Agenda item

The Committee considered a report of the Director of Adults and Communities which set out the outcome of the award of contracts for personal care services provided in home and outlined the arrangement for the transition to the new Help to Live at Home (HTLAH) service. A copy of the report marked “Agenda Item 8” is filed with these minutes. A copy of hourly maintenance rates for each provider and a map displaying location of all providers within Leicestershire tabled at the meeting are also filed with these minutes.

The Director of Adults and Communities introduced the report and provided the following feedback in regard to the launch of HTLAH on 7 November 2016:-

(i)    Shortly prior to the launch of the service one of the providers, TLC Homecare, had withdrawn from the contract.  There had also been capacity problems with some of the other providers which affected service provision.  A contingency plan had been deployed which meant that the majority of the affected service users received care from the existing providers.  Some were receiving care from a new provider on an interim basis and in some cases the Council’s Homecare Assessment and Reablement Team (HART) was being deployed to meet need in the short term. Transitional arrangements would remain in place until the contract was let again;

(ii)  The vast majority of service users had transferred smoothly to the new service. The Department had worked closely with providers in order to achieve this and would continue to do so to enable the providers to take on new work and to support discharges from hospital.  The safety and wellbeing of service users remained the key priority for the Department;

(iii) It was acknowledged that it was not acceptable for any service user not to receive care.  To that end, the Customer Service Centre was open for extended hours and any service user who had not received care could contact it. The Customer Service Centre would then deploy staff to provide care to these service users including volunteers from the Adults and Communities Department.  The Director expressed his gratitude to these and all officers involved in the launch of HTLAH.

The Cabinet Lead Member for Adult Social Care advised that notwithstanding the difficulty arising from TLC’s withdrawal from the contract, the new service was a good example of the County Council and the NHS working together to provide a more responsive service with pooled resources to reduce duplication and achieve savings.  The new service would focus on improving outcomes for service users and maximising their independence. He commended County Council officers who worked on the service development and implementation, and those who volunteered their time outside of the usual working hours, including over the weekend, to ensure all users of the service received the care needed. 

Mr. J. Kaufman CC, the Chairman of the Scrutiny Review Panel on HTLAH, which reported to the Committee on 2 June 2015, having been invited to speak on the item, welcomed the report, though he raised a concern that one of the recommendations of the Panel, to ensure there was more than one provider per area seemed to had not been followed. The Director advised that the service was being delivered within 18 smaller ‘lots’ corresponding with the Clinical Commissioning Groups’ and Leicestershire Partnership NHS Trust’s localities, cross-cutting district and borough boundaries. This meant that there were multiple providers in each geographic district/borough area.

Arising from discussion the following points were noted:-

(i)    The detailed reason for TLC Homecare’s withdrawal from the contract was not known, although it had reported issues regarding the volume of business.  The County Council had raised concerns with TLC Homecare shortly before they withdrew from the contract regarding staffing numbers.  However, the current focus of the Department  was to ensure safety of service users; any contractual issues would be addressed once all transitional arrangements were satisfactorily in place;

(ii)  TLC Homecare had met the requirements for quality of service and financial viability at the time of awarding the contract and there had been no reason to believe the provider would withdraw. Due diligence checks had been carried out for all providers, which included them providing a detailed description of their overarching delivery model including sufficient staff levels and project management. Risk assessments had also been completed for each provider, taking into consideration Care Quality Commission reports. In addition, the Committee was advised that no contracts had been awarded to providers with an “inadequate” rating for safety or leadership;

(iii) All service users had received a letter advising them that they would transition to the new service on 7 November 2016.  For the majority of service users, the transition went as planned.  As many service users as possible who were affected by TLC Homecare’s withdrawal had been contacted by telephone, others received a letter;

(iv) Any delays in receiving care reported before Monday, 7 November 2016 had not been related to the launch of HTLAH and could be a result of many issues, such as staff shortages due to short-term sickness;

(v)  Though it was too early to provide comprehensive feedback on lessons learnt, the Director advised that some providers had mobilised exceptionally well to provide the service and that assessment of early findings should focus on replicating that. In addition, members were advised that having a contingency plan in place had been recommended by the recent Peer Review of the Department.  It was felt that this had enabled the effective delivery of the service to majority of the users;

(vi) The Committee was advised that the domiciliary care market was fragile and that funding was a national issue.  In terms of the HTLAH mobilisation, funding was not necessarily an issue as Leicestershire paid the second highest amount across the East Midlands for services and was in the top quartile nationally.  It was acknowledged that the capacity of the market locally was an issue which would need to be considered as part of the medium term planning for the service.

RESOLVED:

(a)  That the report and the information now provided be noted;

(b)  That an update on the delivery of Help to Live at Home service be provided at a future meeting of the Committee;

(c)  That the Committee’s thanks be extended to staff who had volunteered to work additional hours or provide care for those service users who had reported missed appointments.