Agenda item

¾    It was agreed to establish a new model for providing and commissioning domiciliary care based on sub-areas, and jointly-commission with the Health Board.

¾     It was approved to implement on the grounds of the favoured option, namely support a mixed market by tendering in a way that is likely to lead to achieving the aims of the department.

¾     To ask the Department to review the financial model in order to ensure that it does not hinder their ability to achieve their savings and report back if there is a risk of that.

Presented by Cllr Dafydd Meurig

DECISION

¾     It was agreed to establish a new model for providing and commissioning domiciliary care based on areas, and to jointly commission with the Health Board.

¾     It was approved to implement on the grounds of the favoured option, namely to maintain a mixed market by tendering in a way that was likely to lead to achieving the aims of the department.

¾     To ask the Adults Department to review the financial model in order to ensure that it did not hinder their ability to achieve their savings, and to report back were there any risk of that.

DISCUSSION

The report was presented and the decision was noted, emphasising that the reason the new model was needed was to move away from the practice of funding per package or individual, and to create a flexible provision across areas. It was added that the favoured option was to maintain the internal:external market split. It was noted that financial and legal risks had emerged during the negotiation phase, but that arrangements were in place.

It was expressed that a number of pilots had been undertaken at various geographical locations across the county. It was expressed that these had demonstrated strong examples of flexible care and that the service users were happy with the care received. It was added that the new model for providing and commissioning domiciliary care would be jointly commissioned with the Health Board.

To provide context, the Senior Operational Manager added that there was a shortage of domiciliary care available. It was expressed that in order to further understand what was needed, the situation as a whole needed to be looked at. It was noted that discussions had been held with service users and emphasis was placed on the importance of a pilot in order to turn the idea into reality.

Observations arising from the discussion

¾     It was noted that discussions had been held with the unions. The unions were reasonably supportive but there was a need to ensure as little an impact as possible on staff. It was expressed that residents and service users were central to the new model, with staff a very close second. It was expressed that there was no intention for people to transfer to other providers should they not wish to do so, and arrangements would be in place to protect staff. It was added that discussions were being held with the unions to ensure that the transfer process had as little impact as possible on staff and to ensure that employment was maintained.

¾     The new model was welcomed, but it was emphasised that recruitment was a historical problem, and enquiries were made as to whether the new model would change this. It was expressed that the new model would encourage and give staff the opportunity to be more creative, and that a higher proportion of the funding available would go to staff.

As funding the scheme meant using savings deriving from changes to work arrangements and as the Adults Department was also dependent on this to achieve its savings programme, concern was raised with regard to the financial model following the Cabinet's discussions the previous week around the Department's performance. It was emphasised that there was a need to ensure that the new model did not hinder the Adults Department's ability to achieve its savings, and it was asked that the situation be thoroughly assessed, and reported back upon should there be any risk of that.