Report of the Director of Health and Care
The Cabinet Member Health and Care introduced a detailed report on the care homes situation in Staffordshire and the support provided from Government and the County Council. She highlighted the challenges to care homes during the pandemic, including the introduction of infection control measures; the impact on residents and carers; staff absence, recruitment and retention rates and a drop of occupancy rates bringing financial challenge. She indicated that care homes had been supported by the Council throughout this period, in particular with managing outbreak control measures.
The Cabinet Member advised that new pressures had impacted on care homes capacity to accept new referrals, this impacted on the wider Health and Care system in terms of delayed discharge from hospital and a lack of choice of homes available for residents. There was some recent recovery of occupancy numbers and additional Government funding to address pressures and support care homes but where no progress or improvement was made, action would have to be taken. There was ambition to improve the standard of care by assisting care homes to use more technology and a range of activities and initiatives.The Director of Health and Care indicated that the commissioning initiatives outlined in the report would help to ensure the sustainability of care homes into the future.
The Cabinet Member highlighted that access and affordability were important to individuals’ family and carers and that the Council would continue to pursue value for money and stability for home care market by increasing the number of block booked beds and continuing to use dynamic purchasing system. A report to Cabinet in Summer 2022 would consider the review of Council owned nursing care homes capacity.
The Director of Health and Care gave thanks to all care homes and their staff for the extraordinary efforts they had made to look after some of the most vulnerable residents over the course of the pandemic. The Chairman and Committee echoed these comments.
The following comments and responses to members questions were noted:
· Approximately 20% of Staffordshire County Councils funded placements were in care homes rated inadequate or required improvement.
· Locally and nationally, more was needed to understand the costs coming through the reforms in the Social Care Act. The three main element of reforms in the Social Care Act:
a. A cap that the individual pays towards cost of care in their lifetime (£86,000).
b. A rise in capital assets individual allowed to have before starting to pay for their care from £23,350 to £100,000.
c. A fair cost of care principal which would effectively equalise the amount that self-funders and Local Authorities pay for care.
In relation to (a) the cap: It was understood that self-funders paid more for care but there was no information about how much more. Self-funders would be given the right for the Local Authority to purchase their care, over time that would have the effect of equalising the care costs, which would create financial pressure for the Local Authority.
In relation to (b) & (c): the care cap and capital thresholds would create an increase in assessment needs. This would require new social workers and administration of new funding forms, this would increase the cost of assessments for the Local Authority.
· Purchase of 200 block booked beds aimed to give stability of price and quality for self-funders and the Council, greater stability to the market, and provide value for money.
· Members highlighted that residents and staff mental wellbeing had been impacted through the pandemic, some restrictions were now reducing, and members hoped restrictions would decrease more.
· The 450-place decrease in occupancy rates for 2020-21 during the pandemic was for a variety of reasons, including death rates, that care homes were less desirable place to be, and that people chose to stay in their community. Occupancy level had increased by 250 places, but were still 200 places down from pre-covid levels. Demand for Adult Social Care was currently quite high, but demand was unsettled, there would be a clearer picture of demand and capacity by the Autumn 2022.
· Out of County placements were necessary where specialist care not available in Staffordshire was required, however the most common reason for out of County placements was people’s choice to move closer to their family.
· Partners were working closer together and had joint teams with NHS to monitor and support quality improvement and quality assurance in care homes across the County. There may be opportunity for deepening integrated care arrangements to consider joint purchasing arrangements and to think about commissioning and contracting for placements and to make best use of purchasing power across the County Council and the NHS.
· Assurance was provided that access to care home placements was timely and that there were three standards for finding home care placements: highest priority referral (1 day), urgent referral (7 days) and routine cases referral (28 days). Collectively 85% of placements were achieved in timescales for December. In January due to Covid outbreaks 61% were placed within timescales. Care homes that were closed for admissions peaked at 75 a few weeks ago and were now down to 50. Members were assured that the data demonstrated the right direction of travel.