Professor Roy McConkey:

The Deputy raised an important point about how we manage the transfers of people from congregated living, and how we prevent other people going into those settings. We have a lot of international experience on how to do this, and how it can be done well. It requires what is called “bridging funding”. In addition to maintaining ongoing costs of service provision, additional moneys are needed to develop new styles of services that prevent people from going into such settings. That money is ultimately recouped, because the investments that exist in the congregated settings will be released through time. That can then pay back the bridging moneys that were involved in the first place. Some of that comes from the redeployment of staff. Additional staff are no longer needed, because current staff can be transferred to these new services.

There is also capital realisation. The National Health Service, NHS, in the United Kingdom has found this to be a lucrative source of funding, because it was able to sell off capital, such as large campus arrangements, which have often been recreated as housing developments in particular areas. Much money can be released over time.

The key strategy is very much looking at the future needs of people. Many people want to continue living with families and many families want to continue looking after their relatives. However, it is well-known that others will want and need alternative care provided for them. This requires forward planning. If one starts to do this before a crisis arises, then they can avoid getting into these emergency placements, such as in nursing homes or existing congregated settings. That planning needs to include opportunities for people to have accommodation in local housing, and the support that they will require. Some of that can be provided in the person’s family home. There may be options for people to continue living in the family home, with additional support staff and personal assistants coming in to help them. There are myriad ways of creating new styles of services around individuals that prevent the emergency crisis admissions, as well as finding ways of relocating people out of congregated settings. International practice tells us how to do it. Local jurisdictions have to find the resources to make it happen.