Agenda item - Jane Macdonald - Commissioning Manager, B&HCC

4.1          Jane Macdonald Commissioning Manager introduced the Market Position Statement for Brighton & Hove City Council and the intended audience was for future providers of Adult Social Care Services.

4.2         The Statement has an Equality Impact Assessment (EIA) tool that is used to help inform the commissioning of services.

4.3         The Executive Director of Adult Services expresses in the Introduction of the Market Position Statement about the very challenging time in the care market, ensuring there is ongoing quality and value for money. The new Care Bill and the Better Care Fund are about moving some of the services from hospitals into the community including homecare and nursing homes.

4.4         The key messages were that there was a rise in the number of people who required services. Of those older people who required care it was more likely that their needs were increasingly complex. The focus was on prevention and keeping people healthy, to help reduce the need for access to statutory services. There would be a 18% reduction in the council’s budget by 2017. The eligibility criteria for services had not changed. There would be an increase in direct payments as individuals chose services they wished to buy. Fifty percent of the Adult Social Care gross spend for 2012/13 was for care homes, which was higher than comparative authorities.

4.5         The commitments within the Market Position Statement were:

• Keeping people safe
• Focusing on the most vulnerable
• Keeping people fit and healthy
• Offering more choice to individuals
• Innovative accommodation to assist older people to lead independent lives
• Continue to work with the community and voluntary sector to make best use of resources
• Provide good information so that older people can make informed decisions.

4.6         Statistics with the Statement show that the population of the city was projected to increase by 6% by 2021., the number of older people aged 75 years or over is expected to increase by 10% from 2021, with a projected 26% increase in the number of people aged 65 or over with dementia, by 2030.

Questions included:

4.7         With a budget of nearly £100 million, how many people was this for? Care costs varied for individuals depending on their needs. Some individuals would need £500 or upwards per week, as others may need two calls per week. The service was challenged by how individuals would find their own care in the future, would this be care homes? Did the city have the right provision for individuals’ future needs?

4.8         If a person was initially self-funded and their finances diminished, would they have to move to fit into the council’s budget criteria? The Care Bill would change this all as people would have their care packages calculated before being placed in care homes. This included a financial assessment to ensure they were in the correct home to minimise people having to move later on.

4.9         Were services reaching out to other ethnic groups, as care homes tended to have predominately white residents? In reality it was uncertain whether the council were actually managing to reaching reach out to such groups, however there was ongoing work to try and improve this.

4.10      Why was a letter sent to patient when they were in a Community Short Term Service bed and told to move into a care home? Short Term Services were provided to individuals with a period of re-enablement and rehabilitation from an injury or illness and to prevent service users from staying in beds inappropriately. These re-enablement beds were not means tested and so were precious. People would be assessed to move into long term services. All people in long term services will have a review and identified whether they were happy or unhappy with that service. It was pointed out that relocating could be traumatic to a person who was vulnerable. People were told from the beginning that they were in a short term service and this was not long term.

4.11      Who carried out ensuring that the 79 care homes in the city worked to the correct service standards including staff training? The council’s Contract team had the responsibility of auditing commissioned services. Care homes with poor quality received more audit visits than others that performed well.

4.12      The service was committed to Telecare and assisted technology to promote independent living. Homecare services had purchased £50 million of community equipment for people who were frail and disabled.

4.13      Care homes are to become more community activity places so that people could purchase, day activities, lunches and have bathing facilities open to people outside of the care home too. Somerset Day Centre had a Lesbian, Gay, Bisexual and Transgender (LGBT) Open day the last Friday of every month. Personal assistance was a growing market and could be accessed on the internet.

4.14      Care workers signed National Disclosure forms so why couldn’t this information be used to strike off malpractice workers; the Nursing & Midwifery council and also Hackney Carriage Drivers were all closely monitored and action taken against workers who did not comply to standards? The Council had Contract officers who audited care workers. Checks included what training workers had, job references and other details to safeguard service users.

4.15      The website “It’s local actually” informed people about activities they could get involved with in their area.

4.16      Further to information on questions raised at the Older Peoples Council and the public, included the membership of the:

Promoting Good Quality in Care Panel; Membership includes from Brighton and Hove City Council contract managers, commissioners, representatives from workforce development, reviewing officers and complaints officers.

Health Watch, representation from the Clinical Commissioning Group and representation from Sussex Partnership Foundation Trust are also included.

The Service Improvement Panel

The membership includes Commissioning Support contract managers and operational managers.

With regard to Craven Vale it was mentioned in the last Committee paper to Adult Social Care committee:

‘Consideration was given to developing additional beds at Craven Vale Resource Centre.  This is not being taken forward as the focus is on growing community services rather that developing more bed based services’.