Agenda item

Report of the Director of Adult Services and Housing

The Cabinet Member considered a report of the Director of Adult Services and Housing which provided an update on adult social care quality assurance and management of market failure.

Where people within Coventry are eligible for a care and support service following a needs and wellbeing assessment under the Care Act 2014, the quality of that care was critical to ensuring that the person with care and support needs has a good experience of social care and that their needs and outcomes were met.

The majority of care and support services in Coventry were provided under contracts by the City Council with independent providers of care and support. Therefore, effectively managing and monitoring contracts is a key responsibility for Adult Social Care alongside ensuring that effective mechanisms are in place to respond to issues of provider failure (where a provider is no longer able to continue to deliver their contract).

The report was produced following a review of the processes currently in place. The review was initiated as a result of the learning from the Covid pandemic which had proved to be a major and persistent challenge to the care market.

The report covered revisions to the following two key processes for ensuring quality and business continuity in commissioned care and support services:

1.  How contracts and the quality of care and support was monitored, based on a set of indicators and the risks associated with specific services.

2.  How the City Council responded to issues where a provider, or number of providers, cannot continue to deliver services due to a range of factors including quality issues, cost issues, or provider choice not to continue. This was often referred to as ‘market failure’.

During the height of the Covid pandemic, quality assurance visits had to be scaled back from in person to a largely remote function with on-site visits made in exceptional circumstances. This change was due to infection prevention and control restrictions. During this period visits were still conducted where absolutely necessary to those services where the most significant concerns were apparent and were supplemented with other means of understanding the quality of provision and user experience.

A number of providers of care and support also ceased trading during and following the pandemic. This was due to a number of reasons including financial stability as a result of high numbers of vacancies and provider choice where owners of care and support organisations decided to no longer operate. Each of these situations, although managed effectively by the City Council, prompted a review of how provider failure of this kind is managed to ensure continuity of service for people affected.

The City Council has a number of duties in respect of the social care market under the Care Act 2014 including to facilitate and shape the care market to ensure a sustainable and diverse range of care and support, continuous improvement in quality and choice and the delivery of cost-effective outcomes.

The main changes from the previous approach for managing and monitoring quality within social care and support were:

·  The introduction of an improved risk-based approach with greater clarity on levels of concern and appropriate oversight and action for all provision (reducing the risk of poor quality care not being uncovered).

·  Improved processes and management of providers where there are quality concerns with clear escalation process within shorter time scales (reducing the time taken for improvements to be implemented).

The changes proposed with the refreshed market failure plan were as follows:

·  Precision around emergency situations of service closure

·  Enhancement of the number of transport options available in the plan to ensure appropriate transport is available in an emergency

·  An updated and increased number of agencies who may be available to support in an emergency to include recruitment agencies

Further detail on the approach to emergency provider failure was outlined in the Market Failure Plan attached at Appendix 2 of the report.

The Health and Social Care Scrutiny Board (5) considered the report on 6 July 2022 and were fully supportive of the Adult Social Care Quality Assurance and Management of Market Failure report and recommended that the Cabinet Member agrees the recommendations contained within the report.

The Cabinet Member having considered the report, commented that the pandemic highlighted risk areas which had resulted in subsequent improvements to the system. She noted that there were other reports in the pipeline and was eager to get scrutiny involved from the outset.

RESOLVED that, the Cabinet Member:

1.  Approves the revised risk-based approach to Quality Assurance.

2.  Endorses the revised Market Failure Plan including the approach to managing provider failure in the event of an emergency.

3.  Considered comments from the Health and Social Care Scrutiny Board (5) resulting from their meeting on 6 July 2022 in relation to the above.