[Presentation To Follow]
Officers from the Adult Social Care team provided a presentation on the Adult Social Care market in Croydon (as provided in the agenda pack). This highlighted the gap between funding and demand and how this is expected to grow, the fragility of the care market and contributory factors. Risks were detailed including the lack profitability of Adult Social Care beds and the impact this had including difficulties discharging patients from hospital.
Information was provided on what mitigation had been and was being taken by the Council to address the difficulties including prevention and dynamic purchasing to encourage higher quality care. It was highlighted that workforce development was key in terms of driving the quality of care. However, a national funding solution was still required which it was hoped would be provided in Green Paper due in December 2019.
In response to Member questions, officers provided the following points of clarification:
· Croydon had sought to protect itself from provider failure by putting in place diversity of provision and limiting exposure to any one provider. Contingency planning had also been put in place to address any provider failure;
· The KPMG cost of care review, currently being undertaken was to provide clarity on market rates for care;
· Croydon was paying about the average rate for home care, lower than the average for older, nursing and residential care and over the average for care for under 65s;
· The Council’s planning was beginning to have an impact; still managed to provide care despite budgetary pressures and most of the care provided was rated as good. Resident feedback also demonstrated satisfaction with the quality of care provided;
· In order to attract care workers, Croydon had become an ethical care provider. This meant offering the London Living Wage, agreed levels of training and support, zero hour contracts were no longer used and contracts with flexible, school hours etc were offered;
· The One Croydon Alliance had reduced the length of hospital stays resulting in benefit in terms of costs (longer stays in hospital were to be avoided as they resulted in greater frailty);
· It was noted that Brexit may exacerbate everything in the report;
· Care standards are set nationally by the Care Quality Commission (CQC). Croydon never place with an inadequate provider. All in borough providers that were identified as needs improvement were visited with the CQC and their action plan considered. Croydon had its own quality monitoring which went further than the CQC. The Council’s monitoring team was being restructured to be able to undertake repeat provider visits every 12 rather than every 18 months. This meant the Council had better intelligence than Ofsted which inspected every three years;
· All providers had to have a CQC registration in order to offer any form of personal care. The Council work closely with the CQC; inform the CQC of any concerns which has led to inspections being triggered; and
· Acknowledgement of the advantage of the Council developing its own workers and encouraging market entry by new workers. Apprenticeships were being highlighted. A workforce strategy was the next big piece. It was due early in 2019.
RESOLVED: Members resolved to note the content of the presentation and to thank officers.