Southwark Council’s cabinet will consider the recommendation at a meeting set for September.

The sub-committee was reporting on its overall assessment of care provision in the borough.

As evidence to the assessment the Care Quality Commission (CQC) presented the sub-committee with an overview of the four care homes in Southwark – two were rated as Inadequate, one as Requiring Improvement – and contrasted this with the home rated Outstanding.

Lay Inspectors also commented on the care homes.

These summaries were cited by the sub-committee as “clearly demonstrating” problems being faced in some of the borough’s care homes.

The homes rated as Inadequate or Requiring Improvement were provided by HC One & Four Seasons.

Key issues identified were:

• · People did not receive medicines safely.
• · Standards of cleanliness were not maintained.
• · People were at risk of infection.
• · Staff were not always supported effectively.
• · People who lacked capacity were not supported to have their needs and choices met.
• · People were not supported to have food and drink in a timely manner.
• · The management team needed strengthening and there was a high turnover.
• · Systems to monitor quality were in place, but not used effectively.

The care home rated  Outstanding was provided by Anchor.

Here the CQC  found:

• · People were treated with kindness, respect and compassion.
• · Staff knew people well.
• · People were involved in discussions about their care, including end of life care.
• · Staff were motivated and supported.
• · An pen culture – people and staff could raise concerns.
• · Sustained good leadership by the care home manager.
• · Staff retention.

In October last year it was announced that Camberwell Green Care Home – currently operated by HC One – would be closing.

At the time of the announcement of closure, there were 35 residents within the home – three with a NHS fully-funded place and 32 receiving NHS Funded Nursing Care (FNC) contributions of £112 per week paid to residents in nursing beds.

The home has committed to staying open until all the current residents have been re-located.

But the announcement came at a time when Southwark’s care homes were already under a pressure with two in special measures and rated Inadequate.

Southwark Council has an embargo on both homes and, though both are not at capacity, they are recognised as continuing to engage with “significant challenges” and not in a position  to re-home residents from Camberwell Green.

Though the sub-committee cited its “particular concern” that Camberwell Green residents were re-homed at Tower Bridge despite its Inadequate rating.

And Camberwell Green is acknowledged as having its own issues including a building that is not fit for purpose and challenges with staff retention.

Though a new manager and support staff were recruited, the home did not see the improvements needed, and this resulted in its closure.

In its findings, the sub-committee urged the council to make serious consideration of establishing its own care homes, citing the resources that the Council is currently having to put into our care homes, the broader crisis in care homes and concerns over the viability of providers in the long-term.

The council is developing a 10-year strategy for care homes due to be published later this year.

Currently the council has a long term block contract with Anchor Care homes, who provide residential care only for older people.

Residents requiring both nursing and residential care are usually using the services of providers HC One and Four Seasons with care paid for through spot purchasing.

In its report, the sub-committee said it was “extremely concerned” by the current provision for Southwark residents receiving nursing care as a component of residential care, and the lack of a guarantee from both HC One and Four Seasons that they will be able to keep open the remaining care homes in the borough.

This, the report says, presents a “significant risk” to residents, who may ultimately end up having to go out of the borough.

While extra support offered to care homes was welcome, the sub-committee was again concerned about the “huge number” of external resources having to be brought in to services which continue to remain inadequate.

The Committee believed that there may need to be a “much more radical reassessment” of the way in which care Home services are provided in Southwark, seeing merit in assessing whether the council should be looking to provide its own buildings and care home service which could be privately contracted out.

This was cited as having worked well with the Anchor Homes in Southwark which provide retirement living assisted and independent living opportunities.