Agenda item

This report is an opportunity to explore and consider the issues and the responses currently in place to support both the wider Care and health workforce in B&NES and specifically the workforce related to the provision run directly by the Council.

The Senior Commissioner, Community Transformation introduced the report to the Panel. She said that she hoped that it contained within it enough information to give them an understanding of both the services that the Council runs and those that it commissions.

Councillor Michelle O’Doherty asked how sustainable it was to have roughly a third of the workforce over 55 years of age and if it was known why there was a low uptake of staff, only 33%, who have a care qualification. She stated that she would like to see it made more of a highlighted career and would welcome the Panel discussing the issue in more detail at a future meeting.

The Senior Commissioner, Community Transformation replied that the work that has been carried out with United Care B&NES, jointly the Council and the RUH, has been important and contributed to the level of pay and terms and conditions that are in place. She added that they have also worked closely with their provider organisations on the challenges highlighted in the report.

Councillor Joanna Wright referred to section 3.3 of the report and asked what the hourly rate for home care is that meets the thresholds recommended by the Home Care Association.

The Senior Commissioner, Community Transformation replied that it is £25.42 and that this is a combined rate based on hourly, half hourly and weekend/evening shifts. She added that this was now seen as the Council’s starting point and linked to our ‘Fair Price of Care’.

Councillor Wright asked if any further comment could be given on the creation of the BSW Academy Domiciliary Care Steering Group.

The Senior Commissioner, Community Transformation replied that the Director of Adult Social Care has led this work alongside the ICB to investigate the concerns and challenges particularly for domiciliary providers. She added that around 12 months ago, following Covid and Brexit, it was very difficult to find domiciliary care provision. She explained that Dr Sarah Green is leading this brief across the ICB to look at how the workforce can be supported under Suzanne Westhead’s leadership.

Councillor Wright asked if the work of the Steering Group has proved useful.

The Senior Commissioner, Community Transformation replied that it has and has enabled a range of opportunities to discuss their challenges. She added that there is a high degree of staff turnover to contend with and that this can sometimes add to the issues connected with additional training.

Councillor Wright referred to section 6 of the report, Risk Management, and said she was concerned about the issues mentioned within it.

The Senior Commissioner, Community Transformation replied that she wanted to highlight these issues to the Panel as the number of older people needing care is increasing year on year and the funding associated with that is not likely to keep pace. She added that most of the staff are on the minimum wage for what is a skilled role. She stated that good terms and conditions need to be in place for these members of staff alongside an understanding of what their needs are so that all parties can get the most out of their role.

Councillor Wright asked if staff within this workforce had appropriate access to be part of the Local Government Pension Scheme.

The Senior Commissioner, Community Transformation replied that this was an important to raise in terms of supporting people and enabling our provider organisations to do the same. She added that they have received additional funding recently through the Market Sustainability Fund which shows that the Government has recognised a need to put additional measures in place. She said that providers need to work positively with their staff on this matter.

The Assistant Director – Operations added that B&NES pays above the real living wage and will continue to do so for these members of staff. She stated that they also have access to the Council’s pensions scheme and staff benefits.

Councillor Paul Crossley asked what the definition was of a prime or anchor provider.

The Senior Commissioner, Community Transformation replied that this would be significant organisations within the locality such as RUH, HCRG Care Group, B&NES Council and the Integrated Care Board. She added that these are seen as bodies that influence and engage with others.

Councillor Crossley asked if we have a list of all providers of care within B&NES and asked how they are reviewed and evaluated.

The Senior Commissioner, Community Transformation replied that we do and that it was her role to assess any new providers to assure that they meet the requirements of our framework. She added that each provider is subject to an annual review and are reviewed through RAG (Red, amber, green) ratings when this has been carried out.

Councillor Crossley asked how our pay rates compare to that of the anchor providers.

The Senior Commissioner, Community Transformation replied that it was slightly above and that our terms and conditions are also favourable in terms of pensions and annual leave.

Councillor Crossley asked though why was this still resulting in not being able to recruit enough staff.

The Senior Commissioner, Community Transformation replied that it was not solely always about pay and that timing of shifts, number of hours and locality were also factors that staff would want to consider.

The Assistant Director – Operations added that she believed that all agencies were struggling to recruit and that recently a review of some shift patterns had been carried out for care staff with changes due to be implemented.

Councillor Liz Hardman praised the honesty of the report and said that she was particularly concerned with the following wording -  “ongoing risks to the Council in meeting its statutory obligations to provide care and offer this at best value to the individual, the Council and the ICA. The lack of capacity and particularly the growing number of people who need care will continue to bring pressures”. She asked how great are the risks of the Council not meeting its statutory responsibilities.

The Senior Commissioner, Community Transformation replied that it was a real challenge, not just for B&NES, but across the country. She said that care needs to assessed from both a social care and health perspective. She added that the work that has already been done has seen a reduction in the number of people now waiting in hospital.

Kevin Burnett asked if a point had yet been reached where a package of care had not been able to be delivered and if so, what action was taken.

The Assistant Director - Integrated Commissioning replied that elements such as this were part of ongoing live discussions with national policy makers and funders. She added that last year all Local Authorities were asked to develop a Market System Ability Plan and within that they were asked is there enough money to meet the demands of the market, and the answer nationally was no.

She stated that we need to be clear with the market what we can and can’t afford and identify our high risk points. She said that we are paying comparably high figures for our home care, but have chosen to do so as it is better for people to be in their own home for as long as possible. She added that she would welcome input in making self-funding residents aware of when they should begin the process of seeking a formal assessment.

Councillor Alison Born commented that she takes part in regular meetings, arranged by the LGA, with colleagues across the South West and so the issues raised should be fed back to the Government.

The Panel RESOLVED to note the report.