Issue - items at meetings - Review of Home Care Contract

Report of Director of Adult Social Services (copy attached).                    

(1)       That it is agreed that the training programme is revised for providers and assessment staff so that the Outcome Based Commissioning of home care model can be introduced over the coming year to take forward the personalisation agenda.

(2)       That subject to the budget set by Council in February 2013, an enhanced rate is paid to providers for covering calls beyond 8pm in the evening with effect from 8^th April 2013 as described in section 3.2.3 of the report.

(3)       That subject to the budget set by Council in February 2013, the rates paid to providers are increased by 2% to reflect the increase in costs, particularly petrol with effect from 8^th April 2013 as described in section 3.2.5 of the report.

38.1    The Committee considered a report of the Director of Adult Social Services which provided a review of the implementation of the new home care contract since its implementation on 4^th June 2012 and indentified significant factors that had had an impact within the local home care market.  The review highlighted a range of benefits which the new contract had introduced. The volume of the service appeared little changed and capacity overall appeared to have increased but turnover remained an issue.

38.2    The report proposed recommendations that supported home care providers to sustain the service and reflected the additional burden of increased petrol prices that had a particular impact upon some home care workers.  As there was a need to increase capacity for home care visits to be delivered beyond 8.00pm an enhanced rate for this work was recommended to incentivise home care providers to respond to this need. 

38.3    The Head of Performance & Contracting informed the Committee that Appendix 2 of the report showed that providers responded very differently in relation to matters of pay and terms and conditions.  Broadly it was thought wages across the sector had increased  but it was disappointing that not all providers were paying the local living wage.    

38.4    The review had shown that quality had been sustained and there had been no significant issues with quality in the sector.  The home care contract was monitored very closely and no significant concerns were being reported.  Meanwhile, a quality rating system was being developed. 

38.5    There had been four new providers in the city, although one had dropped out.  The other three were now established.  The service was subject to regular monitoring and review.  There was a free training programme in place.

38.6    Councillor Hawtree noted that the care workers would need to drive round the city to visit service users.  He asked for details about petrol costs and how many miles a week a care worker would be expected to drive.  The Head of Performance & Contracting explained that care providers were allotted a small geographical area of the city.  Some worked in the centre of the city and could walk to visit service users.  In other areas they would need to drive.  The details would vary with each provider.  

38.7    Councillor Meadows asked if more staff were required to avoid a delay in accessing care.  She referred to the proposed 2% increase to providers, and asked how Members could be reassured that the increase was being passed on to care workers.  Councillor Meadows referred to the financial implications at paragraph 5.2.  This stated that the council had recently agreed to a new procurement approach as part of the process of seeking living wage accreditation.  She made the point that if people were not getting the living wage they were not complying with a legal requirement. 

38.8    The Head of Performance & Contracting replied that there was a capacity issue with the evening service which was the reason why there was a proposal for an enhanced evening rate.  The contract did not specify that a person had to be paid the living wage.  The Council had taken significant steps in setting the rates paid to providers and through the procurement process itself to support providers paying a living wage. There were no current contracts in social care which specified wage rates and related terms and conditions. Whilst the increase would encourage providers to pay the living wage,.  the local authority could not be sure that the 2% increase would be passed on to care workers as this could not be enforced contractually.  With regard to access issues, it was explained that if the main provider did not take up work then the work would be done by a back up provider.  

38.9    The Senior Lawyer explained the law regarding contracts.  She stated that it was difficult to impose terms and conditions that went beyond the subject matter of the contract. 

38.10  The Director of Adult Social Services stated that she believed wages would increase as more providers moved into the market.   She noted recent discussions held with some of the major providers which confirmed their intention to improve terms and conditions for staff.

38.11  Councillor Meadows asked why the council was paying the living wage if providers were not passing it on to staff.  This was providing more profit to the companies concerned. 

38.12  The Chair replied that the majority of providers were paying the living wage.  He did not think the council were wasting money.

38.13  Councillor Mears referred to recommendations which were subject to approval by budget council.  She stated that if details had been set out in a financial report it would have been easier for Members to make a decision.  She requested that an email should be sent to all committee Members setting out a financial breakdown of the proposals. 

38.14  Councillor Mears noted the legal implications with regard to the living wage and made the point that there could be no guarantees that it would be paid to staff.  Councillor Mears asked if the Equality Impact Assessment had been carried out.  The Director of Adult Social Services replied that the EIA had been completed and could be circulated. 

38.15  Councillor Robins asked for details of the electronic monitoring system and the lay assessor’s scheme.  The Head of Performance & Contracting explained that lay assessors were trained people who provided an objective view of the quality of the service.  The electronic monitoring system had a range of functions.  For example, it allowed providers to plan better delivery routes.  Officers and providers could look at a screen to check if someone was late or to monitor continuity of care.  It provided electronic invoices and a performance report to the Contracts Team.  It was an important tool.

38.16  Councillor Barnett stressed that service users were vulnerable.  She asked how they could be encouraged to report concerns about the service they received.  The Head of Performance & Contracting explained that groups of users were selected for interview by the lay assessor scheme.  The interviews were confidential.  This was one way of gaining information. 

38.17  Councillor Norman asked if it was known which providers passed on the living wage.  This was a concern to Members and he would like to have more information.  The Head of Performance & Contracting replied that it was known what each provider was paying, however the situation was complicated given the different rates of pay providers paid as outlined in appendix 2.  For example, new staff may be aid a lower rate than experienced staff.  The Director of Adult Social Services suggested that a review was carried out in a few months time.  

38.18  Councillor Barnett stressed that Members needed to know which agencies were paying the living wage.  Petrol was currently being paid out of the basic wage.

38.19  Councillor Hawtree stated that he was glad that there was support for the living wage.  He was concerned to hear that some agencies were receiving the money and not passing it on to care workers.  He would like to have more information on this matter.

38.20  The Chair requested information that would be in a form that was easy to understand.  He stressed that a minority of providers did not pay the living wage.

38.21  RESOLVED - (1)      That it is agreed that the training programme is revised for providers and assessment staff so that the Outcome Based Commissioning of home care model can be introduced over the coming year to take forward the personalisation agenda.

(2)       That subject to the budget set by Council in February 2013; an enhanced rate is paid to providers for covering calls beyond 8pm in the evening with effect from 8^th April 2013 as described in section 3.2.3 of the report.

(3)       That subject to the budget set by Council in February 2013; the rates paid to providers are increased by 2% to reflect the increase in costs, particularly petrol with effect from 8^th April 2013 as described in section 3.2.5 of the report.

Note:  Councillors Meadows, Barnett, Marsh, Mears and Robins abstained from voting on this item on grounds of lack of financial information.