Report of the Executive Director Strategic Commissioning and Director of Adult Social Care

This report describes a proposed new model of homecare – ‘Our Manchester homecare’. This report further sets out the key current issues for our homecare recipients and providers and explains why the existing model needs to change.  The new model of homecare will go out to tender later this month.

The Committee considered the report of the Executive Director Strategic Commissioning and Director of Adult Social Care that described a proposed new model of homecare – ‘Our Manchester Homecare’. The report explained that in order to achieve the ambition, it was important that the model met the needs of people who used our services and help supported family carers.

The Executive Member for Adults, Health and Wellbeing stated that the new model was therefore:

·                focussed on the outcomes that matter to people;

·                strengths based, starting with the positive what people could do for themselves and supporting people build or maintain skills and confidence;

·                place-based: matched to the footprint of Integrated Neighbourhood Teams;

·                centred on continuity of care: the top priority of people using homecare; and

·                predicated on building a trusted partnership with homecare providers.

The Executive Member for Adults, Health and Wellbeing referred to the main points of the report which were:-

·                Describing the context of homecare: what it was; who received it and the associated costs;

·                The case for change;

·                Recent developments;

·                How the new model was different and a description of the key features of Our Manchester homecare;

·                Personalisation and personal budgets;

·                Finance and Cost Benefit Analysis;

·                How social value would be achieved through the procurement of Our Manchester homecare;

·                Equality Analysis; and

·                Next steps.

Members supported the move away from a ‘time task’ model of care and a more person centred approach to homecare and sought clarification of what would happen if the allocated ‘budget’ of hours were not used by the individual in receipt of care. Members commented that the allocation of hours needed to be consistent and allocated fairly to everyone who received care. Members asked how these changes would be communicated to those in receipt of care.

Members discussed the figures that presented a breakdown of who received care in Manchester and sought clarification on how this was to be addressed to ensure there was an equality of allocations.

Members noted and supported the procurement activities that were described in the report and in particular welcomed the inclusion of the voluntary and community sectors.

Members discussed the issue of subcontracting of care and sought an assurance that any such arrangements would be vigorously monitored and all staff would be paid the Manchester Living Wage as a minimum, noting that this was important to ensure the continuity of care and reduce levels of staff turnover.

Members sought further information on the proposed savings that were to be achieved through the new model of care.

The Executive Member for Adults, Health and Wellbeing advised that the new approach would better meet the needs of those in receipt of care and for staff delivering care. She said that people in receipt of care had been fully consulted upon, in addition to carers, service providers and a range of health professionals, and had been involved with the coproduction of this new model

The Executive Director Strategic Commissioning and Director of Adult Social Care said the new model would enable people to remain in their own homes, supported by and close to their friends, family and community. She said the current model was too rigid and needed to change. She described the new approach as offering flexibility and consistency in the care provided with a person centred, strength based approach that better met the needs of the individual.

The Executive Director Strategic Commissioning and Director of Adult Social Care described that the commissioning of services would address the issue of inequality of care across the population of the city. She said that the establishment of integrated Neighbourhood Teams would help develop a local knowledge of the community and establish links with those in the community who may not currently access care.

The Executive Director Strategic Commissioning and Director of Adult Social Care commented that the ‘budget’ of hours was agreed following conversations with the individual and assessed on their needs and the subsequent support plan was focused on outcomes. The hours were flexible and the support plans could be reviewed with the individual at any time to best meet their needs. In response to a Members comment regarding the emerging care needs for the Trans Community she said she acknowledged this and it would be considered.

In response to the concerns expressed regarding sub-contracting the Executive Director Strategic Commissioning and Director of Adult Social Care advised that any contact awarded to a primary lead provider of care would specifically dictate the terms of any subsequent subcontracting arrangements. She said contracts would be robustly monitored and reviewed on annual basis and that these reviews would include the views of individuals in receipt of care.

The Executive Member for Adults, Health and Wellbeing said that subcontracting arrangements would allow for local, not for profit organisations to bid in local neighbourhoods and this would strengthen the offer and provide local innovations to deliver care. She said the new model would recognise caring not as a job but rather a career of choice that offered career progression and this would contribute to the continuation of care.

The Executive Director Strategic Commissioning and Director of Adult Social Care advised that communication with individuals regarding the changes would be managed in an appropriate manner.

In response to the comments raised regarding budgets the Executive Member for Adults, Health and Wellbeing said that funding remained a challenge however the delivery of an improved model of home care was central to the ambitions and delivery of an integrated health and social care system.

Decision

The Committee endorse the proposed new model of homecare for the people of Manchester.