Care Market

Adult social care is a complicated mix of state-funded and privately financed care, provided by many different organisations, most of which are independently-owned businesses, at prices determined by local market forces and the funding available to local authorities.

Understanding the complexity, scale and state of the care market in North Yorkshire was therefore a must-do for the committee at its first meeting. We heard how there are now:

· very low nursing and residential home vacancy rates with limited capacity across North Yorkshire;

· challenges with sourcing home care particularly in Selby and Scarborough and in some cases where people require very bespoke/specialist support;

· non-regulated Day Service providers continue to offer a blended model of support with some face-to face and some virtual services; and

· workforce issues across health and care sector;

Overall, sustainability of the care market remains a priority, with pressing issues relating to financial stability and workforce recruitment and retention.

In the face of all these pressures, it is good that we do have well established working relationships with the care market, voluntary and community sector and health are all committed to working together as a local health and care system.

The committee was once again reassured by the action and intervention measures to support the care market. These range from funding initiatives - for example to assist and promote recruitment and retention, regular engagement with new and potential new providers, working with homecare providers and stronger communities to identify opportunities to sub-contract non-regulated care, and a wider transformation plan incorporating national health and care reform.

Charging for Social Care: The Care Cap

While the Health and Care Bill goes through Parliament, social care is preparing for the changes it will bring – as part of wider government reforms – to financial assessment and funding regulations. In particular, this includes the introduction of a cap on what self-funders must pay towards their care before they become eligible for state-funded care. It is going to be a significant challenge to address the changes. From October 2023, no eligible person starting adult social care will have to pay more than £86,000 for personal care over their lifetime. The reforms mean more people will qualify for local authority assistance than previously which will have significant implications across all of our services.

We heard how NYCC has agreed to become one of five national trailblazer sites which will implement the reforms in January 2023. This decision is not without risks for the council – especially in financial terms – but the committee recognised the argument that we have to do it anyway so why not do so with support and be able to influence. If it works well, then early implementation will bring benefits to the population of North Yorkshire earlier than elsewhere.

North Yorkshire has some aspects that make it very different from many of the other Trailblazers. We have high numbers of providers, high number of self-funders and have remote rural and coastal communities. Being a trailblazer gives us the opportunity to re-design some of the ways we go about our business generally and how we manage this local mix.

Members welcomed the extent of the work the directorate has undertaken to prepare, whilst recognising the scale of the work ahead and the tight timeline in which to be ready for what is going to be a huge task.

Given the self-evident significance of this initiative, the committee has indicated it would wish to keep a “weather eye” over activity towards implementation and then monitor its progress and effect.

Looking Ahead

For the next meeting in September, Richard Webb has agreed to give a strategic overview of the state of adult social care in North Yorkshire, including the financial pressures upon the service.

COUNTY COUNCILLOR KARIN SEDGWICK

6 July 2022