Agenda item

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 input on this through a Scrutiny Review Panel. If a Panel were established it would wish to focus on how aspects of domiciliary care and the delivery of services could be improved.

AGREED:

(a)  That the overview of the provision of domiciliary care services for adults and older people in Leicestershire be noted;

(b)  That the Scrutiny Commissioners be recommended to establish a Scrutiny Review Panel at the appropriate time to enable members to contribute to the development of the future domiciliary care policy as referred to in paragraphs 36 to 41 of the report.