To consider a report detailing an overview on residential and nursing care homes.

(Note: presented by Jo Williams, Director of Adult and Community Services, Torbay Council and Lee Baxter, Divisional Director, Adult Social Care,Torbay Council).

The Divisional Director of Adult Social Carepresented the submitted report which provided Members with an update in relation to Residential and Nursing Care Homes and an overview of how the care home market currently supported the Local Authority in meeting individual needs together with achievements and challenges.

Members were informed that it was important to recognise that the Local Authority retained accountability for the market but the regulator for Adult Social Care was the Care Quality Commission (CQC).

It was explained that there were 76 care home providers within the Torbay area commissioned by the Integrated Care Organisation (“ICO”).  There was very good performance around discharge from hospital to assessment which was really focused on working with partners to assess people’s needs.  A current piece of work being undertaken was to engage with people and families who had been transferred into care homes in Torbay to better understand how co-designed processes could be improved enabling a better experience.

Members were informed that from a market overview perspective there had been an increase in demand, some of which was due to hospital discharges.  It was also important to keep costs under review since they had escalated probably due to the Covid response originally together with the way the market had changed and the increased pressures on the NHS to discharge people quickly.  Challenges included workforce as rates of pay were not competitive when compared with other parts of the sector.  The need for residential nursing care was also higher and a large number of individuals were entering residential care with complex long term needs.  This required highly skilled staff, so it was important for the Council and the ICO to find ways of making systemic change that prioritised upskilling staff alongside structural development within the sector.

It was explained that moving forward it was important to have a clear plan as a Local Authority, in terms of how to develop the market and explore other options, for example, how the domiciliary care market linked in with the Housing Strategy; how to align the Joint Strategic Needs Assessment plan with the Strategy; ensuring a clear pricing strategy; how to develop the specialist high end area of the market with emphasis on more rehabilitation, focussed on returning people home as soon as possible; reducing waiting list times for the wider sector and working with providers to ensure that quality was at the heart of delivery.  It was also important to have the opportunity to create space so that the market was competitive on price and quality and remained strength based around contracts with NHS partners and others.

Members received responses to the following questions:

·         Did all care home residents have access to digital support and interactions such as Skype and Facetime?

·         Was any work being carried out engaging with care homes about information and advice available for family members as the voluntary sector could assist people?

·         Was it possible to increase staff with a higher range of skills?

·         What was the difference between the enabling housing based model and increasing the number of people maintaining their own independence to stay at home?

·         How often were care homes assessed by CQC?  What happened when they required improvement – did they have to produce an improvement plan and were they then re-assessed at a later date?

·         When would re-inspection take place?

Resolved (unanimously):

1.         that Members of the Sub-Board noted the contents of the Residential Nursing and Care Homes Report;

2.         that the Director of Adult and Community Services be requested to review the joint approach with the Integrated Crae Organisation (ICO) to provide care homes with information and advice; and

3.         that the Director of Adult and Community Services be requested to ensure that the ICO reviews the approach to Finance and Benefits assessments, ensuring that people and their relatives have access to information and support.