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A decision made (16.04.2009) to approve the response to Scrutiny Long Term Care of the Elderly Review Report.

Decision Reference: MD-H-2009-0034
Decision Summary Title :	DS – Scrutiny Response Approval – April 2009		Date of Decision Summary:	14th April 2009
Decision Summary Author:	Dominique Caunce Director of Tenant Services		Decision Summary: Public or Exempt? (State clauses from Code of Practice booklet)	Public
Type of Report: Oral or Written?	Written		Person Giving Oral Report:	N/A
Written Report Title :	WR- Housing Response to SR12-2008 – March 2009		Date of Written Report:	17th March 2009
Written Report Author:	Dominique Caunce Director of Tenant Services		Written Report : Public or Exempt? (State clauses from Code of Practice booklet)	Public
Subject: Response of the Minister for Housing to SR12/2008 Long Term Care of the Elderly Review
Decision(s): The Minister:- 1. Approved the response to SR12/2008 Long Term Care of the Elderly Review
Reason(s) for Decision: In pursuance of “Guidance for Ministers responding to Scrutiny Reports”
Resource Implications: None.
Action required: Director of Tenant Services to arrange for response to be presented to the Chairman of the Health, Social Security and Housing Panel and for the report to be referred to the Assistant Greffier and sent to Publications Editor for presentation to the States.
Signature:		Position:
Date Signed:		Date of Decision (If different from Date Signed):

Long Term Care of the Elderly Scrutiny Review - Response of Housing Minister

HOUSING MINISTER’S RESPONSE TO THE HEALTH, SOCIAL SECURITY and HOUSING SCRUTINY PANEL REPORT

SR12/2008 Long Term Care of the Elderly Review –

presented to the States on 2nd December 2008

Overall reaction to the Panel’s Report

I welcome the Health, Social Security and Housing Scrutiny Panel’s review of Long Term Care of the Elderly and fully support Recommendations 1 and 18 which relates to the work of my Department.

Any policies relating to the provision of the long term care for the elderly needs to be founded on good accurate and up to date information on likely need. In the Housing context this has historically been difficult to achieve. One of the key reasons for this difficulty is the lack of a single registration point for access to social rented homes or other forms of affordable housing.

Under existing arrangements those needing housing can register with any number of providers, the Housing Department, any of the Housing Trusts and a number of Parishes. All maintain separate lists some of which are means tested although many are not. It is not clear whether the same people are registered on more than one or all lists and therefore it is difficult to quantify the overall long term housing requirement of the population - not least our ageing population. It also creates the risk that individuals fall between two stools and that their housing needs are not properly met because we do not know that they are in need. This is wholly unacceptable and is something that I am trying to address through the setting up of a single means tested 'Gateway to Affordable Housing' which was introduced as a concept in the debate on Jersey Homebuy. This concept would require anyone wishing to access any form of affordable housing to register and be assessed through the Gateway where a master list would be maintained. Applicants would then be assessed for the most appropriate form of housing for them which could include Parish Housing, States Rental, Housing Trusts and schemes such as Jersey Homebuy. Crucially because there would be one point of access for all possible housing types applicants could not fall between two stools and we would always have access to reliable information of the true need for affordable housing. The Housing Department is also committed to providing appropriate “life long home” type accommodation through acquisition and refurbishment.

Senator T J Le Main

Minister for Housing

March 2009

KEY RECOMMENDATIONS FROM THE HEALTH, SOCIAL SECURITY & HOUSING SCRUTINY PANEL, REPORT		RESPONSE FROM HOUSING
1	It is recommended that a working group be established to look at the organisation of long term care, headed by the Minister for Health and Social Services, joined by the Ministers for Social Security, Housing and Planning and Environment, to consult with relevant bodies and produce a report for the States by 30th June 2009 responding to the recommendations in this report. Consideration should also be given to setting aside law drafting time for related work in 2010	The Housing Minister would welcome the opportunity to work alongside the Ministers for Health & Social Services, Social Security and Planning & Environment in order to play an appropriate part in this piece of work.
2	The working group should be tasked with agreeing a strategic plan for a more unified system for long term care and prioritising options for development of future public provision. It is recommended that this should include setting up a single commissioning body bringing together the funding and procurement of all States-funded nursing home, residential and home care, to operate at arms-length from both public and private sector providers.	The Housing Minister subscribes to this aspiration.
3	The Panel believes that this plan should specifically include an evaluation of the potential for redeveloping the existing Overdale site as a centre for public long term care provision, training and all associated facilities including day-care, respite, sheltered and extra-care housing	The Housing Minister subscribes to this aspiration.
4	A priority of the working group should be to investigate possibilities for establishing a contributory insurance-based scheme for the future funding of long term care, to cover the costs of both residential and community-based care from within a single hypothecated fund	The Housing Minister subscribes to this aspiration.
5	Consideration to be given to employing a partnership insurance approach whereby a proportion of the costs could be the subject of a separate co-payment or private insurance; it should also be considered whether such a scheme should be designed to cover all long term care needs for individuals of any age, rather than limiting benefits solely to care of the elderly	The Housing Minister subscribes to this aspiration.
6	A unified assessment and funding system should include specific proposals to enable funding to ‘follow the client’ in future to improve choice, flexibility and independence for those with long term care needs	The Housing Minister subscribes to this aspiration.
7	Service level agreements should be established with all providers of services to the public sector, backed up by contracts for individual care packages between providers and clients which should become a requirement under the new regulatory system	The Housing Minister subscribes to this aspiration. However, would be concerned whether this could be delivered within existing resources.
8	Health and Social Services and Social Security should work together to produce an accessible guidance and education package about entitlements to care and funding support for the elderly to enable people to plan for their own and their family’s future	The Housing Minister subscribes to this aspiration.
OTHER RECOMMENDATIONS FROM THE HEALTH, SOCIAL SECURITY & HOUSING SCRUTINY PANEL, REPORT
9	The funding of elderly care should be approached as a discrete issue and considered as a matter of urgency rather than being tied to agreement on the entire ‘New Directions’ package	“New Directions” presents a holistic approach to healthcare, for an entire life, the fragmenting of which may reduce the effectiveness of the strategy.
10	The ability to carry out effective police checks on all care staff should be investigated	The Housing Minister subscribes to this aspiration.
11	The working group should consider a requirement for registration of all those working in social care	The Housing Minister subscribes to this aspiration, although is mindful of whether this could be delivered within existing resources.
12	Changes to the funding of regulation should bring in an appropriate ‘user pays’ contribution from the industry	The Housing Minister subscribes to this aspiration, although concerned that this could lead to higher costs to the public as the industry strives to recoup the increased costs.
13	All care providers with clients who receive benefits under Income Support or other public funding should be required to comply with an ‘open book’ policy to enable appropriate levels of support to be established and maintained by means of an annual review	The Housing Minister is concerned with how this would work in practice.
14	Respite care services should be reviewed in consultation with care providers and carers (believed to be in hand as part of the Carers’ Strategy consultation)	This is indeed in hand as part of the Carers’ Strategy; the Housing Department has already played a part in the development of this strategy.
15	Possibilities for delivering a continuing programme of training opportunities for care workers supported by (refundable) States grants should be investigated as a priority by the working group	The Housing Minister subscribes to this aspiration.
16	The Comptroller and Auditor General and the Public Accounts Committee should be requested to look into the financing of elderly care, to identify overall costs and possible efficiency savings of moving to a more unified system and including an analysis of the financial benefits (or otherwise) of outsourcing care beds and services in the medium to longer term	The Housing Minister subscribes to this aspiration.
17	Accommodation for public long-stay patients should be addressed to ensure that single rooms become the norm for all long term care provision (except in the case of couples where both partners are in need of care or wish to stay together). Plans should be brought forward for the replacement or redevelopment of any outdated facilities as part of the strategic planning process recommended in 12) above	The Housing Minister subscribes to this aspiration.
18	The Planning and Environment and Housing Departments should produce an analysis of requirements and definitions for new sheltered and extra-care housing as part of their respective ongoing reviews of the Island Plan and Social Housing	The Review of Social Housing will make various comments and recommendations in respect of the demand for social housing – however, it is unlikely that this will include any detail in respect of extra-care housing as this was not included in the terms of reference. The Minister intends to create a “Gateway to Affordable Housing” which will allow for a single point of access to affordable housing and could certainly be developed to include sheltered and extra-care types of accommodation – though this would clearly require an increase in resources.