Agenda item

Pre-Decision Scrutiny

To select appropriate items from the Cabinet Board agenda for Pre-Decision Scrutiny (Cabinet Board reports included for Scrutiny Members)




The Committee chose to scrutinise the following Cabinet Board items:

Establishing a Managed Account and Payroll Support Framework

The Committee were provided with a report which was seeking approval to undertake a process to establish a Framework of approved providers, who would be able to appropriately support Direct Payment recipients with Managed Account and Payroll activity.

Members queried what the current waiting time was to change accounts from managed to direct payments, or vice versa. It was confirmed that this takes very little time and was not an issue for Officers within the Directorate. The Head of Adult Services mentioned that the issue with direct payments was relating to obtaining a Personal Assistant (PA).

Officers were asked to provide information relating to the current waiting times for assessments for direct payments, and how long it takes for a PA to be found and matched with a service user. It was noted that the service was up to speed with the assessments, however it was difficult to provide a definitive timescale of the waiting times. The Committee were informed that there was an issue in trying to obtain PA’s in the first instance; this was the same across all forms of care, including residential and domiciliary care. It was added that part of the delay, if there was a delay, was pertaining to Disclosure and Barring Service (DBS) checks, putting training in place and where insurance was required.

Following scrutiny, the Committee was supportive of the proposal to be considered by the Cabinet Board

Procurement of a Specialist Domiciliary Care Framework

Officers delivered a report for Members to consider approval to undertake the process to establish a Framework of domiciliary care providers, who would be able to appropriately deliver specialist domiciliary care and use this Framework to purchase individual packages of specialist domiciliary care.

The circulated report highlighted that this framework will include providing mental health care; Members asked if this included those with dementia. Officers explained that the Directorate had a routine framework that was already in place for the older age group (over 65’s); this framework was applied to the individuals in this age group who had age related frailty, dementia and/or disabilities.

Members were informed that the report before them was in relation to an additional, specialist framework which would apply to working age groups, and children and young people; this framework will assist those with learning disabilities and mental health, as well as providing a range of children and young people services.

It was detailed in the circulated report that presently the number of adults with complex needs receiving specialist domiciliary care in their own home was relatively low; Members queried why the numbers were so low, and asked if the data collection on domiciliary care would improve in the future. Officers explained that there was currently a small number of people with learning disabilities and mental health that receive domiciliary care in their own homes; a lot of people with learning disabilities and mental health currently live in supported living accommodations or specialist care homes, therefore the demand for specialist domiciliary care wasn’t as high.

Further to the above, it was mentioned that there would be wider options available for individuals by developing the framework. Officers highlighted that they were currently trying to support and enable people to live by themselves in their own homes with a package of domiciliary care; this work falls into the other work Officers were going to give and promote independence.

Officers stated that if the specialist framework was in place, they would be able to obtain better data, as the packages would go through the framework which would enable more data to be collected.

Following scrutiny, the Committee was supportive of the proposal to be considered by the Cabinet Board.

Uplift To Older People Care Home Fees

A report was provided in relation to an uplift to fees in order to support the sustainability of older people care home services in Neath Port Talbot.

Members made reference to the uplift fee of £30 per person, per week, and asked if Officers were expecting this to change due to the current cost of living crisis.

The Director of Social Services, Health and Housing confirmed that they were anticipating that the fees will need to be risen in the future; this will depend on the outcome of the next few months in regards to the cost of living crisis, however Officers were continuing to review this. It was added that this report was the first step of an uplift programme that will need to put in place over the coming years.

Further clarity was provided in that the uplift fee detailed in the circulated report was for the current financial year. It was noted that Officers undertook an exercise to look at the fee levels for this financial year; however from the beginning of April 2022 to now, there had been a lot of factors that could not have been predicted, that have directly impacted on the financial viability of care homes. Following this, it was explained that Officers carried out a detailed piece of work with the care home sector to review the financial pressures that they were facing; it was identified that they needed an extra £30 this financial year to be viable. Officers added that they were currently trying to identify what the fees should look like for the next financial year of 2023/24; given the current inflation, they expect there to be a significant uplift next financial year.

Reference was made to the current fees paid to older people care homes; Members queried the little difference between what was currently paid to residential care homes, and what was currently paid to nursing care homes, given the difference in the type of work they undertake. Officer clarified that the amount contained within the circulated report was the fee that the Council would pay to nursing homes; there was also a Funding Nursing Care (FNC) fee in which the Health Board pays for, on top of the amount provided by the Council. It was concluded that the overall fee for a nursing home payment was higher than that amount detailed in the report circulated report; as it only detailed the uplift and the amount that Social Services contribute.

A brief discussion took place in regards to the fees that families pay towards care homes, and what would happen if a family was not in a position to pay for the additional charges going forward. The Head of Adult Services confirmed that this was referred to as a third party top up; most care homes were now charging a top up fee, with the average being around £65. It was explained that this was due to care homes claiming that they weren’t being paid enough to cover the costs; where families could not afford to pay this, and where the service were placing people care in homes, The Council were paying the top up fee. Members were informed that increasing uplift fees, could assist with moving away from the top up fee; families would therefore not have to contribute financially towards the care home.

Following scrutiny, the Committee was supportive of the proposal to be considered by the Cabinet Board.