Threat of ‘outsourcing’ for mental health inpatient facility in Bedford

Cedar House is located at Bedford Health Village on Kimbolton Road (image: Google Streetview November 2020)

Mental health rehabilitation service Cedar House at Bedford Health Village could be subcontracted to a voluntary sector provider.

A report presented to the Health Overview and Scrutiny Committee on Monday (16 January) said Cedar House was established in 2006 to accommodate 16 Homes for Life service users following the closure of Fairfield Asylum.

It added that over the last 15 years, that cohort of service users has gradually reduced to six.

Michelle Bradley, director of mental health and wellbeing services in Bedfordshire and Luton, said: “We are an inpatient facility and that requires us to do things that we wouldn’t normally do when somebody’s in their own homes.

“If an area is registered as a care home or as an inpatient facility, the ask is different.

“We have nurses around the clock, 24 hours a day, because it’s an inpatient unit and we’re required to [that], whereas with most care homes you wouldn’t find nurses, you would have skilled and trained staff, but they wouldn’t be nurses.”

Committee chair, councillor Graeme Coombes (Conservative, Wilshamstead) said: “Forgive me if I’m not getting this, but that suggests that either you’ve got nurses there now that aren’t needed, or you’ll be moving to something where they would be absent,” he said.

Ms Bradley ELFT repeated that the nurses are a requirement because Cedar House is an inpatient unit.

“We’ve got a high number of people where this is their home, and whilst they have needs those needs could be met by other skilled and trained [staff],” she said.

Councillor Coombes said: “We’re dealing with people who are extremely vulnerable here and have high intensity of needs.

“It looks like this might be being driven by cost savings, have you done any evaluation of the likely savings that will be made by outsourcing the management of Cedar House,” he asked.

Ms Bradley said there’s around a £100,000 per year saving when comparing somebody being supported in a Bedfordshire care home to somebody who’s staying at Cedar House in a similar way to a care home.

“We’re absolutely not saying that people shouldn’t be supported,” she said.

“What we’re saying is for a high group in this unit they don’t need occupational therapy, they don’t need psychology.

“Every week people are discharged from our acute hospitals and they go into community placements, which aren’t Cedar House,” she said.

“People with severe and enduring mental illness being supported.

“That care and support is available to anybody that steps out of any of our inpatient wards into a step down rehab care package.

“[Currently] we’re getting people to live in an inpatient ward and that’s not okay.

“And that’s not what national guidance says we should do.

“Step down is about making sure absolutely that there’s that provision and those care needs are met.

“For everybody else currently it’s predominantly being supported out in the community, and that is for people with severe and enduring mental illness.

“They don’t all have to come through Cedar House,” she said.

A six-week engagement programme on the proposals will start next month and an updated report will be presented to the Committee later in the year.

by John Guinn
Local Democracy Reporter