Equality, Health and Wellbeing and Human Rights

Positive

• Those requiring HBCCC would be cared for in one location with the specialist staff required to deliver that care
• This change of function could provide development opportunities for staff
• The EHSCP have successfully moved people from care homes previously with good outcomes
• 1-2-1 meetings with staff would take place if proposals are approved to understand their needs and preferences regarding ongoing employment opportunities
• The Residential Review Team (RRT) would assist each family throughout any planned move
• There is enough capacity in our other care homes to accommodate residents in friendship groups with familiar staff should they choose to move together
• Strategically, there is no HBCCC service in the North West meaning people requiring this service do have to travel currently.  There are other care homes in the North West of the city so how can we manage the existing residents but enhance the service offering available. A new service in a good facility could be seen as a gain for the North West
• Current links to local schools where students can come to the care home and learn from residents. This relationship could continue even if the function of Drumbrae changes.

Negative

• Moving the current residents into other care homes and the associated risks with moving elderly and or frail people
• Concerns surrounding the psychological impact of moving frail and vulnerable residents
• Residents choose a home for life and changing the function of Drumbrae does mean the existing residents will lose their home
• Current residents’ families local to the Drumbrae area and would have difficulties in travelling further to be able to visit, many are elderly themselves
• Potential for impact on residents’ families, particularly if they have a disability, could lead to isolation of residents if their family are unable to visit them regularly
• Impact of uncertainty for staff currently working in Drumbrae
• Staff are a surrogate family for resident’s, particularly during the pandemic when visiting was suspended.  Residents, especially those with dementia need consistency and moving them without the staff could have a negative impact on wellbeing
• Significant number of BAME staff in employment and an analysis of needs is required to ensure these staff members are supported through any transition and not disadvantaged.
• 23/73 staff have protected characteristics and if a decision is reached, 1-2-1 discussions will take place with them to identify their preferences, a matching process is undertaken and every effort made to support staff in their onward choices
• Low staff morale is evidenced and concern regarding existing residents is causing anxiety among staff at Drumbrae
• Communication has not been open with Drumbrae care home staff. Disparity in the communications provided to CEC and NHS staff, inconsistent leading to anxiety
• Change brings uncertainty and this will affect morale and retention rates, losing staff means loss of experience and skills
• Data suggests a rising population of BAME in the community and moving these staff will dilute the culture
• Population of Drumbrae feeling disregarded and need an opportunity to engage
• Staff have worked hard to improve standards of care and practice at Drumbrae care home and there have been many requests for the brochure which suggests this is a valuable resource. Interest has increased recently with family members returning to work who now need to source care for their relative.

Affected populations

• Residents and Families
• Staff (NHS & CEC)
• Local community
• Citizens of Edinburgh

Environment and Sustainability

Positive

• A change in function is unlikely to alter the environmental impact of the building
• HBCCC is not a high traffic service, therefore expected admissions and associated transport will be low
• The change in function of Drumbrae supports wider system redesign and would allow for an increase in intermediate care capacity for recovery and rehabilitation and also the withdrawal from the Liberton hospital site which has been sold for redevelopment
• The change in function of Drumbrae would allow for the HBCCC service to reduce bed numbers in line with benchmarking and modelling projections
• Drumbrae would be a suitable facility to accommodate HBCCC and would allow for units to be split into male and female which is not available at present
• A change in function doesn’t remove the facility from the community; it would still be a community asset and would create job opportunities
• The building is very energy efficient, rated A

Negative

• Currently the home is operating with only 11 residents which is not sustainable or viable long term
• Roads and parking in the area need assessed, Drumbrae is in a residential area and access can be challenging especially if increased traffic flow and more ambulances City planners should be involved in assessing traffic and environmental impact
• If the four older homes are to be decommissioned, has consideration been given to the potential of utilising the buildings differently therefore, negating the need to use Drumbrae?
• How does a reduction in care home capacity support projections of an ageing population?
• Additional information needed to evidence an increase in community capacity
• Drumbrae has a range of services and facilities in the community and would removing the care home causing a negative impact to the community
• Although the care home would cease to function it would be replaced by a similar facility in terms of scale and size, it would be staffed to support full occupancy and would bring new workers into the area
• Drumbrae provided day care services and the kitchen provided the lunches for those services (day care services are currently suspended)
• The timescales set out in the redesign proposal are concerning and not realistic.  Noted – these were indicative and no decisions have been taken by EIJB.

Affected populations

• Residents and families
• Staff
• Local community
• Citizens of Edinburgh

Economic

Positive

• There would be an HBCCC NHS led facility in the community providing care to the most frail and vulnerable citizens
• Any impact on staff of moving to a different location in terms of time and also cost would need to be assessed through 1-to-1 consultation, paying particular attention to those with protected characteristics
• The Residential Review Team (RRT) would work closely with residents and their families to understand any socio economic challenges a move to another care home could cause
• By introducing nursing provision into the remaining larger care homes, the EHSCP can reduce unnecessary hospital admissions, enable discharge from HBCCC units and provide local authority funded nursing care which is not provided currently;
• Potential positive impact for staff who could be better trained and if better trained, they could be better paid
• Staff may have less travel to their place of work, decreasing travel costs

Negative

• Taking a residential care home out of the local community where there is a diverse mix of people from different socio economic backgrounds and the impact on future demand for this type of care in that area
• Concerns were raised that the occupancy at Drumbrae had been deliberately run down. In 2020, the care home was under an Improvement Notice from the care inspectorate which means admissions were suspended, during that time the impact of COVID was felt and due to outbreaks admissions could not take place.  Demand overall for residential level care is also decreasing with increased demand for nursing provision
• Drumbrae has been testing the model of care with nursing proposed for all homes so it should be leading the way on redesign
• The skills and practice that have been developed at Drumbrae care home could be lost when the staff team is broken up. Staff are already leaving or looking for other jobs
• Staff may have to travel further to their place of employment, increasing travel time – any additional cost would be recompensed for a 4 year period
• Trade unions represent a lot of low paid workers, if workers were paid better, local economies could grow
• If unable to provide a suitable role for existing Drumbrae staff this could lead to unemployment
• There are 66.3 FTE in Drumbrae at present and there are adequate vacancies across the city. The EHSCP are committed to retaining the workforce and there is a no compulsory redundancy policy in CEC
• NHS staff are also involved in these proposals who have different T&Cs and different policies relating to organisational change
• Trade Union colleagues felt the no compulsory redundancy policy won’t be in place next summer due to the political landscape
• The overall impact on jobs of closing Drumbrae and 4 other homes needs to be known
• Retrofitting or rebuilding properties could create new jobs, there is no economic benefit from private organisations.  Sixty pence of every pound us spent in local communities, if the private sector operates these establishments the money goes into their profits
• There is no private sector organisation involved in these proposals
• Concerns were raised on the economic impact of reducing care home capacity and the potential reliance on the private market.  Work needs to be done to evidence the balance of care needed for the city and the kind of care we want for people.

Affected populations

• Residents and families
• Staff
• Local community
• Citizens of Edinburgh