July 01 - Government Says The GSD “Continues To Show A Complete Disregard For People With Alzheimer’s And Dementia”
The Government has issued the following statement:
It is incredible that the GSD are still of the opinion that they would have continued with their plans for Dementia Residential Unit at the Royal Naval Hospital site had they remained in Government.
Opposition spokesperson for Social Services, Mrs Isobel Ellul-Hammond, brazenly stated in Parliament during the course of her budget address that the GSD's plans for this place were perfectly acceptable and well within the guidelines and recommendations for NHS registered elderly homes and, had they continued in office, they would have continued with the facility as planned. She says that the single rooms measuring 9.62m2 are an accepted size for the restoration of an existing historical building.
Mrs Ellul-Hammond demonstrates that she simply doesn’t have a clue what she is talking about. She refers to standard room sizes but she is looking at the wrong standards. More worryingly, she completely misses the crucial point that the needs of people with dementia can be quite different from those of patients or residents of other type of care homes.
While UK minimum standards are not mandatory in Gibraltar, they should be used as guidelines. The relevant standards are the National Minimum Standards, Care Home Regulations (Care Standards Act 2000). Under Section 23, minimum room size on new builds is 12 meters squared of usable area (not including en-suite facility) and 10 meters squared of usable area (not including en-suite) for existing buildings. Under Section 21, en-suite facilities (at minimum a toilet and hand basin) must be provided to all service users in all new build. The 80 bedded unit at RNH did not provide this. The 9.6 meter squared rooms quoted by Mrs Ellul-Hammond is not usable space as defined by National Minimum Standards.
The reality is that the previous administration regularly increased the number of rooms in a desperate attempt to resolve a problem entirely of their own making. Initially, the facility was to have provided 66 beds (58 beds for dementia); this figure rose to 80, then 90 and then back down to 80.
Our greatest criticism is that the previous administration did not consult the right experts to advise them on the proper layout of the project. They initially relied on the Care Agency and the GHA, neither of whom are experts in dementia design. The GSD say that the specifications were provided by the Care Agency and the GHA all along and that their brief recommended rooms sizes with the NHS minimum standards. Nothing could be further from the truth: on the 7th April 2011 the Care Agency’s then Chief Executive wrote to Mr Netto who was the Minister in charge at the time expressing concerns. The letter states “Following discussion with the Nursing Co-ordinator and the Clinical Standards Compliance Director we feel that this is not workable, and compromises the safety of residents and staff.” After this letter of protest, no further contact was made with the Care Agency in relation to the works until the change of administration.
Shortly after taking office, the Minister for Equality, Social Services and the Elderly visited the dementia residential site and had serious reservations about the room sizes. Upon consulting the management of the Care Agency she was told that they felt that the rooms were too small and not fit for purpose. They added that they had advised the previous government of this but their advice been ignored. Given that this was a £10 million project, the Minister immediately engaged an expert in dementia design to provide an objective opinion on the way forward. The Care Agency’s advice that the facility was not fit for purpose was verified by the findings of Mr Bob Wilson from Chaplow Wilson Associates. In his first report he stated that the project demonstrated the consequence of inexperience; inexperience both of the client in preparing and presenting the brief to the architect and inexperience of the architect in translating a partial brief into a workable scheme and failing to take advantage of published information in dementia design. Mr Wilson lists the shortcomings and deficiencies which not only relate to the size of the rooms but also include insufficient seating areas and wandering routes and the lack of an onsite kitchen. Not a single one of the 80 rooms had an ensuite facility, no consideration was given to infection control. His report concludes that, ‘the design which forms the basis for the present contract is unsuitable and will produce a scheme which is not fit for purpose.’
Clearly, this Government did the responsible thing by taking independent advice and following its recommendations. There was no point in continuing with a design that was not fit for purpose as this would have resulted in a total waste of the £10 million that the project cost.
In Parliament, Mrs Ellul-Hammond also asked what the construction workers have been doing for 16 months and the subsequent cost to the tax payer. She can rest assured that, while a design brief was being prepared for the new plans, the workforce on site were initially deployed to finish the exterior so as to minimise delays later on. Once this was done, they were deployed elsewhere on the RNH site to complete the works on the mental health facility which is the adjacent building, an equally important facility. The deploying of the workforce has been co-ordinated so as to cause as little disruption as possible and no additional cost has been incurred because of this.
A press conference and an onsite visit was held on the 4th March 2013 in order that the media and members of the Alzheimers and Dementia Society could see the problems for themselves. The Chair of the Alzheimer’s and Dementia support group was interviewed by the media. Daphne Alcantara’s words, as quoted in the press were, “I felt quite saddened at what I saw. Following the presentation [by the minister and the consultant in design] I actually feel that they have gone into some detail and it certainly feels that we are going to get a residential home which will cater for those people affected by dementia and meet their needs. What we saw on site was not adequate. Most importantly residents need to carry on with their lives in much the same way as in their home.......the works that we saw on Thursday are totally inadequate.”
It is clear that the delay in completion and the inherent cost is wholly attributable to the previous government for not having bothered to get things right from the outset.
Commenting on the matter, Minister for Equality, Social Services and the Elderly the Hon Samantha Sacramento said, “Isobel Ellul-Hammond has accused me of using the elderly as a battleground for scoring political points because I have not embraced the RNH building as they GSD left it. Nothing could be further from the truth. This is a Government that cares for our community and values our elderly and we want to give them the respect and dignity they deserve. All that we have done for the elderly in the past 18 months is a testament to our commitment.
“Mrs Ellul-Hammond is seriously deluded if she really thinks that anyone is going to believe her when she says that the RHN dementia unit is perfectly acceptable when the professional evidence is exactly the opposite. The opinion of an independent expert in dementia design is that the unit is not fit for purpose. I invited the press to the site some months ago so that, through them, the people of Gibraltar could see the truth of the mess that we inherited from the GSD, it is not the pictures that lie.
“For the GSD to have approached this in the manner that they have now really shows their true colours. It also shows the disregard that they have for people who suffer from Alzheimer’s and, indeed, for their families. To me, the words of the people from the Alzheimer’s and Dementia support group on 4 March were particularly poignant and I am proud that we have intervened to make this facility a proper one.”
“The Opposition’s attitude is callous and shameful. They should really learn to hold their hands up and take responsibility for their wrongdoing”
(Pic shows artist's impression of new facility)