Agenda and minutes

Mr D W Houseman MBE CC, Cabinet Lead Member for Adult Social Care (minutes 46, 47 and 48 refers)

Ms Fiona Barber, Healthwatch Leicestershire (minutes 46 and 48 refers) 

The minutes of the meeting held on 21 January 2014 were taken as read, confirmed and signed.

The Chief Executive reported that no questions had been received under Standing Order 35.

The Chief Executive reported that no questions had been received under Standing Order 7(3) and 7(5).

There were no urgent items for consideration.

The Chairman invited members who wished to do so to declare any interest in respect of items on the agenda for the meeting.

Mr J Kaufman CC declared a personal interest in the item entitled ‘Overview Report: Domiciliary Care’ as Director of an Employment Agency which supplied care workers.

There were no declarations of the party whip.

The Committee received a report of the Director of Adults and Communities which provided an overview of a range of factors in relation to the provision of domiciliary care services for adults and older people in Leicestershire. A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

The Chairman welcomed Mr D W Houseman MBE CC, Cabinet Lead Member for Adult Social Care, to the meeting for this and other items. Mr Houseman CC explained how the Department aimed to work with the Clinical Commissioning Groups (CCGs) to co-design an integrated domiciliary care model as part of the Better Care Fund (BCF). This new model would be based on delivering outcomes whilst providing a cost effective service. There were currently approximately 3,000 people in receipt of domiciliary care services across the County. It was important to recognise the good work being undertaken by carers through a number of care providers.

The Chairman also welcomed Fiona Barber, Healthwatch, to the meeting for this and other items. Healthwatch recognised that it was challenging to provide adequate domiciliary care services, especially in a large rural county such as Leicestershire. Ms Barber explained that due to the high turnover of care staff, in some instances this had caused delays in people receiving domiciliary care services. The County Council needed to ensure that there was an adequate provision of carers in the more isolated rural areas of the County.  

Arising from discussion the following points were raised:-

(i)       The Committee expressed concern at the high number of zero hour contracts for care staff and the relatively low wage level paid by care providers. It was recognised that this may be a contributing factor to the high turnover of care staff and difficulties in recruitment in the sector. It was explained that the County Council commissioned care providers to provide care packages and it was the responsibility of those providers to define the terms and conditions for its employees, not the Council. A planned fundamental review of domiciliary care services would help to provide more cost effective solutions for the County Council and in future commissioning of contracts, additional support to care staff would be explored;

(ii)     It was explained that although the wage levels for carers was relatively low, often this was considered a foundation stage before people moved on to more specialised work within the sector such as at care homes, hospital ancillary care and nursing. The County Council needed to ensure that it monitored and regulated contracts with care providers. The CQC also monitored providers;

(iii)    It was explained that pay for time spent by carers travelling between visits varied by provider. Often staff would not receive pay for travel between visits but would receive a mileage rate;

(iv)    Care assessments were carried out to determine the length of visits, in 15 minute increments, required for each individual. Approximately 10% to 15% of service users received the minimum time frame of 15 minute visits as part of their care package. The use of 15 minute visits were currently being reviewed to ensure that they were not used for personal care visits, which by their nature required longer time frames;

(v)     The County Council looked at best practice and engaged with providers to ensure that services provided were of a high standard. It was noted that compared to other local authorities, the County Council provided a good standard of domiciliary care services;

(vi)    The Director and Lead Member were currently exploring options for future domiciliary care policy for implementation in 2015. It was suggested that the Committee could have an  ...  view the full minutes text for item 46.

The Committee received a report of the Director of Adults and Communities which provided an update on the progress in taking forward the development of the County Council’s Extra Care Housing Strategy in Leicestershire. A copy of the report marked ‘Agenda Item 9’ is filed with these minutes.

Mr D W Houseman MBE CC, Cabinet Lead Member for Adult Social Care, was pleased to note progress in this area. The County Council needed to promote Extra Care housing with district councils to ensure it was given due consideration when districts were developing their core strategies or considering new housing developments.

Arising from discussion the following points were raised:-

(i)       The Committee welcomed the work undertaken by the County Council in relation to Extra Care housing but noted that work in this area had been slow to progress;

(ii)     It was noted that the County Council currently funded or commissioned 166 placements in five of the seven Extra Care housing schemes in Leicestershire;

(iii)    The Committee was pleased to note that the capital receipt from the transfer of the County Council’s nine Elderly Person’s Homes would be available for investment in new Extra Care schemes subject to an appropriate business case. It was hoped that this capital would be available as soon as was reasonably possible;

(iv)    There was a need to better understand the future ambition for Extra Care in Leicestershire. It was explained that the goal of 500 Extra Care units between 2010-15 set in 2009 would no longer be achievable due to the current economic climate. The County Council would seek to develop sustainable schemes on an individual site by site basis with a view to reviewing the Extra Care Strategy in 2015. An officer stakeholder group had recently been established to help develop future Extra Care strategy;

(v)     It was suggested that the new Sustainable Urban Extension (SUE) to be developed at Lubbesthorpe would be a suitable site to create a new Extra Care scheme using Section 106 monies;

(vi)    All Extra Care schemes included overnight support and the Council provided a subsidy for this provision. It was explained that basic level support services were provided to all residents in the Scheme. If a person required any personal care services then these would be subject to means testing and charged for appropriately;

(vii)   Where a person passed away in Extra Care housing, it was queried if their spouse would be required to vacate their housing unit. It was explained that each Extra Care scheme had its own specific rules in relation to the retention of housing, and that specific information could be provided to members if required. It would be usual for the tenancy for rented accommodation to transfer to the surviving spouse.    

AGREED:

That the progress on the development of the Leicestershire Extra Care Housing Strategy 2010-2015 be noted.

The Committee received a report of the Director of Adults and Communities which provided an update of the Adults and Communities Department performance at the end of Quarter Three of 2013/14. A copy of the report marked ‘Agenda Item 10’ is filed with these minutes. 

Mr Houseman stated that he had been pleased with those indicators that were green, mindful of those that were amber and appropriately concerned with those that were red.

Fiona Barber of Healthwatch suggested that it would be useful for service user data to be included in any future performance reports. The Committee was advised that soft data was collected through surveys and other means to ensure that all service user and staff views were taken into account. This ensured that an accurate representation of departmental performance was provided

Arising from discussion the following points were raised:-

(i)       It was explained that performance data provided in the report had been produced according to set performance measures outlined in the National Performance Framework. This enabled the Department to better identify where it was and was not performing well. Data parameters needed to be set to allow comparison between quartiles;

(ii)     The Committee suggested that it would be useful in future performance reports for the previous quarter performance figures to be included. This would allow the Committee to better monitor trends in performance levels. It would also be beneficial to have the contributing factors to service areas current direction of travel outlined where appropriate;

(iii)    The Committee queried the mechanisms in place to increase performance where required. The Director responded that where an area was identified as needing improvement, relevant officers would report on the issues and appropriate actions would be undertaken. It was acknowledged that in some areas, such as personal budgets and library services, it would be difficult to improve due to changes in client systems and service reconfiguration;

(iv)    It was explained that some service areas outlined through the performance indicators would be included as part of the Better Care Fund plan from next year;

(v)     In respect of library issues it was noted that correspondence had been received from some parish councils by local members in relation to the proposed devolved management of community libraries to local community partnerships. Arising from concern expressed regarding legislation preventing parish councils from running community libraries, it was explained that the County Council had the power to delegate authority to parish councils, or other community bodies, to run libraries on its behalf. It was noted that a meeting was scheduled to take place on Monday 31 April with local parish councils. Guidance on this matter would be provided to members of the Committee in due course.           

AGREED:

That the update of Adults and Communities performance at the end of quarter three of 2013/14 be noted.

The next meeting of the Committee is scheduled to take place at 2pm on Tuesday, 10 June 2014.

It was noted that the next meeting of the Committee would be held on Tuesday, 10 June at 2.00pm.