Agenda item

Maintaining a Stable Adult Social Care Market

Report of the Executive Director, People, Sheffield City Council

Minutes:

7.1

The Chair informed the Members that she had received a letter from lawyers on behalf of Sheffield Care Association expressing  its concerns at the contents of the report.  She said the Association thought that it was the Cabinet that was going to make a decision on this matter.  She wanted to let people know the letter had been received, and that the Committee was not ignoring the issues raised.

 

 

7.2

The Committee received a report setting out the Council’s approach to reviewing the adult social care market and setting the fees for contracted, independent sector care homes, home care, extra care, supported living and day activity providers in Sheffield for the  Financial Year 2021-22. The report also described the review of rates for Direct Payments for people who chose this means of arranging their own care and support.

 

 

7.2

Present for this item were John Doyle (Director of Strategy and Commissioning) and Joe Horobin (Head of Commissioning, Strategy and Commissioning, Adult Services).

 

 

7.3

Joe Horobin introduced the report and stated that it was always challenging to analyse the market, but it had been particularly challenging during the current climate.  The report showed the process and methodology that was followed and asked for the Committee’s input into the process. The Service was working through feedback from care providers which will form part of the final report to be submitted to Cabinet in March, 2021.  She said the report was an annual process and this year there was additional input from some external consultants working on the strategic review of the adult care sector.  John Doyle added that it was always a difficult process for the care sector, but there were more pressures around fee rates and occupancy, the changing marketplace and very uncertain pattern of demand.

 

 

7.4

Members of the Committee made various comments and asked a number of questions, to which responses were given as follows:-

 

 

 

·                It was acknowledged that fundamentally, the Council needed to be commissioning services that were co-produced and co-designed with those who used them. 

 

 

 

·                Relating to direct payments, it was hoped that annual market analysis and fee review would reflect more on customer experience, and that the customer and carer voice would come through  in that analysis. The Service was keen to hear the views of Members of what they think could be factored into the analysis. The Council had a duty under the Care Act to meet the needs and wellbeing of the people of the city. 

 

 

 

·                The focus of the report formed part of a bigger discussion. The wider strategy was about how do we support families sooner.

 

 

 

·                The Council was looking into a review of the services it provided and it was important to look at this year on year to keep going forward, because it was essential that the Council didn’t  stand still on these issues.

 

 

 

·                In terms of the contribution that an individuals made towards the cost of their care, there was a difference between the calculation for home care and residential care in that if someone was receiving home care, the value of their home wasn’t  taken into account. 

 

 

 

·                The Consumer Price Index (CPI) was determined every year in September, in line with the level of pensions determined by the Department for Work and Pensions and was used to determine the CPI for the next financial year. 

 

 

 

·                Consultants had been engaged to carry out the strategic review into Older Adult Care Homes, and initial feedback has been very useful A final report of the review was expected by the end of February 2021, before submission to Cabinet in March 2021.  The review would show the medium and long- term recommendations for the future demand for, and shape of, the care home market and support for older people. The pandemic has had a catastrophic impact on care, and had shown that providers needed to shift to a different footing and work closely with the older care sector.  One area was to ensure the level of capital expenditure to support the aging housing ?? stock and ensure ?? sure the Council had a 10-15 year strategy for older peoples care homes, ensuring they are well designed and fit for purpose.

 

 

 

·                The Council needed to understand what the effect the current low occupancy in care homes would have on the long-term funding strategy. At present, there was 78%-79% occupancy of beds in the city, and it was not known what support would come from the Government.

 

 

 

·                The draft White Paper did not suggest anything about more funding for the care sector, and there hadn’t been any investment over many years.  At present, there was a two-tier system, with those who could  pay for care and those who could not, but it was considered there was a need to offer good quality of care for everyone.

 

 

 

·                One concern for care home providers was the non-staffing element and whether it was  sufficient to cover their costs.  In Sheffield, there were fewer homes with a mixed economy of self-funders and Council-funded placements, so cross-subsidy was far less than it used to be.  The Council’s duty, when understanding the cost of care, was to ensure the rates it paid was sufficient to ensure quality of care that assumed no third-party contribution. However, this does not mean cross-subsidy does not exist.

 

 

 

·                The Council could anticipate that there would be less demand for care homes in that people would want to receive more care  in their own homes.  The pandemic had been damaging to the reputation of care homes, and it was anticipated that there would be shorter lengths of stay and higher turnover of residents in care homes, resulting in a need for the costs of these changes to be assessed.

 

 

 

·                Care homes had the lowest turnover of staff as they tended to work as a team and supported living teams have a more stable cohort., Staff delivering home care tended to have the highest turnover, and the aim was to ensure that staff were properly renumerated, supported and respected, with the aim of reducing the level of stress and build in a more resilient workforce.

 

 

 

·                Strategic Review means as much about staff and it does about buildings.

 

 

 

·                It was acknowledged that this was an annual process which has historically been fixed on fees and providers, and that the Council must be able to account for that.  The stakeholders were largely health and social care professionals, and the invitation to be involved could be extended to include Healthwatch, the Carers Centres and the next step was to consider what the people of Sheffield want, which should be highlighted in the Strategic Review.

 

 

 

·                The trade unions had not been part of the Review but there was no reason why not to engage with them.  The Council holds regular meetings regarding changes to home care.

 

 

7.5

RESOLVED That the Committee:-

 

 

 

(a)      thanks John Doyle, Joe Horobin and Councillor Jackie Drayton for their contribution to the meeting;

 

 

 

(b)      notes the proposal set out in the paper;

 

 

 

(c)      calls on Government to urgently respond to the national funding crisis in adult social care;

 

 

 

(d)      recognises the difficulties that care providers in the city are facing;

 

 

 

(e)      will schedule a future look at the full strategic framework for Adult Social Care as soon as is appropriate; and

 

 

 

(f)       would like to see a wider range of stakeholders involved in the consultation process including trade unions and service users.

 

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