Agenda item

Domiciliary Care across the Borough


The Board considered a report of the Strategic Director, Communities which gave the Members an update on the current home care provision in the Borough.


The Board was advised that there were different options of purchasing domiciliary care in Halton.  Individuals could choose to buy care through a direct payment or a commissioned care route. When individuals opted for the commissioned route, they could be reassured that all the care providers were monitored by the Quality Assurance Team (QAT) and by the Care Regulator, Care Quality Commission (CQC).


The Board was further advised that providers in Halton were rated as the following:-


Six    – Green ( Good / Excellent);

Four  – Amber ( Adequate / Satisfactory); and

None were rated as Red (Poor- with actions).


It was reported that adequate rated services received additional monitoring and spot checks to improve standards within agreed timescales.  The CQC had rated two domiciliary care services as requiring minor improvement actions and the rest had been fully compliant.


Furthermore, it was reported that there had been a drop in performance across domiciliary care in Halton from the last period. Three providers fell from a good rating to adequate. The main theme was a lack of training in areas such as safeguarding, risk assessments, dementia, challenging behaviour and pressure care. A number of HBC E learning modules were available for providers to access free of charge and additional training was available at a charge of £50 per person. However, providers were reporting difficulties sustaining levels of good quality training in the current financial climate where the Providers operational costs were increasing and the Councils budgets were reducing. QA officers would continue to monitor the levels of training undertaken within each agency and contract compliance action plans were in place to ensure that required levels of training were maintained.


In conclusion, it was reported that there was a formal tender process for domiciliary home care in Halton starting in September 2013. As part of this process, financial standing, recruitment, quality, performance and policies and procedures would be evaluated.


The following comments arose from the discussion:-


·       Clarity was sought on whether it was possible to terminate a contract early.  In response, it was reported that if possible defaulting on a contract was avoided and actions put into place to avoid this course of action; and


·       Concern was raised that most care providers in agency work were on a minimum wage or were on a zero contract and moved frequently between establishments.  This did not provide any stability or they were unable to build a sense of pride into their work due to the constant change.  In response, it was reported that agencies had zero contracts, but all employees received regular supervision and  training and they also ensured the continuity of care.  The impact of zero contracts had been acknowledged, but it was reported that some zero contracts provided employees with some levels of flexibility.  In addition, it was reported that the service would be going out to tender next month, with a view of providing the best possible stability for carers.  It was also reported that the tendering process would take six months to complete and the contracts would be awarded at the end of March 2014.


RESOLVED: That the report and comments raised be noted.

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