Agenda item

The purpose of the report is to provide the People Overview and Scrutiny Committee with background information on the requirements set out in Government policy and legislation on the reform of Adult Social Care and to provide an update on the approach to implementation in Oxfordshire.

The Committee is RECOMMENDED to note the update provided on Adult Social Care Reform implementation in Oxfordshire.

It was noted by the Committee that the expected report from Helen Coombes was not present as it was not ready for publication. It was confirmed by Karen Fuller that it would be ready in time for the next ordinary meeting of the Committee in November. It was AGREED by the Committee to add this item to the work plan for the November meeting.

Cllr Bearder, Cabinet member for Adult Social Care, introduced the presentation. The Council spent almost half its budget on adult social care, making the changes faced in this area highly significant for the Council overall. The reforms to adult social care meant significant increases in the number of people the Council would need to support. Without correct funding for such a significant increase in demand, the situation could prove very challenging for the Council.

Karen Fuller, Interim Corporate Director of Adults, proceeded with the presentation, providing background information on the requirements set out in Government policy and legislation on the reform of Adult Social Care and to provide an update on the approach to implementation in Oxfordshire.

The Health and Care Act 2022 involved multiple strands: the Build Back Better work, which includes the care cap; implementing CQC assurance for local government; integration with the NHS; Fair Cost of Care, which concerned reviewing the fairness and sustainability of care; and the publication of a Market Sustainability Plan. The first priority for the Council amidst this suite of reforms was to complete its work around Fair Cost of Care to meet the October 2022 deadline. Other work is however, proceeding concurrently. For example, legislative changes to the Liberty Protection Safeguards preparation. This work was confirmed to be underway and the Council will be responding to the national consultation in July. It was noted that the proposed changes would involve undertaking assessments on young adults aged 16 and over, requiring collaboration with children’s’ services also.

In response to the requirement from government that a Fair Cost of Care exercise be carried out, the Council would be using the government methodology and relevant tools and would be engaging an independent organisation to undertake the work to ensure impartiality and fairness throughout the process. Early research highlighted a number of important issues, including the relatively high number self-funders which the council potentially will have to support.

The implementation date for the care cap is scheduled for October 2023, but there is the opportunity that assessments can commence in April 2023 in a transition stage which does have some benefits as it does avoid a significant spike in workload caused by an expected increase in demand for assessments of approximately 50% in October. The Council, via the Oxfordshire Way transformation work in Adults has positively reduced waiting lists for assessment by 45% over the previous year which is positive compared to the national picture where waiting lists have increased.

A key pressure to be understood relating to the Fair Cost of Care is that there is no confirmation yet as to how much funding the Council would be allocated in relation to the outcome of the aggregation of the Fair Cost of Care reviews nationally by central government.

At present, the Assurance process is being designed by CQC but it is anticipated that they would include how the Council works with individuals, ensures safety within the system (including working with partners), and leadership within the local authority.

The Council was aware that with the significant changes much work would be necessary to ensure information for stakeholders was available online. The work for this was significant but underway. IT support was also being devoted to improving the efficiency of data-collection and sharing following initial care assessments as well as ongoing work.

Following the presentation, the Committee sought clarification on a number of matters. IN the first instance, the Cabinet Member was asked for his vision for the adult social care sector and how, in light of the duty on the Council to shape the market, it would be expected to look in the future. As a newly appointed portfolio holder, Cllr Bearder was currently meeting with key stakeholders whilst the outcome of the Fair Cost of Care exercise was being awaited to understand the issues prior to reforms then shaping the outlines of the market. Only when that was known would it be possible to take a firm position. In a broader sense, however, his vision was that people should be supported to remain within their own homes and communities for as long as possible and communicating the import of the reforms. An important part of communication and implementation was the adoption of digital technologies. Knowing that many older people do not, however, use technology, it was also recognised how well the Customer Service Centre was providing signposting.

Other issues raised included the shape of the social care market, which, through procurement, was undergoing a move away from care home provision, and towards prevention and care at home. However, it was also emphasised that the biggest change in the coming 18 months was over how care was funded and managing and responding to that would be the primary focus of the Council’s activity. In the longer run, learning from the success of the Oxfordshire Way, the belief that any individual can be successful, through support from cross-organisational local support. That success meant that the county was performing very well overall, with 93.3% of care providers rated good or excellent by the CQC, and that radical changes, apart from those being imposed extraneously through the reforms, were unlikely.

The importance of maintaining a view of reducing the number of those waiting for the Council to do so something was emphasised. It was suggested that the Local Account, currently out of date, would be refreshed in the coming months. The Committee suggested this could act as a dashboard for Scrutiny to keep a view on progress in addressing waiting times for individuals.

Clarifications were also sought on the operation of the cost of care cap, the type of care homes which fell within the remit of the calculations, whether care homes currently in development were being included in calculations, and the capacity to deliver the increased number of care assessments the Council would need to provide.

It was AGREED that the Scrutiny Officer would follow up as to how the Committee could continue to monitor progress and standards.

No recommendations were made in relation to this item.

Cllr Bearder, Stephen Chandler and Lorna Baxter left the meeting at this point in the meeting.