To provide the Health, Care and Wellbeing Scrutiny Committee with an overview of home care services in Herefordshire, both services commissioned by the council and the wider market. The report also outlines plans to support hospital discharge arrangements over the winter and provides information on the council’s Shared Lives services.

The committee considered a report on home care services, discharge arrangements during the winter, and Shared Lives services.  A presentation was given and the slide pack was published to the webpage for the committee following the meeting (link to the presentation).

The slides presented by officers from the Community Wellbeing Directorate are identified below, along with a summary of the principal points of discussion.

Home Care

A            The Interim Head of Care Commissioning presented the Home Care slides:- Legislative Framework; Key Facts; Commissioning History / Arrangements (1); Home Care Framework Providers – Areas; Commissioning History / Arrangements (2); Current Provider Landscape; Overview of Quality of Provision; Legacy Provision; Apr 2021 Estimated Demand to Sep 2023 Delivery; Commissioned Home Care Customers and Weekly Hours; Weekly Cost of Commissioned Home Care; Community Waiting List for Home Care; Challenges; Response to Challenges; Future Plans and Next Steps.

a.1.          It was noted that, unlike the Primary Framework, the Secondary Framework was not based on specific geographical areas.

a.2.          It was reported that demand had been lower than anticipated (the estimate for April 2021 was 710 people but the actual numbers were 559 in April 2021 and 593 in September 2023) but the total hours were similar (the estimate was 9000 hours but the actual hours were 8282 and 8882, respectively), reflecting the appropriate management of pathways but also increasing levels of acuity.

a.3.          The Chairperson noted the improvements that had been made in recent years and thanked the officers for their hard work.

a.4.          An overview was provided of the work of the Commissioning Support Unit (including brokerage, quality and review, and contract support) and the activities undertaken as part of the quality assurance process.

a.5.          It was noted that the Care Quality Commission (CQC) undertook inspections of providers periodically and there could be changes in the intervening period.  In terms of the one provider commissioned by the council currently rated as ‘requires improvement’, it was reported that the council was working closely with the provider to monitor and support improvements, and intelligence was shared with the CQC to inform the risk profile. 

a.6.          The committee was advised about the due diligence process undertaken for potential new providers prior to appointment to a framework.

a.7.          It was reported that care providers had to apply for a licence to recruit social care workers from overseas, intelligence on practices was shared via regional networks, and sanctions could be taken against providers if they were in breach of licence conditions.

a.8.          The committee was advised that, at the point of commissioning, an equality impact assessment was undertaken to ensure that diverse characteristics and emerging needs were considered in formulating the specification for the service.

a.9.          It was reported that there were regular fora with providers, there was a complaints process for individual clients, and an external process for obtaining feedback was being introduced.  The Vice-Chairperson commented on value of previous scrutiny activity involving providers.

a.10.      The council was working with providers to identify clients that  ...  view the full minutes text for item 16