Two Edinburgh council-run care homes have been slated for closure as part of a new raft of cuts to the city’s health and social care services which will hit the capital’s “poorest and most vulnerable”.
Clovenstone and Ford Road care homes will shut by March 2025 with their combined 68 residents moved into other facilities if cash-saving plans are approved by Edinburgh Health and Social Care Partnership’s joint board.
To help bridge a £60m budget gap the organisation is also set to slash funding for third sector organisations, disability and mental health support, scrap a day care service which supports older people through exercise and memory programmes and reduce the availability of overnight care.
Health and social care chief Pat Togher said the city faced “unprecedented financial challenges” and the measures proposed would protect “core” services while balancing the books.
The two care homes “provide excellent care for their residents” but the buildings were “not designed to meet the growing need for nursing care,” he said.
He added: “We know that the communities who make up our care homes are more than the bricks and mortar.”
Independent Edinburgh councillor Ross McKenzie blasted the idea, saying it would be “criminal” to close and not replace them.
“Private, profit-making care homes dominate in Edinburgh and they allocate most of their beds according to ability to pay. On the whole, we know that it will be the poorest and most vulnerable who suffer from these cuts,” he told the LDRS.
The Edinburgh Integration Joint Board (EIJB) which is made up of councillors, NHS staff, third sector representatives, service users and carers and has oversight of Edinburgh Health and Social Care partnership (EHSCP) will meet to agree the so-called savings and recovery programme on Monday, March 18.
Of a £60m savings requirement for 2024/25, £15m has been identified through ‘grip and control’ projects designed to ensure there is effective financial management throughout the organisation, while a £21.5m cutback was approved by the board last year. It is also anticipated that NHS Lothian will contribute £6.65m towards the shortfall.
The latest round of cuts, totalling £8.55m, will have “clear impacts on services, performance, citizens and staff,” a report said. “Current levels of expenditure are unsustainable and failure to address this risks jeopardising the future provision of key services and supports.”
It said Clovenstone and Fords Road care homes “have reached the end of their design life expectancy” and “can only offer residential level care which means that the buildings are not suitable for people with nursing and/or dementia care”.
Staff jobs “would be protected”, it said, adding the move would also “reduce reliance on agency staffing”.
Where possible residents would “move in their friendship groups to help their transition to their new accommodation,” an impact assessment said.
It added: “Where possible, some staff will also move with residents to help them settle into their new environment and offer familiarity to the residents.”
However the decision would reduce the overall capacity of residential care places “which could result in more people needing to remain at home with packages of care”.
The report said the controversial plan should be seen in the “wider context” of the commissioning of a feasibility study to reopen Drumbrae as a care facility and “a costed proposal to operate 40 to 50 additional nursing and frailty beds within the EHSCP’s Castlegreen and North Merchiston Care Homes”.
It’s estimated £1m could be saved by moving around 130 people with homecare packages exceeding 45 hours a week into care homes by developing “a new policy on admission to care homes that specifies the threshold of need and cost at which social workers must consider a care home alternative to care at home”.
There will also be a move away from providing overnight carers for some in adult social care and towards “co-located support in groups of flats to reduce cost of overnight sleepover” in a bid to save around £3.5m.
The report said the changes “aim to increase independence and improve outcomes” but there was a risk that altering existing support arrangements “may still cause concern/stress to supported individuals and their families and may result in increased complaints”.
In addition it is proposed to end Be Able, an early intervention and preventative service accessed by around 350 elderly people – with a further 300 on the waiting list – which offers “exercise programmes which have been proven to improve strength and balance, stamina, and energy levels, and increase confidence and independence” and a programme “to help stimulate, improve, and maintain memory”.
The report said while there was evidence of “good outcomes” from the scheme these “can be provided through HSCP and wider community assets”. 20 people employed within the service “would require redeployment to alternative roles”.
The cost-cutting measures will also see a 10% reduction in grant funding given to providers of day care for older people and other third sector organisations which specialise in early intervention and prevention work.
Mental health services are also due to be cut by £700,000 by reassessing care packages for people provided with housing with support placements, where individuals receive support tailored to their needs alongside their housing.
But if people are “assessed down” and have support reduced, which could potentially force some to be rehomed, there will be “pressures on other parts of the business,” as “when peoples packages go down they seek support elsewhere,” the impact assessment warned.
Cllr McKenzie said the proposals were “riddled with betrayals and false economies”.
He said: “The effects of these so-called ‘savings’ will bounce back to the Council or the NHS one way or another, and we’ll be left with another round of cuts next year.
“It would be criminal to close Clovenstone and Ford’s Road care homes without replacing them. Private, profit-making care homes dominate in Edinburgh and they allocate most of their beds according to ability to pay. On the whole, we know that it will be the poorest and most vulnerable who suffer from these cuts.
“There has been a shameful conspiracy of silence from across the political spectrum on health and social care cuts.
“None of the big political parties want to admit how bad the situation is. It suits them that many of the people worst affected by these decisions can’t speak up for themselves. I’m disgusted.”
Mr Togher said: “Like health and social care integration authorities across Scotland, Edinburgh is facing unprecedented financial challenges and we are taking measures to ensure that we protect core services and return to a stable financial position.
“Despite the significant challenges posed by an estimated £60m pound budget deficit in the next year, we are implementing a package of reforms which will not only cut the structural deficit in a manageable way over the coming years, but will allow us to protect services for the people of Edinburgh.
“We are acutely aware of the impact these changes may have on the people of Edinburgh and Staff, and we are taking measures to mitigate consequences.”
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