority of individuals

requested assistance with in the future.

Interestingly, when asked if they would like this to

be part of their package of care, they seemed

surprised that this could be included. Activities

discussed included assistance with shopping for

clothes as a leisure activity, the possibility of

meeting other current day service users within the

community at a café for example.

From the feedback given it appears that there is some dissatisfaction with the activities presently on offer at Corben Lodge.

5. Conclusion

There is a high level of anxiety amongst residents, those accessing the day service and their family members about the future of Corben Lodge. For residents who have been living at Corben Lodge for a considerable period of time the prospect of moving is very daunting. For a number of residents and their families a move to independent living or another alternative does not seem feasible due to the complex nature of their conditions. Although some have recognised that a move is not necessarily an impossible feat. In respect to those accessing the day service at Corben Lodge, there appears to be concern around losing the concept of a day service rather than what is currently provided at the facility. Comparisons were made between the service from the Vanguard and what is offered at Corben Lodge; in their opinion with the former seen as a better service. Frustration has been expressed around the perceived lack of clarity on the possible options for users of both services. It was felt that this made it difficult to visualise alternatives to Corben Lodge. The same issue was also echoed by those accessing the day service at Corben Lodge. It is essential that up to date social work assessments are carried out to ascertain the needs of individuals and what could possibly be provided within the community should the service close. Sections six and seven of this report contain the responses and opinions gathered for this consultation; these views that have formed the basis and evidence for the summary's and conclusion above. 6. Residential Service User Feedback

Residential service users and their families were invited to attend an open meeting with myself and the advocates on 1st June to discuss and give their views on the potential closure of the facility. It was considered that although there would have been a

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benefit of having a wider knowledge of a member of Adult Social Care present to facilitate discussions around alternative options, this was outweighed by the need to ensure people felt free to raise their views in an uninhibited manner. One option discussed with service users at a

previous meeting held on 13th May 2014 was a

possible move into Extra Care Housing, also known

as independent living.

The group were asked how they felt about this as

an option. The following responses were recorded.

"I'd be lonely" Service User

"Miss the safety and security"

Service User

"Staff are 24/7 here, I wouldn’t get that elsewhere" Service User

"I'd miss the fresh air and access to the

garden" Service User

"Companionship"

Service User

"Regular food and socialising" Service User

"Wouldn’t see people"

Service user

"Would miss the garden, I have a patch to plant in outside my window"

Service User

"The move would have an adverse effect for all of them"

Relative

Many of the issues expressed could be addressed within an Extra Care setting but the comments above reflect the concerns raised by the individuals at this point in time.

Service users and family members expressed that they felt part of the local community, accessing many of the facilities local to Corben Lodge;

"I can go shopping in Highland Road here" Service User

"Some of us attend the local church"

Service User

The group expressed that they felt part of the wider community within the area and that any move from Corben Lodge would disrupt this. They felt that their disabilities were not seen by local residents and raised concerns that if they were to move to another area, they could be open to prejudice. The group were asked to give some examples of the other facilities and services that they use outside of the home. The majority were regulars at The Good Companion, a local pub where the owners have installed ramps especially for the Corben Lodge residents to ensure easy access. All were patients at local doctors' surgeries and raised concerns that a possible move might result in a change of general practitioner. Relatives and residents were very anxious about this as a possibility as they felt that their current doctors all know and understand their individual medical needs.

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The majority of residents also access the day services that operates from Corben Lodge and expressed that they would miss the interaction with other service users that this offers if they moved.

Residents' were asked what words they

would use to describe Corben Lodge to

them:

• Family

• Community

• Safe

• Social

• Friendly

• Encouraging

Issues raised

"I've had a look at the flats at the time and I was quite put off" Service User

"Nobody can live independently, what is the

REAL package? Who will get them up for breakfast?"

Relative

"We asked if we could go for a trial period, still no answer"

Service User

"Nobody made me come here, I've been happy here. All this is quite a strain on everybody. I

don’t have any objection to anyone who wants to go. I can go to my room, use the lift, I feel safe

here" Service User

"What are the options for them"?

Relative

"They'll all be on different levels" (Comment relates to building levels)

Relative

"The Good Companion had their ramps done especially for the residents', they're part of the

community here" Relative

"We all go to the Good Companion"

Service User

"It’s the only place outside of here (Corben), where we can meet our son"

Referring to The Good Companion pub Relative

"They all use the day service here"

Relative "Where are the respite clients? Don’t they have a

say"? Relative

It was explained that respite provision would continue regardless of the outcome of the Corben Lodge consultation and that provision would be made elsewhere in the city. As non-residents, the consultation was not open to respite clients at this time.

"Mum did live on her own for a while; she kept falling over and was left all night on the floor until the carers came. Sometimes they didn't

even show up. We have peace of mind knowing that care is 24/7 here"

Relative "It’s a weight off our shoulders, knowing mums

here" Relative

"Its my choice, nothing to do with her

(daughter)" Service User

The above response when asked where they would like to live.

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"Could Corben Lodge be changed into a supported living unit, rather than move

everybody out?" Relative

"It's not full because people don’t want to be

here, it's because they're not getting the referrals" Relative

"Where are the plans? Or the visits we were

promised" Relative

JG pointed out that the plans were on the walls but nobody seemed aware of this.

"People do still want to live in these types of

facilities; Croft House in Fareham always has a waiting list"

Relative "It would be horrible, disastrous if we left here"

Service User

"Have they (Portsmouth City Council) thought about the damage it will cause people if they move them? What is the potential effect on individuals? Being moved against their will?"

Relative

"What will be the level of care? It can't be 24/7 like here" Relative

"How do I know the level of care I'm going to get? The friendships I have here will be lost"

Service User Elderly parents of one resident were particularly concerned about the future for their son. He moved into Corben and they thought settled there for the rest of his life.

"Now they worry all the time for the future" Relatives

"Surely living independently will cost more? They'll have to pay out for food, everything.

Who's going to pay for that?" Relative

"Who will monitor their diets?"

Relative "It's not just about how nice it is here, there are basics, I can't go to the toilet on my own, I can't

stand up, I need someone to put me to bed. Who will do all this?"

Service user Residents and their families were offered the opportunity to speak about their own personal feelings by arranging one to ones with the engagement officer. Three families made appointments, one of which included a service user. All meetings were held at Corben Lodge at agreed times with the family and resident. For reasons of confidentiality and due to the small number of resident, names and the gender of each resident has been replaced with X. Family A

Has one of the local nursing homes been offered Corben? That’s what I'd heard. Is it being sold?

What other alternative is there for X? Put in a place full of old people? X can't live on her own. X's been assessed as needing 24/7 care! X can't do anything!

X's not really aware of the situation at the moment. X knows when people are talking about it but I don’t

really discuss it with X, not until we know what's happening.

X has never been out on X own due to the severity of

X cerebral palsy.

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We've still had no contact from Hampshire (at the time of interview 18.08.14).

X has recently had an assessment from a social

worker, assessed as critical! There is no way X could have independent living.

Twice a week X goes to Henderson Road (day

service), which X loves

X will take part in any activity! Activities here, well it depends whose on duty. Staff have changed since it

first opened.

My other sister worried about X all the time, especially now with all this going on.

The people here can't be independent!

X is funded to have 121 but I'm not sure she's getting

it. I've asked but no answer. Family B

Family members and resident present

The family informed JG that a meeting with a

member of Hampshire County Council social

services had been arranged for the day after the

meeting.

Maritime House has been the only option presented

to us. It's difficult because we're not local

We'll need sufficient time to look for a new home for

X

We have discussed the possibility of X moving back

with the family

Use to spend more time out of Corben, but that’s

tailed off now. It's like it's been on shut down for a

while now.

X gets taken to church by Sandra (a member of the

local church) but she's not been very well so that’s

stopped. Nobody here has offered to take X

I can't go to the Good Companion on my own, I need

help

SU

There used to be volunteers who would take X out

for IT support

X was asked what their preferred outcome would

be regarding Corben Lodge;

I can't answer, worried about getting it wrong.

Upsetting people

SU

There was concern expressed as to whether X

could manage in a semi-independent setting.

X has become reliant on staff here, they know when

X is in discomfort, and they pick that up

More agency staff here now, feels like its running

down. The physical care and quality of care I have no

problem with but activities have decreased

The relatives felt that if the opportunity had arose

15 years ago that it would have probably been a

viable option but thought that it could possibly be

too late now.

If it stayed (Corben Lodge) it would need to change

I like the sense of community

Nobody asks X if X wants to do anything, like go to

the cinema for example

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X would need training to live independently, that

should be provided by an outside agency

What happens if X moves and it doesn’t work?

Family C

The meeting had been arranged with both family

members and the resident had been made aware

of the meeting. Unfortunately on arrival, staff

informed me that X had been taken to church that

day and so was not present at the meeting. The

relatives were unclear as to why X had been taken

out as the unit were aware of the meeting.

X still gets to go out , every Sunday morning and

afternoon, use to do archery and sailing in the

summer but that’s all stopped. I don’t think the

sailing club operates anymore.

Our major concern is that X does not have either the physical or mental capacity to live on X own.

Institutionalised for 25 years, it'll be a shock to the

system.

If Corben Lodge were to close, ideal scenario is that

X goes to one of the other facilities but cared for in

the respite side. Personally I feel uncomfortable

about X living alone. X has spoken about living with

Y (partner) but we don’t know where that’s come

from.

X used to use the kitchen facilities but stopped when

X burnt them self with a kettle. Sometimes is unable

to even use cutlery, can be quite vacant, unwell at

times

Relatives stated that there had been some contact

with the social worker but this had not been in

relation to the potential closure of Corben Lodge.

A full assessment had been carried out and issues

around capacity to handle money were identified.

A social work assessment is crucial, what does a

package of care include?!

The carers here know when X is unwell; they have a

long term relationship with each other

It feels like it has been constructively closed down

over the past 4-5 years. Where have the respite

clients gone? If the building passed the CQC

inspection, why say it's unfit for purpose?

I have reservations about packages of care that

people have; the qualifications of people

Would Portsmouth City Council arrange and take

care of X's finances? So X can just live?

The relatives explained that they had been asked

by a social worker to sign a report which would

mean they would take over control of X's finances,

which they felt uncomfortable signing. They stated

that the assessment suggested that X was entitled

to more benefits than currently receiving and is

entitled to higher mobility and Disability

Allowance.

Why was this not picked up before? The accuracy of

information about X's needs could have an effect on

the package of care

We did receive an invitation to go to Caroline Lodge

but it was during the day. We couldn’t attend

because we both work. I was alarmed to find out

that there was nobody around after 5pm to show us

around and speak to. Who is running it in the

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evening? What's the handling of the people like?

Otherwise we're just looking at a room?!

Will X be placed with older people?

Has anyone thought of the practicality of placing

people on different floors? X cant weight bare

anymore

Some of the residents here are already looking at

other options, older peoples' residential homes for

example.

X has never been capable of living on X own

Care spread over a number of people is surely

cheaper than individual carers seeing each person on

their own?

Be honest, the reasons financial!

7. Day Service Feedback

No one seems to come from Hampshire to

hear my views or listen to my fears about up

coming events. Concerning my placement at

Corben and early Horizon. I feel forgotten.

Hampshire client

It looks like once again, its up to me to fight

X's corner. Re writing letters to ALL parties!

Hampshire Relative

(My) husband has been coming for 11 years.

Relatives disappointed that vanguard closed

so quickly. Lack of communication since

coming to Corben. The carers are our loved

ones mouth pieces.

Portsmouth relative

This state of limbo is very unsettling for the

people we care for. My husband really enjoys

his time at Corben, but needs to be assured

that stability will be there in the near and

longer term future.

Portsmouth relative

Corben Lodge is not just for the service user,

it's very important for carers as well!

Portsmouth relative

The way things were done in 2013, very

upsetting for all the people attending

Corben Lodge. People from Vanguard

treated very badly. What is going to happen

for the future?

Portsmouth relative

We want top people from the council to

come to meetings. X has been attending

Corben for 15 years. Please take them out of

limbo and leave them where they are. These

adults do not like change.

Relative

I am just a friend and visitor at this meeting.

I feel these adults have lived here for long

time, they are human beings and you are

taking their home away from them, so

please take them out of limbo and leave

them where they are.

Relative

X was very upset when arrived at Corben

and took a long time to settle in. X can not

talk using communication board to

communicate. X can get very worried and

this affects X at home. We need to know

now where the daycentre is going as leaving

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it to the last minute is not good. X needs to

get use to the idea.

Relative

Why were we evicted from Vanguard under

false pretence and still empty a year later

and now we're getting kicked out of Corben

at Some point?

Portsmouth service user

Have any decisions been made to type of

place they are wanting to put us in?

Whilst at Vanguard we had been led to

believe we were going to St James and were

being told that we couldn’t go down as

there were alterations. When we were

eventually allowed to go down there was no

building, work being done.

As there is a need for this service would it

not save money to leave Vanguard clients at

Corben Lodge and save money from building

a news place, or are they going to not give a

set place to us? There are supposed to be a

list of people who want to use this type of

service. We have been told by a friend who is

a social worker that they are not allowed to

tell clients about the service.

Portsmouth service users

We need people from the top to let us know

what's going on and what is happening to

Corben when its closed. I expect its going to

be flats, I think all this meeting is a waste of

time as your minds are already made up.

What are you doing?

Relative

We want TOP people to attend from the

Council. What they need this place for and

why? They're not cattle moving from place

to place, this is their homes.

Portsmouth relative

Very anxious since moving and where they

going?

Portsmouth Service User

X has used this service for 35 years

Portsmouth relative

We had been told that it would take a long

time to arrange things when moving and yet

from getting a letter in January, it only took

8 weeks or a bit more to set us up in Corben.

We have been told there are several people

wanting to use the service, so will it be the

same at Corben as it was at Vanguard, they

whittle us down. And Finally, say you don’t

need a certain place as there is not enough

clients using the service?

Portsmouth Service User

Do you have any questions on the proposal

for Corben Lodge?

X does not mind that Corben closes

as long as the next centre is bigger

than here and same as the

Vanguard.

Keep the place open if nothing can

be done for Vanguard

More things to do, gardening

X wants to stay, likes arts and craft

What words best describe Corben

Lodge/Vanguard Day Service to you?

Friendly!

Local

A Lifeline

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Corben services are great but area is

too small

Horizon group confined, too small,

not enough room for activities when

different from other working clients

What are your thoughts about the

proposals for the service?

We have not been given any

proposals therefore do not have any

thoughts at the moment.

What proposals have you given?

What is the proposal - what are you

actually offering us?

What is your perception of the future of

Corben Lodge/Vanguard Day Service?

That the future is not good

Goes in one ear and out the other!

All talk - no do!

Confused and frightened

Don’t know, sad, worried, upsetting

Nice environment, I've been coming

since Horizon

You'll take place away

The staff are really friendly but need

more room

The future for clients is very grey, no

future

Several meetings with day service clients were

held; the following points were raised at the third

meeting. The meeting was attended by two service

users, one relative and a personal assistant.

Would like more space, the rooms here are

too small here

Can only get two people in any one room

Computer room can only get one person in

at a time

Use to have cookery sessions at the

Vanguard, this has stopped since moving to

Corben

No hot meals are provided

I come here, have a cup of tea and a chat

Sometimes have outings, went to the

Victory at the Dockyards but wasn’t my

thing

Go to the beach sometimes

He use to go horse riding

Enjoy painting

I'd like the people who arrange things to be

honest

I use to go shopping (be supported to go).

When we first moved here, things were

looking better but this only lasted a week

Southdowns' College come in during term

time and work with X on literacy

I was told today that I couldn’t photocopy

pictures anymore because of copyright

If I can't paint I don’t want to come

anymore.

I like shopping and I'd like someone to take

me out, do more in the community

Both service users expressed an interest in accessing more activities in the community but highlighted that assistance would be required.

We use to work in the garden at the

Vanguard, providing vegetables for the

kitchen

Perhaps we could have a timetable of

activities

My social worker did not know that Corben

was closing (Hants client)

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integrated commissioning unit - portsmouth d… · corben lodge is a residential care facility run...

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