| The
NSE distributed it's 'Newsletter No 1' around the local Chalfont St.
Peter Community in September 2003. The
following commentary looks at the NSE newsletter page-by-page to present
an alternative perspective. |
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| The
NSE's Perspective |
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sense's
Alternative Perspective |
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Background
The NSE must undertake major redevelopment of its residential accommodation
in order to meet new standards in the provision of care, set by the
Care Standards Act 2000. These new standards became mandatory in April
2002. If NSE is to continue providing care for people with complex
epilepsy, it must comply with these new standards.
NSE conducted a thorough evaluation of current residential accommodation.
This concluded that the new standards cannot be met through renovation
of the existing buildings, several of which are more than 100 years
old.
The charity has been advised that redevelopment will cost £25
million and is proposing to raise the necessary funds through the
release of a small parcel of land for residential development (seven
hectares: 5% of the total land owned by the Society).
NSE has pledged to keep the local community informed as they seek
to achieve the requirements of the new legislation. A public exhibition
was held at NSE on July 4th and 5th, when the proposals were outlined
to the local community. This newsletter reports on the exhibition
and sets out progress made since then.
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Background
The NSE has known since approximately 1998 that substantial
changes must be made to it's residential accommodation to meet new
standards set by the Care Standards Act 2000. Since 1998 the NSE has
invested in an MRI scanner (a good idea), a substantial facility for
outpatient treatment (a good idea), a bookbinding facility in which
to employee it's care residents (a good idea). It has not, however,
applied
any capital funding to support its long-term care residents.
The
NSE now seeks to raise £25 million to improve the accommodation
facilities for it's care of residents by selling off a substantial
chunk of greenbelt land. sense estimate that the cost
of a straightforward raze and rebuild of accommodation for 150 long-term
care residents would be in the order of £5-£6 Million.
The discrepancy has yet to be explained by the NSE.
The
NSE say they will keep the local community informed. To date this
has been in a biased and selfish manner that discredits the good
and reasonable aspirations of their long-term residents.
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Introduction
Our public exhibition, 'Outlining the need for change', generated
a lot of interest and we thank all those who attended and those
who have since contacted us to find out more about our proposal
for redevelopment of our estate at Chalfont.
We are grateful for the many messages of support that we have received
and have taken careful note of the objections that have been raised.
The exhibition, which took place on July 4-5 was attended by almost
600 people. Around 350 questionnaires were returned to us and these
continue to arrive. We have written individually to some 50 people
in response to specific queries and will continue to respond to
questions as they are received.
A number of common themes emerged, which we will endeavour to address
in this and subsequent newsletters.
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Introduction
In July 2003 the NSE invited the local community
to see their presentation about their proposed development schemes.
This was at short notice
at the start of the school holidays. Nevertheless, quite a few were
able to attend.
The affair was professionally 'stage-managed' and (quite naturally)
presented matters very much from the NSE's perspective in isolation.
Of particular note was the 'Questionnaire' in their handout pamphlet. This
set out to engage the attendees in a debate about trivia and/or
irrelevant issues.
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Traffic
issues
Many people were concerned about the potential increase in traffic
on Chesham Lane and Rickmansworth Lane. Others were concerned about
the speed of traffic and the increased likelihood of traffic taking
short cuts through side roads. Opinion was divided on how these problems
should be tackled.
We are in discussion with the Highways Authority and our consultant
engineers, the Dennis Wilson Partnership, about the points raised.
The decision on exactly what works will be done is always taken by
the Highways Authority as they are the responsible body and have the
expertise and knowledge in relation to what will work best. The NSE
will be contributing to the cost of any necessary roadworks that are
required.
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Traffic
issues
As the NSE well knows, after failed representations to the local traffic
planning authorities, there is no intention by the local council to
implement any "traffic calming" measures in the foreseeable
future. Including a large section about this in the Questionnaire
is a distraction. Of course, were 400 cars to suddenly appear in the
area, problems may arise - speed probably not one of them!
Note how the NSE wash their hands of things outside their site. "This
is a problem for the Highway Authority." |
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Type
of houses
A number of people expressed concerns about the types of housing proposed
and the density of the housing.
Current government policy requires that all new developments must
provide no fewer than 30 dwellings to the hectare and so we have had
to design a mixed development that achieves this.
We have also taken into account Chiltern District Council's assessment
of housing need in the local area and tried to address the identified
needs. The final housing mix will be determined in consultation with
the local authority.
In line with Chiltern District Council's affordable housing policy,
we propose that 20 per cent of the private housing would be 'affordable'
housing. This would be provided as a mix of shared equity housing
and housing to rent, owned or managed by a local housing association.
It would be for the Council to decide how many of these properties
would be earmarked for 'key workers'.
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Types
of houses
Opening up a discussion about "types of houses" gives the
impression that the decision to build houses of some kind has already
been taken. In fact, 95% of the problem is whether any should be built
at all. If (and only if) it transpires they should be built need a
debate about type (5% of the problem) occur.
The NSE's stated requirement for residential accommodation to meet
standards for their long-term residents can be met by a capital injection
of circa £5-£6 million. Given that over 100 long-term
care residents are forecast by the NSE to leave the site (plus a number
of carers as well) this could actually be funded by developing and
selling off the "excess" current housing as retirement properties
or old people's facilities, particularly suited to single-storey design.
The
proposed housing estate need not be built at all.
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Erosion
of Green Belt
The land that we are proposing to sell for residential housing is
within the building line of NSE's existing facilities. When the last
local plan for Chalfont St Peter was produced in 1996, the government
inspector recommended that the NSE estate should be removed from the
Green Belt on the basis that the land was already developed and did
not meet any of the five existing definitions of Green Belt. The District
Council rejected the recommendation, but the fact remains that we
are not proposing any building development outside of the existing
perimeter of our site - nor do we have any intention to do so in the
foreseeable future.
We have no desire to see any erosion of the Green Belt beyond our
perimeter and we seek only to sell the minimum amount of land needed
to raise the capital required to maintain the viability of our work.
Our proposal is to sell approximately seven hectares of land - the
minimum acreage to enable us to raise the £25 million capital
needed to redevelop our residential services.
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Erosion
of Green Belt
Now we're talking. The land earmarked for the NSE housing estate is
mostly on a greenfield site at one corner of their estate. It's not
within their active day-to-day site at all. As far as sense
can make out, the NSE seem to think that a couple of isolated cottages
at the junction of Tate Road/Rickmansworth Lane constitute a boundary
to magically grant them 'building rights' over a very large area (at
least three times as large as their current active site). They don't.
Sense also note that two of the three cottages are
uninhabited. This is presumably part of a longer-term NSE plan.
And
what, actually, does the expression "we have no desire to see
any erosion of the greenbelt beyond our perimeter" mean? The
NSE say they want to sell off only 5% of their land - is the "perimeter"
their total estate? sense are unclear because the
NSE's information is unclear - if the "perimeter" is indeed
the total estate, everyone in the area should be extremely
concerned.
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Raising
the funds
Several people made suggestions about ways in which NSE could raise
funds other than through the release of land for private development.
First, we would like to put our current funding into perspective.
The majority of our income comes from Social Service departments to
pay the fees for the care we provide to the clients in our care. We
have contracts with nearly 90 authorities from around the UK. This
income is specifically for this use and cannot be diverted elsewhere
within the organisation.
Aside from this, NSE's fundraising operation realises around £2
million each year. A significant proportion of this funds our core
services, such as our information and education services, our communications
to raise awareness and understanding of epilepsy, our research programmes
and, indeed, the fundraising effort itself.
A portion contributes to the replenishment of our reserves, which
have been depleted in recent years as we have struggled to bring our
fee income up to a level that realistically covers the cost of individual
care for each of our residents.
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Raising
the funds
It is of real concern that, right now, the NSE is making a loss on
it's long-term care operation. In theory all costs should be covered
by the local authorities from which the residents are referred. If
the £25Million cited really was necessary for long-term care
of the residents, this should be depreciated over (say) 50 years,
increasing the annual deficit by £500,000. This is not sustainable.
As already explained, sense believe the amount required
by the NSE for their stated goals is only a tiny fraction of the £25
million they say they need. As already stated, they have spent substantial
funds on good causes over the last five years, prejudicing the needs
of their long-term care residents while doing so. Furthermore, the
NSE has recently done quite well financially having made surpluses
in the last three years, (over £1Million in 2003). sense
find it surprising that the NSE have chosen not to put any of these
funds into their development schemes for their long-term care residents. |
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Capital
appeals
We also undertake capital appeals. Our current capital appeal seeks
to raise in excess of £1.6 million to purchase a new MRI scanner.
This is not a luxury. It is integral to our work, in particular to
our world-renowned research programme which is seeking better forms
of treatment for epilepsy, a life-threatening condition.
Our previous appeal to raise £2.4 million to fund a new epilepsy
assessment centre took nearly four years to complete. To raise the
£25 million needed to fund our redevelopment is not, therefore,
an option through usual fundraising. Such an amount would take too
long to realise in the normal way and we have to take urgent action
now to raise this capital and undertake the necessary redevelopment
work if we are to be able to continue providing our services.
However, we are considering launching a public appeal for funds to
help us with the redevelopment of the Centre and depending on the
success of this we may be able to reduce the scale of housing development
proposed.
We have evaluated other uses for our land but the potential to realise
sufficient income through any use other than residential housing falls
far short of the required amount.
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Capital
appeals
The NSE only requires around £5-6 Million to meet it's stated
goals.
This can be realised fairly easily as outlined above. Alternatively
they could apply their annual surpluses to stage the work over 5
years.
The
major benefits are:
1 Reduced disruption for the care residents
2 Minimal impact on greenbelt land
3 Simplified planning burden
4 Speed of implementation.
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Government
funding
As suggested by many who visited our exhibition, we have written to
the secretary of state for health, Dr John Reid, to ask for support
from the Department of Health. We await his response, but we are not
optimistic that the necessary funding will be available from government
sources.
Cheryl Gillan, MP for Chesham and Amersham, has also written independently
to Dr Reid to appeal for support on our behalf.
We also look forward to welcoming health minister Dr Stephen Ladyman
MP to NSE in November when we will be highlighting the importance
of our work and the difficulties we face at the present time.
Any support that local residents feel able to give by also writing
to the secretary of state could only improve our chances of securing
funding from the government and thus to avoid the need to release
land for housing.
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Government
funding
By all means try. There are many things upon which the NSE could
use such money.
The NSE is a national organisation (it's in their title). So some
form of central funding seems appropriate. From the Government's perspective
the argument may well be that the care residents are fully funded
by local government - so why throw more funding at the NSE when there
are other deserving cases around too?
It is in everybody's interest to resolve the situation quickly and
effectively. Sense
do not know the timescales involved in this area. |
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Other
options
We have thoroughly investigated European grants, social housing grants
and private finance.
We recently met with an officer of the Strategic Grants Programme
of the Community Fund. We are told they have a total budget of just
£31.6 million in their current grants programme. While there
is no upper limit to the application we might make through this route,
we are informed that awards are typically below £250,000.
We will continue to explore potential funding streams through the
Community Fund, just as we will continue to seek alternative ways
to fund the necessary redevelopment of our residential accommodation,
but in the meantime we feel that we have no option but to continue
in our endeavour to raise the capital through the sale of some of
our land.
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Other
options
See above
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'Fit
for purpose'
For NSE to continue to operate in its current form is not an option.
We are regularly inspected by representatives from the National
Care Standards Commission (NCSC). The purpose of such inspections
is to ascertain whether or not a home is 'fit for its purpose' and
to ensure a home continues to warrant its registration certificate,
i.e. its licence to trade.
We have 15 individually registered care homes on our estate. The
inspections carried out since April 2002, when the new care home
regulations came into effect, have highlighted a number of areas
in which our homes fall short. For your information, at the end
of this newsletter I have included a list of just some of the areas
where NSE is currently failing to meet standards.
Under normal circumstances, a care home would be set a requirement
to put matters right within an agreed timescale. Failure to act
to meet these requirements may well result in prosecution and could
ultimately result in closure. This is a very real threat to the
future of NSE.
The area manager of the NCSC has written to us to confirm that the
only reason that the NCSC has not been more proactive in taking
enforcement action is because of the proposals we have put forward
for the renovation of the site. We have been told that the future
of NSE and the people who live here is dependent on this work going
ahead.
NSE is committed to providing the very best in care for people with
complex epilepsy and to be able to continue to do this we must bring
our accommodation up to the required standard. The NCSC shares our
objective. We pledge to keep our neighbours informed as we seek
to secure planning consent, and to consult with our neighbours throughout.
We thank you once more for your time and interest in our work.
Yours faithfully
Graham Faulkner
Chief Executive
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"Fit
for purpose"
The NSE has operated for a number of years at standards falling
below what is currently regarded as "fit for purpose".
No one should be proud of this, particularly in the management of
the NSE. They have, conveniently, ignored this in their documentation,
as if it is somebody else's problem.
Nevertheless,
sense agree and accept the long-term care residents
should get a better deal. We want that to happen. But in a way that
makes sense.
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The
need for change
NSE is currently failing to meet the required standards, as defined
by the Care Standards Act 2000, in each of the following areas:
Standard 24.3
This standard states that existing larger homes - a description that
applies to the homes at the NSE - are to be organised into clusters
of up to 10 people sharing a staff group, dining area and other common
facilities by 1st April 2007. In several NSE homes, there are up to
20 clients. Unless the proposed redevelopment takes place the NSE
would not be able to meet this standard.
Standard 24.11
From 1st April 2004, premises must meet certain requirements of the
Disability Discrimination Act 1995, Part 3. NSE's existing residential
homes do not comply and the structure and layout of the buildings
is such that they cannot be made to meet these requirements. Unless
the redevelopment goes ahead this standard cannot be achieved.
Standard 25.4
Single rooms in current use accommodating wheelchair users and service
users with complex nursing needs have at least 12sq m of usable floor
space excluding en suite, providing sufficient additional space for
turning, transferring and accessing belongings and for medical equipment
and nursing requirements. Numerous rooms on the NSE site do not meet
this standard.
Standard 26
This standard talks about the furniture and equipment that needs to
be provided in service users' rooms. This includes two comfortable
chairs, low-level windows (that those in wheelchairs can look out
of), and individually controlled heating. Currently the NSE is not
in a position to provide these facilities.
Standard 28
This standard talks about the need to provide a range of comfortable,
safe and fully accessible shared spaces for shared activities and
private use. This would include domestic style kitchens and laundry
facilities as well as a private space for visitors to be received.
Such provision is not currently available in all the NSE's homes.
Standard 29
This standard talks about the need to provide environmental adaptations
and disability equipment necessary to meet the home's stated purpose
and the individually assessed needs of the service users. Such equipment
and adaptations include: overhead tracking for hoists, stair rails,
appropriate bathing equipment, lowered work surfaces etc. The NSE
is not able to provide such adaptations or equipment unless a major
renovation of the properties is undertaken.
This is not an exhaustive list. It is just a sample of some of the
ways in which we are failing to meet the required new standards.
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The
need for change
sense
are not
experts in this area. Nor do we need to be. We have no reason to think
the NSE is not stating the rules and regulations properly.
But we can say that the 'need' can be met without recourse to a massive
pair of developments together worth £100Million. |
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