To agree the redesign and procurement of a home care service to be known as Help to Live at Home.

The cabinet member for health and wellbeing introduced the report. She highlighted that this was an area of significant expenditure for the council and that it was important to provide good services to allow residents to remain independent.

The joint commissioning better care fund manager gave a presentation to the meeting. Copies of the slides used were circulated as an appendix prior to the meeting.

In the discussion following the presentation the following points were made:

·         that providers had indicated in their feedback to the consultation a need for between 700 and 2,000 hours of care per week to sustain a viable business, depending on the size and type of provider

·         that the proposed hourly rate had been derived using a number of factors such as the national living wage, travel costs and reasonable on costs for providers; the proposed rate is consistent with those used by other authorities

·         that providers had expressed a preference for a single hourly rate rather than separate urban and rural rates so long as each provider had a mix of urban and rural care packages to deliver

·         that the proposed new framework would reduce the number of providers working with the council, this would give them greater certainty over the quantity of work available and allow the council to develop closer relationships with providers

·         that there would be flexibility to adjust the zones in future, to take account of demographic changes for example

The cabinet member for contracts and assets argued that the council should not set an hourly rate but should allow the market to dictate the cost of the care packages. It was suggested that this approach could reduce the costs to the council.

In response it was noted that while some packages did achieve a lower hourly rate under the present system than that now proposed, other packages, particularly in more rural areas, had to be funded at a much higher rate and some were extremely difficult to allocate. Where providers did not pick up packages or withdrew from packages because they were felt to be unsustainable the council had to step in with expensive emergency measures. It was also noted that tendering individual packages required a significant amount of officer time.

In response to a question from a group leader the assistant director operations and support stated that the service redesign was part of a programme of work associated with the whole systems approach to transformation within adults and wellbeing and that it was focussed on achieving outcomes for individuals.

A group leader noted that 17% of respondents to the service user questionnaire issued as part of the consultation on the new model felt they were treated differently because of who they were. He queried whether this was a recent development or whether there had been a trend over time.

The commissioning officer adults and wellbeing responded that the figure was reflective of the cohort in general and that there had been no recent increase. He stated that this was  ...  view the full minutes text for item 55