Like many councils up and down the country, Leeds has spent a lot of time and effort working out how best to deliver home care in coming years. Keeping things the same was not an option – changes in legislation, best practice, service users’ expectations, and resources mean that change was necessary. Leeds City Council also wanted to ensure home care is commissioned in a way that directly improves the terms and conditions of homecare staff. Mick Ward, Interim Chief Officer, Commissioning, in Adult Social Care describes the changes and what they mean for service users, staff, the home care providers and other organisations working with care users.
The scale of homecare in Leeds in itself brings challenges – with the service in Leeds delivering over 1.5 million hours of home care a year. At the same time we were acutely aware we needed to deliver these changes at a time when the council is under huge financial pressures. It has been fantastic to see that even while facing these financial challenges, the council has invested substantial extra resources into homecare to meet the desire to improve quality and to improve the wages of staff.
It is also worth noting that our home care plans are part of our wider commitments to helping people live independently in their own homes and to making Leeds the best city in the UK to grow old in.
For home care we are moving to a system where the city is divided into six sectors, each served by a main provider who we commission to deliver the majority of home care in that area. This means that other staff working in that locality will have a better chance of knowing who people’s homecare provider is. Underpinning this is a supplementary framework which will act as a reserve option as well as ensuring people have a wider choice if they wanted to use Direct Payments to buy their own care.
As you might imagine there was a lot of competition for the work on offer and making a choice wasn’t easy. However, by setting prices as part of the commissioning process (at a higher rate than previously) meant we could choose the best providers entirely on quality and we now stand ready to see the new service delivering the home care people in Leeds want.
It is true the whole process has taken time, but I feel it has been worth it. We used that time to consult extensively and co-design with stakeholders – including elected members, service provider representatives, service user representatives, NHS representatives, trade union representatives and other ASC colleagues. We also made sure service users were actively involved in assessing the bids from those seeking to be new providers to inform the final decision.
In the next few weeks the new providers are going to be delivering home care as people’s care moves to them, care that will be provided under an extensive ‘Quality Standards Framework’. This framework has, again, been developed jointly with service users and providers, or delivered by a provider chosen by a client and paid for through a direct payment.
As I noted at the start, among the improvements we are seeing are those stemming from the council signing up to Unison’s ethical care charter last year. This means we expect the new providers to meet these standards, and this means paying the Leeds Living Wage (£8.01 per hour), paid training and travel time and a starting point for commissioning of visits being client need and not a particular number of minutes or tasks. Workers will have more freedom to provide appropriate care and will be supported to work together to plan how best that care will be delivered. I believe there is a strong link between treating staff well and the quality of service, and that this is a real investment into both staff and quality.
We’re also bringing in new care monitoring and brokerage systems, managing how care is monitored (for example, ensuring visits aren’t missed or too late, too often) and how it is arranged between social care and the providers. Like all new systems this will take some getting used to, but experience elsewhere shows that it works well and delivers better for service users, staff and organisations, whilst we will not be forgetting it is the human touch that is most important.
A lot of people – including ASC staff, service users, councillors, providers and trade unions – have put a lot of hard work into planning these changes and I want to thank them all for their efforts. As the new scheme moves from plans to reality, we are likely to face challenges and teething problems. However, there is real commitment to making home care in Leeds as good as it can be and we’ll learn from our service users throughout the lifetime of the new contracts to make sure we continue to improve service delivery.
We hope this is going to be the start of something really good, so we’ll monitor what is happening closely and want anyone involved to let us know if they have any ideas for improvements or changes.