Agenda item

Report of the Director for Health and Care

The Director of Health and Social Care provided an update on social care performance.

Committee noted the following comments and responses to questions:

·       In relation to ‘maintaining a market for care and support that offer services at an affordable price’. The Director responded that the cost-of-living issues including cost of energy was putting pressure on care providers and that was being monitored along with implications for local authorities.

·       Affordable cost of care. Assurance was provided that ‘fee uplift’ to providers was given with a clear indication that funds should be directed towards pay for staff. Providers that pay more tended to recruit and retain staff which had a levelling up effect.

·       Models in terms of dealing directly with employees. Over the last decades the Local Authority direction was to greater outsourcing, Staffordshire was currently looking at enhanced home care as there was shortage of capacity affecting home care. The Council was unlikely to move towards large in-house services, it was more likely that gaps in the market would be dealt with as they arise.

·       Financial assessments were of concern for two reasons,  first excess of demand over supply, secondly some services may need review and redesign. 

·       The backlog in financial assessments may result in complaints relating to the charges for home care.  Residents did not know what they were going to be charged and then complained when they had retrospective bills. This leaves the Council open to financial risk and criticism when people accrue debt and cannot pay.  This is one of the processes to review this year.

·       In relation to the difference in rating between nursing care homes and care homes. Members understood that it was not likely that the rating was linked to funding. Care homes were able to bid, and they do that on economic viability of their business. A lot of support had been put into clinical specialism in the sector, including nurses seconded from NHS, clinical leadership and improved access to training. There were a wide range of approaches for improvement but there were still quality issues. CQC had changed the inspection regime over the Covid pandemic period, this had now changed again and there were plans to re-inspect homes that had required improvement for some time. Residential care homes tended to integrate into the community and nursing care tended to have the highest levels of frailty and risk.

·       It was considered that including care homes that had no rating in the figures, whilst statistically correct, may be misleading in the data- with only 52% of community care homes good or outstanding, it seemed there was a way to go to improve. The Director advised that the rate of inspections of care providers could not be controlled, there were a lot not rated. SCC also used local intelligence and they used their teams to support providers.  Members were advised that by applying SCC local intelligence to the unrated homes and overlaying CQC ratings, approximately 80% of all providers would be outstanding or good with fewer requiring improvement.

·       In relation to exploring additional capacity to carry out financial assessments and the timeframe to catch up with backlog of financial assessments Members were advised that SCC was looking to increase capacity in the financial assessment team and to try to streamline the processes.  Officers would look at a more limited range of information for the assessments and would be monitoring this and any other processes to speed up the assessments.

·       Lasting Power of Attorney (LPA) and Court of Protection – Adult Social Care Reforms were expected next year and in preparation information would be reviewed and renewed for the public. Preparing for old age, which would include things about LPA.

·       Home Care  - A question was raised about sufficiency of  home care workforce across the County to help people to live in their own homes. The aim was to have 90% care workers to maintain a consistent rate of care supply. To achieve this, factors such as enhancements for rural providers, short term gaps, new carers, had to be considered.

·       There was a challenge around recruitment and retention of carers, vacancy rates of 6%, the gap was met through additional staff hours and agency workers. SCC had put a lot of support into the sector through care market development team which provided access and support to learning and development, and by increasing the rate paid for home care last year.

The Chairman thanked officers for the report, he acknowledged that this was a challenged area and highlighted that it was a case of quality and availability. The Social Care Reforms and need to upskill and update information and processes moving forward would be considered at a future meeting.

Resolved:

1.    That Health and Care Overview and Scrutiny Committee receive the update report.