Issue - meetings

This commissioning strategy sets out the future approach and intentions of BCP Council and NHS Dorset Clinical Commissioning Group (CCG) regarding the commissioning of care home placements for older people. It follows on from an in-depth review of care home provision and commissioning carried out in 2021.

It covers all types of care home provision including residential care, funded nursing care and fully funded NHS Continuing Care where this takes place in a care home.

The commissioning strategy sets out several objectives that seek to reduce the overall demand for care home places, with a focus on meeting those with complex care needs, reviewing the current contractual arrangements and fee structure to ensure best value and improve partnership working with care home providers.

RESOLVED that the Care Homes of Older People Commissioning Strategy be approved.

Voting: Unanimous

Portfolio Holder: Adults

Reason

Ensuring a diverse, vibrant, sustainable and quality market for Adult Social Care is a key duty for all local authorities under market shaping requirements of the Care Act 2014. This commissioning strategy supports meeting that duty in respect of care homes for older people.

The Portfolio Holder for Adults presented a report, a copy of which had been circulated to each Member and a copy of which appears as Appendix 'A' to these Minutes in the Minute Book.

Cabinet was advised that the commissioning strategy set out the future approach and intentions of BCP Council and NHS Dorset Clinical Commissioning Group (CCG) regarding the commissioning of care home placements for older people, and that it follows on from an in-depth review of care home provision and commissioning carried out in 2021.

In relation to this Cabinet was informed that it covers all types of care home provision including residential care, funded nursing care and fully funded NHS Continuing Care where this takes place in a care home.

Further to this Cabinet was advised that the commissioning strategy set out several objectives that seek to reduce the overall demand for care home places, with a focus on meeting those with complex care needs, reviewing the current contractual arrangements and fee structure to ensure best value and improve partnership working with care home providers.

The Chairman of the Health and Adult Social Care Overview and Scrutiny Committee addressed the Cabinet advising that the Committee had been extremely supportive of the report at their recent meeting.

RESOLVED that the Care Homes of Older People Commissioning Strategy be approved.

Voting: Unanimous

Portfolio Holder: Adults

This commissioning strategy sets out the future approach and intentions of BCP Council and NHS Dorset Clinical Commissioning Group (CCG) regarding the commissioning of care home placements for older people. It follows on from an in-depth review of care home provision and commissioning carried out in 2021.

It covers all types of care home provision including residential care, funded nursing care and fully funded NHS Continuing Care where this takes place in a care home.

The commissioning strategy sets out several objectives that seek to reduce the overall demand for care home places, with a focus on meeting those with complex care needs, reviewing the current contractual arrangements and fee structure to ensure best value and improve partnership working with care home providers

The Director of Commissioning for People introduced the Care Homes for Older People Commissioning Strategy 2022 – 2030 report. The main points of the presentation were:

Background:

·       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.

Local Profile:

·       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.

Going Forward:

·       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  ...  view the full minutes text for item 146