To consider the report of the Portfolio Holder for Adult Services.
Minutes:
Documents:
· Report of the Portfolio Holder for Adult Services
Discussion:
· The Portfolio Holder explained the need for the review and the aim to achieve a stable care market
· There were fewer earlier admissions to residential care but those being admitted were older or had more complex needs
· Powys had received negative media reports last year as paying the lowest for places in residential care homes across Wales
· The proposals would drive quality and ensure appropriate recompense
· It will also emphasise that a career in care is valued which complements other initiatives such as the Powys Health Academy
· The Head of Commissioning provided a detailed presentation on the methodology used to assess care home costs and the results obtained
· The review had applied to 18 homes in the private sector but not to those homes subject to a separate contract with Shaw
· Uplifts had not been provided in recent years and whilst value for money had been obtained, the value of care had not been recognised
· The Authority has worked on the basis of 95% occupancy in the past but, in line with Welsh Government requirements, will now work on the basis of 90% occupancy through the remainder of the pandemic until reverting to 95% occupancy when business as usual resumes.
· Actual occupancy through the pandemic has been between 70% and 80% with the Welsh Government Hardship Fund providing financial support to bridge the gap
· The Committee asked if occupancy rates were likely to fall further after the pandemic – the Welsh Government is predicting a slow increase in demand for care homes. Providers are already concerned about their sustainability in the short term. The Welsh Government Hardship Fund has been extended for a further 6 months – this contributes £50 per resident per week to a home. If there is lower than 90% occupancy compared to the levels for 2019/20, the Welsh Government is paying for those voids. In the longer term with increased use of technology and extra care housing, there may not be the demand for residential care homes. Ideally that funding could be used to support people within their own communities. There is concern that there could be unplanned closures but there is a recognition that there may not be the demand for as many care homes.
· Gold and Silver standards will be created which will encourage homes to invest over the longer term in improving accommodation. Officers said that a premium would be continued for those who can provide a gold standard
· Members asked how the changes mean we now compare to other authorities and officers confirmed we will sit above average.
· Self-funders and those from out of county are subject to separate arrangements with individual homes
· The homes have been advised of the outcome of the review and have welcomed the proposals
· The Head of Commissioning was asked which was more cost effective, caring for someone at home or in residential care. Caring for someone at home would be cheaper but the Welsh Government have placed a cap on charges – residential care is means tested and generally generates more income making it cheaper to care for someone in a residential setting.
· The need for continuing specialised care was noted
· Members asked what day care services may be provided to supply respite for carers. The Portfolio Holder suggested that a scrutiny session on day care opportunities be held. The views of service users have changed over the course of the pandemic. The Chair and Portfolio Holder agreed to discuss a way forward outside of the meeting.
· It was suggested that by introducing the proposals and a positive communication strategy, this could have a positive impact on recruitment and should be promoted in this way – communications were proposed over the next few days. Members needed to be aware that the Pre-Election Period would commence on 19 March 2021
· Rockhaven were the company used to provide the specialist knowledge to undertake the review. There had not been the capacity within the service to undertake the review in house. The Chair emphasised the need for Members to be aware of the costs and the value obtained
· Providers are aware that additional payments are finite and will not continue after the pandemic. The Head of Commissioning meets with providers on a weekly basis and confirmed that they are aware of the limitations of additional support
· There is awareness that the care home market may reduce through less demand, but this needs to be managed to ensure genuine options are available.
· Third party top up payments have been challenging and it is hoped that the proposals will avoid the need for any future top up payments.
Outcomes:
· The proposals were supported
· The Chair and Portfolio Holder to discuss future scrutiny of day opportunities and respite care
· A copy of the presentation to be circulated to Members for information
Supporting documents: