Issue - meetings

22.1     The Director of Adult Social Care and Health introduced the report highlighting the following:

·                There has been a consistent pattern over time in that East Sussex performance is below the national average for all delayed transfers of care (DTOCs) but better than the comparator group of authorities delays attributable to social care. In this East Sussex is consistently better than both the national average and the comparator group for DTOCs.

·                There has been a significant deterioration in performance over the last year which reflects national and regional trends.

·                Reasons for delays change week to week but there are some key areas which are the biggest contributors overall to social care delays:

o   capacity in the independent sector – home care: recruitment challenges particularly affect home care and areas with high levels of employment where there are other, less demanding, jobs available at similar wage.

o   capacity in the independent sector – nursing care: this shortage is partly due to fee constraints but also because the market has historically been based around residential care. Population needs have increased but the sector nationally has not yet adapted to providing higher level care. Local response is to develop the ‘care home plus’ model and in-reach from community health teams.

·                As part of winter plans the local NHS has agreed additional investment in two initiatives:

o   block purchase of independent sector beds in the Eastbourne and Hastings/Bexhill areas to enable easy access to these beds.

o   recruitment of generic health and social care workers to be based in locality teams which will also help in pulling people out of hospital promptly.

·                An Operational Executive Group oversees use of bed capacity on a weekly basis and provides integrated management, reflecting the direction of travel towards accountable care.

22.2     The following additional points were made in response to the Committee’s questions:

Independent sector capacity

·                There are issues with services pulling out of providing placements at local authority prices – the department is negotiating fee increases in the context that providers are requesting a significantly higher increase than the budget allocated in the Council’s medium term financial plan.  Providers are impacted by increases to the National Living Wage. Ultimately, the level of fee increase impacts on the number of placements the department can provide, as the budget is fixed.

·                The department is working to support small providers via Support with Confidence and the purchasing unit, and working with the Councils for Voluntary Service to change their offer to include support for very small businesses via community resilience work.

·                The main challenges with home care relate to complex packages of care required for people leaving hospital with higher needs and it tends to be larger agencies which can provide these packages. The department is looking at ways to pay for care differently which would simplify the process for providers.

·                There have been care home closures in the county for both finance and quality reasons, or because they no longer provide the services needed. There have also been  ...  view the full minutes text for item 22