The model for a “future-proofed” 40-place care facility to replace St Rognvald House in Kirkwall has now been approved this week by the Integration Joint Board (IJB).
This follows agreement to fund the cost of building the replacement home by Orkney Islands Council in June this year, subject to the approval of the care model by the IJB. The IJB’s decision will now be formally reported back to the Council.
It is hoped that tenders will now be invited for the work to begin on the new £12.27 million care home in the summer of 2021, with delivery at the end of 2023, depending upon the effects of the COVID-19 restrictions on productivity of the construction industry.
The single storey structure to be built at Soulisquoy in Kirkwall will be made up of four wings and include en-suite bathrooms.
Members of the Integration Joint Board approved the revised model – a reduction from the earlier 60-place option – on Wednesday, noting that care home places are only a small part of a huge range of continually developing community services that keep people in their own homes.
The revised proposal is to deliver the 40-place facility with the flexibility to add two 10 en-suite room accommodation wings in future and in the meantime build the central services, such as kitchen, laundry, offices as per the earlier design to allow for the easy addition of one or two of the original 10-room wings, if and when, demand exceeds the existing capacity.
There are a number of reasons for the revised figure with an emphasis on creating a social care package to ensure care can be delivered at home whenever possible.
The report before IJB Board members outlined the reasons for the revised model:
- Previous plans for 60 places were based solely on demographic projections without adjustment for new approaches to service provision and revised statistics for people staying healthier for longer;
- Changes in care delivery- Intermediate Care team, doubled-up homecare teams, responder service second team created to enhance capacity; and other changes currently being explored, including “Home First”;
- Despite the current position Orkney usually performs well with regard to delayed discharges;
- In 2019 the average waiting time for residential care was 25 days;
- Orkney had the highest percentage of adults aged 65+ living unsupported at home throughout Scotland during 2018/2019;
- 90% of people in the community spend their last six months of life at home.
It is the duty of the Council, however, to fund the costs of accommodation where care at home is no longer safe and it is the duty of the Integration Joint Board to decide on the model of care provided and the number of places needed.
Gillian Morrison, Interim Chief Officer with Orkney Health and Care (OHAC), said: “There is a shared desire to take forward a flexible way of working where ‘Home First’ is the ethos and which recognises the changing needs of older people.
“The principal desires of clinicians and professionals were flexibility within the system and that, in planning a new care home, it should be part of an overall system of care including supported housing in due course.
“The aim would be that, as older people’s care needs fluctuate up and down, those needs can be met with care provision flexing up or down within the overall system, with an emphasis on ‘Home First’. A broad analysis of more recent figures looked at shows that OHAC is supporting people in the community for far longer, or until end of life.”
Mrs Morrison added: “The age of St Rognvald House means that the design of care homes has developed over time, and the smaller rooms and a lack of en-suite facilities are not optimal in supporting people with complex needs.
“It is recognised in Orkney and demonstrated by Hamnavoe House that small group living is a model of choice.”
IJB Chair Rachael King said: “How often do we hear the criticism that there is no ‘joined up thinking’? The decision of the Integration Joint Board today demonstrates that everyone who is involved in the ongoing and future care of residents who are either unable to remain in their own homes or who require a period of additional support in order to return to their homes is truly a ‘joined up’ decision.
“It has involved people who use these services, carers, professionals across health and social care and third sector colleagues to provide an assurance that to the best of this community’s abilities we will consider not just the needs of people living within this homely setting but also the needs of professionals to allow the evolving services they provide to be delivered in a way that respects the rights and aspirations of those receiving their care and support.”
IJB Vice-chair David Drever, said: “The new Kirkwall Care Home will bring much improved care for its residents as well as playing an important role in a flexible model of care in Orkney that meets the different needs of our elderly population.”
