Abuse at another Care Home

Like many people on Wednesday I listened to the various commentary ahead of the evening’s Panorama programme about abuse at a Care Home in Essex and so was to some extent, ready for what I watched. However even after far too many of this type of report, I was shocked at the disgusting lack of human kindness shown by some care workers at the home in Essex.

Over the past few years I have had the privilege to be, at least politically, involved in the world of care homes and have in my time, previously in the role of Cabinet Member for Adult Care at Suffolk and more recently as a member of the LGA National Board for Community and Wellbeing learnt a great deal about domiciliary and residential care standards and their implementation.

I have sat down at length with successive Care Ministers and most recently with Norman Lamb MP and I know we all share the same frustration, in that how through National Policy, national policing of standards through the CQC, an open culture through top tier authorities prioritising and funding a robust Adult Safeguarding Board and it’s processes, through to the culture of the Care Home providers in an area showing real leadership. An integral part of this is the role of the local authority local authority paying a sufficient rate for a care bed and importantly providing the public thought timely and un-bias useful information, enough advice for the 60% of the market who make their own arrangements to avoid and thus ‘starve out’ poor providers, encouraging the good providers to flourish.

In Suffolk the County Council actually ‘buys’ some 40% of the total number of care beds in the system for those who do not have the means to pay for residential care for themselves. Over a 4 year period I got to know a large number of the providers through chairing the joint meetings between the County Council and the Suffolk Association of Independent Care Providers and helping to facility workshops and conferences with them over that period. I also came to have a good understanding of the market and its financial drivers as I lead the 18 month process Suffolk went through with my determination to deal with the problem successive administrations and previous Cabinet Members has not dealt with, namely the last 16 of Suffolk’s residential care homes and our eventually decision to transfer to Care UK who are currently working through a programme of £60 million of investment in 10 new state of the art homes.

In terms of the local authorities whilst they must not waste the public purse they must make sure they pays a rate for the beds they buy that allows appropriate staffing levels to be maintained.

There is across the system an ever increasing pressure on budgets and as I exit the Suffolk’s County Council cabinet, I am absolutely determined that those in the cabinet are acutely aware of their duty to those vulnerable members in our community that we must maintain adequate funding to look after people and as I suspect thinks do come down to the crunch it is not about defending departments budgets but to stop doing things that do not matter and focus on those things that do, such as funding care and making sure the authority has the capacity to react to such shocking stories as seen last night, if they were to occur in Suffolk.

Much is said about care worker pay rates and the private market operation of care homes and actual profit. But in my understanding of the national picture abuse is not limited to purely private sector homes. You only have to look at the Francis Report on abuse at Mid Staffs Hospital Trust, a more public sector organisation you could not wish to find, yet right out in the open, not even behind the closed doors of a Residential Care Homes abuse was happening.

Also it is often said or implied that because private providers seek to make a profit they pay badly and this can lead to abuse. I would contest this based on my actual experience working with different providers seeking to take over Suffolk County Councils 16 care homes. The market is investing vast tracks of money, just look at the £60m we achieved being invested in Suffolk and that was one smallish deal. Such levels of investment and long term approach to their business model requires a high standard of care so that partners such as Suffolk do not break the relationship, equally listed companies can be devalued by such reputation damage and so the good providers are intently focused on maintaining a high standard of care precisely because they want to make long term sustainable profits.

What is also clear is that for all the above, for all the regulation, making sure pay rates are sufficient both in terms of bed rates and pay for care workers and every other thing that Leadership can effect, I would say that personal responsibility must play a part and the care workers who indulged themselves in such shocking behaviour and I use the right word for such a lack of basic human kindness is a self-indulgence in not behaving appropriate, should be utterly ashamed of themselves and frankly should receive a tariff based ban from working with vulnerable people. We must all work to stamp this out.

Suffolk planning for future care needs

It’s been a busy couple of days, on Tuesday I announced the preferred bidder to take over the 16 Suffolk County Council Care Homes in the SCC cabinet meeting and have done quite a lot of media interviews since.

The key as we navigate the incredibly complex procurement process has always been to make sure that we discuss our thoughts with Residents, their families and carers and staff first and everyone else second, yet at the same time there is a legal framework that has to be worked through.

As was to be expected following the announcement the press were keen to know the answer not to the question where will the preferred bidder be investing and building new homes but where might be closing.  A reasonable question but one that simply can’t be answered yet, but I did make the point somewhat repeatedly that when that is fully worked through the very first to know will be residents, their families and carers and staff.

Throughout this process uppermost in my mind has been the fact that whilst they might be SCC’s Residential Care Homes, to those who live there it is their home and I have at times been dismayed at the lack of sensitivity to that, in some of the comments others have made. No one is more aware of the cocners of residents and their families and carers than myself and our officer team, that is entriely naturally and right and proper but in the visits I undertook to each and every home to discuss our thoughts, we explained why we need to change the way we provide and over the next few months I shall be keeping a promise I made to go back and to explain, in person, what we are doing.

Personally I thing this is great news, the Preferred Bidder – Care UK is an extremely well respected provider and the level of investment I will be able to confirm in the coming months is a good leap along the path we as a county need to take to make sure over the coming years we are providing the sort of facilities we would all want for our loved ones and ourselves.

Since we started this process, over the past couple of years I have heard a lot of words spoken by those opposed to SCC us no longer being a provider, much of it lacking rigour and I think some of that nonsense has been extremely worrying for residents and families.

This change will bring about delivery of new homes and an increase in the capacity particularly the higher needs end of residential care; something that we most definitely will need here inSuffolk. We simply do not have the capital needed to do this as a Council ourselves.

Above all else it seems to me that the role of the Council must always be to make sure we plan for our ageing population, deliver services as cost efficiently as we can so that we can help the maximum number of people and how we can be there to make sure standards are upheld, maintained and improved.

As the council stops being a direct provider it will be able to focus its attention on making sure that if you or I need help and support as we all grow older the County Council is there to protect us now and in the future. Along side the coming announcements we will be talking about the councils future role to help shape the quality we would all want for our loved one, ourselves included!

New Planning

One of the more interesting aspects of the Localism Bill that is making its way on to the statute books is the new Planning regime and the changing role of Councillors in the decision making process; more that administrators of tight directive nation policy it will be for Councillors to have opinions and make real decisions based on their debate The days of Councillor just going along with those who shout loudest in a Community usually the NIMBIES, are gone.

Councillors, me included, have long argued that we should have the power to decide what is built where but with power comes responsibility, a responsibility to show real leadership of their communities, often when communities themselves are not immediately in agreement real leadership to delivery economic grow through planning commercial build and real leadership to delivery new homes both private and socially rented to those who need homes in our community but just can’t afford the full market price.

Beyond commercial and residential development since I have been the Suffolk County Council Portfolio Holders for Adult and Community Services my focus has been on how we are addressing and are going to address the housing needs of our aging population.

This week I spent couple of days at Warwick University looking at the implications of the New Planning Regime and using the time away from the day jobs, really thinking about the how the changes will effect Suffolk FlexiCare, our system wide approach to working with the District and Borough Councils looking at the projected growth and housing demands of older people not at a strategic countywide basis but in each town and village.

Getting this message across to the experienced Councillors and Planning Officers in each planning authority is a challenge but with the introduction of the neighbourhood plans that challenge is even greater. To help individual communities as they draw up their plans to understand what planning for an aging society really means from buildings for life standards, to allowing land allocations for ExtraCare and Residential Care Home developments.

The quality of life for all residents is affected by good planning and the future needs of an aging population must be in everyone minds that will have influence of the future of housing and development in our communities.

A trip around the county

As promised in the October Cabinet paper about the future of Residential Care Homes in Suffolk, we are just about to embark on visit to all 16 of the council run homes with our first tomorrow at Lehmann House in Wickham Market.

The format is that managers have had advance sight of the information and lots of information is being sent to each home for the day. Each meeting is scheduled to last 2 hours which we feel should give us plenty of time to discuss and develop ideas with people. I will open each meeting with a short presentation of facts and figures about the issues before us for about 10 minutes or so; then open up the meetings for Residents, Families and Carers; not to mention our excellent staff who welcome to come in towards the end to ask questions or in certain locations because space is tight we will be having meeting after each with the staff.

We have not made up our minds as to how to do this that is what we are now doing and I really hope from the meetings is that the discussions with officers helping me to answer what I am sure will be a wide range of questions and opinions, will give us more thoughts and a better understanding of what needs to be done.

No one is under any illusion that these meetings will be anything but difficult but if we are to make robust decisions as to which option to pursue and we pursue those options, it is right and proper that we take the time to explain on a one to one basis why we must take the actions we are taking for the good of residents in Suffolk in the future. However the programme is quite grueling for the team as each meeting, between the travelling time to and from, the actual meeting and writing up the comments and thoughts it’s a day’s work for each and we have a team of three, myself and support staff.

I really hope that the effort we are putting in is rewarded by what people have to say and I am convinced we will get a lot out of the meetings; as we decide which is the best way forward for us to no longer be a provider of Residential Care homes but use those savings to help support the market place and be able to provide Residential Care homes places for more people in the future.

Below is the notes I have written to help me articulate the slides we will be presenting as I say we need to explain why we are doing what we are doing and allow the time and space for people to develop their own thoughts and help us make the right decisions.

 “Good Morning/Afternoon, my name is Colin Noble and I am the portfolio holder for Adult & Community Services at Suffolk County Council.

This means I have the political responsibility for adult social care, and all the many varied services we provide, services that includes this care home and how we can afford to provide support for everyone who needs the Council’s help now and in the future.

I would like to say a big thank you for coming along today to meet and discuss this with our team, I can appreciate what I have to say is not welcome news and will cause immense anxiety until we have all the answers you need, and clearly understand what is going to happen, so that you can plan ahead when those decision are made.

I am going to be speaking for about 10 minutes and present the facts, not what the papers have reported or you will have heard on the grape vine, the facts and stark choices before us, then I hope we can have a discussion about the options before you.

Consultation – A word or two about consultation and what it means to me: this is about explaining the reasons early about why we can no longer afford to own and run our care homes, even though you and everyone who lives in them as well as family members will no doubt think that I am wrong. This is about allowing me the opportunity to listen to your views and to answer your questions about the difficult choices that we need to make, well in advance of when I present the final paper to Cabinet for their consideration in March 2011 to consider the options for the future of our homes.

Caring – That is not to say I do recognise that is your or your loved ones home. I remember well my Great Aunt who was so fiercely independent but came to call her residential care home,……..home.  By going to each and every one of our homes, I hope you recognise the commitment that we are making officers, my fellow councilors and I consider what the best way to make the change away from running the homes.

Misconceptions and determinations – I also thought it would be useful to clear up a couple of misconceptions about what we are doing I have heard on my travels. Firstly, let me be clear: the decision to stop being a provider of Residential Care Homes is made, but the commitment and determination to continue to support people needing Residential Care home places is undiminished, as are our aspirations to respond and develop services for those who want to stay in their own homes for as long as is possible. The aspiration to stay in your own home is one I am sure we all share for our loved one and for ourselves.

But I recognise there are a significant number of people they need a supportive, professional environment with high care standards that only a good Residential care home can provide

In Suffolk today we the County Council are very much a minority players in the provision of Residential Care homes, we support 476 in our own homes and 2,300 in the private sector we buy 40% of the entire market for those that cannot afford it for themselves and so we have real on the ground knowledge of the good and excellent standards in our homes and the good and excellent standards enjoyed by the 2300 we support in the private sector.

For those who cannot afford it for themselves, the Council has a statutory responsibility and beyond that its one that Councilors and Officers believe it is it is one of the fundamental roles a Council is there for.

But it is equally clear and decided that we are no longer going to be providers of residential care ourselves and the presentation I am about to give explains why.

Comprehensive Spending Revue -I don’t know about you but having watched all the coverage about the comprehensive sending review I really do get confused as to what it all means. But I am not confused about what it means to Local Government in this regard. They have been extremely clear, they are cutting our funding by 28% over 4 years front loaded, which mean this coming year we have to make 10% savings across the council.

People say to me what does this mean? and I simply say life changing in term so far how the what the council is able to do. These cuts are not something open to negotiation: we will simply get less money;

I make no bones about talking about money because it costs you and me as tax payers a great deal of money to support the almost 3,000 people we do in care homes across Suffolk and the 14,000 people who receive other services.

We spend £166M pounds a year supporting people across Suffolk and we are going to have to make savings now and over the coming years just to deal with less money.

But beyond this immediate financial imperative, here in Suffolk we have another issue and so I thought I would start with:

Slide 2:

Giving you a sense of the longer terms issue that I and the team have to consider, living is such a beautiful part of the county and with the great medical advances we have seen and the fact that we are all healthier, means that there will be many more older people in Suffolk and many more older people who will need our help and Support.

The figures on this slide speak for themselves and show a 90% increase in the numbers of older people between now and 20 years time and 100% increase in the numbers of older people with dementia. 

I cannot see no evidence we will be resourced to meet that demand and so it is up to us if we are to provide services to ever increasing number of people then we simply cannot afford to lose money where we know we can save money.

If we do nothing, we will over a period of time deliver less and less services to more and more people.

Slide 3:

Here we can see the actual figures that have formed a part of our decision making process.

In our homes it costs us per week £637 to deliver a care bed and yet we buy off the private sector and by private sector I mean private care homes, Charities that run homes, registered Social Landlords and the not for profit social enterprises that run homes, and we know because we pay the bill that we by those beds on a scale form £306 to £504.

Now is does not take an accountant to see that this means we are overspending between £3M to £4M on our care homes.

A simple calculation shows that if we were to buy alternative places to the ones we provide in all of our care homes at the price we can buy the care for, we would have a significant saving to contribute to the frighteningly wide budget gap. 

So simply put in the provision of residential care beds we are currently losing money where we know we can save money.

At this point I must state my appreciation of the dedication of our staff working in our homes: it is because of their professionalism that the quality of care provided in our homes is judged by inspectors to be good or excellent. Unfortunately, our buildings’ layout and room sizes do not help: they are costly to maintain and run.  This will be an increasing problem as residential care homes provide more places for people with dementia and complex physical needs.

Slide 4:

Rooms are on average twice the size of ours with private en-suite facilities to support the dignity and privacy of people living in homes are something that we will all increasingly expect but we cannot offer these in some of our homes.

They increased use of personal Budget swill also effect the decision that people make.

All of this means that our care homes will fall behind in comparison in the standard of accommodation the independent sector can provide, they may be great today but we simply so not have the money we will need to invest in the future.

How much do we need over the next ?? years Peter?

And do we have that money? – No we do not but the private sector does and people will increasingly vote with there feet.

Slide 5:

So here I want to move from the theory to the actual, here is an example of a new private Care home being build at Balham as we speak, and the people who are building this one, run another couple in Suffolk and are very active members of the Suffolk Association of Independent care providers which we work very closely with.

Its an example of the independent sector investing in a new care home for people with dementia.  It will provide an environment which is comfortable, safe and affordable for people with dementia.

Slide 6:

Here is an example of a brand new very sheltered housing scheme where people can buy or rent an apartment with care on site.

These are examples of standards that we will all increasingly demand.

What are the options for our care homes? The options we are considering must reduce our costs.  They must deliver quality services and they must be realistic.

 Slide 7, Option 1:

This option would mean that your home would close, but I must stress that this would not be straight away.  We would spend time working with you and your family and make sure that you had the necessary social work time and support to help you find an alternative home to meet your preferences.  This might include help to attend open days in other homes so that you could meet the other residents and see what it would be like living there.

Slide 8, Option 2:

This option would mean that another organisation would take over the running of your home and employ the staff who care for you as well as look after the building.

You could choose to stay in your home, if this was to happen, but the new organisation would be asked to modernise the home and make it more efficient.

Slide 9, Option 3:

This option would mean that some homes would close and be sold, which would provide us with money to help pay for changes.  The rest of the homes would be transferred to another provider so that they could be re-developed.

With this option, we would be able to influence the new services.  These could include new, larger and more efficient homes for people with dementia which would be more affordable.

We have named some homes, but these homes might not necessarily be the ones that would close in this option and  decisions about this would depend on conversations with the market.

The new provider would be required to develop new homes in the areas of most need.

Slide 10, Option 3 (continued):

If your home was to close under this option, it would not close immediately but, again, we would spend time working with you and your family and make sure that you had the necessary social work time and support to help you find an alternative

home to meet your preferences.

Slide 11, Your Alternative Options:

I want to consider any other options you can suggest for the future of our homes, other than the ones I have spoken about. These might include other ways in which the home could be run or developed and the type of services it could provide.

As I have explained, all options must reduce costs as well as deliver quality services and they must be realistic.

Slide 12:

I will end this short presentation by saying that your views are very important, if they were not and this was a box ticking exercise, it would be precisely that and we would not be here today. This is why we have arranged to come here today and am going to all 16 of our homes to listen to your comments and to answer your questions.

In closing my bit I must emphasis that the decision to continue to support people needing Residential Care home places is undiminished, as are our aspirations to help people who want to stay in their own homes for as long as possible do so.

We recognise that for a significant number of people in our neighbourhoods need a supportive, professional environment with high standards of care that only a good Residential care home can provide.

And as I said at the start, for those who cannot afford it for themselves; not only does the Council has a statutory responsibility, its one we welcome as an important part of our role to support people and we will continue to do so.

As we go thought this morning / afternoon we will be taking notes of what is said and these will be published on our web site where you can see what was said here today and importantly what is being said in our other homes, At the end of out time here today Peter Tempest will sum up the threats of our discussions and we’ll be here at the end if you did not get the chance to ask your question, you are most welcome to my business card to contact me personally and if you think of other things later the consultation is open until on the 24th January.

Thank you for listening to me and who would like to ask the first question?”

Residential Care Homes the future

Today I presented to the Cabinet of Suffolk County Council a paper asking for permission to go out to consultations as to how best to stop being a provider of residential care homes and instead buy the rooms for people from the private sector. 

In addition I also had quite a few press interviews with journalists and both Look East and Anglia Tonight and I had the opportunity to meet and talk about the proposals with some of the Care Home Managers who will be effected by the changes, I thought what they said gave me a really interesting take on things, I hope as we visit all 16 of Suffolk’s County Councils homes I can continue to learn what people really think and that when the team work up our final proposals for March our thoughts are all the better for having undertaken such an extensive programme of meetings.

I also had a first in that I was interviewed by Look East ‘down the wire’ which meant rather than be asked questions by an interviewer standing beside a video camera I had to look directly into the lens and be interviewed by Susie Fowler-Watts who was in the studio in Norwich, sounds simply until you do it!, the most distracting part is that you stare into the camera and see the lens system moving as it adjusts as you wait for the questions in one ear. I watched it later with Lisa my partner and she could not stop laughing!

For me I think in the interviews and my speech to introduce the paper I hope I got across how important to me and the team it is to go out to each home and meet with Residents and explain why we are doing, what we are doing and how we can support them during the process. 

What I said in my speech was:

‘Can I start by welcoming the visitors who have come here for this paper today[the care home managers I had the opportunity to meet with].

As the Councillor responsible for this county’s adult care services, I am very much aware of how this issue affects the lives of some of the most vulnerable people in our county, and, therefore, how important it is that, whatever we decide to do, we do with extreme sensitivity, consideration and care.

In my own family I have experienced the need for, and the loving environment that a good care home provides people in their twilight years and I also know from personal experience that a care home is more than facts and figures, more than the number of beds and more than ratings for this and that, it is a loved one’s home. 

Firstly I think it is important to explain why this paper is being discussed today.

In June we launched our Suffolk Flexicare Strategy, which aims to bring together Councils, Health Partners, Care providers, the Voluntary sector and communities to look at our demographic pressures and what the residents of Suffolk are telling us so we begin to shape the services we will need to meet those aspirations.

At the same time we are, along with councils across the country, facing unprecedented necessary cuts to our funding as central government work towards reducing the deficit we have in this country, after 13 years of a Labour Government.

At the same time, we consider it our moral duty to protect the most vulnerable in our communities, and that’s a corner stone of what we as Councillors and I don’t just mean Conservative Councillors, I mean all of us here, are about.

The Council’s New Strategic Direction is our plan, across all our service areas, to improve outcomes for people while we are receiving much less money.  We are determined to find ways of shielding the people of Suffolk from the worst of the financial climate.

This paper is a first step along that road, with regards to how we care for older people in the county.

I must stress that point: this is just the first step. I have heard a number of people say that when they read it in the media or heard it on the radio it was the first they have heard about it, just as with a child’s first step, it is the first step, in the way a council does things this paper is how we first propose a strategy, so be definition this is where we first heard things in Cabinet, in the democratic domain.

What we are looking to do as a result of this paper is consult residents and families in our residential care homes about the best and most cost effective way of providing long term care in future.

It will be part of a dialogue, which has already started – information about the proposals has already gone out to families, care home staff, residents and their carers as we published this paper last week.

The next steps will include public meetings at all 16 council-run care homes, which I will be attending with officers to hear what people have to say.

The public consultation period runs for 12 weeks from November to January, and people’s feedback will be a crucial part of our final decision next March.

This is an important and emotive issue.

Each care home is different, and we must do our best to support and ensure the wellbeing of all residents, and I firmly believe the paper asks for Cabinet to agree a consultation that will sensitive to this.

Nothing will change before Cabinet takes it final decision in March, when any decision and its outcome will be carried out sensitively and with the needs of our residents in the forefront of our minds. Until then, nothing will be changing. 

So let us remind ourselves why we are making these proposals.

Firstly as it says in the main body of the report, on page 22, paragraph 20, in Suffolk today there are 67,000 people aged over 75 years old by 2015 this will rise to 77,000 and by 2030 127,000 of us, almost double, will be over 75, in Suffolk we are an aging population and must recognise this pressure.

What every national and local survey tells us, not in some sort of 49% of people said this and 51% of people said that but almost 100% ‘of people surveyed said’ we want to stay in our own homes and so that must be our number one priority when we are designing services.

What we also know is that today, when that burning ambition is no longer possible because of a person’s frailty or increased memory loss there are 5,500 Residential Care beds for those of us who need them.

To some extent when I heard different people speak of our proposals I think many people thought that the vast majority of those beds were provided in Council run homes and I suspect it comes as a bit of a  shock to many people to learn that in fact the county council in terms of the number of homes and beds it provides is quite a small player, in our 16 homes we provide 526 beds of which 50 people pay for themselves and so in our own homes we support 476 people, we are 9.5% of the total provision across Suffolk.

Yet we actually support 2,300 people, that’s over 75% of the number we support, we do so very successfully, in private homes. That’s almost 40% of the total number of those who live in residential care homes across Suffolk and contrary to some of the unhelpful comments UNISON have made in their recent press release, is not a damming indictment of the council nor means we would not have the ability to deal with any care home failures, just as last year, we would have precisely the same role and abilities to support the market when a problem occurs.

It is true that the quality of care provided by council-run homes is high, and compares favourably with the best homes operated by the independent sector. Both provide a warm, loving, caring and professional standard for people to enjoy in their twilight years.

However, because the vast majority of those we support we do so in private homes we know that the cost to the council to provide residential care is significantly higher than it is for the equivalent private homes. 

At less cost, they are able to provide equal or better standards of care in their homes, at better value. 

Given the extreme budget position we face, and the need to make sure we make the most of all our available resources, it would therefore be odd if we didn’t explore the potential options contained in this paper.

At this stage I want to pay tribute to the staff in all our homes at this very difficult time as they maintain our high quality and standards and also begin this difficult consultation process and very uncertain time. Their commitment and support is exemplary and I recognise the difficult position they have been placed in as they to continue to manage their home in the coming months. I say Thank You to all our staff for what they have done and I know what they will continue to do.

It is also absolutely essential that we look to meet the demand going forward. 

As I said older people tell us that they want to live independently in their own home wherever possible.  For this reason we must focus on supporting people to do more themselves: by moving away from running care homes, the council can develop more community-based support services to do just that and so respond to the new demand.

Our New Strategic Direction is all about enabling people to decide what they need, when they need it. With this in mind, long term care is not always the best option by any means.

Through Suffolk Flexicare we are working with our partners to deliver outstanding and sustainable housing and related support to older people by 2020.

By working with our partners in health and the voluntary sector, we are already seeing creative ways to provide more responsive services in people’s communities. This reduces spending, cuts out unnecessary bureaucracy and, most importantly, provides better support to our customers.

Equally the introduction of personal budgets is making a huge difference to the way in which people can decide what they need, when they need it, even purchasing services in some cases using a direct payment.

By continuing our dialogue and providing essential information at every step of the process, I am confident that we can agree on the best solution for the older people we support, their families and carers.

I welcome the interest and debate. I want to hear from communities about options for the future but everyone has to bear in mind that the county council has an agreed policy through the New Strategic Direction.

There is a need to respond to the budget crisis, a need to empower communities and a need to manage these uncertain times and find a way that, together, we can support our older residents through the current difficult climate and into a better, more sustainable future.

However it is very easy to sit in an office and council chamber here in Ipswich and make coldly logical decisions about how to allocate money.

I fully understand that, for those who live in our care homes, such logical reasoning doesn’t count for much.

That is why we are taking great care with this review. 

That is why the managers of our care homes are working hard to reassure people: answering their questions; explaining how they can influence our decision on the best option for each home.

That is why I and my team will be visiting every single care home and I will be inviting Councillors to come along to those meetings as well.

And finally that is why I commend this paper to Cabinet so we can consult on the sensible options before use and bring a paper back to Cabinet in March 2011 with our considered opinions as to the way forward.’

A number fo constructive comments were made by Councillors which are taking on board.

Now we embarking on the 16 care home visits which I do not expect will be easy but as the officers and I have discussed and as I said in my speech we really do want to take this time to think about each home on a individual basis and to explain first hand to Resdients, Familes , Carers and Staff what we are about.

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