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Report to: |
People Scrutiny Committee |
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Date of meeting: |
24 March 2022 |
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By: |
Director of Adult Social Care |
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Title: |
Developing Care Markets – Home care and Care Homes |
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Purpose: |
To provide the Scrutiny Committee with an update on the market position in relation Older Peoples and specialist bedded care and Home Care |
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1. Background
1.1 This report provides an update on the position for Older Peoples and specialist bedded care and Home Care, following the previous Scrutiny report in September 2021.
1.2 The report focusses on the areas of social care provision with the highest volumes of activity and highest levels of spend, namely Home Care and residential/nursing care or ‘bedded care’ for older people and for adults with complex mental health and learning disabilities. The slides in Appendix 1 contain additional supporting information.
1.4 These services are all regulated by the Care Quality Commission (CQC) and East Sussex compares favourably to other areas in terms of the proportion of regulated services rated ‘Good’.
1.5 Adult Social Care work very closely with independent care providers to arrange packages of care to meet individual needs. Choice and control for the client and service quality are key considerations which must be balanced against the availability of suitable provision at Local Authority rates.
2. Supporting information
2.1 Since the September 2021 update, the social care sector has continued to face significant challenges in relation to Covid19 and workforce shortages. Care homes have continued to manage outbreaks, resulting in the need to close to admissions; deal with significant staffing shortages and sometimes restrict visiting arrangements to meet the necessary infection, prevention and control requirements.
2.2 In January 2022 the number of monthly confirmed cases of Covid19 amongst staff and residents in East Sussex Care Homes was 1,346. This had increased from a position of 149 in October 2021. In February 2022 the figure was still relatively high at 771 confirmed cases amongst staff and residents.
2.3 The workforce pressures also continue to challenge all types of social care provision, nationally and locally. The latest figures published by Skills for Care show vacancy rates in the East Sussex Social Care sector increasing from 5.9% in March 2021 to 9.5% in January 2022. Locally there are a range of recruitment and retention initiatives in-train to support Local Authority and Independent Sector providers with this ongoing pressure. As previously reported, there were workforce pressures prior to Covid, but the pandemic and a range of other factors have compounded this issue.
2.4 On 7 September 2021, the government set out its new plan for adult social care reform in England. This includes a lifetime cap on the amount anyone in England will need to spend on their personal care, alongside a more generous means-test for local authority financial support. Under the new plans, from October 2023:
· There will be an £86,000 cap on care costs across an individual’s lifetime.
· Anyone with less than £20,000 of assets won’t have to pay anything towards their care from their assets.
· People with between £20,000 and £100,000 of assets will be eligible for some means-tested financial support on a sliding scale. The current limit is £23,250. This means more people will be eligible for some state support than before.
2.5 The government also intends to tackle ‘persistent unfairness’ in the social care system by ensuring that self-funders are able to ask their local authority to arrange care on their behalf, so they can get a better deal. Currently, people who fund their own care usually pay higher fees than people who are funded by their local council.
2.6 The slides in Appendix 1 show the percentage of the local care market currently purchased by ESCC. Most of the care is purchased by people who fund their own care in East Sussex. The impact of the social care reform plans will therefore be significant for the Local Authority and work is underway to model and quantify this further. More specifically, Local Authorities are required to complete a Cost of Care review by September 2022. We will work with local providers to complete the review and work will commence on this in the coming weeks.
2.7 In recognition of the pressures facing all providers of adult social care in East Sussex and following negotiations with the East Sussex Registered Care Association, we will be allocating a 6% increase to Local Authority fee levels in 2022/23. For a second year in succession a one-off uplift payment has also been agreed. The 2022/23 fee uplift levels will therefore be brought forward by three months to 1 January 2022.
3. Conclusions and Recommendations
3.1 The Adult Social Care Supply Management and brokerage teams have long and well-established relationships with providers of Home Care and bedded care in East Sussex.
3.2 The Adult Social Care Department will continue to work with the market to support recruitment and retention issues and develop new ways of working including the role that technology can potentially play in supporting peoples care needs.
3.3 Work on the cost of care review and wider social care reform has commenced.
3.4 The 6% fee uplift and one-off uplift payment brought forward to January 2022 has generally been welcomed by the local care sector.
3.5 The committee is recommended to consider the current market position for the areas of social care provision covered in this report.
MARK STAINTON
Director of Adult Social Care
Contact Officer: Debbie Endersby
Head of Supply Management and Learning Disability Commissioning
Debbie.Endersby@eastsussex.gov.uk