Agenda item

This report provides a commissioning overview of the care market in York, with a particular focus on the needs of older people; and  describes an approach to the challenges of the next few months.

Committee Members considered a report that provided a commissioning overview of the care market in York, with a particular focus on the needs of older people and to describe the council’s approach to the challenges of the next few months.

The Assistant Director of Joint Commissioning was present to provide the update and with the Corporate Director of People, answer Members’ questions.

She stated that:

·        The latest Care Quality Commission (CQC) ratings showed that 74% of residential and nursing home settings were good, 8.6% outstanding and 17.1% required improvement and that since the report had been written, for community settings, including supported living, one provider had shifted from ‘inadequate’ to ‘requires improvement’. 

·        A complex network of partners continued to work together to support the care system and ensure the right range of services were available to enable people to live as independently in their own homes for as long as possible.

·        A new Market Position Statement was in the process of being co-produced with the sector for publication in 2021.

·        The Council sets a standard weekly fee rate for its placements, known as the Agreed Cost of Care (ACOC), with higher costs by exception.

·        In 2019 a capacity and demand exercise was commissioned to better understand the pathways relating to urgent and unplanned care.

·        The Coronavirus Act 2020 created a new financial mechanism as well as new service models and requirements, allowing care providers to build on the strategic agreement that Home First is York’s default, supported by the Hospital Discharge Service Requirements.

·        Care providers in York had been supported by the CCG and Council teams to fully implement the Capacity Tracker, which had supported communication about available capacity and the status of services in relation to risks.

·        The Adult Social Care Action Plan and the Winter Plan continued to be developed and it included the establishment of a designated residential care setting at Peppermill Court for patients who had tested positive for Covid-19, to enable safe discharge from hospital and a unit at Haxby Hall for people who had come in contact with the virus but tested negative.

·        After the initial wave of infections in the earliest phase of the crisis, providers had implemented excellent infection prevention and control, with no outbreaks for a long period of time.

·        All local care homes were receiving the vaccine.

The Assistant Director noted that a range of services had to be extended or created to manage the steep rise in demand and she thanked staff and partners for their dedication. She commended the partnership working and integrated commissioning approaches that had made great progress in response to the pandemic. 

In answer to Members questions, the Assistant Director confirmed:

·        A temporary care home setting was a good asset to have in the system for those who required short term care when discharged from hospital.

·        The findings from the independent exercise, that had been jointly commissioned to update the ACOC model, was currently being considered, including any implications of the changed circumstances linked to Covid-19. When the document was publically available Members could be updated at a future meeting.

·        Individual care providers do have the ability to breakdown their weekly costs and the sector does have an understanding of the expected profit margins.

·        Recruitment was continuing and there was a range of resources to ensure new staff were supported and encouraged to continue in the field once the immediate crisis was over.

·        Voluntary organisations, service users, families and previous users were all included when surveys were issued, to ensure a wide response was received

The Assistant Director and Corporate Director of People answered a specific question raised regarding the selling of a council asset that was designated as a health and social care building and the transparency around this.  They stated that the council had a strategic overview of all their assets in the city and that officers ensured they had sufficient types of buildings for the whole range of care services. Overtime these requirements could change and if a particular building was no longer required it would revert back to being a council asset to potentially be used in a different way. 

The Assistant Director agreed that any future monitoring reports could include past data to enable the Committee to compare how the inspection framework had developed and improved over the last few years.

The Assistant Director was thanked for her update and for the tremendous work achieved throughout the pandemic.

Resolved: That the report be noted.

Reason: To keep the Committee updated on the care market in  York.