Agenda item

Report of the Locality Director (Care and Health) (ACH/21/135) relating to the sufficiency of the adult care and health provider market in 2021, attached.

RESOLVED

(a) that the financial risks associated with the impacts of Covid-19 on the adult social care market be noted and also taken into account as part of budget preparation;

(b) that the actions being taken to tackle the market sufficiency issues be endorsed; and

(c) that the Market Position Statement be updated to reflect the Report including detail related to the relevant sectors.

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

The Cabinet considered the Report of the Locality Director (Care and Health) (ACH/21/135) relating to the sufficiency of the adult care and health provider market in 2021, the Report having been circulated prior to the meeting in accordance with regulation 7(4) of the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012.

Whilst the purpose of the Report was to update Cabinet on the sufficiency of the adult care and health provider market in 2021, it identified the most significant market sufficiency issues, including the impact of Covid-19, and outlined actions underway to support and develop the market.

In terms of an overview, the adult care and health market was fragile and challenged due to the ongoing impacts of the Covid-19 pandemic and uncertainty linked to Brexit. Market issues that were present prior to the pandemic had been exacerbated and some risks might not be fully understood for many months.

There remained a strong partnership between the Council, the NHS and independent sector providers, which was critical to ensuring that the Council continued to meet people’s needs and fulfil its statutory duty to ensure a sufficient care market (Care Act 2014). There were a range of immediate operational and long-term structural impacts on the sufficiency of the adult care and health market. These were summarised below, with a more detailed overview for each market sector in section 4 of the Report.

·         Business Resilience – providers facing long-term sustainability issues;

·         Workforce pay and conditions, and increasing vacancy rates; and

·         Increasing complexity of need, changing demands and fragile carers

Section 3 of the Report outlined some of the actions to address market sufficiency issues. There were a number of short to medium term actions underway to support providers, summarised below, but detailed project plans, with associated milestones and timeframes for each of these actions were in train, with Section 4 of the Report providing more detail on the issues relating to each sector of the market.

·         Care Homes - including a care home fee model review, development of specialist dementia and complex care solutions with partners and a review of capacity of care homes for people under 65 with complex needs;

·         Personal Care – including implementing new models to meet care needs, consideration of incentives to the workforce, use of agency staff from outside the County to backfill shortages in the short term and the potential of a Teckal to support the market;

·         Housing with Support – develop a specification and pricing structure under a new contract, stimulate targeted development of housing, develop short-term crisis support for people with complex needs to enable them to live in their community;

·         Day service - including developing outreach hubs, use of private dwellings, and test new solutions learning from innovations developed in the pandemic;

·         Enabling - improve market oversight and data for monitoring, new contracting arrangements and support workforce recruitment and retention.

·         Replacement care - including identifying quick wins for carers support, based on need and develop commissioning strategy to achieve ambitions; and

·         Workforce (LoveCare programme) - immediate actions with the NHS were being developed to improve career pathways, recruit overseas nurses and develop a bank of temporary staff to help cover gaps, celebrate and value the workforce through Proud To Care and the Appreciative Inquiry (December) and develop an Integrated Workforce Strategy across the Integrated Care System (Oct).

Alongside these actions, the four key areas of development required to support the market over the longer-term were highlighted below. Workplans with associated timeframes were in place to deliver these key areas.

·         Improve workforce recruitment/development through the LoveCare campaign;

·         Improve responses and solutions to people with more complex needs;

·         Work with providers and District Councils to increase the range of good quality homes across Devon; and

·         Develop new and innovative models of service delivery.

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

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

RESOLVED

(a) that the financial risks associated with the impacts of Covid-19 on the adult social care market be noted and also taken into account as part of budget preparation;

(b) that the actions being taken to tackle the market sufficiency issues be endorsed; and

(c) that the Market Position Statement be updated to reflect the Report including detail related to the relevant sectors.