Agenda item

(To receive a report by Edward Baker, Contract Manager, which provides the Committee with an overview of the Home Based Reablement Service)

Consideration was given to a report which provided the Committee with an overview of the Home Based Reablement Service.  Members were advised that the aim of this service was to maximise a person's independence whilst enhancing their quality of life, with the intention of reducing the need for care and support in the future.  An effective reablement service was vital in supporting people to gain or regain the skills necessary for daily living, which had been lost through illness, deterioration of health and/or increased support needs.

Additionally, at time of market failure within the homecare market Lincolnshire County Council could request the Home Based Reablement Service provider to act as 'the provider of last resort' and use their capacity to support people with long term needs in their own homes on a short term basis.

Members were advised that the contract for the Reablement Service had been awarded to Allied Healthcare in 2015 for a period of three years with the opportunity for a further two year extension.  However, at the beginning of November 2018, the Care Quality Commission (CQC) had written to 84 affected local authorities to make them aware of significant and immediate concerns regarding Allied Healthcare's financial viability.  Lincolnshire's contract was the fourth largest in the country.  Following extensive discussions with a number of organisations, including Allied Healthcare, the contract was successfully transferred to Libertas.  It was noted that one of the immediate actions taken was to reach out to the workforce across the county to keep then updated of the situation.  The transfer of staff from Allied to Libertas was undertaken within 10 days.

Tom Carter, Managing Director and Claire Lee, Head of Operations at Libertas were in attendance for this item and provided updates to the Committee and the following points were noted:

·         It was a joint approach between the County Council and Libertas in offering reassurance to the workforce, and there were some significant practical changes which had to be overcome, such as the loss of IT systems.  The aim was to achieve stability for the service, and the organisation was able to deliver that stability.  Work had continued over the previous three months, and work was now underway to think about the development of the service and what could be delivered in the future.

·         The primary focus had been to connect with everyone in the service and inform them of what was going to happen and the expected timeline.  New systems were brought in and the staff undertook training on the new systems.  All staff were supported through this change so that reassurance could be given to service users that the only changes they would see would be the uniform and name.  It was important that the workforce was behind Libertas, and therefore there was normal working from day one of the contract.

·         It was highlighted that the work which had taken place to make this happen could not be underestimated, and despite the changes in provider Delayed Transfers of Care (DToC) continued to reduce.  Members were also reminded that this had happened at one of the most difficult times of the year.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was commented that reablement was a very important service for people and it needed to be in place for when they came out of hospital and it was highlighted that it was not thought that there had been any complaints during this time. 

·         The Executive Councillor for Adult Care, Health and Children's Services thanked all those involved for their work during this time.

·         The Executive Director for Adult Care and Community Wellbeing summarised for members the process undertaken when it became clear that there were questions regarding the financial viability of a provider such as Allied Healthcare.

·         It was noted that Libertas had increased the percentage of people reabled to no service from 71.7% service users to 91.3% in February 2019.  It was queried what Libertas were doing differently to Allied and members were advised that they were working with the reablement service closely and each referral was being looked at individually, and each one which was declined was also looked at.

·         Officers were congratulated for the work they had carried out in ensuring the service had continued uninterrupted.

·         It was queried whether there had been an increase in costs and members were advised that the contract had transferred to the new provider at the same cost.  It was noted that Libertas had stretch targets in place for monitoring performance.

·         It was queried what happened when something that needed changing was observed, it was confirmed that this feedback would be passed on and there was a good working relationship with this provider.  It was also noted that Libertas was a prime provider for home care in two zones (Louth and Gainsborough).

·         It was commented that it was thought that the service had got back into a good state in a relatively short space of time.  There was a need for stability in order to grow and develop the service.  In the future it was hoped that there would be an integrated reablement service, which would be similar to what is set up a few other areas of the country.

·         It was suggested that the Committee may want to think about where this service should go in the future and what did 'good' look like.

·         At this time it was not clear what the timescales would be for integrating the reablement service, as it was the NHS' intention to invest more in primary care.  However, there was a question of whether more should be invested into reablement as the Council had evidence to show that it commissioned well and had a good commercial offer.  It was acknowledged that it could sometimes take some time to persuade partners that this was the path to follow.

RESOLVED

            That the information presented within the report be noted.