Agenda item

Ms Jan Major, the Council’s Assistant Director Direct Care and Business Delivery (Provider Services and Commissioning), advised that local authorities were encouraged to produce an Adult Social Care Market Position Statement (MPS) under statutory guidance issued under the Care Act 2014.  The MPS set out the current demand for care and support services, projections for future demand and opportunities to develop / provide the support that would be required from 2024 to 2027.  Consultation was currently underway and it was anticipated that document would be read by existing providers, potential providers, voluntary and community organisations and service users.

The report stated that different approaches were being used to ensure a diverse market of quality services.  Ms Major advised that residents had a range of choices and could purchase services through Direct Payments.  The views of residents were also sought through groups such as the Disability Assembly and the Older People’s Assembly.  It was agreed that Ms Major provide the Democratic, Civic and Ceremonial Manager with examples and further detail of what this meant to residents in reality for circulation to the Committee. 

Members asked about the benefits of integrated commissioning for Hillingdon.  Mr Gary Collier, the Council’s Health and Social Care Integration Manager, advised that there were circumstances where there were low volume / high costs specialist services needed which meant it was difficult to give a personalised approach in Hillingdon.  However, working with colleagues in North West London meant that economies of scale could be achieved when using the same specialist service providers.  There might be times where Hillingdon would act as the lead commissioner. 

With regard to personalised care and personal health budgets, Ms Major advised that some individuals would use this budget to employ a personal assistant.  For example, a blind resident had been using their personal budget to employ a personal assistant who had been teaching them to cook.  As such, as well as domiciliary care agencies, the Council now also signposted individuals to personal assistant recruitment providers.

It was noted that Hillingdon had a higher number of care homes than other local authorities (44) but it was queried whether these were of a high enough standard and fit for purpose.  Ms Major recognised that the report had not provided that level of detail but advised that the Council had been working with the care homes to ensure that they met a minimum standard and would put measures in place where necessary to help them achieve this standard.  Standards in Hillingdon were comparable with those in the rest of North West London. 

Work had been undertaken with partners to ensure that residents were kept at home for as long as possible before moving into a care home.  Interventions such as extra care provision and telecare (assisted living technology) had been developed to help achieve this objective. Ms Major advised that there were three extra care services in Hillingdon that the Council was responsible for and a fourth where the local authority had 100% nomination rights.  This provision enabled residents to stay more independent for an average of 5½ years longer than they would otherwise. 

The report stated that the Council would be exploring options to directly provide a nursing care home.  Ms Major advised that this work was ongoing but that there were no firm timescales for this initiative. 

The Council currently directly provided three care homes for people with learning disabilities but there had been changes to CQC requirements under the guidance of -Right Support, Right Care, Right Culture.  As such, the Council was now looking to develop two smaller care homes to address the local need in line with the guidance.  A planning application would need to be submitted for these properties and action would need to be taken to ensure that it was compliant with the new CQC requirements.

It was noted that there had been 17.4% growth in the 65+ population and 27% increase in the 90+ population in Hillingdon since the 2011 census.  Given that this significant increase was likely to continue into the future, Members asked whether there were enough care home places and staff to support the needs of this growing population and the resultant future increase in demand for care services.  The Council’s bed based strategy had been to support residents to remain in their community and independent as long as was possible and, with the Homecare and Extra Care provision (230) flats in the Borough, this was supporting the Council to ensure care provision was available to support a range of needs and reduce reliance on residential care.

Ms Major advised that the Council had been building close relationships through the Domiciliary Care Framework and the Dynamic Purchasing System Framework.  The Quality Assurance Team in Social Care monitored and supported all care providers in the Borough and part of their monitoring included looking at the recruitment of staff and provider compliance with things such as UKVI sponsorship licences.  To this end, the Provider Risk Panel and Governance Care Board held monthly meetings.  The Council currently had 230 flats in its extra care provision but there were neighbouring local authorities that tried to place their residents in Hillingdon care homes.

When the extra care provision had been developed, it had been seen as a bold move.  Members queried whether the extra care occupancy levels were high enough and whether this provision had delivered on expectations.  Ms Major advised that there had been some voids but that officers held weekly meetings to review and decide which residents would be able to move in. 

Mr Collier advised that the extra care provision had provided other opportunities such as hospital step down beds during the pandemic.  Although this use had stopped last year, consideration was being given to reinstating the facility as it also gave residents the opportunity to experience what it would be like to live there when the time came.  Further work was also being undertaken to develop a waiting list for the extra care provision.

RESOLVED:  That:

1. Ms Major provide the Democratic, Civic and Ceremonial Manager with examples and further detail of the different approaches that were being used to ensure a diverse market of quality services for circulation to the Committee; and
2. the report be noted.