Agenda item

The Committee considered a report of the Director of Adults and Communities, the purpose of which was to provide the Committee with an overview of the current position in care homes across Leicestershire and the support being offered to them by the County Council to provide safe and effective care, in the context of the ongoing Covid-19 pandemic.  A copy of the report marked ‘Agenda Item 9’, is filed with these minutes.

In introducing the report, the Director highlighted that in response to the requirement set out by Government, designated care settings had now been established in Leicestershire for people discharged from hospital who had a Covid-19 positive status to help prevent further outbreaks in care homes.  Occupancy levels were currently low, but this would change depending on increasing rates of infection.

Arising from discussion the following points were raised:

(i)            With regard to the hospital discharge process it was confirmed that there continued to be focus on the Home First approach and that the increase in temporary admissions was partly due to the effects of the pandemic.  One of the future aims would be to have more care facilities available that specialised in reablement services which could temporarily accommodate those with a higher level of need, helping them prepare to return to their home environment and thus avoid them being placed in a long-term care facility which was often not their preferred choice.

(ii)           The composition of the care home market was diverse in that it was made up of many different sized enterprises.  Locally, providers were more regionally (not nationally) based with some operating a range of between 20-50 care homes across the County and surrounding area.  It was acknowledged that larger group failure would be far more challenging to manage than, for example, a group of one to five care homes, and would likely require the support of other providers to assist in delivering suitable accommodation.

(iii)          During the Covid-19 pandemic the Council had held weekly, and more recently fortnightly, meetings with care home providers to give support and guidance on matters such as Personal Protective Equipment (PPE), testing and training. Whilst it was difficult to quantify how many had taken up the Council’s support offers, many providers had been keen to engage with the Council during this period and overall communication had therefore improved as a result.  It was noted, however, that the level of engagement depended on the situation of the care home and the level of support that had been required.  For example, care homes that accepted very few Council placements might be less likely to engage than those that had accepted many.

(iv)         In terms of Care Quality Commission (CQC) ratings, the Director confirmed that regard was given to these before a person was placed into a care home. However, it was important to note that due to the length of time between CQC inspections, the ratings did not always accurately reflect the current picture, so the Department also relied upon a wider range of intelligence to keep up to date with any issues, which may also require reporting to the CQC, or improvements being made.

(v)          Given the current higher than normal level of vacancies, and the Council’s strategic aims around preventing inappropriate admissions to residential care, instead supporting more people to live more independently, it was seen as unlikely that capacity would become an issue in the short term.  Therefore, in terms of future builds, the focus would likely be on replacement facilities rather than new capacity.

(vi)         Discussions were underway with care home providers that were experiencing higher levels of vacancies to identify their support needs and to explore ways in which the Council could support them to become more sustainable for the longer term.  A member commented that there would likely continue to be a downward trend in the number of occupancies in care homes due to a number of factors including the high costs and complex nature of running a care home. In respect of the work undertaken by the Department to move identified cohorts of working age adults from residential care to support living, the Director clarified that this work had already begun.

(vii)        In response to a question raised by a member the Director confirmed that although there was an element of risk to the Council with regards to the recovery of forward payments made available to care homes to help or prevent cashflow issues, it was in the Council’s interest to work with those homes to ensure the stability of care for residents.  In any event, the majority of care homes had already agreed the terms for repaying the money loaned, either in one instalment covering the total amount or smaller instalments spread over a period of time.

(viii)       The Committee thanked officers for the report and the level of insight and assurance this provided in respect of the exceptional work that had been undertaken to support care homes during this very difficult period and requested that a further update be brought to a future meeting when the Director considered this to be appropriate.

RESOLVED:

(a)          That the analysis undertaken of the current position of the care home sector in Leicestershire and the update now provided be noted.

(b)          That a further update on Care Home Sustainability be provided at a future meeting of the Committee when the Director considers to be appropriate.