Issue - meetings

To consider a report of the Deputy Leader of the Council and Cabinet Member for Adult Social Care.

This report outlines the commissioning proposals and 2019/20 fee setting for the most significant areas of externally commissioned service provision for adults with care needs: Care Homes in Stockport; Home Support to enable people to live in their homes for longer; Day Care Services and Learning Disability Services.

The report is designed to be considered in the context of budget setting proposals and is intended to clarify the fee changes position for 2019/20 to allow for early implementation at the start of the financial year. This will provide financial certainty to the market and support care providers with their cash flow. It will also prevent internal inefficiency caused by the need to make back payments as well as conforming to good commissioning and procurement practices.

The Cabinet is asked to endorse and agree the approach set out in this paper; and recommend that the Council Meeting approves the proposed uplift at the meeting in February 2019.

Officer contact: Vincent Fraga, 0161 474 4401, Vincent.fraga@stockport.gov.uk

The Deputy Leader of the Council and Cabinet Member for Adult Social Care submitted a report (copies of which had been circulated) inviting the Cabinet to consider the 2019/20 fee setting recommendations for the most significant areas of externally commissioned services within Adult Social Care.

The Deputy Leader provided an overview of the process for reviewing fees, and some of the challenges facing the local provider market and the Council in commissioning these services, notably the increasing demand for care.

The Leader of the Council acknowledged the significance of the proposals for fee uplift in the report to allow for the provision of the real living wage, and welcomed the ongoing impact of the Ethical Commissioning Framework, particularly in the context of the financial pressures on the Council.

RESOLVED – That the Annual Residential / Nursing and Home Care Fee setting approach, including fee uplifts as set out in the report, be approved.

To consider a report of the Borough Treasurer.

The report outlines the 2019/20 fee setting proposals for the most significant areas of externally commissioned services within Adult Social Care. The following services are included within the scope of this report.

•           Residential and Nursing Care Homes

•           Homecare provision offered within an individual’s home

•           Day Care services

•           Learning Disability Services

The report is designed to be considered in the context of budget setting proposals and describes the proposed fees for 2019/20. This will allow for implementation at the start of the financial year and will provide financial certainty to the market, supporting care providers with their cash flow, as well as supporting the process for assessment of client contributions. It will also prevent internal inefficiency caused by the need to make back payments as well as conforming to good commissioning, procurement practices and will meet both policy and legislative requirements.

The Scrutiny Committee is asked to provide comment on the approach and proposed fee increases for 2019/20 ahead of this paper being presented to Cabinet for approval in February 2019.

Officer contact: Vincent Fraga, 0161-474-4401, vincent.fraga@stockport.gov.uk

A representative of the Borough Treasurer submitted a report (copies of which had been circulated) outlining the 2019/20 fee setting for the externally commissioned adult social care services, including residential and nursing care homes, homecare, day-care and learning disability services.

The Cabinet Member for Adult Social Care (Councillor Wendy Wild) attended the meeting to respond to questions from the Scrutiny Committee.

The following comments were made/ issues raised:-

·         Clarification was sought on vacancy rates, particularly in relation to nursing and managerial posts in care homes. In response it was stated that analysis of vacancies was done at a Greater Manchester level and shared with localities. CQC Inspections often highlighted an over-reliance on agency staff in nursing homes as a key challenge for quality and a cost pressure. Specifically in relation to managerial posts it was stated that there tended to be a correlation between consistency in a facility’s manager and its quality.

·         Further information was requested in relation to turnover of staff in care homes and concerns were expressed about the impact this had on quality of care, particularly for vulnerable residents. In response it was stated that anecdotally there were lots of examples of providers training staff who would then quickly move on to a job in a non-care field. It was stated that more systematic feedback from providers could be south.

·         Assurances were sought in relation to impact on residents/ service users through the increased fees. In response it was stated that service users would not feel any impact as the payments made were based on their ability pay, determined through a financial assessment. It was hoped that the uplift in fees would help to mitigate some of the impact of top-up fees. Ultimately the uplift would be of benefit to residents as it was better reflective of the costs of the providers.

·         The uplift in fees was welcomed, as was the positive general message from the report about positive engagement with providers.

·         Clarification was sought on whether the increase in fees would have an impact on the financial assessment level at which contributions would begin. In response it was stated that this would not be the case, but that previous decisions had sought to phase in changes to how homecare charges were made to ensure they were meeting more of the costs and were therefore more sustainable.

·         The general ‘direction of travel’ set out in the report was welcomed, particular the increased use of incentives to encourage improvements in provision. Specific mention was made of activities for residents as this had a significant potential impact on a resident’s wellbeing.

·         Further information was sought on the Ethical Care Framework. In response an undertaking was made to provide a report to a future meeting.

·         Comment was made to references in the report to non-recurrent funding was. Disappointment was expressed that the much anticipated green paper on adult social care funding had not yet been published.

RESOLVED – (1) That the report be noted.

(2) That the Director for Adult Social Care be requested to submit a report to a future meeting on the impact of the Adult Social Care Ethical Commissioning Framework.