Decision Maker: Health and Adult Social Care Overview and Scrutiny Committee, Cabinet
Is Key decision?: Yes
Is subject to call in?: No
To seek approval for the strategic approach to
shaping and developing the care home market that meets the needs of
the Council and NHS Dorset Clincial Commissioning Group.
· The strategy had been developed in consultation with the Institute of Public Care and the Local Government Association.
· The strategy had been based upon a collection of data and detailed analysis.
· Developments in the strategy would be worked through with professionals, carers and others to respond to the high-level issues identified.
· The pandemic had significantly impacted on care homes and finances and these costs had been temporarily offset by short term Government grants.
· Over a number of years there has been an increased rate of dementia cases, in both care homes and the community.
· Fee levels have increased significantly over several years.
· Care home occupancy levels were down in the first quarter of 2021 due to the pandemic. Some occupancy levels had dropped by 20-27% and some providers have closed business due to difficulties in staffing.
· There are currently 1200 beds vacant, with active care homes seeing vacancies of up to 500-600.
· Profits have slowly declined over the last decade for some providers however some providers have seen profits.
· BCP has a high number of care homes (113) for older people, when compared to the national proportion of people going into care.
· BCP is around the middle/top 40% of Councils who place people into care homes each year.
· There are 30% more beds in BCP than the national average in older people’s care homes.
· BCP is an ‘importer’ of people when it comes to provision of care for older people.
· 50% of people in care homes are self-funders and once capital limits have been used up, that’s when they come to the Council for funding.
· Relatively few people out of the total population go into care homes but this area is a significant budgetary impact for the Council and NHS.
· 90% of care homes are rated as good or outstanding by the Care Quality Commission and are in the top 15% of Councils for this.
· Technology will have a large part to play in care provision.
· Quality is not currently a major issue of concern but is also not something to ever neglect.
· The care home fee structure needs reviewing.
· Data collection and analysis requires improvement in order to prevent frequent scouring of the market regarding placements.
Key Commissioning Objectives:
· The aim is to reduce the number of care home admissions made through the Council and the NHS.
· To review and revise the commissioning arrangements with care homes, including the fees structures.
· To support care homes in developing and maintaining the workforce.
· To better support care homes as they continue to provide safe, effective and high-quality care.
· To reduce the number of un-necessary care home admissions by self-funding.
· To enable people to make better choices at the right time when it comes to their care.
The Committee asked several questions following the report. Answers were provided by the Director of Commissioning for People. The questions and responses were:
· A member asked what happened to those care homes that were rated below good or outstanding by the Care Quality Commission. The Committee heard that there were many stages involved in assessing quality, such as the Council’s service improvement team’s routine monitoring visits to care homes each year and the assessments of the policy procedures, medicine administration and staff training. The Care Quality Commission can impose sanctions or improvement plans on those care homes that are rated as ‘requires improvement’ or ‘inadequate’. The NHS and CCG also have a quality team who monitor the quality of nurse provision and clinical provision.
· A member raised the issue of the rate-setting strategy to which the Committee heard that the criteria for this was set nationally and was in-line with the Care Quality Commission.
· Members heard that on the issue of staff training that the Care Quality Commission, CCG and Dorset/BCP Council all had respective responsibility to train their staff adequality.
· The Committee were informed that an increasing use of technology was being used in care homes, such as fall and bed sensors as an example. The NHS work closely with care homes on this and the adult social care service were looking at how to use technology more effectively overall to monitor people’s activity and provide an effective response where needed.
RESOLVED that the Committee noted the report.
Report author: Phil Hornsby
Publication date: 17/09/2021
Date of decision: 26/07/2021
Decided at meeting: 26/07/2021 - Health and Adult Social Care Overview and Scrutiny Committee