The delivery of homecare services

The information requested
We ask the council to provide a response to the following questions.
For the avoidance of doubt, references to “home-based care and support” and “homecare” should be interpreted as meaning domiciliary care services regulated by the Care Quality Commission.

Section 1. The Council’s calculation of the cost of homecare

1. Please provide any calculation undertaken by the council to assess the hourly cost of delivering homecare services for older people during 2017-18, for example by undertaking a cost of care exercise, with providers, or by the council conducting its own modelling. For the avoidance of doubt, we ask the council to provide a numerical breakdown of its assessment of what it should pay for homecare service, taking into account the component costs, which include: careworkers’ wages; National Insurance and pension contributions; holiday and sickness pay; mileage reimbursement and the providers’ operating costs and profit or surplus. Please note that we are asking the council to provide evidence about whether it has undertaken an assessment of the likely costs of care incurred by its providers in a way that is likely to have satisfied Paragraph 4.31 of the “Care and support statutory guidance, updated 12 February 2018”.

Devon County Council established market rates through competitive tender in July 2016 with the introduction of its Living Well at Home Contract.

The contract has an in-built annual inflationary uplift methodology which references a number of national inflationary indicators including; National Minimum Wage 21+, National Living Wage 25+ and CPI.

The inflationary fee methodology within the Living Well at Home contract which the Council has used to calculate the percentage inflationary uplift paid to homecare services is detailed below. This calculation has been used to calculate inflationary uplifts since April 2017 and will remain in place for the duration of the Living Well at Home contract.

An example is available which demonstrates the April 2018 inflationary uplift calculation via the link below:

https://devoncc.sharepoint.com/:b:/s/PublicDocs/InfoMgt/EeaE0CYpWapOp9JsFzGymTABOHrHQkM1Ki2T0gtRhHpDSA?e=DU0E7e

 

In applying this methodology, Devon County Council believes it has satisfied the requirements of paragraph 4.31 of the February 2018 update to the Care and Support Statutory Guidance: The service commissioned promotes the well-being of people receiving care and support, and allows the service provider to meet its statutory obligations to pay at least the National Minimum Wage and provides for the effective training and development of staff.
Devon County Council further believes the rates it pays for the provision ‘personal care’ allow for the retention of staff and adequately supports innovation and improvement in quality in the homecare market.

Devon County Council’s decision to invest in the homecare market through its Living Well at Home contract ensures typical rates paid for the provision of ‘personal care’ continue to be higher than the 2018/19 UKHCA suggested ‘benchmark’ rate of £18.01 per hour published in January 2018.

2. Has the council undertaken a cost of care exercise for homecare services in consultation with its local homecare providers within the last 3 years? Please answer ‘Yes’ or ‘No’.

Please refer to our answer to question 1 above.

3. On what date did the council last increase the prices it paid for care to the majority of its homecare providers in response to inflationary cost pressures? The “majority” of providers should be interpreted as at least 75% of homecare providers with which the council trades.

April 2018

Section 2. Service users whose care was affected by the care provider handing a contract back to the council
During the 12 month period ending February 2018, please specify:

4. The total number people aged 65 years and above receiving home-based care and support purchased by the council

The total number people aged 65 years and above receiving home-based care and support purchased by the council, during the 12 month period ending February 2018, is 8709.

5. The total number of people in question 4, above, whose provider of care changed during this period for any reason;

The total number of people in question 4, whose provider of care changed during this period for any reason, is 332.

6. For the figure provided in question 4, above, the total number of people whose provider of care changed as a result of:
a. a request by the provider;
b. a request by the service user;
c. a safeguarding concern;
d. a decision by the council other than for a safeguarding concern;
e. a mutual agreement of the council and the provider.

Devon County Council do not hold this information as set out in these questions. We are unable to extract this specific information from the case files without an individual review of the 8709 files. On the basis of, say, 10 minutes per file, this would require a total of 1,452 hours work.

This information is therefore exempt from disclosure pursuant to s.12 of the Freedom of Information Act 2000.

7. For the figure provided in question 6a, above: the total number of homecare providers who have made such a request.

Please refer to our response to question 6 above.

Section 3. “Approved provider” lists

8. Please confirm whether the council, or another organisation acting on the council’s behalf, maintains a list of contact details of homecare agencies in the local area from which people, either from their own means or by using a Direct Payment, may purchase homecare services? Please answer ‘Yes’ or ‘No’:

Devon County Council do not accredit or approve homecare agencies, but a list is available on Devon County Council’s Community Services Directory ‘Pinpoint’ http://pinpointdevon.co.uk. Information about homecare agencies is also available from the Care Quality Commission website which can be viewed at:

http://www.cqc.org.uk/

9. If the answer to question (i) is ‘Yes’, does such a list contain details of:
a. all the registered homecare providers in the local area, or,
b. a selection of local homecare providers which have approved or vetted by the council, or
c. a selection of homecare providers which have agreed to have their details appear on the list, whether or not the council has approved or vetted such providers?

Homecare providers who choose to register their organisations on the pinpoint website are not approved or vetted. The homecare providers who have chosen to display their details on the list are displayed whether or not the provider has been vetted.

Section 4. Commissioning
During a 7 day period, which includes Monday 5 February 2018, please specify:

10. The total number of homecare visits commissioned by the council for people aged 65 and above; (note that we are reporting hours, not visits here)

For the week starting Monday 5 February 2018 and ending Sunday 11 February 2018, 31327 homecare hours were commissioned by the council for people aged 65 and above

11. The percentage of homecare visits commissioned by the council for people aged 65 and above that were shorter than 30 minutes.

For the week starting Monday 5 February 2018 and ending Sunday 11 February 2018, the percentage of homecare visits commissioned by the council for people aged 65 and above that were shorter than 30 minutes is 4.11%

12. Please provide a copy of the most recent report prepared by any officer of the council which demonstrates that the council has assessed whether it commissions homecare services in a way that is consistent with the National Institute of Health and Care Excellence (NICE) Quality standard [QS123] Quality statement 4: Length of homecare visits.

Devon County Council has not prepared a report on this but the very small volume of 15 minute visits (please refer to question 11 above) which are commissioned are minimal and are not commissioned to deliver intimate personal care to individuals.