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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
Contents
1. Purpose of the report p1.
2. Background & Context p1.
3. Summary of Resident and p1.
Relative Consultation
4. Summary of Day Service p.2
Consultation
5. Conclusion p3.
6. Residential Service User Feedback p.4
7. Day Service Feedback p.9
1. Purpose of the report
The key aim of this report is to ascertain the views
and experiences of people currently living fulltime
at Corben Lodge and their family members on the
potential proposed closure of the facility.
The report will also look at the impact a closure
would have on those accessing the day service,
which now operates from the facility since the
closure of The Vanguard.
This report will be split into two sections, one
covering the views of residential clients and their
families, the other those accessing the day service.
2. Background
Corben Lodge is a residential care facility run by
Portsmouth City Council for adults with physical
disabilities.
The Unit offers both long stay and short stay/respite for adults with a physical disability, providing 24 hour care. At the time of writing this report seven individuals are occupying the long stay beds. The views of individuals accessing Corben Lodge for short stay respite have not been included in this consultation
as the service they receive will not be affected by the potential closure.
As part of this review, the methodologies sought
to gain the views of service users and their families
were via questionnaires, one to one interviews and
focus groups.
All service users currently using the service were
given written notification of the intentions of the
consultation and offered the opportunity to meet
as part of a focus group or individually with myself.
Focus groups were organised at Corben Lodge and
facilitated by myself on behalf of the Integrated
Commissioning Unit and Adult Social Care.
SEAP Advocacy have been commissioned to offer
both residential and day service clients the
opportunity of additional support to air their
views.
3. Summary of resident and relative consultation
A. Loss of Social Networks
Social isolation appeared to be the one of the main areas of concern for both residents and relatives as individuals have built up networks in the area. It was felt that if residents moved from Corben Lodge this would be lost. Due to the length of time individuals have lived at the facility, relationships between residents were strong with this extending to the day service clients. For some there was great anxiety that they would not see the other residents again should they leave Corben Lodge. This was echoed when speaking about the locality and wider community, for example the use of the local church and pub which have become important social networks for the residents. There was concern that the local community accepted them and there is fear around not being accepted elsewhere.
B. Ability of residents
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
There did not appear to be confidence in the physical and mental ability of some residents to move into more independent living accommodation. This was raised by some relatives and residents themselves when talking about completing day to day tasks such as preparing meals, paying bills as well as domiciliary care. Personal safety, risk of falls and the potential for individuals to be left unattended for long periods of time were raised as concerns.
C. Quality of Future Care
The possible change from onsite care 24/7 to a different package of support was a concern for both residents and their families. The potential change from having staff available at all times to a number of visits per day was not seen as a positive move and there was a feeling that this would create a risk to personal safety. Ensuring that any change to residents' placements would be tailored to their individual needs was raised as an issue; for many Corben Lodge was seen as the only option for them. The frequency of visits from agency staff within an extra care placement was a concern for relatives and service users; many expressed the importance of the relationships they had built with the current staff at Corben Lodge and relatives reported satisfaction with the level of care delivered at the unit.
D. Financial Savings
It is the perception of many residents and family members that the closure of Corben Lodge is only being considered in order to make financial savings for Portsmouth City Council and that the welfare of its residents is of no consequence.
E. "Decline Of Corben Lodge"
Whilst the physical and quality of care delivered by the staff at Corben Lodge was not in question, relatives did express that they felt there had been a distinct change in the running of the facility in the past few years. It was commented that activities
had ceased and that morale seemed low; in some cases this was attributed to the potential closure of Corben Lodge. A move to the use of more agency staff was also
seen as confirmation that the unit would be closing
and that the consultation was purely a paper
exercise.
From the feedback given by both residents and
relatives who took part in the consultation it is
clear that there is great concern about the future
for service users and the options are available to
them should Corben Lodge close.
It is important to state that not all residents and
families chose to take part in the wider
consultation, other than initial meetings. Only
three accepted the offer of one to one meetings to
discuss their individual concerns.
4. Summary of Day Service Consultation
A. Availability of Activities From the feedback given by users of the day service it appears that there is some dissatisfaction with the choice and availability of activities presently on offer at Corben Lodge. It was stated that in the past there had been regular trips organised for service users and activities such as horse riding and archery which have now ceased. There is also some confusion for day service clients around members of staff, i.e. who is working with residents and who works with those who only attend the day service. It was reported that this has an impact on what activities take place and what assistance they feel is on offer to them. It was suggested that a timetable of available activities would be useful as it appears that some clients are unaware of exactly what it is they can do at Corben Lodge.
B. The Vanguard
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
Throughout the consultation comparisons between the service at Corben Lodge and The Vanguard were made, particularly around the facilities and range of activities previously available to service users at the old service. Activities such as cooking and growing vegetables were reported as having stopped since the move to Corben Lodge.
C. The Building Day service users focused more on keeping the building open, rather than looking at what the service actually offers individuals. It is seen as a good place to socialise and for many the only times they interact with their friends and others who have the same needs as themselves. However, it was recognised that the building itself did not lend itself to a day service with reports that the rooms were not sufficient size to carry out groups work and some activities. The main lounge was reported to be used for socialising, drinking tea and having lunch but not really utilised in any other way.
D. Independent Living and Community Support
Accessing facilities outside of the Corben Lodge
was something that the majority of individuals
requested assistance with in the future.
Interestingly, when asked if they would like this to
be part of their package of care, they seemed
surprised that this could be included. Activities
discussed included assistance with shopping for
clothes as a leisure activity, the possibility of
meeting other current day service users within the
community at a café for example.
From the feedback given it appears that there is some dissatisfaction with the activities presently on offer at Corben Lodge.
5. Conclusion
There is a high level of anxiety amongst residents, those accessing the day service and their family members about the future of Corben Lodge. For residents who have been living at Corben Lodge for a considerable period of time the prospect of moving is very daunting. For a number of residents and their families a move to independent living or another alternative does not seem feasible due to the complex nature of their conditions. Although some have recognised that a move is not necessarily an impossible feat. In respect to those accessing the day service at Corben Lodge, there appears to be concern around losing the concept of a day service rather than what is currently provided at the facility. Comparisons were made between the service from the Vanguard and what is offered at Corben Lodge; in their opinion with the former seen as a better service. Frustration has been expressed around the perceived lack of clarity on the possible options for users of both services. It was felt that this made it difficult to visualise alternatives to Corben Lodge. The same issue was also echoed by those accessing the day service at Corben Lodge. It is essential that up to date social work assessments are carried out to ascertain the needs of individuals and what could possibly be provided within the community should the service close. Sections six and seven of this report contain the responses and opinions gathered for this consultation; these views that have formed the basis and evidence for the summary's and conclusion above. 6. Residential Service User Feedback
Residential service users and their families were invited to attend an open meeting with myself and the advocates on 1st June to discuss and give their views on the potential closure of the facility. It was considered that although there would have been a
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
benefit of having a wider knowledge of a member of Adult Social Care present to facilitate discussions around alternative options, this was outweighed by the need to ensure people felt free to raise their views in an uninhibited manner. One option discussed with service users at a
previous meeting held on 13th May 2014 was a
possible move into Extra Care Housing, also known
as independent living.
The group were asked how they felt about this as
an option. The following responses were recorded.
"I'd be lonely" Service User
"Miss the safety and security"
Service User
"Staff are 24/7 here, I wouldn’t get that elsewhere" Service User
"I'd miss the fresh air and access to the
garden" Service User
"Companionship"
Service User
"Regular food and socialising" Service User
"Wouldn’t see people"
Service user
"Would miss the garden, I have a patch to plant in outside my window"
Service User
"The move would have an adverse effect for all of them"
Relative
Many of the issues expressed could be addressed within an Extra Care setting but the comments above reflect the concerns raised by the individuals at this point in time.
Service users and family members expressed that they felt part of the local community, accessing many of the facilities local to Corben Lodge;
"I can go shopping in Highland Road here" Service User
"Some of us attend the local church"
Service User
The group expressed that they felt part of the wider community within the area and that any move from Corben Lodge would disrupt this. They felt that their disabilities were not seen by local residents and raised concerns that if they were to move to another area, they could be open to prejudice. The group were asked to give some examples of the other facilities and services that they use outside of the home. The majority were regulars at The Good Companion, a local pub where the owners have installed ramps especially for the Corben Lodge residents to ensure easy access. All were patients at local doctors' surgeries and raised concerns that a possible move might result in a change of general practitioner. Relatives and residents were very anxious about this as a possibility as they felt that their current doctors all know and understand their individual medical needs.
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
The majority of residents also access the day services that operates from Corben Lodge and expressed that they would miss the interaction with other service users that this offers if they moved.
Residents' were asked what words they
would use to describe Corben Lodge to
them:
• Family
• Community
• Safe
• Social
• Friendly
• Encouraging
Issues raised
"I've had a look at the flats at the time and I was quite put off" Service User
"Nobody can live independently, what is the
REAL package? Who will get them up for breakfast?"
Relative
"We asked if we could go for a trial period, still no answer"
Service User
"Nobody made me come here, I've been happy here. All this is quite a strain on everybody. I
don’t have any objection to anyone who wants to go. I can go to my room, use the lift, I feel safe
here" Service User
"What are the options for them"?
Relative
"They'll all be on different levels" (Comment relates to building levels)
Relative
"The Good Companion had their ramps done especially for the residents', they're part of the
community here" Relative
"We all go to the Good Companion"
Service User
"It’s the only place outside of here (Corben), where we can meet our son"
Referring to The Good Companion pub Relative
"They all use the day service here"
Relative "Where are the respite clients? Don’t they have a
say"? Relative
It was explained that respite provision would continue regardless of the outcome of the Corben Lodge consultation and that provision would be made elsewhere in the city. As non-residents, the consultation was not open to respite clients at this time.
"Mum did live on her own for a while; she kept falling over and was left all night on the floor until the carers came. Sometimes they didn't
even show up. We have peace of mind knowing that care is 24/7 here"
Relative "It’s a weight off our shoulders, knowing mums
here" Relative
"Its my choice, nothing to do with her
(daughter)" Service User
The above response when asked where they would like to live.
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
"Could Corben Lodge be changed into a supported living unit, rather than move
everybody out?" Relative
"It's not full because people don’t want to be
here, it's because they're not getting the referrals" Relative
"Where are the plans? Or the visits we were
promised" Relative
JG pointed out that the plans were on the walls but nobody seemed aware of this.
"People do still want to live in these types of
facilities; Croft House in Fareham always has a waiting list"
Relative "It would be horrible, disastrous if we left here"
Service User
"Have they (Portsmouth City Council) thought about the damage it will cause people if they move them? What is the potential effect on individuals? Being moved against their will?"
Relative
"What will be the level of care? It can't be 24/7 like here" Relative
"How do I know the level of care I'm going to get? The friendships I have here will be lost"
Service User Elderly parents of one resident were particularly concerned about the future for their son. He moved into Corben and they thought settled there for the rest of his life.
"Now they worry all the time for the future" Relatives
"Surely living independently will cost more? They'll have to pay out for food, everything.
Who's going to pay for that?" Relative
"Who will monitor their diets?"
Relative "It's not just about how nice it is here, there are basics, I can't go to the toilet on my own, I can't
stand up, I need someone to put me to bed. Who will do all this?"
Service user Residents and their families were offered the opportunity to speak about their own personal feelings by arranging one to ones with the engagement officer. Three families made appointments, one of which included a service user. All meetings were held at Corben Lodge at agreed times with the family and resident. For reasons of confidentiality and due to the small number of resident, names and the gender of each resident has been replaced with X. Family A
Has one of the local nursing homes been offered Corben? That’s what I'd heard. Is it being sold?
What other alternative is there for X? Put in a place full of old people? X can't live on her own. X's been assessed as needing 24/7 care! X can't do anything!
X's not really aware of the situation at the moment. X knows when people are talking about it but I don’t
really discuss it with X, not until we know what's happening.
X has never been out on X own due to the severity of
X cerebral palsy.
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
We've still had no contact from Hampshire (at the time of interview 18.08.14).
X has recently had an assessment from a social
worker, assessed as critical! There is no way X could have independent living.
Twice a week X goes to Henderson Road (day
service), which X loves
X will take part in any activity! Activities here, well it depends whose on duty. Staff have changed since it
first opened.
My other sister worried about X all the time, especially now with all this going on.
The people here can't be independent!
X is funded to have 121 but I'm not sure she's getting
it. I've asked but no answer. Family B
Family members and resident present
The family informed JG that a meeting with a
member of Hampshire County Council social
services had been arranged for the day after the
meeting.
Maritime House has been the only option presented
to us. It's difficult because we're not local
We'll need sufficient time to look for a new home for
X
We have discussed the possibility of X moving back
with the family
Use to spend more time out of Corben, but that’s
tailed off now. It's like it's been on shut down for a
while now.
X gets taken to church by Sandra (a member of the
local church) but she's not been very well so that’s
stopped. Nobody here has offered to take X
I can't go to the Good Companion on my own, I need
help
SU
There used to be volunteers who would take X out
for IT support
X was asked what their preferred outcome would
be regarding Corben Lodge;
I can't answer, worried about getting it wrong.
Upsetting people
SU
There was concern expressed as to whether X
could manage in a semi-independent setting.
X has become reliant on staff here, they know when
X is in discomfort, and they pick that up
More agency staff here now, feels like its running
down. The physical care and quality of care I have no
problem with but activities have decreased
The relatives felt that if the opportunity had arose
15 years ago that it would have probably been a
viable option but thought that it could possibly be
too late now.
If it stayed (Corben Lodge) it would need to change
I like the sense of community
Nobody asks X if X wants to do anything, like go to
the cinema for example
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
X would need training to live independently, that
should be provided by an outside agency
What happens if X moves and it doesn’t work?
Family C
The meeting had been arranged with both family
members and the resident had been made aware
of the meeting. Unfortunately on arrival, staff
informed me that X had been taken to church that
day and so was not present at the meeting. The
relatives were unclear as to why X had been taken
out as the unit were aware of the meeting.
X still gets to go out , every Sunday morning and
afternoon, use to do archery and sailing in the
summer but that’s all stopped. I don’t think the
sailing club operates anymore.
Our major concern is that X does not have either the physical or mental capacity to live on X own.
Institutionalised for 25 years, it'll be a shock to the
system.
If Corben Lodge were to close, ideal scenario is that
X goes to one of the other facilities but cared for in
the respite side. Personally I feel uncomfortable
about X living alone. X has spoken about living with
Y (partner) but we don’t know where that’s come
from.
X used to use the kitchen facilities but stopped when
X burnt them self with a kettle. Sometimes is unable
to even use cutlery, can be quite vacant, unwell at
times
Relatives stated that there had been some contact
with the social worker but this had not been in
relation to the potential closure of Corben Lodge.
A full assessment had been carried out and issues
around capacity to handle money were identified.
A social work assessment is crucial, what does a
package of care include?!
The carers here know when X is unwell; they have a
long term relationship with each other
It feels like it has been constructively closed down
over the past 4-5 years. Where have the respite
clients gone? If the building passed the CQC
inspection, why say it's unfit for purpose?
I have reservations about packages of care that
people have; the qualifications of people
Would Portsmouth City Council arrange and take
care of X's finances? So X can just live?
The relatives explained that they had been asked
by a social worker to sign a report which would
mean they would take over control of X's finances,
which they felt uncomfortable signing. They stated
that the assessment suggested that X was entitled
to more benefits than currently receiving and is
entitled to higher mobility and Disability
Allowance.
Why was this not picked up before? The accuracy of
information about X's needs could have an effect on
the package of care
We did receive an invitation to go to Caroline Lodge
but it was during the day. We couldn’t attend
because we both work. I was alarmed to find out
that there was nobody around after 5pm to show us
around and speak to. Who is running it in the
9
Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
evening? What's the handling of the people like?
Otherwise we're just looking at a room?!
Will X be placed with older people?
Has anyone thought of the practicality of placing
people on different floors? X cant weight bare
anymore
Some of the residents here are already looking at
other options, older peoples' residential homes for
example.
X has never been capable of living on X own
Care spread over a number of people is surely
cheaper than individual carers seeing each person on
their own?
Be honest, the reasons financial!
7. Day Service Feedback
No one seems to come from Hampshire to
hear my views or listen to my fears about up
coming events. Concerning my placement at
Corben and early Horizon. I feel forgotten.
Hampshire client
It looks like once again, its up to me to fight
X's corner. Re writing letters to ALL parties!
Hampshire Relative
(My) husband has been coming for 11 years.
Relatives disappointed that vanguard closed
so quickly. Lack of communication since
coming to Corben. The carers are our loved
ones mouth pieces.
Portsmouth relative
This state of limbo is very unsettling for the
people we care for. My husband really enjoys
his time at Corben, but needs to be assured
that stability will be there in the near and
longer term future.
Portsmouth relative
Corben Lodge is not just for the service user,
it's very important for carers as well!
Portsmouth relative
The way things were done in 2013, very
upsetting for all the people attending
Corben Lodge. People from Vanguard
treated very badly. What is going to happen
for the future?
Portsmouth relative
We want top people from the council to
come to meetings. X has been attending
Corben for 15 years. Please take them out of
limbo and leave them where they are. These
adults do not like change.
Relative
I am just a friend and visitor at this meeting.
I feel these adults have lived here for long
time, they are human beings and you are
taking their home away from them, so
please take them out of limbo and leave
them where they are.
Relative
X was very upset when arrived at Corben
and took a long time to settle in. X can not
talk using communication board to
communicate. X can get very worried and
this affects X at home. We need to know
now where the daycentre is going as leaving
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
it to the last minute is not good. X needs to
get use to the idea.
Relative
Why were we evicted from Vanguard under
false pretence and still empty a year later
and now we're getting kicked out of Corben
at Some point?
Portsmouth service user
Have any decisions been made to type of
place they are wanting to put us in?
Whilst at Vanguard we had been led to
believe we were going to St James and were
being told that we couldn’t go down as
there were alterations. When we were
eventually allowed to go down there was no
building, work being done.
As there is a need for this service would it
not save money to leave Vanguard clients at
Corben Lodge and save money from building
a news place, or are they going to not give a
set place to us? There are supposed to be a
list of people who want to use this type of
service. We have been told by a friend who is
a social worker that they are not allowed to
tell clients about the service.
Portsmouth service users
We need people from the top to let us know
what's going on and what is happening to
Corben when its closed. I expect its going to
be flats, I think all this meeting is a waste of
time as your minds are already made up.
What are you doing?
Relative
We want TOP people to attend from the
Council. What they need this place for and
why? They're not cattle moving from place
to place, this is their homes.
Portsmouth relative
Very anxious since moving and where they
going?
Portsmouth Service User
X has used this service for 35 years
Portsmouth relative
We had been told that it would take a long
time to arrange things when moving and yet
from getting a letter in January, it only took
8 weeks or a bit more to set us up in Corben.
We have been told there are several people
wanting to use the service, so will it be the
same at Corben as it was at Vanguard, they
whittle us down. And Finally, say you don’t
need a certain place as there is not enough
clients using the service?
Portsmouth Service User
Do you have any questions on the proposal
for Corben Lodge?
X does not mind that Corben closes
as long as the next centre is bigger
than here and same as the
Vanguard.
Keep the place open if nothing can
be done for Vanguard
More things to do, gardening
X wants to stay, likes arts and craft
What words best describe Corben
Lodge/Vanguard Day Service to you?
Friendly!
Local
A Lifeline
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Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer
Corben services are great but area is
too small
Horizon group confined, too small,
not enough room for activities when
different from other working clients
What are your thoughts about the
proposals for the service?
We have not been given any
proposals therefore do not have any
thoughts at the moment.
What proposals have you given?
What is the proposal - what are you
actually offering us?
What is your perception of the future of
Corben Lodge/Vanguard Day Service?
That the future is not good
Goes in one ear and out the other!
All talk - no do!
Confused and frightened
Don’t know, sad, worried, upsetting
Nice environment, I've been coming
since Horizon
You'll take place away
The staff are really friendly but need
more room
The future for clients is very grey, no
future
Several meetings with day service clients were
held; the following points were raised at the third
meeting. The meeting was attended by two service
users, one relative and a personal assistant.
Would like more space, the rooms here are
too small here
Can only get two people in any one room
Computer room can only get one person in
at a time
Use to have cookery sessions at the
Vanguard, this has stopped since moving to
Corben
No hot meals are provided
I come here, have a cup of tea and a chat
Sometimes have outings, went to the
Victory at the Dockyards but wasn’t my
thing
Go to the beach sometimes
He use to go horse riding
Enjoy painting
I'd like the people who arrange things to be
honest
I use to go shopping (be supported to go).
When we first moved here, things were
looking better but this only lasted a week
Southdowns' College come in during term
time and work with X on literacy
I was told today that I couldn’t photocopy
pictures anymore because of copyright
If I can't paint I don’t want to come
anymore.
I like shopping and I'd like someone to take
me out, do more in the community
Both service users expressed an interest in accessing more activities in the community but highlighted that assistance would be required.
We use to work in the garden at the
Vanguard, providing vegetables for the
kitchen
Perhaps we could have a timetable of
activities
My social worker did not know that Corben
was closing (Hants client)
12
Corben Lodge Residential Unit And Day Service: A Service User & Carer perspective 2014
Integrated Commissioning Unit
James Gagliardini Consultation and Engagement Officer