Agenda item

The Scoping Document for the review of Domiciliary Care is attached.  The Commission is recommended to approve the Scoping Document and agree how the review should be progressed.

Background information on the tendering process is attached in the exempt part of the agenda for Members only.

The Commission received the scoping document for the review of Domiciliary Care.  It also noted that background information on the domiciliary care tendering process was included in the exempt part of the agenda.  Concern was expressed at the large volume of information that had been included, and that there was no index and some of the pages did not appear to contain much, if any, information.

The Commission raised the following comments and questions during discussion of the scoping document:-

·           Zero hours contracts should not be being used;

·           The aspirations contained in the service specification document were good, but could be hard to implement, as low paid staff could be less motivated towards them;

·            Rather than just assess people’s very basic needs and provide a level of service that met them, people should be given the service they wanted.  For example, they may want to visit a day centre, or go shopping, but if this was beyond their basic needs this level of service would not be provided;

·           If a service user was difficult, or refused to accept care, or the care provider felt unable to continue to provide care for someone, the Council would work with the user, and their family if appropriate, to manage such situations.  The Council’s statutory duty to provide care and support would remain, but carers could not be required to work with an individual in these situations.  If this developed to the extent that an agency could not continue to provide a person’s care, alternatives could be examined, such as establishing a tailor-made service from the user’s personal budget, or linking the user to a personal assistant;

·           How was the break-down of time for visits worked out? Information also was needed on what was included as activities and how time was allocated to these, as there currently appeared to be a mismatch between aspirations and outcomes;

·           Approximately 6% of users had 15 minute visits allocated to them.  However, these could be part of a package that included other visits on the same day of different durations.  The Commission requested that the actual number of people receiving 15 minute visits be provided;

·           Work was underway to phase out 15 minute visits over the next 12 months, as users’ reviews were completed;

·           Information was requested on who the providers were;

·           A quality assurance framework was built in to the Domiciliary Care framework.  This could be made available to the Commission;

·           The Commission asked whether any form of “mystery shopping” was done and, if so, how often and what sample size was used.  It also requested that information be provided on whether service users were asked for feedback on their care;

·           It would be useful for the Commission to hear the experiences of users of domiciliary care and / or their families, in order to get a broad overview of the service;

·           Some users could be concerned about spending money.  This could cause problems if their families were unaware of the user’s resources, or the user had no family with which to liaise; and

·           Home carers could support users’ very specific needs and could identify issues that prevented adequate care being given, (for example, if there was inadequate hot water in a home).  When the things that were important to individual users were understood, it was usually possible to work to accommodate them.  Service contracts stipulated that employee training and development work had to be carried out by suppliers to enable carers to work with these situations.

It was noted that the Chair had requested the opportunity to accompany a care worker for a day, to get a better understanding of their work.  Confidentiality and privacy would be respected at all times and appropriate arrangements would be made to ensure this.

NOTED:

1)    The scoping document for the review of Domiciliary Care;

2)    The concerns of the Commission about the way that background information to this item had been presented; and

3)    That examples of anonymised care plans could be viewed via the Democratic Support Officer.

RESOLVED:

1)    That the Communications Manager be asked to work with the Commission to issue an appeal for users of domiciliary care and / or their families to discuss their experiences of domiciliary care, both good and bad, the appropriate setting for these discussions to be decided;

2)    That the Director of Adult Social Care and Safeguarding and the Director of Commissioning and Care Services be asked to provide the Commission with the information requested during discussion on this item, as recorded above; and

3)    That the review of Domiciliary Care continue at the Commission’s next ordinary meeting.

(See also minute number 74 below)