Report of the Deputy Chief Executive (People)
The Cabinet considered a report of the Deputy Chief Executive (People), which set out proposals in relation arrangements for the provision of accommodation based support for older people, predominantly in residential and nursing home placements.
The report indicated that The Care Act 2014 placed a duty on the Council to ensure that the care and support needs of people in the City who meet the eligibility criteria for care and support are met. Although the Council’s overall objective was to support people to live at home, there were a number of people whose care and support needs were such that this was not feasible. In these cases, accommodation based support was required. In many cases where accommodation based support was required, Housing with Care, where people have their own flat with care and support was provided on site, was used but for some the level of need is such that residential care, which provided a more intensive model of support was required.
The Cabinet noted that the majority of residential placements within the City were purchased through a contract that enabled the Council to purchase placements from providers as required, with no guarantee of availability and with the cost being variable based on the needs of the individual and available supply at the point a placement was required. Some residential placements were available to the Council on a block basis (through the Anchor Trust PFI) and the Council still operated one residential home for older people with dementia at Eric Williams House.
Approximately 600 older people were supported by Coventry City Council to reside in independent / private residential or nursing care homes at any point in time, at an estimated cost of £16m gross per year. An estimated 500 of these placements were within the city costing approximately £13.5m per year.
Although the existing purchasing arrangements enabled the Council to provide residential placements where required, the variable costs resulted in a position where the costs to the Council were not known with any degree of certainty until a placement was required. This degree of variable pricing did not support the Council with overall market management as there was no benchmark for care home prices purchased within the City.
In addition to ongoing residential placements, the City Council, in conjunction with the Coventry and Rugby Clinical Commissioning Group (CRCCG) also provided 32 short term reablement beds on a block contract basis within three residential care providers at a cost of £1.026m per annum. This provision provided a period of rehabilitation, supported with occupational and physical health therapists so as to maximise independence over a period of up to six weeks, supporting people to regain independence lost following an acute episode or other incident. The objective of this provision was to support people to reach a level of functioning so that they can return home.
In respect of ongoing residential care placements the Council was seeking as a result of a procurement process, to establish a number of care home placements which the Council could access for a fixed fee through securing a series of nomination rights. This would remove some of the price variation and provide availability at a set cost funded by the local authority. For the remainder of the market an ‘approved provider’ list would be established which would operate on the variable pricing model that was currently in place but under updated and revised contract terms.
In respect of short term reablement capacity the Council was seeking, as the result of a procurement process to secure 32 short term reablement beds to be available from when current contracts expire on 25 May 2020.
RESOLVED that, the Cabinet:
1. Approve the commencement of a procurement process for permanent residential and nursing home placements to enable the City Council to deliver its duties to older people who are eligible for social care support and require residential and nursing care.
2. Approve the commencement of a procurement process for short term care home services to support people to regain independence following an incident or acute episode.
3. Delegate authority to the Director of Adult Services, following consultation with the Cabinet Member for Adult Services, for the award of contracts following conclusion of the procurement process.