Consultation report just published recommends closure of Bowles Lodge!

Bowles Lodge Consultation Report

Consultation Questionnaire Feedback - just released

Consultation Questionnaire Feedback

Decision timetable

Decision Making Process for the Future of Older Persons Provision

Meeting with Graham Gibbens & Christy Holden

These are the questions I prepared and asked at my meeting today at 9am.

1. Have you made any decisions yet regarding the future of older person's provision in Kent County Council?

2. When and how will they be announced?

3. As you make the decision is there congruence between your role as Cabinet Member for KCC and you, in your heart, as an individual human being?

4. Why was my proposal rejected before your decision has been announced?

5. Have you seen the report prepared by officers?

6. Is it finalised yet, if not when will it be?

7. Will any part of the report be restricted? If so to who and for what reasons?

8. How and when will it be available to the public?

9. Will staff have access to it at the same time as the public or at a different time?

10. Will managers be briefed before other staff and the public?

11. When & how do you intend to brief residents and their families, friends, advocates & carers?

12. Greg Clark asked you that research be done, as an important element of the consultation process, concerning the availability of suitable spaces in private/independent sector care homes for all permanent residents that may need to be moved - has this been done? If so what are the results and can I have a copy? If not, why not?

13. Are you aware that in October this year KCHA surveyed 450 homes regarding vacancies in the private/independent sector. Only 35 replied revealing 105 vacancies - the great majority of these in coastal towns in Kent?

14. Are you aware that Oliver Mills is meeting with Karen Cooper on 11th January, Kent Care Homes Association, to discuss contract prices and that he has already indicated that he will seek to negotiate a reduction in price for newly placed people who are funded through KCC - the contract with these homes?

15. Are you aware of the deep concern in the private/independent sector about this issue?


16. Homes rated excellent will have a majority of self funders and a waiting list (Mount Ephraim House in TW & High Hilden in Tonbridge for example). Homes that are not performing so well are more attracted to block contracts with KCC. Spot contracts allow KCC funded people to be placed in excellent homes but it is likely that family & friends will have to top up above the KCC ceiling. Do you agree that this can create a two-tier level of care - the more money you have the better care you can purchase?

17. Tell me what you understand the impact has been so far since the consultation was announced in June on the residents of the homes being considered?

18. The equality impact assessment I requested on my mother, Vera Waylor, was made several months into the process and Oliver Mills wrote to me to say this would be done after the decision was made. Why did no-one consider doing an interim assessment under your legal duty of care to examine any impacts on residents' physical & psychological health & well-being?

19. What evidence do you have that moving very elderly and frail people does not increase their risk of dying prematurely?

20. If you do decide to close homes and residents that have to move die prematurely as a consequence, how will you feel?

BBC Radio Kent interview

www.bbc.co.uk/iplayer/episode/p00cm9pj/Breakfast_with_John_Warnett_and_Clare_McDonnell_Wikileaks/

Go to 1:19.30 - its about 8 minutes

Council reject our proposal - too early!

From: John Porter [mailto:john@balloons.plus.com]
Sent: 14 December 2010 21:42
To: 'Christy.Holden@kent.gov.uk'
Subject: RE: Alternative Proposal for Bowles Lodge

Dear Christy

This is a premature response. My lawyer is very interested that you have chosen to respond in this way despite the fact that that graham Gibbens has not yet announced his decision. It sounds defensive as though you are actively supporting the closure of Bowles Lodge. Graham Gibbens has said from the outset that he will weigh all the submissions and although he will listen to his professional officers it is a political decision - not the officers. I am glad that Graham had sight of my full proposal, as indeed all the Cabinet and Scrutiny Committee have had as well.

Regarding your specific points I make the following observations:

· I am well aware that Bowles Lodge is being used for respite care when permanent places become available. The main reason for availability so far is death with one move to another home (and subsequent death within a few weeks) and another planned move.

· You are both right and wrong concerning the duplication of services with local community hospitals. I have met with senior people from PCTs in Kent and the cost of unnecessary extended stays in local community hospitals is at least three times the cost of a place at Bowles Lodge. Running costs at Bowles Lodge are in the lowest quartile for Kent homes for the elderly.

· Repairs have begun on the roof at Bowles Lodge. The fabric of the building is very sound according to a structural engineer I engaged. The whole roof does not need replacing. How did you arrive at the figure of £280,000? Do you have three quotes?

· I accept that Bowles Lodge will change. My proposal allows for an enhanced service to also be provided to the existing permanent residents - particularly the intervention of a dedicated falls team in a group setting. Permanent residents that have fallen have required acute hospital admission. The public are becoming more aware of the astronomic costs of these admissions compared to the relatively low cost of a preventative approach.

· Your point about the PFI is correct. We should not put money before the lives of those most frail and elderly people who have served our country and now need to live the rest of their lives in peace. There are alternative sites though there are political and local difficulties with all of them. Again, what will the public think about this?

· I have presented my proposal to an independent consultant whose findings will be released to the media when I choose. It is a viable proposal. It just does not sit within your constrained thinking. A Chief Executive of an NHS Acute Hospital Trust is particularly interested in it because it saves the NHS money.

The consultation is taking its toll on the residents at Bowles Lodge which started with the inept briefing of residents and their families in June this year. That briefing created anxiety which has steadily intensified. The permanent residents will usually not disclose to their relatives how worried they are as they do not want to cause anxiety to them. One resident I speak to every week is often in tears - sick with worry about what will happen to her. My mum at her annual review with her social worker and the manager at Bowles Lodge disclosed how worried she is. It took my mum more than eight months to settle and she has thrived at Bowles Lodge, as all people do that my mum's social worker has referred there. That speaks volumes!

It is a pity that you chose to respond to me before Graham and others have seen the report. You have, however, provided additional reasons about how flawed this consultation has been and your tone suggests that the decision has already been made - something that Graham has rightly stated time and again is absolutely not the case.

You could partially restore my confidence in the transparent consultation process by providing me with a copy of the report that went to Cabinet that resulted in the proposals being formulated in the first place before June this year. It will be critical to see that report and to read it in conjunction with the report that is being prepared for Graham to assist his decision making. Reviewing the original rationale, the submissions and how they have been assessed and the final report is vital to a fair and just decision and something the courts have expected in previous judicial reviews.

Regards

John Porter

From: Christy.Holden@kent.gov.uk [mailto:Christy.Holden@kent.gov.uk]
Sent: 14 December 2010 12:05
To: john@balloons.plus.com
Subject: Alternative Proposal for Bowles Lodge

Dear Mr Porter

Thank you for the submission of an alternative proposal for Bowles Lodge.

Your proposal has been fully evaluated by a Panel consisting of representatives from Kent Adult Social Services Finance department, Personnel, Service, Policy and Standards, Provision and Commissioning.

The submission and response will be included in the final report which is being prepared ready to be presented to the Cabinet Member for decision in January 2011.

Observations from the panel include:

o Bowles Lodge is currently being used for respite when permanent beds are being vacated. With the development of the Enablement at Home service over the last year, which is a KCC care service, people are now wanting more to be supported at home when they leave hospital.

o The local community hospital undertakes a similar role to the alternative proposal you have submitted and there would be both duplication and over supply if this proposed service was to be developed longer term at Bowles Lodge.

o Bowles Lodge would need capital investment for services to continue longer term including, for instance, £280,000 for the roof to be replaced.

o It is recognised that families understandably do not want services to change for the permanent residents.

o This proposal would mean that KCC and Tunbridge Wells Borough Council would lose its share of the PFI funding to develop extra care housing in the district. There is no option for an alternative site to be found for the extra care housing. The panel agreed that the priority should be to secure services for older people through extra care housing for the future.

It was therefore considered that this alternative proposal is not viable.

Please do not hesitate to contact me if you have any queries.

Christy Holden

Project Manager & BHAL PFI Contract Manager

Public Private Partnerships & Property Team

Kent Adult Social Services

Brenchley House

Maidstone

Kent ME14 1RF

07920 780623

01622 694272

!

A personal message to Graham Gibbens

From: John Porter [mailto:john@balloons.plus.com]
Sent: 29 November 2010 07:29
To: 'Graham.Gibbens@kent.gov.uk'
Subject: One year ago

Dear Graham

It is one year ago today since my mum arrived at Bowles Lodge. My campaign has always been about the frail elderly people who live there, not the building that has become their cherished home. This central purpose might have lost amongst the hubbub of public meetings, debates, TV, radio and press interviews were it not for my weekly visits to see mum at Bowles Lodge and to chat with other residents.

I wonder how it is for you with all the political, fiscal and governmental pressure that you are under right now. I know you rely on your professional officers and, of course, it is they that are preparing a report for your consideration. I trust that their collating and editing will hide nothing of importance from you as you review it and make your decision. You have my positive proposal that I sent to you directly as part of the mass of information that must be considered.

Last Friday we had mum's annual review with her social worker and the manager at Bowles Lodge. It was an extraordinarily powerful reminder to me about the key thread of my campaign - the impact of moving residents from their home on their physical and mental health and wellbeing.

The review meeting revealed several things to me:

• First was how well mum is compared to when she arrived one year ago - her social worker said she could see that mum had thrived at Bowles Lodge both physically and mentally
• Bowles Lodge has saved mum's life
• It took mum about six months to settle in and orientate herself to her room, the lounge and access to the toilet
• Her new GP referred her to a geriatric consultant who adjusted her medication that has resulted in a sharp reduction in the number of falls she was having
• She revealed for the first time how worried she was about the possibility of Bowles Lodge closing

This was a very painful moment in the meeting for me - I had spoken to other residents who shared their anxieties with me about the proposal though they all said they had not mentioned it to their families as it may worry them (!) so for mum to disclose this at the meeting is very significant.

I appreciate that Bowles Lodge is just one home in the review of services for older people across Kent but mum's review meeting has deepened my purpose and resolve even more as leader of Bowles Lodge Stays!. As I have said, this campaign is not about a building it is about very old and frail people's home, their sense of belonging and security.

As a society I believe we are only just beginning our discussions about old age and respecting elderly people for who they are now, what they can offer to society now as well as the contributions they have made to our country. The campaign is not about winning or losing. Unfortunately we can be distracted by politics, economics, scale, money, personalities, reputations, professions and the law. All of these have their place but we are talking about sacred human life and when I looked into mum's eyes last Friday, feeling my own burn with welling tears my whole being shouted silently for compassion.

So, there you have my intensely personal message on the anniversary of mum being at Bowles Lodge. Whatever your decision Graham I want to respect you and the officers as people, as public servants of conscience and I am happy to contribute to our ongoing discussion about aging in its widest sense. For now I think of you as you consider the many submissions and leave the decision in your hands, knowing that you will search your heart, mind and conscience as you sift and weigh all the conflicting views and evidence.

Kind regards

John

Daily Telegraph item

Our proposal

Below is the proposal I sent to Graham Gibbens, the person who decides the fate of Bowles Lodge, two days ago. Today marks the end of the consultation.

My mum served her country in the Second World War and now wants to enjoy the peace that she and many thousands of others fought for. Something we always remember at this time of year.

29th October 2010

Dear Graham

As the formal consultation process draws to a close I have, as leader of the Bowles Lodge Stays! Campaign, a proposal that I ask you to consider. I do so in the firm belief that you have not yet decided on the future of Bowles Lodge. I appreciate that your decision will not be easy due to the pressure from your professional officers, government policy, the PFI aspect and campaigners against closure like us! I have confidence that you will weigh all the submissions carefully and independently as a politician elected by the people of Kent, to protect and enhance the quality of life for the very frail and elderly residents and day centre attendees. This is a major political and public decision!

By far the SAFEST option is to let the current permanent residents carry on living at Bowles Lodge until their death. Five have died since the consultation was announced. In my view the temporary decision not to accept any more permanent residents pending the outcome of the consultation, which I support, should be made permanent. I propose that the places (and these will increase until all the remaining permanent residents have died) be turned into an Enhanced Advanced Respite Centre that could attract Beacon Status and a centre of excellence. This is a great opportunity to tap directly into the money announced in last week’s Spending Review for adult social care that seeks to tackle the, quite frankly, ludicrous battles that have taken place over the years between the NHS and local authorities about who pays for what and whether a person’s needs are purely social or medical. In truth the edges have always been and always will be blurred. I welcome the Government’s approach.

Partnership with the NHS in this Centre will challenge the main current purpose of respite care – giving family, friends and carers a much needed break. If Dorothy Lucy Centre is retained it could focus on this traditional form of respite.

Here are the key points behind my rationale and criteria:

· Elderly people who are admitted to hospital for an acute reason are then often transferred to convalesce and recover in cottage hospitals. These will be the type of temporary resident in this Centre. It means they can be discharged earlier from cottage hospitals providing they are free of contagious infections.

· The approach at cottage hospitals such as Sevenoaks and Hawkhurst is to have multidisciplinary teams working with patients to assist in their healing, recuperation and to build sufficient strength for them to return to independent or semi-independent living (at home with/without carers or in Extra Care accommodation).

· Hospital beds in acute hospitals are extremely expensive and beds in cottage hospitals are expensive.

· The Enhanced Respite Centre will take people that are infection free and provide a programme of activities with the prime purpose of assisting them to live independent and semi-independent lives.

· It will also take people that are considered to be at risk of an acute admission to hospital such as a sequence of falls. This proactive approach could save thousands of pounds and enable them to return home stronger with the intervention of the falls team and other staff.

· Carers, friends and family could also be invited to attend group classes (particularly falls prevention exercises) at the Centre which encourages participation and mutual support as progress can be celebrated.

· The partnership between the NHS and Kent County Council is crucial though I propose that even this be widened to form a comprehensive and cohesive multi-disciplinary/multi-dimensional approach.

· Many of the existing care staff team have all the skills necessary to assist in helping people with their social needs.

· This team should be supplemented by the expertise of a falls team (one of the biggest factors for re-admission to hospital) which could be two people – a physiotherapist and an occupational therapist. This would also encourage increased physical movement, build weak muscles and sense of well being.

· They would work with each resident and help them back into living in their own accommodation.

· Existing district nurse provision may be sufficient or could be stepped up due to the higher demands of the anticipated resident group.

· I propose a team of volunteers be recruited who can spend time getting to know and befriend residents and people there for enhanced respite – particularly those who have a history of social isolation and feel like they have little control of their destinies and those whose relatives live more than 25 miles away which is likely as the centre would be a Kent-wide resource.

· The current social, educational and physical activities, much of which is funded by donation, through the dedicated Friends of Bowles Lodge, will continue.

The Day Centre should be retained as it becomes an integral part of the Centre. People that are suitable for living independently can attend every day to ease the transition. This may require a few reserved places.

There are challenges having people with different needs in the same home but, so long as no-one is admitted with a contagious infection then I think this can be managed. As the current permanent resident population decreases through death, which has already been reduced by 15% in three months) then the Centre can be exclusively for enhanced respite.

I believe this proposal is the safest option for my mother and the other permanent residents at Bowles Lodge and that it gives Kent County Council an opportunity to enhance its reputation in the UK by creating an enhanced facility that Hawkhurst and the rest of Kent tax payers will be proud of and may need soon or in the future.

I appreciate that retaining Bowles Lodge and gradually transforming its function will be logistically challenging and that another site will need to be found if the full PFI Extra Care project is to proceed. Elderly people that would normally be placed in Kent County Council’s residential homes for the elderly and are unsuitable for Extra Care can be placed by block or spot contracts in the independent sector.

I have consulted the Care Quality Commission whether this gradual shift in use from permanent care to enhanced respite care would mean that the existing provision of non en-suite facilities at Bowles Lodge would be a problem with the new rules and they said no so long as there are toilet facilities within a short distance of bedrooms and lounges which is the case.

With an increasing aging population Kent is adopting a good approach by providing a range of options such as Extra Care. The Enhanced Respite Centre widens that range and facilitates independence thus preventing the need for permanent residential care or extremely expensive nursing care.

I have included the political and reputation dimensions in this proposal because they can significantly influence what the public thinks, perceives and feels about public authorities that they fund. Kent County Council is all too aware, as an excellent rated local authority, how tough it can be to sustain this standard as its children’s service is all too aware!

Thank you for all your work and willingness to discuss these vital issues that may impact positively or negatively on the life or death of those most vulnerable in our society. I and our campaigning team are confident that you will carefully consider this proposal and we look forward to a favourable decision so that Bowles Lodge Stays! will no longer be needed.

I am sending this to you today, Friday 29^th October and copying it to Greg Clark MP who I met with this week at the House of Commons and Roger Manning, your colleague county councillor whose constituency includes Bowles Lodge. I will post this proposal on the Bowles Lodge Stays! Blog on Monday 1^st November and release it to the media and all other interested parties the same day.

Regards

John Porter

Campaign Leader

Bowles Lodge Stays!

Mum's 89th birthday today

HAPPY BIRTHDAY MUM!

Another resident dies

Millie was a lovely lady who celebrated her 100th birthday this year. I noticed she was not in the lounge when I visited my mum last week. Mum said yesterday "I'll miss Millie, she was my friend... we had a laugh together".

Two other residents I spoke with yesterday also said how sad they were that Millie had died.

This is the third resident that has died at Bowles Lodge since the consultation began.

A former resident who moved out of Bowles Lodge to another home once the consultation was announced died shortly afterwards.