The Panel will receive an update, via PowerPoint presentation from the Assistant Director Commissioning, on issues arising in relation to promoting a sustainable and diverse market place following the Commissioning for Better Outcomes Peer Review undertaken in the borough.
Minutes:
Charlotte Pomery, Assistant Director Commissioning, provided an update on issues arising for the Council in relation to promoting a sustainable and diverse market place in light of the Care Act and following the Commissioning for Better Outcomes Peer Review that had been undertaken in Haringey during February 2015.
To set the scene, Ms Pomery commenced her presentation by providing information on the Department for Health’s Care Markets Work Programme. The Panel was informed that a number of workstrands had been supported by the government in order to support local authorities to achieve the ambitions and statutory requirements for commissioning, market shaping and contingency planning and provider failure set out in the Care Act. Information was provided on the following:
- The Government’s Market Shaping Review
- A CIPFA project on adult social care finance, costs, fees and sustainability
- Local contingency planning.
Following discussion by the Panel in January 2015, it was noted that a key line of enquiry related to promoting a sustainable and diverse market place. With this in mind, the presentation from Ms Pomery, focused on both strengths identified by the Haringey peer review team and areas identified for consideration / action moving forwards.
The Panel was asked no note:
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Areas identified by the Peer Review
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Action Taken |
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- The generation of positive engagement with provider partners and wider stakeholders |
- Strengthening of provider forum
- Reinvigoration of Voluntary and Community Sector Forum
- Development of co-production model |
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- Significant additional engagement required around next steps of budget consultation, ensuring clarity of options under consideration |
- Statutory consultation on proposed service model changes
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- People do not feel listened to (providers, carers, service users, staff) |
- Co-production model and Steering Group established
- Review of Partnership Boards underway
- Stronger internal and external communications
- Stepping up of user and carer engagement mechanisms |
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- Training and development for the whole ASC workforce is required (including consideration of resources required)
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- Whole staff engagement in Professor John Bolton’s thinking on model for social care
- Development of Integrated Target Operating Model |
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- Lack of approach to address inflation up-lift and Fair Fee process
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- Building costs of care approach through development of Dynamic Purchasing System
- Stronger understanding of current and projected costs of care
- National work underway on social care market overall |
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- Lack of collation of intelligence on the diversity of the market place i.e. what’s out there
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- Consistent use of CarePlace, development of HariCare
- Mapping of community and other assets to inform day opportunities and wider work |
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- Market intelligence to inform micro and macro-commissioning
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- Detailed market analysis across all forms of care and support
- Supported Housing Review – needs and market analysis complete
- Establishment of brokerage – finance, quality assurance, service finding, value for money and appropriate provisions |
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- Systematic quality monitoring of capacity of the market to deliver
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- Brokerage delivering contract monitoring, quality assurance
- DPS with contract monitoring functionality, including introduction of electronic call monitoring system for home care
- Multi-agency Quality Assurance sub group established and reports to SAB |
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- Underdeveloped response to the current and future needs of older people and market supply of care |
- Needs analysis across all care groups
- Confirmation of requirement for more extra care sheltered |
During discussion, reference was made to the following:
- The fact care workers had lodged a case at the employment tribunal to complain that a number of contractors had not paid their staff the national minimum wage for work carried out in the borough.
- The Panel was informed that the tribunal was ongoing. However, it was noted the Council had paid contractors enough money through contract fees to ensure all live-in carers could receive the national living wage for 24 hour care provided. In addition, it was noted the council required all contractors to obey minimum wage law, including remuneration for travel time.
- The Panel was advised that the Council no longer had in place any contracts with Sevacare, following serious concerns raised by the Care Quality Commission in April 2016.
The Panel went on to discuss, more generally, the pros and cons of various service delivery options including shared services, outsourcing, and “insourcing”, among others. It was commented that any model that moved away from direct provision raised questions about democratic accountability. In response to questions, the Panel was informed, that as part of the options appraisal process, an in-house option was developed as standard practice. The Panel was informed that each option was considered to assess whether they could improve investment, modernise services, enhance organisational capacity, achieve efficiencies and achieve regeneration and other social benefits such as reducing inequality, generating employment and improving the environment.
AGREED: That the Commissioning for Better Outcomes (Update on Actions) presentation be noted.