Agenda item

To receive an update on the effectiveness and progress of Home First and the Adult Care Market Sufficiency.

Members also received a report which focussed on the sufficiency of a number of areas including Reablement and short term services; Home care services (domiciliary care); Supported living and supported housing services (including support to individuals in transitions) and Care homes. It builds on the report presented at the November 2021 Committee meeting. It also confirmed the continued shortage of home care and therapy provision in the Dorset area and also highlighted the significant impact the Omicron Covid-19 variant was having on the care home market. A presentation was also given which is attached as an annexure to these minutes.

Areas of discussion/questions

Was there scope for further care hotels? Yes, there was more scope but there was not the care workforce to facilitate it. System partners via the Home First Board are considering the best use of any additional staffing capacity.

Consideration to be given to approach job centres and look at skills of unemployed people. Consideration also to be given to communication messages to see how members could help with recruitment and also look at re-engaging with neighbourhood contact teams.

Mention was made of empty wards in Portland and whether they could be used. Details of volunteering to be circulated.

All resources across the health and care system were being reviewed constantly.

In terms of the cost of beds, officers were undertaking two cost of care exercises to give an open and transparent account of what the costs actually are. Cost of care models would be presented to members at their March meeting.

Reference made that this is not just a Dorset issue but a national issue. Reference was made to the four care home closures since the start of the Covid-19 period. There were various different types of contracts, but officers were not aware of any large provider contracts that had been returned. There had been a number of ‘handbacks’ where the provider was not able to fulfil their arrangements.

Were arrangements in place to make provision for more care home beds? Officers advised that if all the care home beds were open that would be sufficient for the local need. However, strict infection, prevention and control measures were in place.

Communication with the family, the individual and social worker in respect of their placement in a care home was highlighted.

The balance of risk in respect of Omicron in care homes was highlighted. In respect of the funds available from government, do they need to be spent or just committed by the end of the financial year? Officers advised the funds had to be used by 31 March, if not the Government would be calling it back. Officers were working through a set of proposals for the rest of the money. The importance of taking provider views on board was highlighted.

Consideration will be given to car park permits being extended to health colleagues.

Reference was made to the recent ADASS national survey. Dorset was in a better position than some other national and south west authorities.

Staffing issues highlighted, members were pleased to hear about work that was being done to try and secure more staff.

The average number of home care packages has increased since the onset of Covid-19. Would a high percentage of these continue? Officers advised this is likely to continue to be the new average. The importance of getting reablement and rehabilitation in place as early as possible was highlighted as was the need to build a narrative within the community that care work is good and valued career to have.

There was discussion around the number of unpaid carers. Officers advised that Healthwatch and Friends of both acutes were currently conducting surveys to try and understand carers’ experiences and those of people coming out of hospitals. If voluntary carers were being used more effectively and were better supported, it was felt this would make a difference It would be invaluable to look at the response from the surveys.

The Dorset Council offer to carers was highlighted.

Consideration was given to the formation of a Task and Finish Group to sit alongside the work that was being carried out. The Chairman undertook to look at membership of a group. The following members expressed an interest in being part of the Task and Finish Group: Mary Penfold, David Taylor, Paul Kimber, Molly Rennie and Peter Wharf.

Members felt it would be helpful to have an all member briefing on this area to which the Portfolio Holder for Adult Social Care agreed to lead on.

The Chairman proposed an additional recommendation which Cllr Rennie seconded.

Decisions

That the Committee:-

1.    Considered, commented and noted the updated position and further deterioration in Dorset’s market sufficiency of social care provision since the November 2021 report as a result of additional workforce pressures caused by the new Covid-19 variant 

2.    Considered, commented and noted the change in Government guidance since the last report and the additional funding released into the sector and the actions Dorset are taking in response to this

3.    Considered, commented and noted the level of risk for Dorset residents and Dorset Council as an organisation

4.    Reviewed the progress on the short term and medium-term actions to mitigate the risk and new actions identified.

In light of the last slide on the slide deck (attached to these minutes) members considered and commented on the role of the community with regards to care. Cllr Wharf offered to provide a ‘what members could do to help’ briefing document.