FAQs on Brushwood and Millvina House care homes

Brushwood care home, Speke
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The following frequently asked questions follow the announcement last week that Brushwood and Millvina House care homes will close due to the economic impact of Covid-19:

Posted 30 September 2020

Mayor Joe Anderson told a meeting of councillors that a deal had been struck with Shaw Healthcare to keep the homes open until next spring, while talks continue to see if a new operator can be found. Read more here.

Posted 18 September 2020

I have heard that residents are only being offered alternative homes that are rated “requires improvement” or “inadequate” by the Care Quality Commission (CQC).

This is not true. Sixteen alternative homes have been offered, six of these are rated as “requires improvement” and 10 are rated as “good”.

Posted 9 September 2020

Is there a clause or other arrangement with the current provider which prevents another operator taking over these services?

No. There is nothing that prevents the council seeking a new provider. However the challenges that Shaw Healthcare is facing are being faced by many other providers and this makes it unlikely that we will be able to find other provider but the council is inviting expressions of interest from alternative providers.

I am worried about moving my loved one to another home in case they catch Covid-19.

When a home experiences an outbreak, the Infection Prevention and Control Team advises the home. This usually includes closing the home to new admissions. The council will not move any resident into a home with an active outbreak.

Also, the safety of care homes has been significantly improved in recent months by the introduction of regular testing. Under this scheme, all residents are tested once every four weeks, whilst staff are tested every week. This allows any potential cases to be identified quickly and appropriate measures taken to protect other residents.   

Why is Millvina House closing when it has not had any Covid-19 deaths and no residents have contracted the virus?

The council recognises the hard work staff have done in protecting residents from Covid-19 however this does not alter the slower than anticipated fill rates or the impact that the virus has had on the industry as a whole.

I am confused about when the homes are due to close.

The homes are planned to close by 30October. If all residents have been resettled before then, they may close earlier. The date may be extended if viable offers to keep the homes open are received, to allow more time for negotiations with a potential replacement provider.

If the issues are all about Coronavirus, then why were the council and Shaw having discussions about financial concerns in January.

The council and the provider had a number of contract management meetings, which is normal. Shaw were concerned to make sure both homes filled up as quickly as possible as this would ensure the success of the financial model. The pandemic, however, made the prospect of filling the remaining vacant beds rapidly very unlikely.

Is Shaw Healthcare going to be penalised for withdrawing from the lease after such a short period of time?

One of the primary reasons for the homes becoming unviable has been Coronavirus, which neither the council nor the provider could have anticipated. Attempting to force the provider to continue to operate the services in the face of such substantial losses or to otherwise penalise them could potentially impact on their wider business. In addition, as full payment of the rent was linked to occupancy levels the council itself also stood to make losses.

I heard that care homes have had a lot of additional support from the council and government during the pandemic, so why can’t Shaw use this money to keep the homes open?

Care homes have received additional funds, however the funds from the council were to address additional costs associated with the pandemic, for example increased staff absence due to self-isolation, PPE, additional cleaning and so on. The funding from government came in the form of the Infection Control Grant.  This could only be used for specific things and it did not include supporting providers with losses due to low occupancy.

Why are some care homes economically viable and others not?

How care homes’ finances work is not straightforward, but the level of occupancy is a major influence on whether a home is economically viable and this is connected to the amount they receive for or from each resident. This can differ according to the proportion of people funded by the NHS, fully by a local authority, people who pay the full cost of their own care and whether or not a home charges a top-up for some or all of their beds.

The costs of running care homes also vary enormously and depends on factors including whether organisations running the home have loans, rent and mortgages, specialised care equipment, training, IT, utility bills and significant wage overheads.

In short, a home may experience financial pressures if some or all of the following conditions apply: if it has a high proportion of local authority placements, it does not receive any top-ups, it has an occupancy rate lower than 85 per cent, it has high loans, rents or dividends to pay, and/or has a high wage bill.

Posted 27 August 2020

Why are the homes closing when they only opened last year?

When the homes opened last year the effects of Covid-19 on the whole care sector could not have been anticipated. One of the pandemic’s impacts has been that families are not choosing residential care for their loved ones which has a financial impact on services which has resulted in significant and unsustainable losses for providers across the sector.

I thought these were council homes. Doesn’t the council decide if they close?

The council owns the buildings and rents them to Shaw Healthcare, an independent care provider.

Could the council take over the running of the homes from Shaw Healthcare?

Liverpool City Council does not have the experience of running the type of complex specialist nursing care provided at the homes.

Families have become reluctant to place their loved ones in care homes, so it is likely that the vacancy rate will remain, and the homes will struggle to return to levels which make them financially viable for some time.

Will the council explore whether another provider can take over running the two homes?

The council has had conversations with nursing home providers and has also advertised the opportunity for providers to express an interest in running one or both of the homes, but the issues facing the existing provider would also be faced by any other provider. The council will of course speak to any specialist provider, but we don’t underestimate the challenges involved. Shaw Healthcare is a specialist provider, and has not been able to make these homes viable in the current climate, which will be just as difficult for a new provider.

Would it not be possible to keep the homes operating until the pandemic ends?

Shaw Healthcare has indicated that it would not be possible. If a vaccine is developed it will not be for many months, and it is unlikely to be rolled out across the whole population until late 2021 at the earliest. Even then, the impact of Covid is likely to be felt in the care sector for a long time, so the issues that the council and providers are facing now will continue even if the pandemic was declared to have ended.

Couldn’t the council agree to pay additional funding to the homes?

Unfortunately, there is no additional funding to do this. The council is having to make substantial savings to its budget in coming years, both because of the underfunding of local government and social care and because of a £23m financial gap caused by Covid-19.

Also, the council must treat all providers of the same types of service fairly. For example, the council pays set fees for residents with different levels of care and it pays the same rates to all of the care homes in the city. We would not be able to favour one provider with extra funding.

I’ve heard that Millvina House and Brushwood receive calls from interested new residents all the time?

The two homes provide specific types of care and some of the requests received fall outside of this of specification

The calls that the homes receive are from the council brokerage teams looking to place people with specific care requirements. Shaw Healthcare and Liverpool City Council have an agreement on the levels of care that can be facilitated at the two services. If a person requires a greater level of care than can be provided in a home it would not be safe to accept them and would also be in breach of the agreement.

Why can’t the residents in one home be moved into the other so that only one home would need to be closed?

The homes are dependent on a mix of care beds in order to be viable. Putting the residents of the two homes together would not necessarily provide the right care levels.

What will the council do to support my family member?

The council has placed a team of social workers at both Brushwood and Millvina House and they will be working with residents and families to find new homes. All residents will be found a placement at another home.

Will we be able to visit other homes when choosing new accommodation for our family members due to Covid?

The council is currently talking to the care home sector about how families will be able to safely visit homes. The council will work with the alternative care homes to ensure that full PPE is provided to ensure that families can safely visit or arrange other measures such as video tours.

Is it true that the buildings are going to be converted into hotels?

No. The expectation is that the buildings will stay in the health and social care sector.