Following yesterday's post, we've been asked for more information about the advice (of a man paid more than the Prime Minister) that was ignored (by Bristol City Council). The ex-executive Director of the Care Quality Commission (CQC - the government's regulator of care standards) was employed by Bristol City Council for ten months as the interim Director of Health and Social Care. His name is David Johnstone and his appointment marked the first occasion that anyone from outside of Bristol City Council had been appointed to lead the Directorate.[1] He advised in October 2010 that homecare packages commissioned from the private sector by Bristol were larger than those of comparator authorities.[2] One of his plans to save money was to focus on the external contracts the Council had made with private care providers. In his opinion, contracting and procurement could be improved because the size of home care packages purchased from the independent sector was too high.[3] Johnstone was employed as a consultant from May 2010 and departed unexpectedly in March 2011. He received a total payment of £159,250.[4] If he worked every day for those ten months (and we still dont know that he did), he would have been on approx £723.85 a day. He was only a part-timer, his daily rate would work out to be much higher.
Specifically, Johnstone:
1. Submitted a report to Cabinet in October 2010 (which they accepted) in which no reference was made to discontinuing in-house Homecare services
2. Personally held meetings with Homecare workers across the City to assure them that his plans did not mean the closure of the service, but its retention with a specialist dementia-care focus
3. Promised workers specialist dementia care training and security of employment
4. Confirmed his plans meant they would retain 80% of their existing client base because dementia affected such a high proportion of older people in Bristol
Johnstone left the Authority suddenly, what followed:
1. In April, Bristol City Council wrote to all homecare workers and service users to inform them that the service would close
2. Withdrew those notices in May when the unions highlighted that such a move was unlawful
3. Proceeded to remove service users from the care of local authority care workers and transfer them to private providers (a process which is ongoing)
4. Wrote again to Homecare workers asking them to identify their preference either for voluntary redundancy or redeployment elsewhere in the Council with an end August 2011 deadline
Why Johnstone left Bristol City Council so suddenly remains a mystery. But its a mystery which perhaps makes a little more sense when the behaviour of the Council before his departure is compared to their behaviour towards Homecare workers and service users after he had gone.
[1] Bill McKitterick transferred from Avon County Council to undertake the role when Bristol first became a unitary authority in 1996 until he left amid a financial crisis. From 2005 the role was undertaken by Annie Hudson, who had previously been divisional director of Children’s Services http://www.guardian.co.uk/society/2005/nov/02/publicsectorcareers.careers9. January 2009 Cathy Morgan was appointed as Interim Director of Health and Social Care, she had spent most of her working life at Bristol, working her way up from being a mental health social worker. David Johnstone took on the post in May 2010 having previously worked as Director of Operations at the Care Quality Commission and prior to that as Director of Adult and Community Services at Devon County Council http://www.lgcplus.com/briefings/services/adult-services/johnstone-heads-to-bristol-from-cqc/5014731.article
[4] Annual salary for directly employed Director of Health and Social Care would have been £101,226 per annum. See FOI request response about Johnstone’s salary at http://www.whatdotheyknow.com/request/use_of_consultants#incoming-185355
Thanks for this really informative blog - I'll definitely be there on Saturday. I note that almost all the workers are women - could anyone tell me roughly what percentage of your homecare clients are women?
ReplyDeleteCharlotte
Bristol Fawcett Society
cuts@bristolfawcett.org.uk
Hi Charlotte. EXCELLENT -you are very welcome at the demo on Saturday, we've got some great speakers (more later). I will find out about the percentage of homecare clients who are women, I have seen the information before and I know it is well over half (which I guess confirms your suspicions). Will post more detail later. All the best
ReplyDeleteCharlotte - info from Cabinet report of 28th October 2010 says:
ReplyDelete"The majority of staff providing long term care services and the majority of service users are women. However, the council is mindful of the need to ensure a response to the changing balance over the next 20 years. The relative lack of male care workers in the industry may need to be addressed in order to provider male service users with the choice of a male care worker and particularly to provide male company in care homes where residents may not leave the home very often.
While prevalence rates vary, the NHS Executive has accepted dementia prevalence rates of 4.62% (of population aged 60+) amongst men and 6.48% amongst women. However, the percentages rise to 18.5% of men and 22.8% of women aged 85-89 years – again a substantial increase in the older ages. It has also
been estimated that at any one time, around 15% of people with a diagnosis of dementia will be cared for in residential homes, 11% in nursing homes, 10.6% in hospital and just under 50% at home with
an informal carer. Of particular concern are the estimated 13.4% who will be living at home alone.
The above figures deal with diagnosed cases of dementia. However, it is estimated that at least two thirds of older people in hospital wards and care homes have mental health problems. A lot of people with mild dementia may not be diagnosed.
The predictions for Bristol of people aged 65 and over predicted to have dementia between 2008 and 2025 are:-
BRISTOL 2008 2010 2015 2020 2025
Males 1387 1424 1526 1675 1847
Females 2963 2937 2843 2869 3058
Total 4350 4361 4369 4544 4904
However, women form the majority of informal, unpaid
carers and if a change in women's working patterns or life expectations take place, then it is likely to have a significant impact on the number of carers available. This will have a knock on effect on the level of paid formal care that is required in the market and also on the number of people who may require higher levels of home care, very sheltered housing or residential care as a result of the lack of informal carers to enable them to remain living at home."
HOPE THIS HELPS