Demand for occupancy in the rural Care Units reduced in recent years, as the homecare service extended the services for supporting people with complex needs at home and the support required for those unable to be cared for in their own home exceeded the care unit service.
The Western Isles Integration Joint Board (IJB) consulted upon the use of the three Care Units in Lewis.
The IJB invited consideration of how best to manage four competing demands: the need to respond to community preference; the regulatory requirements attaching to the care units; the commissioning needs of the health and social care partnership; and the need to find efficiencies as part of our financial plan.
At its meeting in February 2019, the IJB agreed to consult on the future use of the care units. The following four options were put forward for discussion:-
- Status Quo (highlighting existing challenges and reasons for change)
- The redevelopment of one of the three care units into a respite care facility, with the residual resource being taken as a saving as a result of two remaining care units closing.
- As per the option above, but with the residual resource split between homecare and savings.
- Alternative proposals put forward by respondents to the consultation.
It was agreed that option c) was the preferred option of the IJB.
An online consultation on the care units ran from 21st February 2019 until 26th April 2019.
Three public meetings were also held in each of the care unit localities. These were all well attended.
In addition, 68 written responses were also received.
From the public consultation, sentiments expressed included:
Support for the retention of the care units, in one form of another;
A willingness from attendees to explore alternative uses for the care units given the profile of demand;
An indication that more imaginative solutions were available, and a request for the IJB to work with communities.
Of the written responses received:
28 respondents argued in favour of the status quo (41%) (Option A)
8 respondents argued in favour redeveloping a care unit into a respite care facility (13%) (Option B)
24 respondents argued in favour of redeveloping a care unit into a respite care facility and investing further in homecare (35%) (Option C)
8 respondents preferred another option not specified in the consultation document (13%) (Option D)
Of those who outlined alternative suggestions, some favoured a mixed model of care and respite care; some suggested the units be used as intermediate care beds to support reablement and discharge from hospital; and some suggested development into nursing care
If a care unit were not required by the IJB, some respondents suggested they should be used as social housing; others suggested early years’ childcare.
The majority of respondents highlighted the importance of being able to support older people in their natural communities.
Of the Key Themes: We Did
The feedback shared from the Care Inspectorate confirmed that the aspirations to provide 24/7 care services within the Care Units, for permanent or respite care, would require a care home registration application, major adaptations and a significant increase in staffing. Such investment was deemed to be inappropriate given the limited redesign potential of the assets. This was tested through the technical appraisal work associated with Lewis Residential Care. Infection Prevention and Control learning as a result of the pandemic response has emphasised the need for residential/housing related services to be designed with significant personal space for living and personal care as well as spacious communal areas if required.
The IJB will work to advance a coproduction model, working with communities to develop new models of care and support, while at the same time recognising the need to make savings.
Locality Planning Groups have been meeting with us in early 2021 to further support more localised planning and delivery of services, and to build upon the natural strengths and resilience already established within our communities.
Of the Key Themes: We Did Not Do
The Care Inspectorate indicated that the care units would need to be registered as care homes if they are to offer respite care; unfortunately, the units do not meet the standards required by the Care Inspectorate. This rules out the use of the care units as respite facilities, without substantial capital redevelopment.
An EQIA was produced in June 2019 to support the suspension of the assets as Care facilities. The assets are subject to disposal in line with policy.
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The Western Isles Integration Joint Board (IJB) is currently reviewing the use of the three Care Units in Lewis. Over the last few months, they have been engaging with staff, stakeholders and community representatives to discuss changes that could be introduced.
Why We Are Consulting
Currently, community care needs in the Isle of Lewis are supported by a range of services, including homecare, residential care, reablement, and respite care for unpaid carers and the care units. The homecare service operates from 6.30am to 1.30am and provides a service to over 300 people on any given day. Homecare continues to be the foundation of community care provision, and as part of their strategy to support people safely and independently at home.
What Happens Next
Having undertaken this work, the Western Isles Integration Joint Board would now like to hear from the public on which of the four options they should implement. (Lewis Care Units Consultation (Opens in a new window or downloads a file) (Opens in a new window or downloads a file))
Responses should be received by Friday 26th April to email@example.com or by paper copy to the Health and Social Care Partnership, Sandwick Road, Stornoway, Isle of Lewis, HS1 2BW.
In addition, there will be three public consultation events, as follows:
Monday March 4th at Ionad Stoodie (Garrabost) from 7.30-9.30pm
Monday March 18th Uig Community Centre (Crowlista) 7.00-9.00pm
Tuesday March 19th Carloway Community Centre 7.30-9.30pm