Question 1
To the Minister for Home Affairs:
“In the context of the recent situation where a diagnosed schizophrenic was 'reluctantly' sent to prison by the court because no other suitable facility was available, will the Minister advise where the individual, in this particular case, should have been sent, why he was not and whether the Minister considers that this is satisfactory?
Will he also advise what steps, if any, he is taking to resolve this situation and/or similar situations happening again?”
Answer
Sentencing policy is a matter for the courts.
There are difficulties in Jersey in this area, which are caused by the familiar problem of a small jurisdiction not being able to provide the full range of services which would be provided in a larger jurisdiction. This particularly applies in the area of secure accommodation for psychiatrically ill offenders. In the UK there are a number of levels of security for such people from Rampton and Broadmoor down to low levels of security.
The situation is further complicated by the fact that prisoners who are suffering from mental illness and are taking medication may be well for long periods of time. If they become ill then arrangements are made for them to be temporarily transferred to a psychiatric hospital under prison guard. The big area of difficulty arises in relation to psychiatric prisoners who are ill for most of the time. In recent years the position has improved with a number of these having been transferred to secure psychiatric hospitals in the UK. In recent years there has also been an improvement in services within the prison.
The prison has a Consultant Forensic Psychiatrist who visits the prison on a weekly basis to carry out assessments and provide professional care and support. The prison also benefits from the services of a Community Psychiatric Nurse who attends one day per week to manage a prisoner case load and three of the Prison’s nurse officers are Registered Psychiatric Nurses. Most prisoners with a history of mental illness are kept stable by the administration of appropriate medication.
I have, in the past, held meetings with the Minister for Health and Social Services to discuss this issue and it is the subject of ongoing discussions. Although the current situation is not ideal, I accept that it is the best which can be provided within the available resources.
Question 2
To the Minsiter for Health and Social Services:
“Will the Minister advise how the lack of suitable care and respite units for vulnerable and/or chronically disabled children (e.g. Oakwell) is being addressed?
Will she advise how many beds there are at Oakwell; confirm that these are meant for short term 'respite' care and advise how many of these beds are currently being used for non-respite purposes (i.e., Monday-Friday or longer periods)?”
Answer
Under normal circumstances there is no lack of suitable care and respite units for vulnerable and/or chronically disabled children. In comparison with many UK authorities Jersey, as a small jurisdiction, provides a good level of residential beds offering such residential respite care. We currently have Oakwell and Eden House, run by H&SS Special Needs Service, and Maison Allo, run by Les Amis on behalf of Jersey Mencap.
All of our services used for children’s residential respite have historically been used on a flexible basis and this remains so. Oakwell currently has four beds at its disposal and this unit has a primary role of providing short term respite care. It is regularly used for planned breaks, holiday breaks, shared care arrangements, and has on several occasions been used as a long term home for individual children.
It remains essential that H&SS is able to respond to statutory responsibilities to safeguard the welfare of children. This means we have to be flexible to respond to any prioritised need, on behalf of children and their families.
Question 3
To the Minister for Health and Social Services
Will the Minister advise the age of the child suffering with ‘serious’ liver damage from alcohol abuse who has not been to school for 18 months and is the alleged victim of years of sexual abuse has had to be ‘locked up’ because no suitable accommodation is available?'
Will she advise where this child would have been admitted to under normal circumstances and explain - in detail- why this was not possible on this occasion?
Answer
States Members are reminded of the following requirement which appears in paragraph 8 of the Code of Conduct -.
“… members should not disclose publicly, or to any third party, personal information about named individuals which they receive in the course of their duties unless it is clearly in the wider public interest to do so. Elected members must at all times have regard to all relevant data protection, human rights and privacy legislation when dealing with confidential information and be aware of the consequences of breaching confidentiality.”
It is my opinion that any further disclosure of information in relation to this case or the individual concerned serves no public interest and indeed would only increase the risk of causing significant damage to the individual in addition to adding to the potential for their personal identification.
Whilst matters of policy should quite rightly be exercised in the public domain, it is unhelpful for individual cases of such sensitivity and complexity to be the subject of a public running commentary.
If I were to provide the information requested I would, in my opinion, be acting contrary to the Code of Conduct and would risk breaching the duty of care owed to this individual to promote their welfare and as such I am not prepared to release the information requested.
I am however, pleased to provide Members with confirmation of the range of accommodation available to vulnerable young people in need. In terms of children’s homes La Preference provides for older young people 14 plus, whilst Heathfield focuses on a small number in the younger age group and the White House is a small therapeutic unit. Added to this is the availability of supported accommodation at St Mark’s Hostel and through our partner agency the Jersey Association for Youth and Friendship. In addition we have access to rented accommodation in the public and private sector for young people supported by the Care Leaving Team or other community based staff. These services are complemented by a range of foster placements, used primarily though not exclusively for younger children.
In terms of plans for the future, the Brig-y-Don premises will shortly be re-designed and re-furbished to create a new fit for purpose setting, facilitating the closure of one of the existing homes which is no longer appropriate for the provision of residential care to modern day standards. In addition, the old Les Chenes building is shortly to be developed into 6 purpose built bed sit units for young people moving towards independence.
As members will see, there is a substantial range of accommodation available now, with further improvements coming on line in the near future. However, that accommodation needs to be carefully matched to the child who requires it, taking into account not only their own needs but those of existing residents. The risk of unjustifiable disruption to the hard won stability of an existing resident group must be weighed in the balance, as must the risk to the new resident of exposure to adverse influence if joining a group of residents whose behaviours remain challenging and unstable. The specific vulnerabilities, wishes and feelings of all the individuals involved and the capacity of the care team to meet any specialist needs identified, must be carefully assessed and where necessary mitigated before a placement can be made. It is for this reason that, notwithstanding the good and growing range of placement alternatives which exist, it is not always possible to immediately access an appropriate setting, and there are equally times when an identified setting suddenly becomes unavailable because of the greater need of another child. I can assure members that when such difficulties arise, my officers work swiftly and creatively to promptly identify and put in place appropriate alternatives.
Question 4
To the Minister for Health and Social Services
“Is the Minister satisfied that the Highlands Residential Home or its parent company, the Four Seasons Group are in a secure financial situation to fulfil their obligations to the Health and Social Services Department and what enquiries, if any, has the Minister made to determine this is the case?”
Answer
In order to provide some context to the Deputy of St Brelade’s question, it is important to note that the Four Seasons Health Care Group is the third largest commercial provider of care homes in the United Kingdom (UK).
The Group operates approximately 16,730 beds within 420 care homes. 80% of their clients are funded by UK Local Health Authorities and the National Health Service. This provides a solid business base. In addition, the Group owns 68% of the homes it operates which gives it a strong asset base. The Group also enjoys a reputation better than the industry average for the quality of its homes, where 84.5% of the homes are classified as good or excellent.
As far as Jersey is concerned the Group operates three homes namely Silver Springs, La Haule and Highlands, all of which enjoy a good reputation for the quality of care provided and they continue to fulfil their obligations to the Health and Social Services Department.
The department is fully aware of the financial situation of Four Seasons Health Care Group as a result of its financial due diligence processes. This is a staged process whereby a financial picture of a third party organisation is built up through review of local accounts to group accounts and if felt necessary the purchase of an independent Dunn & Bradstreet (D&B) comprehensive finance risk report.
In the case of the Four Seasons healthcare group the D&B report indicated a high risk of business failure which led to exchanges with the group’s Commercial Director and ultimately to a meeting with him and senior officers of my department in May 2010.
I would want to assure the Deputy and the House that my Department has and will continue to monitor the financial situation facing the Group balanced against the risk of delayed discharge in the hospital and the lack of suitable alternative provision for this client group on the Island.
Question 5
To the Minister for Treasury and Resources
“Will the Minister state whether anything was officially given in writing from the European Union and/or the UK Government that lead to his belief that 'zero-ten', in its current form, would be EU compliant and, if so, will he provide the relevant text?
With regard to zero-ten, will he advise whether he has received any feedback from the Jersey public in relation to the policy’s apparent inequity (where local companies pay tax locally and non-local ones, trading in Jersey, do not)?
Will the Minister advise if and how he is planning to amend zero-ten as it currently stands? If there are no amendments, will he say if and by what mechanisms he is planning to recapture lost revenue from non-resident companies trading in the Island?”
Answer
Jersey’s 0/10 regime has not yet been formally assessed by the Code Group and as a result no formal communication has been received. However during the design and implementation of the regime public assurance was given that a 0/10 regime would not be harmful.
As set out in the consultation document, public reports from ECOFIN and the Code Group issued in 2003 and 2006 respectively made it clear that Jersey’s proposed replacement regime was not considered to be harmful by the Code Group.
Specifically, in the report of the ECOFIN meeting dated 3rd June 2003 it states:
‘…the Code Group has considered the proposed revised or replacement measures….and…has found that none of these are harmful within the meaning of the Code.’
This report refers to a Code Group report which shows clearly that Jersey’s 0/10 regime was included as one of the proposed replacement measures.
The relevant wording in the Code Group’s report to ECOFIN dated 28th November 2006 is set out in the consultation document. Although this report specifically referred to the IOM’s regime, the concept is the same and so it was clear that even in 2006 there was support for the 0/10 regime. There has been no subsequent statements by ECOFIN or the Code Group to suggest that this view has changed.
There were a number of comments in the responses to the public consultation that refer to the apparent inequity of the 0/10 regime. A summary of responses to the consultation will be published in due course.
As set out in the public consultation document, the review is investigating whether it is possible to recoup any of the loss from business that resulted from the introduction of 0/10. This inequity is recognised and if possible it will be addressed but only if there is a solution which will not result in the net decrease in tax contributed by business. It is important that there is a full understanding of the impact of any alternative regime before any decision is made to make any changes. Also given the fact that the Code Group is about to assess the regime, it would be imprudent to make any changes at this time. In fact the EU Commission advised Government officials directly that making changes to the regime during the assessment process can cause confusion and may affect the outcome.
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