Agenda item

Report ACH23-003

The Committee considered a report providing an overview of the delivery of the domiciliary care contracts in accordance with the service specification.

The Committee could review contracting arrangements on an annual basis, where the contract value was over £500k. The Domiciliary Care Frameworks for both the Patch and Framework providers contracts commenced on 28^th August 2021 and had an annual aggregate value that exceeded this threshold. Given the number of providers (40 in total), the report focused on the mobilisation and performance reporting to provide an insight into the first year of these contracts.

The Integrated Strategic Commissioner advised that the providers of domiciliary care were divided across four quarters (East, West, Central and South). There were 8 providers working across these patches, providing care to 1,400 weekly service users. They were also supported by a smaller framework of 32 providers. The contract had been successfully mobilised during the first year and was meeting demand. The Head of Service for Community Living Commissioning advised that the Local Authority had been a trailblazer for this particular model. The Integrated Strategic Commissioner had forged good relationships with this smaller number of providers who were focused on delivering outcomes for service users. They were finding out more about what service users wanted, and what they could do for themselves – they also ensured that providers worked closely with the voluntary sector to prevent people from being isolated at home. This was considered to be a very good model which brought financial efficiencies. It was highlighted that the tender for this contract had been undertaken by the Head of Service for Community Living Commissioning and her team during the pandemic, which had been a difficult time, and demonstrated that the providers wanted to work with the Local Authority.

The Director of Adult Social Care emphasised the huge amount of work that had been undertaken in relation to this contract. This had been part of the transformation programme from previous years – as well as creating financial efficiencies it was changing the way that people were supported in their own homes, and had been an excellent piece of work.

In response to questions regarding outcomes and the data provided, the Integrated Strategic Commissioner advised that they were based on a 360-degree model – this included strength-based assessments that identified strengths that service users had and enabled them to maintain them. The trusted assessor model also allowed packages to be reframed when safe to do so. Increasing skills and reducing care packages helped service users to remain independent. The Head of Service for Community Living Commissioning advised said that the trusted assessor model allowed the team to have a closer relationship with the care workers, who provided regular feedback on the interventions that care management could support. The Director of Public Health said that her team would be happy to look at how the data could be presented more clearly for future reports.

With regards to stakeholder engagement, a Member noted that 262 stakeholder responses had been received. It was questioned if the percentage of respondents was known, and if this was low, consideration should be given as to how this could be increased. The Head of Service for Community Living Commissioning advised that this information could be provided to Members following the meeting.

In response to questions from a Co-opted Member regarding reassessing care packages, the Head of Service for Community Living Commissioning advised that care package increases and decreases were anticipated. The main reason for doing this was to provide bespoke packages of care for service users, and prevent them from being stuck with packages that did not necessarily work for them. Working closely with care workers, who saw the service users regularly, added another level of quality assurance. This would provide further intelligence and allow them to work in a flexible way to support service users. The care packages provided may increase, or be reframed – this would be monitored, and the care workers would be trained to support their recommendations to care management to alter packages of care.

A Member considered that the trusted assessor model was definitely workable, however it was requested that feedback be provided at a later meeting to provide assurance of the monitoring. The Head of Service for Community Living Commissioning said that two providers had been identified to pilot the trusted assessor model – this would be tested, and the feedback reflected on. Additional funds had also been invested in a trusted assessor role within the Local Authority to provide another layer of quality assurance.

RESOLVED that the content of the contract monitoring report on the performance of Patch and Framework providers in the delivery of Domiciliary Care in the initial year of this Award be noted.