Agenda item

Report of the Associate Director of Commissioning (Care and Health) (ACH/20/118) on the Market Position Statement and the sufficiency assessment to improve sufficiency and to inform budget preparation, attached.

An Impact Assessment is also attached for the attention of Members at this meeting and is available at https://www.devon.gov.uk/impact/mps19/.

The Market Position Statement and Sufficiency Assessment are included as background papers to this agenda. Click on ‘view background to item’ on the agenda display screen.

(Councillors Connett, Dewhirst, Hannaford and Whitton attended in accordance with Standing Order 25(2) and spoke to this item).

The Cabinet considered the Report of the Associate Director of Commissioning (Care and Health) (ACH/20/118) giving a Market Position Statement, circulated prior to the meeting accordance with regulation 7(4) of the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012.

The Care Act 2014 placed a duty on local authorities to promote a sufficient and effective market for adult care and support for all citizens. The Market Position Statement (MPS) set out the Council’s sufficiency assessment to inform and support providers to make business and investment decisions and it was also a key element of financial planning.

The Cabinet noted that a lack of market sufficiency was the highest risk factor affecting adult social care and added to pressures on the NHS, especially during winter. They further noted that Members of the Health and Adult Care Scrutiny Committee had contributed to the development of the MPS at the Standing Overview Group on 17th July 2019.

The MPS for 2019: “Vibrant Markets for Happy and Healthy Lives” had been jointly prepared with the Devon Clinical Commissioning Group and the Devon Partnership NHS Trust. It outlined the strategic context in terms of what the future development of the health and care system would be underpinned by including collaboration, prevention, integration and partnership, outcomes and personalised services, innovation, the use of technology and workforce. It also reflected on the demographics and need analysis and the range of factors that affected markets, for example, economic context, quality, workforce, changing profiles of need, investment and suitability of buildings and potentially Brexit.

The Sufficiency Assessment Summary showed the major priorities, as set out in the MPS, which included addressing a shortfall of approximately 40 places in the supply of care home placements for people with complex needs and / or behaviours that challenged and the shortfall of circa 2,500 hours per week (6% of total commissioned hours) in the regulated personal care market, circa 50% of which was in Exeter and South Devon. Delivering alternative “care with accommodation” solutions, especially in relation to Extra Care Housing and Supported Living and improving access to replacement (respite) care and addressing shortfalls in the unregulated market to better support people with disabilities, mental health needs and autism.

The actions to address each of these issues were set out in Appendix 1, together with a summary of activity as set out in the MPS.

The MPS was a key tool for delivering plans, both countywide and at a local level. Without a vibrant market the Council could not fulfil its statutory obligations, nor meet the changing needs of the public. The providers were significant partners as well as contractors and the Council needed to continue to improve dialogue with them to adapt the profile of supply and assist with planning. The MPS needed to be considered in cycles of financial planning across the health and care system.

The Report of the Associate Director of Commissioning (Care and Health) incorporated an Impact Assessment circulated for the attention of Members at this meeting https://www.devon.gov.uk/impact/mps19/. This highlighted that the MPS provided a statement of strategic intent for how the Adult Social Care market would be shaped in the future, therefore when specific proposals, in line with the strategic intent, needed a decision there would be specific Equalities Impact Assessments prepared on that basis.  The MPS however provided an assessment of needs and supply which enabled gaps in provision to be identified and providers to see where opportunities existed to meet that need.

There were no unmanageable impacts arising from the assessment, but key measures of performance and sufficiency in the adult social care market would continue to be monitored through contract management and ongoing business relationships.

The matter having been debated and the options and/or alternatives and other relevant factors (e.g. financial, sustainability, carbon impact, risk management, equality and legal considerations and Public Health impact) set out in the Associate Director’s Report and/or referred to above having been considered:

it was MOVED by Councillor Leadbetter, SECONDED by Councillor Hart, and

RESOLVED

(a) that the Market Position Statement and the sufficiency assessment summarised in the Report be approved, together with the actions proposed to deliver the Council’s duty under the Care Act 2014; and

(b) that an Annual Market Sufficiency Report be prepared for Cabinet each September which sets out a market assessment and actions required to improve sufficiency and to inform budget preparation.

[NB: The Impact Assessment referred to above may be viewed alongside Minutes of this meeting and may also be available at:  https://www.devon.gov.uk/impact/mps19/].