Agenda and minutes

Apologies had been received from Councillors Lynn Denham, Andy Fry, Adrian Kriss, Jo Monk and James Stanley and Cabinet Member with Responsibility Adrian Hardman.

None.

Members of the public wishing to take part should notify the Democratic Governance and Scrutiny Manager in writing or by e-mail indicating both the nature and content of their proposed participation no later than 9.00am on the working day before the meeting (in this case 21 May 2023).  Further details are available on the Council's website.  Enquiries can also be made through the telephone number/e-mail address listed in this agenda and on the website.

None.

Previously circulated

The Minutes of the Meeting held on 24 March 2023 were agreed as a correct record and signed by the Chairman.

Members received a brief summary of the Agenda Report which outlined that the Council was moving away from a time and task approach to domiciliary care to one which was focussed on delivering outcomes, to support people to maintain, or recover, activities of daily living.  Independence Focussed Domiciliary Care (IFDC) providers would be vital to achieving the change.  The Council had created 10 zones across the County, broadly similar in the number of hours of care being delivered in them.  A lead provider and 2 secondary providers would work in each zone and take on new work from the start of the contract, with legacy care packages maintained by existing providers.

Following a full tender process, contracts had been awarded to 8 care providers who would be lead providers in 7 zones and secondary providers in 15 zones.  An additional tender had been published for the unfilled 3 lead providers and 5 secondary providers and submissions were being assessed with the intention that successful contracts would be awarded in July 2023.

Adult Social Care and Public Health Officers were working with providers to identify methods by which outcomes could be better measured for individuals and provide an evidence base of interventions which would support people to maintain their independence for as long as possible.

The change would support the Council’s Plan for Worcestershire by supporting people to live ‘healthily and independently in their own homes for longer and supporting preventative measures to reduce incidents which require NHS or other care services’.

Members were invited to ask questions and in the ensuing discussion, the following points were made:

·         The Council currently purchased domiciliary care at between £20.64 and £25.02 per hour.  The variance was dependent on how the contract was agreed, however, Bank Holidays were paid at time and a half and there could be further additional payments for travel to some rural areas.  Contracts with individual employees would be a matter for the provider

·         Choosing to split the County into ten zones, based on similar hours of care need would ensure they were broadly equal for core hours and ensure no one zone was more attractive than another

·         It was an advantage to have a lead provider, covering around 60% of the hours, and 2 secondary providers, covering about 20% each.  One example given was when a lead provider lost staff and the secondary providers were able to pick up the hours

·         The tender process was outlined and although a complex piece of work weighing up cost versus quality, assurance was given that all providers had to be graded Outstanding or Good by the Care Quality Commission (CQC).  It was noted that around 80% of the County’s providers were already in those categories

·         There had been a good response to the additional tender for the unfilled contracts

·         When asked how Commissioners ensured providers continued to operate in the top 2 CQC ratings, it was reported that Officers worked closely with the Quality Assurance Team and would become aware of potential  ...  view the full minutes text for item 477.

Replacement Care, previously known as respite care, was support provided to an individual due to a family carer having a break from their usual caring role, either planned or in an emergency.  Planned care could include a schedule of individual nights or a longer break whereas emergency care could include the family carer requiring hospitalisation at short notice.  To meet Care Act eligible needs, the Council had 2 main types of replacement care, Older People and adults with Learning Disabilities.

The traditional Older People replacement care offer was outlined and the Panel was reminded of the Council’s move to commission Replacement Care Bed Services procured via a framework rather than a block contract.  This would meet demand, give choice and meet need.  It would also remove the costs of a block contract and enable best value and flexibility.  The framework had set rates for placements which providers had agreed to.

Following a tender process, evaluation had been completed and framework award was in progress, however, it would be re-opened to encourage more providers to become part of the framework.  Officers reported that there had been a lot of interest, however some tenders were incomplete and the Council was now providing advice and feedback to providers.

The block contract was no longer suitable as it was only ever at 60-70% capacity, even before the COVID-19 pandemic.

The Learning Disability replacement care offer worked well on a block contract, supporting around 190 adults using one of five services.  The average number of nights was 46, ranging from 16 to 140 per year.  A commissioning review had been undertaken and in broad terms the current provision was sufficient to meet current and future needs, however, there was a shortage in provision for people with complex needs and alternatives were being explored.  The current block provision was sufficient for both the planned and emergency replacement care needs.

The Chairman asked a question on behalf of a Panel Member who had received reports that planned replacement care was dependent on whether a bed was available and care was mainly focussed on emergency provision.  The situation described therefore impacted, for example, planning a holiday.  In response, Officers reported that this should have been part of the offer with the existing block contract offering 9 beds across 8 homes within Worcestershire.  It was recognised that there may have been pinch points at certain times of the year, however, the new framework would provide more flexibility.

In the ensuing discussion, further points included:

·       In relation to the ongoing impact of the COVID-19 pandemic, it was reported that the impact was greater on the whole family due to wider consideration of health needs.  There had been a higher level of cancellations due to, for example, concerns about mixing with people outside of the family unit

·       When asked about the Council support to providers around tender submissions, it was clarified that it was not due to the standard of the provider, rather the way in which providers approached their submission  ...  view the full minutes text for item 478.

The Work Programme was agreed.