Council chiefs in the Borders are set to scrap their troubled arm’s-length care company and take its workload back in-house in just over two months’ time.
SB Cares, a limited liability partnership launched by Scottish Borders Council in April 2015 at a cost of £1.8m, has faced significant upheaval and adversity over the last two years, including four managerial suspensions and several critical care inspections.
Its short but problem-beset existence now looks set to be curtailed within weeks as a report going before a full council meeting next Thursday, September 26, recommends that SB Cares and SB Support be wrapped up, with responsibility for all their services and their 850-plus staff reverting to the local authority.
The author of the report, the council’s chief financial officer, David Robertson, writes: “There are concerns that the quality of reporting by SB Cares being prepared for the major contracts governance group is not of an appropriate standard to enable members to conduct their governance and oversight responsibilities effectively.
“Reporting of the performance of SB Cares has been limited during the four years of operation, with the partnership often struggling to compile and present a suitably detailed and robust set of key performance and outcome measures when required.
“Against this background, it has been difficult for elected members, the chief social work officer, the chief officer of the integrated joint board and staff overseeing commissioning budgets to gain a clear understanding of the issues facing the business and the performance, quality and overall safety of its services.
“This is in contrast to the depth and breadth of performance and financial information normally provided to elected members as part of their local authority governance role.
“It is difficult not to conclude that management capacity within the partnership has been a factor in the limited information compiled and presented to elected members by the management of SB Cares since April 2015.”
Earlier this month, the council called in government healthcare watchdogs to Deanfield Care Home in Hawick after finding that the quality of care there had fallen below an acceptable standard, prompting a near-£3m emergency investment package to be drawn up.
The involvement of the Scottish Government’s Care Inspectorate at Deanfield is not the first time healthcare watchdogs have been called in.
In July last year, it was revealed that SB Cares, based at the council’s Newtown headquarters, was ordered to make improvements to staff training at Deanfield back in May 2017.
However, a year later, care home inspectors once again had to demand that staff training be improved, despite initially asking for it to be completed within six weeks.
In that same month, inspectors revealed that the toilet facilities at Oakview Day Centre in Galashiels were placing users “at an unnecessary level of risk”.
SB Cares was first warned about the toilet facilities at Oakview in October 2016, but in July 2018 a repeat inspection found that improvement works demanded had not been carried out.
A similar pattern was found at SB Cares’ Home Care East service in March 2016.
The care service was given a six-week timescale to implement improvements, known as requirements, but when care watchdogs inspected the service again in February 2017 a call to improve had to be reiterated, and again SB Cares was given six weeks to improve.
Then in March 2018, inspectors found that that SB Cares had still not implemented the requirement and had to be told to improve the personal plans of its service users a third time.
In his report, Mr Robertson acknowledges this, saying: “Recently, concerns have emerged with regards to the safety of some individual services and the challenges of meeting the requirements of the Care Inspectorate.
“One example was exposed in a 2018-19 report on Homecare Service South where the Care Inspectorate were required to repeat a previously unactioned requirement from a previous inspection.
“This failure may suggest that SB Cares is increasingly struggling to maintain consistently high standards and improve services across the Borders in all of its care settings while managing the day-to-day requirements of this complex front-line service.
“Visits by senior management to care homes operated by SB Cares have identified that the quality of the fabric and furnishings are not being maintained at an acceptable standard in all instances.
“Consequently, the chief executive has instructed a variety of direct interventions, including additional management capacity and instructing immediate action to improve the quality and cleanliness of the environment within care homes.
“It is felt that the governance and oversight provided by the social work service, including the statutory role of the chief social work officer, could now allow for a more rigorous quality assurance approach, supported by the corporate management capacity of the council, should a decision be made to reintegrate SB Cares with core social work functions as part of the council.
“It is the view of the council management team that the benefits of the arm’s-length external organisation structure for SB Cares no longer outweigh the challenges and risks now facing the business.
“These risks, which are likely to increase in future, make it appropriate for the council to now reintegrate SB Cares and SB Supports into the council.”
If that recommendation is accepted, SB Cares will cease to exist on Sunday, December 1.