Issue - meetings

To consider an update on performance and trends in the residential and nursing care sector in West Northamptonshire.

RESOLVED that: the People Overview and Scrutiny Committee:

a)     Agreed to write to the Leader of the Council and the Cabinet Member for Adult Care, Wellbeing and Health Integration supporting representations to the government concerning the need for adult social care to be funded at a level that recognises current pressures on services.

b)     Requested to be provided with a geographical breakdown of the care homes in West Northamptonshire subject to performance improvement plans or contract terminations in 2021/22.

c)     Requested to be provided with further information on the number of care home contract defaults and terminations in West Northamptonshire’s neighbouring authorities. 

d)     Requested that the further information to be provided to the Committee on Disabled Facilities Grant utilisation be circulated to Committee members as soon as it is available.

The Executive Director – Adults, Communities and Wellbeing introduced the agenda item and highlighted the following contextual points:

·         Mandatory COVID-19 vaccination for care home staff from 11 November 2021 increased recruitment and retention challenges in the care sector.  This requirement was due to be extended further to all services subject to inspection by the Care Quality Commission (CQC) from 1April 2022.

·         Vacancy levels in West Northamptonshire care homes were quite low.  However, there was a challenge in how data on this was captured.  Care homes were required to complete a national tracker, which reported vacancies but not the reasons for them.  This could lead acute care colleagues to question why delayed transfers of care occurred when there were apparently vacant care beds in the area.

·         There was a continuing need to lobby the government for a better settlement for adult social care, which would support recruitment and retention.

·         WNC needed to consider potential future scenarios that could arise from pressures on the care sector, given that service users could look to WNC as a provider of last resort.

The Assistant Director – Commissioning and Performance presented the report and gave an overview of current performance and trends relating to residential care provision in West Northamptonshire, highlighting the following points:

·         The profile of performance ratings for care homes took into account that the CQC had not been able to carry out inspection visits during the pandemic and was now working on a risk-led basis.

·         Comparisons of performance with neighboring authorities showed that WNC was not where it wanted to be but was broadly comparable with those authorities.

·         WNC had terminated seven contracts with providers in 2019 and two in 2020, reflecting that fewer monitoring visits were possible during the pandemic.  There had been five terminations so far in 2021.  This was due both to the situation of care homes after the pandemic and an increase in WNC monitoring capacity.

·         Approximately 60% of WNC’s contracted providers had been subject to recent assurance visits.  WNC was committed to reaching 100% by 31 March 2022.  Additional resources had been employed to support providers and to sustain performance improvement.

·         Four contracts had been terminated since July 2021 due to the quality of care.  WNC aimed to work with providers to ensure effective care and did not take this decision lightly.  However, the ultimate priority was to keep residents safe.

·         There were 16 providers currently subject to improvement plans, who were receiving additional support.

·         The current overall position regarding occupancy and declared vacancies in residential care homes for older people suggested that providers were declaring fewer unused beds or that some providers were ceasing to operate.  Providers were reporting concerns about accepting placements that WNC needed to make, due to pressures on staffing. 

·         WNC had worked with care homes following the announcement of mandatory vaccinations to support them in meeting this requirement and to mitigate associated risks as far as possible.  As of 1 November 2021, 96% of care home staff had received one vaccination  ...  view the full minutes text for item 26