Agenda item

Consideration was given to the report of the Corporate Director of Social Services which was presented to provide Scrutiny Members with Contracts and Commissioning information relating to care and support for Blaenau Gwent citizens within their own homes.

The Head of Adult Services spoke to the report and highlighted the main points contained within the report.

A Member enquired how the quality and standard of care given by the private sector was monitored.   The Service Manager Development & Commissioning explained this had been a challenge throughout the pandemic, however, through district nurses, telephone calls and the call monitoring service which was an electronic system whereby carers log in to the system, where the length of calls could be monitored, if there were any complaints or issues this could provide an early trigger warning.  There was a twice weekly two-way communication flow with providers to ensure the service was alerted to any concerns, etc. and there was the monitoring information to validate some of those calls.  There were also copies of reports from providers and their own quality assurance checks.  Any reported issues such as PPE non-compliance or two carers travelling together in the front of a car would be investigated and escalated to the service provider.

With regard to spot checks, the RI would carry out spot check visits on their own staff and produce daily reports.  If a particular area had a number of carers breaching regulations it could ultimately result in an investigation and potentially disciplinary action.  A lot of information had been disseminated to the Domiciliary Care agencies, making sure that they were following protocols.  Working closely with Environmental Health colleagues had resulted in a good source of information coming into the Commissioning Team to be able to respond to issues at an early stage.

A Member raised concerns with the high turnover of staff for some independent providers, with some clients having new carers on a regular basis.  The Service Manager said that continuity of care was vital and was one of the reasons why they had introduced a new tender and not commissioned existing packages as there were concerns around recruitment and growth, providers needed to demonstrate they could recruit a workforce as it was important that service users had continuity.  In the past there had been concerns with the high turnover of staff with providers and after consultation and engagement improvements had been made and as part of the new contractual arrangements providers needed to confirm they could recruit a pool of dedicated carers. 

The Member felt that this area should be Regulated by the Welsh Government and should make the role of carer more appealing with an increase in salary for the important role they undertake in the community.

A Member enquired if consideration should be given to bring this service back in-house.  The Head of Adult Services said there was a new white paper out currently in relation to social care and sustainability in the market position was part of that work.  She felt that it was beneficial to have a mixed economy with both internal and external services to promote diversity across the sector. The cost of bringing this service in-house, at this level, would be extortionate and would require a significant Welsh Government investment in funding for Social Services.

The Corporate Director of Social Services commented that 18 months ago an external provider who was providing 23% of Domiciliary Care provision had gone into liquidation and a new provider had to be sought to deliver that care.  At that time, consideration had been given to bring the service in-house, however, the cost had been an additional £2m to the sum already being paid to the provider, and this would be an ongoing cost.  He also felt that a mixed market needed to be in place to give the right balance between in-house and external providers.  Work had been undertaken to try to expand those numbers of providers to ensure sustainability going forward so that no one provider would be responsible for delivering a huge amount of care provision.

The Committee AGREED to recommend that the report be accepted and endorse Option 2; namely that the report be accepted as provided.