Agenda item

Report of the Deputy Chief Executive (People)

The Cabinet Member considered a report of the Deputy Chief Executive (People) regarding managing care market failure.  The report noted that the Council was committed to ensuring that it commissions or delivers the best quality services possible within the available resources.

A key requirement of the Care Act (2014) was a duty on local authorities to ensure safe and sustainable care and support provision through effective market shaping.  In addition local authorities were required to have plans in place to be used should there be failure of either a single provider organisation or a number of organisations.

The Council’s approach addresses market/provider failure in relation to social care provision.  This included services that may also cater for people supported solely through the NHS through, for example, using Continuing Health Care funding.  Services covered include provision regulated by the Care Quality Commission for example, nursing and residential homes, housing with care and home support agencies and non-regulated services such as day opportunities and community meals suppliers.  The approach was not intended to cover provision which was commissioned by the NHS such as hospitals and community health services. 

In order to meet its legal duties in respect of Market Failure the Council developed a process for responding to situations ranging from large scale disruption, including failure of a major care provider affecting many service users, to smaller scale difficulties, such as the temporary unavailability of a particular service, for example, a small care home affected by flood or fire. This process was endorsed by the Cabinet Member for Health and Adult Services on 14th December 2015 (minute 16/15 refers).

The Care Quality Commission (CQC) had a parallel responsibility for maintaining a Market Oversight regime designed to respond to significant care market failures likely to affect large numbers of vulnerable people in multiple authorities or smaller numbers supported in services that were very specialist and therefore difficult to replace.  The Council worked closely with CQC to ensure appropriate sharing of intelligence and alerts around the potential for market failure.

There had been three exits from the local market over the last 3 years (two care homes and 1 home support provider) from a total of around 120 registered services, however, these had all been small scale and well managed in cooperation with the agencies involved along with CQC and Coventry and Rugby Clinical Commissioning Group (CRCCG) colleagues.

However, the Local Government Association (LGA), Association of Directors of Social Services (ADASS), CQC, Local Authorities and care market organisations recognise an ongoing risk around the potential for major market failure given well documented concerns about financial sustainability of the market in the context of ongoing austerity.

In September 2017, The Association of Directors of Adult Social Services (ADASS) produced a guide for local authorities in respect of regional responses to provider failure outlining key principles, and a checklist of prompts and questions for Regions to use in the event of market failure.  This was followed in May 2018 by a briefing designed by ADASS in conjunction with the Local Government Association (LGA) and included a series of top tips for responding to market failure in the context of 3 priorities:

·  Ensuring continuity of care and support for people using the services

·  Supporting the failing provider to retain its workforce

·  Communicating with service users and their relatives to provide reassurance that continuity of care was the priority

The Council’s proposed contingency planning approach had been updated to reflect this additional guidance and ensure that the approach remained robust in the context of a changing landscape.

The Cabinet Member discussed with officers present the following:

·  Procedure

·  Mapping capacity and provision in the city

·  Early warnings

·  The 3 exits from the local market over the last 3 years

·  Service user support

·  Resource implications

·  Reviewing the plan annually

RESOLVED that the Cabinet Member

1)  approve the updated contingency plan to be used in cases of   market failure.

2)  approve the Plan be reviewed annually as part of the Business Plan   at the Adult Commissioning Board and any significant policy   changes to be considered by the Cabinet Member