Agenda item

1. The report was introduced by Diane Morton, Cabinet Member for Adult Social Care and Public Health, who outlined the Older Person’s Residential and Nursing Care Service Key Decision, taken on July 25^th after receiving endorsement from the Adult Social Care and Public Health Cabinet Committee. Miss Morton provided an overview of the ongoing challenges facing the Adult Social Care sector including the need to strengthen the local workforce and how this new contract aimed to address those issues.

2. In response to comments and questions from Members, the discussion covered the following:

• Richard Smith, Corporate Director of Adult Social Care and Health, explained to the Committee that the contract acted as a framework that identified and enabled partnerships with strategic providers that met price, quality and location expectations.
• Helen Gillivan, Interim Director Adults and Integrated Commissioning, explained that sustainable pricing for both the providers and KCC as well as quality assurances from implementing a Trusted Assessor Model separated this contract from previous versions. Clare Maynard, Chief Procurement officer, elaborated by explaining how the contract did not guarantee providers work, but that joining the framework gave them the opportunity to access KCC’s client base, increasing control on spend and limiting spot- purchase arrangements. It was emphasised that on the current contract, 78% of providers had joined rather than engaging in spot- purchasing.
• Concerning Local Government Reorganisation (LGR), break clauses would be offered in the contracts for new unitary authorities.
• Mr Smith detailed the average annual 10-12% increase in demand for Adult Social Care, compared to the 4% annual increase in funding via taxation and ring- fenced grants. He also highlighted how the framework supported a sustainable service model post- covid, whilst also considering the balance between reducing demand for Adult Social Care and the statutory obligation to provide essential care services.
• Dave Shipton, Head of Finance, clarified that KCC’s commissioned contracts did not receive additional funding as a result of the increase in employer’s National Insurance (NI). He also confirmed that subject to the continuation of the national grant, KCC’s employment of more in-house staff would result in a higher allocation of funding from that grant.
• Mrs Gillivan assured the Committee that an accommodation market position was being co- produced, that would model multiple options to address spot- purchasing and the degree of reliance on the private sector.
• It was explained how the open purchasing system, categorisations of needs and tendering parameters streamlined the process for providers to access the framework, be placed in their respective price banding and access their care needs.
• The premise of the open light- touch framework was to enable new providers to join throughout the duration and to address the locality-of-need issue present in the adult social care division.
• In response to a concern about a red risk identified in the report, Mrs Gillivan clarified that legacy placements would not be included in the new contract. Further financial reporting would be done through Cabinet Committees to address any budgetary deviations from the report.
• Ben Watts, General Counsel, explained that further decisions delegated to officers would not return to the Scrutiny Committee unless specifically requested, as there was no formal requirement to do so.
• Mr Smith explained that the process by which the Care Act 2014 acted as a safety net in the case of inflated financial pressures to ensure the statutory care obligations were met.

3. Following the questions, the Chairman welcomed comments and views from the Committee about the report. These included:

• A Member raised concerns on the over- reliance on the private sector and requested an alternative model that included testing the market to be explored. Specific spot- purchasing percentages were also raised as a figure to be monitored in future reports.
• Members requested a more detailed breakdown of costs and funding within the Adult Social Care sector, to provide greater context on spending for the Committee.
• It was welcomed that options for both in- house provision and external sourcing of providers were being considered.
• It was posed that options be explored to utilise the disposals process to provide additional supply for the care sector.

4. The Chairman called on the Cabinet Member to provide comments and clarifications on the Member’s points of debates:

• Mr Smith welcomed the debate and suggested a dashboard be incorporated into the Adult Social Care and Public Health Cabinet Committee performance report to meet Member’s requests for information.

5. The Chairman proposed that the report be noted and requested that the Cabinet Member and the Adult Social Care and Public Health Cabinet Committee receive a future report on the relative cost of market-provided versus KCC-owned care homes under the new contract, with a suggested frequency of every 12 months and at least more frequently than the lifetime of the contract. The Scrutiny Committee also recommended a focus be given to the mitigation of the high risk associated with the transition from the current to the new contract and to incorporate a performance dashboard including KPIs, specifically on spot- purchasing and the impact of NI into normal Cabinet Committee reporting arrangements. This was agreed by the Committee.

RESOLVED that the Committee note the report and request a future report to the Cabinet Committee on the relative cost of market- provided versus KCC- owned care homes under the new contract, with a suggested frequency of every 12 months and at least more frequently than the lifetime of the contract.