Agenda item

To consider a report of the Corporate Director for People.

The Panel at its meeting on 28 October gave approval to holding three themed meetings based around the three strands identified during the scoping of the Review.

The first of these meetings is based on the tension between the cost and quality of care and the report that has been submitted to the Executive on 17 November in relation to the ‘Care Homes and Care Homes with Nursing Fees Review’ has been appended to this item to stimulate discussion.

Representatives from Borough Care, the Stockport NHS Foundation Trust and Healthwatch have been invited to attend the meeting to assist and advise the Panel.

The Panel is recommended to comment on and note the report.

Officer contact: Vincent Fraga on 474 4401 or email: vincent.fraga@stockport.gov.uk

A representative of the Corporate Director for People submitted a report (copies of which had been circulated) detailing the outcome of the recent review of the Council’s Adult Social Care Fees for Care Homes and Care Homes with Nursing which proposed a fee uplift.

The report aimed to support a discussion in relation to the tension between the cost and quality of care which was the first of three themed meetings being held to assess the wider provision of residential care in the Borough.

The following comments were made/ issues raised:-

·         There was a need to ensure that in setting the level at which the Council would pay for the provision of care, a balance was maintained with the resultant quality of care and the availability of beds.

·         The level of payment needed to be sufficient to ensure that the system was able to provide care not only for those that could afford top-up fees.

·         Where providers did not invest sufficiently in their workforce and began to rely heavily on agency staffing, it was increasingly difficult for them to maintain adequate standards of quality.

·         The recruitment and retention of good quality nurses in the sector was increasingly difficult as many staff moved on to work for the NHS.

·         There had been a drive to increase the level of recruitment from abroad, however this brought with it additional complexities around language and cultural issues.

·         The Council needed to be mindful when setting its fees of the impact of increases in the minimum wage and the advent of the living wage.

·         Recruitment into the sector in Stockport was perhaps more difficult than other areas in Greater Manchester by virtue of its buoyant employment market.

·         There remained concern that the Council was paying an element of the cost of care associated with the cost of healthcare that should more appropriately be funded by the health service.

·         A discussion took place around the benefits or otherwise of providing a readily understood ratings system for residential care homes which would allow families to make informed choices about their choice of provider.  In response it was stated that the Care Quality Commission had previously provided a star rating for homes which providers and potential clients alike had found useful.  In the absence of such a system, a replacement ‘TripAdvisor’ style ratings and reviewing system had been proposed but there had been difficulties over the moderation of such a site.

·         Where there were concerns about the quality of care being provided, the Council was able to suspend purchasing; however this had the effect of limiting their income of the provider which may in turn limit their ability to address the identified deficiencies in the quality of care.

·         The Council had previously provided a degree of ‘support-in-kind’ particularly in the form of training to care home providers.  A discussion took place around the potential for the Council to offer such services on a professional basis which providers could ‘buy-back’ from the Council.  It was suggested that nursing and ancillary training, first aid and moving and handling courses could be included in such an offer.

·         It was queried whether providers were willing or able to allow trained volunteers into their homes.

·         There was scope for greater involvement by elected members in the oversight of residential care homes which might include attendance at open day events for homes within their wards.

·         Work was being undertaken to examine alternative models of intermediate care which sat between a person living independently within their own home and residential care.  It was noted that the ‘extra care’ model was one which Manchester City Council was investing heavily in where people had more independence but had access to a range of high level support.

·         It was queried whether there was the potential for the Council to assist with the collective procurement of sundries for providers to take advantage of economies of scale.  In response it was stated that this was something that had been previously investigated alongside sharing recruitment; however there were a variety of views on the subject from providers which may make attaining agreement difficult.

·         There was scope for some of the smaller providers to come together and form a social enterprise or explore charitable status.

·         The potential for homes to provide additional services to the wider community outside of the residential care home setting was discussed.

·         The extent to which care homes were making adequate provision for services that residents might reasonably expect, such as telephone, television and internet access was discussed.

·         It would be useful to evaluate the information that was provided on the Council’s ‘mycaremychoice’ website platform in respect of residential care to evaluate whether it met the needs of users. 

·         There remained work to be done with regard to the consolidation of the avenues by which a service user or other party could raise concerns about the quality of care being provided, and there needed to be adequate publicity of those.

·         The Council had previously done a lot of work around ‘dignity in care’ and it would be useful to revisit this work.

RESOLVED – That the report be noted.