To receive a report and hear from the Director of Adult Services, Housing and Health and from Shropshire Partners in Care, to understand the impact of Covid-19 on the provision of domiciliary services and understand through the brokerage system patterns of demand, and how changing patterns influence strategy.

Nicky Jacques, Chief Officer, SPIC joined the meeting at this point and was welcomed by the Chair.

Deborah Webster introduced the report and presentation which gave an overview of domiciliary care in Shropshire.  This explained:   the structure, scope and nature of the operation; customer base and care type;  geographical spread; number of providers; the procurement/brokerage process; accreditation and performance of care providers; and the performance oversight system.

Nicky Jacques talked about the requirements for staff training, outlining what carers were required to have and the support for and monitoring of training from the Council and SPIC

She outlined the challenges and support facing the sector both in normal times and particularly in the light of covid.

Members noted the future plans for the domiciliary care market and a move towards outcomes for individuals and a working together approach rather than on time and task based care.   

In response to a number of questions from Members it was explained that: 

·         All domiciliary care agencies had now been invited to book in for covid vaccines

·         The Local Authority had acted as a broker for some self-funders and was looking to do this more of this in the future. It confirmed that this would give a broader picture of complaints across the county.   

·         All carers attended safeguarding training and would know how to take action if their business was not providing adequate support in any matter, for example raising a concern directly with the CQC or contacting SPIC safeguarding leads for help and signposting.  Lynne Cawley reported that Healthwatch was also able to signpost those raising a concern.

·         A number of providers were able to offer live in care and the framework approach taken with the market had been very successful

·         A training needs analysis to identify the requirements of businesses was completed every year and the Workforce Development Fund had not been oversubscribed to date.  There was an opportunity to bid for additional needs through the year if milestones were met.    The latest training target had not been met due to the day to day challenges over the course of the pandemic but there was likely to be increase in claims over the course of the year.  Apprenticeships were encouraged by SPIC which was part of the STP apprenticeship group.

·         Staff turnover was not a particular challenge, at 25% it was a little higher than the England average but in line with the West Midlands average.  Some left to pursue professional qualifications in nursing, health and social care, but most moved from one employer to another rather than out of the sector.  Accreditation was always considered carefully as there were only so many in the county available and wanting to work in the care sector. 

·         Any issues identified relating to proper use of PPE by domestic care workers would be raised promptly with the provider and checks on supply and distribution issues would be made.  In an emergency situation providers could order PPE through the Council.  SPIC worked closely with the CCG Infection control leads.

·         The Council had close links with Powys Commissioners and information was shared about  different provides where there were any issues meeting needs across large sparse areas.  Many providers worked across the border.

·         The Council had a good understanding of the level of purchasing by self funders –which was mostly although not all from same providers.  Commissioning on behalf of self funders would be a big piece of work and would help enhance understanding of the market.

The Committee thanked Deborah and Nicky for the comprehensive report, presentation  and for their thorough answers to questions asked.