Agenda item

This report provides an update on the delivery of care at home to the people of Bath and North East Somerset (B&NES).

The Senior Commissioning Manager introduced this report to the Select Committee. She explained that the Local Authority has a rolling five year contract in place with four key Strategic Partners namely:

·  Care South

·  Care Watch

·  Way Ahead

·  Somerset Care

She said that the contract contains a five year break clause with the next occurring at the end of March 2018.  She added that future contractual arrangements are being considered as part of the Your Care, Your Way community services review being undertaken jointly by the Council and Clinical Commissioning Group (CCG).

She informed them that the Council commissioned a total of 4963 care hours on behalf of 468 people at the time this analysis was undertaken (30^th April 2016).  Of the total, 2174 care hours were being commissioned from either Spot Contract or one-off Agreement providers on behalf of 150 people (with approximately one-third of people receiving a 24 hour care package). 

She explained that in an effort to support the Strategic Providers in recruiting and retaining staff and start to address the capacity shortfalls, the Council agreed to fund early implementation of the National Living Wage from January 2016 on the understanding that the increase would be used to increase the rates of pay directly offered to frontline domiciliary care staff and on the assurance that travel time would be paid at the same rate. This has had a positive effect so far on both staff retention and staff recruitment.

She stated that since October 2015, a new electronic system called DCAS (Domiciliary Care Access System) has been in operation.  The system allows Social Workers to request care packages on a secure site that the Strategic Partners are able to access.  This system is still under development but early reports are being developed that will help the Council and CCG to understand the capacity needed for the population now and in future years and plan this with Strategic Partners.

She said that in order to provide more assurance about care commissioned under a one-off Agreement the People and Communities Adult Commissioning Team are currently working with colleagues in Trading Standards to register all providers who deliver Council commissioned care packages onto the Buy with Confidence and Care Scheme.

She informed Councillors that a project is underway reviewing direct payments across adults, children’s and health, to try to streamline the policy into one across all three areas, and to also streamline the support that is available to people choosing to use a direct payment. She added that the project is also looking to introduce pre-paid cards for direct payment recipients, which will hopefully make them a more attractive offer for people.

Councillor Tim Ball asked why Trading Standards were being used to register providers.

The Senior Commissioning Manager replied that forms of accreditation such as ‘Buy with Confidence’ help to provide additional assurance to those making decisions about which provider they chose. Trading Standards ensure that all those registered must satisfy conditions and standards, which are clearly set out to ensure oversight and transparency to the process of admission to the Scheme.

The Director of Adult Care and Health Commissioning added that this is in addition to the regulatory role of the Care Quality Commission and the Adult Care and Health contract review, quality assurance and safeguarding processes. She added that the intention is to provide additional assurance to those people who are using a Direct Payment or Personal Budget, to help them assess risks and to make informed choices.

Councillor Karen Warrington asked what safeguarding provisions are in place.

The Director of Adult Care and Health Commissioning replied that the Council has a responsibility to safeguard all vulnerable adults and all children and young people and that B&NES has robust safeguarding and quality assurance processes in place, which have been the subject of both audit and a Local Government Association Peer Review. She added that for those people deciding to fund their care through a Direct Payment, whilst the Council ensures that advice, information and support to a Direct Payment is available, it is the individual with the Direct Payment who would ensure anyone providing them with personal care services has the relevant DBS checks, references etc.

Councillor Paul May asked if the Select Committee could receive further information in relation to Adult Safeguarding.

The Director of Adult Care and Health Commissioning replied that a specific report could be provided at a future meeting by Lesley Hutchinson, Head of Safeguarding & Quality Assurance.

Councillor Eleanor Jackson recalled that as part of the Homecare Review which took place in 2010 that one resident found Direct Payments liberating. She said that she would also welcome a separate report into Adult Safeguarding and looked forward to receiving Homecare Review Update in 2017.

Councillor Karen Warrington stated that she was pleased to see an emphasis placed on career development and training within the report. She asked if they had considered discussing recruitment to this work area within schools.

The Senior Commissioning Manager replied that she would discuss that idea further with colleagues.

The Health and Wellbeing Select Committee RESOLVED to note:

(i)  The performance of each of the Domiciliary Care Strategic Partners and the volume of care hours commissioned through either a Spot Contract or one-off Agreement for an individual person.

(ii)  The introduction of the Buy with Confidence and Care Scheme which is being introduced in collaboration with Trading Standards in order to provide local residents with information about approved domiciliary care providers and to provide increased assurance to those funding their care through a Direct Payment.

(iii)The increased collaboration and commitment to joint working and strategic development of domiciliary care through a recent multi-agency event.

(iv)The continued development of formal support for people wishing to take a Direct Payment to help them continue living at home.

(v)  That domiciliary care services are within the scope of the Your Care Your Way Programme and future arrangements will be subject to discussion with the successful bidder who is awarded Prime Provider status later this year.

(vi)The priorities for the development of domiciliary care moving forward.