Read posts about Save Our Care Homes for news on the campaign as it happens.
In June 2021, the Edinburgh Integration Joint Board (EIJB) discussed the proposal to
- close 4 council care homes
- turn Drumbrae Care Home into a hospital care unit
- convert the remaining 5 Council care homes into nursing home.
This would see the Council withdraw from providing residential care homes—instead focusing on care in the community and leaving residential care homes to the private and third sector—and cut over 200 beds from their care provision.
This is part of the Bed Based Care Strategy – phase 1 (PDF). The proposal to cut homes has been opposed by trade unions, activists, academics, families of residents and councillors.
The proposal amounts to a cut to care services provided by the public sector, leaving our family members whose lives benefit from residential care to have their needs met by for-profit and third sector providers or at home. For those that are cared for at home, there looms the threats of
- social isolation
- inconsistency and insecurity of services—delivered by a variety of different provider
- additional strain on families
which the proposals provide little to no detail on how these would be addressed.
Throughout the pandemic, private care homes were vectors of infection, often due to poor working practices and issues caused by the poor terms and conditions of their staff, such as coming work when they should be isolating because they can’t access sick pay. This shows the value of public sector care homes using staff with Fair Work conditions.
We are fighting to ensure that the vision for future of care in Edinburgh is one that is created with, and works for, the citizens of Edinburgh and the workers that provide the care.
The proposals seek to
1. Move services out of Liberton hospital urgently.
2. Increase our intermediate care capacity.
3. Reduce our HBCCC capacity overall, creating a new complex care assessment facility within the existing Drumbrae care home.
4. Redesign the PFI buildings to accommodate intermediate care.
5. Withdraw from the lease at Ferryfield house at the break point in Oct 2022 (submitting notice in Oct 2021).
6. Introduce a new, more specialised model of care within our care homes to include registered nurses.
7. Reduce our care home capacity by decommissioning the four older care homes in our estate and redesign the model of care to provide care to those with the most complex needs.
8. Register all remaining care homes as nursing homes.Bed Based Care Strategy – phase 1
The ‘key themes’ of the strategy are (Tony Duncan, August 2021 EIJB):
- community integration
At the same meeting, Tony Duncan refuted that the homes were not fit for purpose, amending this suggestion to say ‘the way they’re designed is an old fashioned model’.
The Edinburgh Integrated Joint Board (EIJB) is looking to close 5 Council care homes in Edinburgh—turning Drumbrae Care Home into a unit for Hospital Based Complex Clinical Care (HBCCC) and closing the other 4 homes entirely:
- Ford’s Road
- Jewel House.
This proposal went to the EIJB in June 2021, however any decision has been postponed, thanks to the vocal Save Our Care Homes campaign by Edinburgh Council trade unions and Another Edinburgh is Possible.
The EIJB were prepared to make this decision without any consultation with residents’ family members, care home staff or trade unions. The unions were not informed of this proposal, but first heard of it through staff that were told they would be moved elsewhere.
The proposals are worrying because they mean
- the removal of Council-run residential care homes in Edinburgh
- cutting over 200 beds from Council care home provision
- closing valuable Council-owned homes
- insecurity for care home staff, moving to new locations and potential job losses.
We are deeply concerned about the focus on private sector care providers, as this can mean
- care staff with poorer terms and conditions—often lower pay, zero-hour contracts, precarious work, no collective bargaining and union recognition etc.
- care providers are accountable to shareholders, not citizens.
- poorer quality of care—the pandemic has brought the issue of private care homes into stark relief
- income from care homes going to private business and investment funds, that may be funding other problematic businesses, avoiding paying tax etc.
Exposing the problems with integrated joint boards
The EIJB have not consulted with current residents of the care homes, citizens or care home staff, yet submitted the proposals for approval in June. The decision has been pushed back to September, but the papers for the August meeting suggest the EIJB are only interested in consultation if required—doing the bear minimum—and that
As a separate public body, the IJB is not required to work within either NHS Lothian or City of Edinburgh Council frameworks even though the consequence of the eventual IJB decision, may have an impact on services run by both partners.Bed Based Care Strategy for the 17 August 2021 EIJB
Decisions made by the EIJB result in ‘directions’ to the City of Edinburgh Council and/or NHS Lothian. If the EIJB are not required to work within the frameworks of these organisations, this is very worrying.
The Council and NHS have policies and procedures in place to manage changes that ensure staff are consulted with and well informed about. The Council also has a commitment to “Continue a policy of no compulsory redundancies and keep a presumption in favour of in-house service provision”.
It appears that the EIJB can make decisions about public services in Edinburgh that overrule decisions made by the elected Council administration and can decide the fate of Council staff, without paying heed to the Council’s policies.
The Scottish Government looks to further empower IJBs following the recommendations of the Feeley Report, so
On the day of the June EIJB, Unite and Another Edinburgh is Possible, held a demo outside Ferrylee Care Home. Brian Robertson, our branch secretary gave this deputation to the EIJB from demo:
Unison created a petition to save our care homes, which has collected over 2,000 signatures.
Another Edinburgh is Possible have provided a letter template to send to councillors, MSPs and MPs.
On 29 July, Another Edinburgh is Possible hosted a public event on the care home closures, featuring residents’ family members and speakers including our branch convener Graeme Smith.
For the 17 August meeting of the EIJB, Unison, Unite and Another Edinburgh is Possible held a demo outside the City Chambers to protest the proposals. We were joined by Labour councillors
- Cllr Scott Arthur
- Cllr Lezley-Marion Cameron
- Cllr Gordon Munro.
We believe that
- people must have the choice of publicly owned and operated residential care in Edinburgh
- there should be no job cuts as a result of the proposals—which recognise an increased need for care
- any expansion of homecare must use Council and NHS staff, rather than for-profit providers
- care homes are people’s homes, so the EIJB have a duty to consult with residents and their families BEFORE making any decisions
- care home workers build valuable relationships with those they support and are best placed to see the sand they are entitled to a say in their career, so the EIJB must consult with staff BEFORE making any decisions.
New care homes
Des Loughney, secretary of the Edinburgh Trade Union Congress (ETUC), proposes the EIJB should be “commissioning new build care homes to replace the places lost by the closure of the four homes to be run by the City of Edinburgh Council and staffed by local authority employees”.
Unison’s recent newsletter calls for
- A replacement 60 bed Council Care home following the closure of Drumbrae care home and its transfer to the NHS.
- If the Council are paying the NHS £16 million for Liberton hospital grounds, Unison are calling for a replacement for Drumbrae.
- If Drumbrae has to transfer to the NHS for urgent clinical reasons, the “low” number of staff and residents should be accommadated until the replacement unit is built.
- The £15 million earmarked for a replacement 60 bed care home, that was deleted from the Council budget as a saving in February, this year should be reinstated.
Save the current homes
The 4 homes have been marked for closure as their room sizes and lack of en-suite bathrooms mean they don’t meet Care Inspectorate recommendations. However, recent Care Inspectorate reports commend the standard of care in these homes and the legislation that underpins the Care Inspectorate recommendations does not explicitly state these requirements for room sizes or en suites, but that
Premises are not fit to be used for the provision of a care service unless they—
(a)are suitable for the purpose of achieving the aims and objectives of the care service as set out in the aims and objectives of the care service;
(b)are of sound construction and kept in a good state of repair externally and internally;
(c)have adequate and suitable ventilation, heating and lighting; and
(d)are decorated and maintained to a standard appropriate for the care service.The Social Care and Social Work Improvement Scotland (Requirements for Care Services) Regulations 2011
Work needs to be done to understand
- whether the 1.5m² deficit in room sizes truly impacts the experience of residents and the ability of staff to provide care
- what repairs are required to bring the homes up to good condition and the cost
- whether we could bring these homes closer to Care Inspectorate recommendations and the cost of this work.
The BBC strategy is ‘all about community’ in the words of the Edinburgh Health and Social Care Partnership’s Tony Duncan. However, there are no assurances over the services available in communities and the strategy suggests that these would be delivered by for-profit or third sector providers.
This creates too much uncertainty and introduces too many variables. It provides no assurance over the safety of care jobs. It also introduces profit into care, so provision is based on the interests of shareholders—not on the needs of the city.
We call for consultation over plans in the community and demand assurances that care in the home and community is
- appropriately resourced
- provided by the public sector
- planned in advanced with consultation from citizens, not left in the hands of the market.
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