Agenda item

The Strategic Director for Social Care and Education submits a report on the future of domiciliary care.

The Strategic Director of Social Care and Education submitted a report to set out a proposed model for the commissioning of home care which is based on evidence gathered through a commissioning review.

It was noted that members of the Public Health and Health Integration Scrutiny Commission were present to be able to ask questions on this report.

The City Mayor introduced the report, noting that over 2.2k residents currently received home care and that a significant budget was required for the service. Current home care contracts had been in place since 2017 and were due to expire in October 2023 and therefore a procurement was planned for autumn 2023. It was noted that failure in this area could lead to financial impact and a workforce impact.

The Director for Adult Social Care and Commissioning presented the item, it was noted that:

·       The delivery of home care helped the ambition to support people to stay in their own homes.

·       Contracts were currently in place with 32 providers, 29 of those providers were rated Good by the CQC.

·       No one was presently awaiting a care package for this service, showing success in the goal of speed in placements. 

·       A through review had taken place for the next procurement to build on successes. It was proposed that the framework of providers currently in-place would continue.

·       Enhancements set out included the suggestion for time banking so that more flexibility would be possible, and looking at the possibility of provider-lead reviews. Increasing culturally sensitive provision and improving workforce conditions were also goals. 

·       To ensure higher levels of improved communications there would be enhanced training requirements.

·       The aim was to get out the invitation to tender to the market by September or October.

In response to questions from Members it was noted that:

·       Providers were enthusiastic about piloting time banking; therefore it would be trailed in a number of providers. Concerns had been raised around recording of hours under time banking. The Council had been in-touch with another Authority who used time banking.

·       Children’s Services commissioned home care for children, this was done in a spot purchase basis. A holistic approach to Children’s Services commissioning in-line with many other Authorities was being considered.

·       Some providers did provide transport to enable their staff  to go to clients’ homes, such as pool cars. The City Council’s bike scheme had been promoted to providers.

·       Work was ongoing to strengthen the approach in contracts towards zero-hours and sick pay. The first five days of occupational sick pay was already built-in to contracts and therefore covered by the Council’s fees to providers.

·       There was already provision in contracts for night-time support, packages of care could be commissioned and therefore respite provision was possible.

·       The minimum standard for contracts with regard to CQC ratings would increase since the last tender exercise. The key metric when allowing a provider onto the framework would be a Good rating on the ‘Well Led’ domain as this was seen as the main marker of positive direction. Any provider that required improvement would have an action plan which the Council could support them in delivering.

Members expressed concerns that those who required improvement under the CQC were allowed onto the new framework. Members stated they would not be comfortable with their own family being cared for by a provider which had been inspected and requiring improvement.

The Chair requested that an item be put on the Work Programme on the reablement service which looked to be taking on more work in future. An update on time banking and zero hours was also requested.

More details on the Council’s own quality assurance processes were requested.

A breakdown into the calculations of reablement costs was requested.

AGREED:

1.    That the Commission notes the report.

2.    That the Commission recommended that only providers with at least a Good CQC rating should be allowed onto the new framework.

3.    That the Commission requests that a breakdown of the reablement hourly cost as outlined in the report.

4.    That suggested items be put onto the Commission’s Work Programme.