Catherine Wilson, Strategic Lead Commissioning and Procurement, presented the report that outlined the issue of the gap between what the Council charged for domiciliary care and the actual cost the Council paid providers. Members were provided with a brief background to the report and were directed to the different charging options that were being proposed for the public consultation for internally provided and externally commissioned domiciliary care.
The Chair thanked Officers for the report and asked Councillor Halden to speak.
Councillor Halden stated he respected the scrutiny of this committee and as he had stated in his Annual Report presented at Council, care fees would need to be increased and this had now been undertaken in the most transparent way possible. With the gap increase between the cost of services and what was charged for services would create a great instability in the service and the gap had to be closed. Councillor Halden continued to state that he preferred Option 3 of the three options being presented to Members this evening, as this option would be tapped over a number of years, be able to close the gap and allow the Council to programme in above an inflation increase for the providers of domiciliary care. Councillor Halden finally stated that for a stable system that Thurrock residents could always rely on, the Council needed a flexible system to pay the workers more but needed to make sure the revenue was there. Councillor Halden thanked the Chair for giving him the opportunity to speak and left the meeting.
The Chair stated that the increase of fees was feasible and was reassured that it would only be 10% that would need to pay an increase fee.
Councillor Holloway stated that Options 1 and 2 provided figures but the recommended Option 3 there was not a breakdown of how much each year would bring in. Roger Harris stated the increase was approximately a third each year but it was very difficult to provide an exact figure as the Council had to undertake individual financial assessments on everyone and everyone’s situations may be different. Councillor Holloway stated she was not happy with the increases and that it was still an incredible increase even for those 10% even when this was spread over three years. Councillor Holloway welcomed that some services had been ruled out she still had concerns that the increase had not been considered as part of a range of proposals and questioned were there any other options. Councillor Holloway requested her comments be noted for the Cabinet Paper and had not felt comfortable looking at this financial discussion on its own and asked the Chair to add to the work programme the detailed financial proposals that would be proposed for the department for fees and charges and for any other future cuts for the committee to scrutiny. Roger Harris replied by saying that at this stage the committee were only be asked to support the statutory consultation and when the recommendations come back for final decision these would be presented as other options and choices that Members would have to make. Councillor Holloway noted that the process but stated it was vital to get objections and intentions noted early on consultations. The Chair replied that he would check and if feasible would add to the work programme.
Councillor Rigby stated there was not an option not to increase the fees and agreed that Option 3, staged over three years, was sensible and would allow people to plan and would be supporting that option.
Councillor Muldowney referred to the Points of Consultation and questioned that where the responses to the consultation received back stated they did not want any increases there would be no increases. Roger Harris stated that he could not guarantee that as this would need to be looked at as part of the Council budget decisions. The purpose of the consultation was not to get a yes or no answer but would also provide the opportunity to carry out equality impact assessments, look at fair charging policies and a further range of responsibilities would be looked at. Once the results of that consultation came back to committee Members would have to make that decision on a range of budget decisions. Councillor Muldowney asked for her strong objections to be noted and stated that it was wrong that these increases in charges were being made on the most vulnerable in Thurrock. The Chair asked for clarification on the number that would pay the full charge to which Roger Harris stated that at this time this stood at 160 service users who had been assessed to pay the full cost of their care but stated that this figure could change.
Councillor Massey noted that this would be going out to consultation and echoed Councillor Holloway comments on making objections early and that the consultation would be coming back to committee. Councillor Massey questioned when the consultation would start and finish and stated he would like to see more details of financial breakdowns. Roger Harris stated the consultation would start immediately following the report going to Cabinet on the 16 September and following their agreement. Members were informed that this was a 30 day consultation.
Councillor Redsell stated she was in favour of Option 3 but had concerns that not all people would be able to provide their responses back within this timescale. Catherine Wilson stated that the Council would endeavour to reach as many user services as possible with a questionnaire being sent to all those that received care services, the questionnaire would also be put on the portal, arrangements would also be made available for telephone enquiries and face to face meetings would take place.
Kim James requested that HealthWatch be involved in the consultation to capture some independent views and raised her concern on the 30 day consultation period and previously NHS providers that had presented to this committee had been challenged on proposed short periods of consultation and stated that this 30 days consultation period was not long enough to give service users the time to fully respond. Catherine Wilson thanked Kim James for her comments and would take away and review in consultation with HealthWatch. The Chair agreed this was a good point that should be reviewed.
Councillor Holloway stated that a better understanding was required for each individual that were being charged and agreed this should be picked up from the requested financial scrutiny report to be added to the work programme. Roger Harris reassured Councillor Holloway that her concerns were taken into account as part of the financial assessment and would be happy to forward the fair charging policy to Members. That a detailed assessment carried out looked at income and outgoings before any charges were imposed. Councillor Holloway requested that the information should be included in reports that were presented in the future.
Councillor Muldowney clarified that these charges were being made on the most vulnerable in the borough and supported Councillor Holloway that these cuts and charges should be looked at and scrutinised on block and be a substantial item on the agenda.
The Chair noted the comments made and registered Councillors Holloway and Muldowney objections and requested when the consultation report came back to committee it contained more financial data and the options alongside it.
Councillor Muldowney suggested that recommendation 2 be changed to include that the consultation period be extended to which the Chair agreed.
1. That the Health and Wellbeing Overview and Scrutiny Committee reviewed the three options for charging regarding the services in scope detailed in section 3.1
2. That the Health and Wellbeing Overview and Scrutiny Committee supported the three options going out to public consultation. That the consultation would be extended past the 30 days originally set for this consultation.
3. That the Health and Wellbeing Overview and Scrutiny Committee supported consultation with providers, as soon as possible, over the rates the Council pays with the presumption of an above inflation increase to stabilise the market and reflect the increased costs arising from COVID.