Short-notice care home closures
Capacity and resources
Dealing with care home closures has implications for staff capacity and other resources.
We certainly couldn't afford to bring in agency staff. We had some people working round the clock - the remaining staff certainly went 'above and beyond the call of duty' out of loyalty to us and concern for the residentsA care home provider
- Local authorities are required to prioritise the health and wellbeing of residents.
- Given that a failure in the provision of care which causes suffering is a breach of the duty of care, local authorities will need to find the resources to rectify any actual or potential situation.
- Local authorities need to consider the likely resource elements that will need to be addressed and plan how they might meet them.
- Protocols should be established to govern decision making about extra resources in an emergency.
- Staff training should address the whole issue of planning for home closures.
Resources required Open
Managing a closure process will require resources to:
- lead and direct the process
- carry out reassessment and care planning
- undertake the communications and information sharing with all stakeholders
- pay for alternative placements
- pay for additional staffing, or to backfill staff seconded to manage the closure
- transport people to new homes
- supporting existing staff
- mitigate impacts on other parts of the system
- facilitate media activity in terms of communications and press.
Key points from policy and research
- A local authority must arrange residential accommodation for an individual in accordance with their preferred wishes, provided that:
- the accommodation is suitable in relation to their assessed needs;
- to do so would not cost the council more than it would usually expect to pay;
- the accommodation is available;
- the provider is willing to meet the council's terms and conditions.
(Department of Health, 2004)
- Research indicates that that the role of care managers is crucial in the process of re-provision and that they therefore need adequate support and guidance. Demands placed upon them are likely to be complex and stressful, and as their primary responsibility is to the residents, they may have to make decisions that are in conflict with the wishes of families (Le Mesurier and Littlechild 2011).
- Reassessment of needs can result in some residents requiring higher levels of support following deterioration in their health or abilities, for example - people whose dementia has advanced significantly since their last care review or those who may be nearing the end of life (Williams et al. 2005). Care managers therefore had to argue for additional resources to meet higher fee levels.
- 'The Vision for adult social care (DH, 2011)' states that the provision of information and advice is a universal service, and that people funding their own care have a particular need for information and guidance to help plan how their care needs are met.
- Research on staff experience of organisational change suggests it is critical to maintain their organisational commitment. A before and after study of hospital employees during a reorganisation involving closures, reduced budgets and a hiring freeze showed that employees with higher levels of organisational commitment were better able to withstand the effects of increased pressure during this period (Begley and Czajka 1993).
- Managers can enhance commitment by using 'high performance working practices', particularly a participatory style of management, and systems for recognising and rewarding performance (Huselid 1995).
What the regulator says
In the event of threatened or imminent emergency closure, commissioners should make contact with the Care Quality Commission (CQC) at the earliest opportunity. CQC will provide information under its information-sharing protocols indicating any action which it is taking.