Strategic Overview of Adult Social Care in North Yorkshire

Richard Webb provided an excellent comprehensive and informative overview of the key focus and challenges for adult social care and Public Health in North Yorkshire.

The focus for Health and Adult Services in North Yorkshire remains:

· Prevention: universal/targeted, adding life to years/tackling inequalities, specialist housing, social care practice, technology, voluntary sector investment

· Care provision: supply, workforce and quality (including people’s experiences)

· Money and performance: multiple funding regimes, external cost pressures, new national performance regimes.

Service priorities, which in one way or another all feature in our work programme, are:

· Care market sustainability/development/quality

· Workforce

· Practice

· Social Care Charging Reforms / Trailblazer

· CQC Assurance Framework from 2023

· Prevention and housing

· Improving the County’s health

· Health protection – Covid-19 and beyond (monkey pox, avian flu, etc)

· Tackling drugs

At a previous meeting we heard how NYCC has agreed to become one of the six national trailblazer sites which hope to implement the reforms in January 2023. This decision is not without risks for the council – especially in financial terms.

Richard emphasised that no formal decision has been made to jump into this at an early stage, but it presents an opportunity to shape development from a rural perspective. The service wants to see the funding gap properly identified nationally and addressed, along with a realistic timeline. There are also issues around IT and data. The directorate will continue to push on all these issues and, as a committee, we intend to keep it at the top of our list of work programme commitments.

Richard provided further detail for Members on challenges faced by the care market. It was explained that there is currently huge pressure on hospitals and post-pandemic there are now large queues for people discharged from hospital in need of a social care package. Additionally, several care homes are struggling, with a particular depletion in available beds in Scarborough and Selby areas within the last few years. The service has had to intervene at points to ensure the continuation of homes and there are increasing applications from homes for hardship funding.

In this context, workforce shortages and pressures in the social care market, particularly in care homes, remain an area of serious concern. There is fierce competition from retail, hospitality and distribution sectors. Richard and Cllr Harrison have tried to influence issues nationally and in the media around the need for a decent level of pay for care workers, but it is difficult to compete with other sectors and staff vacancies pose a significant issue. Members highlighted the difficulties of providing a competitive wage for care workers and welcomed the efforts of Councillor Harrison and Richard Webb in lobbying at a national level and in local media for better pay.

When members expressed their concerns at the effects of social isolation, they were recommended to speak to their Stronger Communities Manager about local initiatives. Locality Budgets are a useful pot of money to use for improving recreational facilities.

Members also discussed the need to ensure availability of specialist accommodation for the care market. Richard advised that work has been underway with district and borough councils on new housing developments to enable creativity around Extra Care and supportive housing.

It was identified that more locality working on health and wellbeing programmes would be beneficial and that the leisure offer isn’t always consistent across the county. Richard highlighted that a proposal will be brought to the Executive in November around a countywide review of the delivery of leisure.

Members discussed the impact of large housing developments on the capacity of local hospitals. Richard highlighted that while the council is limited in its lobbying of the NHS on such matters, the rurality of North Yorkshire lends itself to doing more around using technology in community care.

Members considered climate change implications in relation to care homes, along with the cost of heating homes, and whether the council can and does ask providers to review practices around sustainable warmth. Councillor Harrison advised that environmental requirements have been enhanced in contracts when procurement is underway, but that with domiciliary care providers it is more around reminding them about practices which help the environment and save money and capitalising on things like doing remote meetings more often. Richard advised Members that there are climate changes leads in adult social care and Public Health, for example looking at electric cars as an option for home care workers and cycling pilot schemes. The directorate is conscious of the need to keep this under review and to adapt and influence where possible.

Looking Ahead

For the next meeting in December, we will continue our review of the preparatory work for the Trailblazer project; review the Director of Public Health’s Annual Report and discuss with Cllr Caroline Dickinson her annual report as Older Peoples Champion.

In March we will look at the new obligations under the Adult Social Care Assurance Framework. This is the government’s plan to reintroduce inspections of local authority’s adult social care functions by the Care Quality Commission, with councils being potentially subject to government intervention for failings.

COUNTY COUNCILLOR KARIN SEDGWICK

4 November 2022