Emma Crowther (Interim Head of Commissioning) and Hannah Shaw (Commissioning Officer) introduced the Commissioning of Domiciliary Care report to the Committee, and highlighted the following points-

a)    Domiciliary Care helped enable people to remain in their own homes, living with dignity and independence. The sector had experienced significant operating pressures during the Covid-19 Pandemic, with frequently changing guidelines/practices and workforce pressures. There had been significant efforts since then to transition away from reactionary working, to a proactive phase with forward planning and preparation;

b)    There were currently 20 Domiciliary Care providers commissioned by PCC, all on SPOT contracts. While these were convenient for some providers, it was recognised that these contracts did not provide long-term security, resilience or relationship building for PCC or contractors, and this would be addressed in the new commissioning plan; 

c)    Each year, approximately 14,000 hours of care per week was delivered to 1,000 adults across the city, by the Council. The waiting list for a Care Package had now reduced from 50 people, to 15;

d)    Each provider in the city had a dedicated commissioning officer from PCC, who regularly engaged with them. PCC were currently undertaking a review of the quality monitoring processes for providers, which would form part of the new contracts for Domiciliary Care;

e)    If concerns were raised regarding the quality of care or standards of a provider, the Commissioning Team could use enhanced monitoring, where appropriate,  and could implement improvement plans;

f)     There were 3 care providers in Plymouth rated as ‘requires improvement’ by the CQC, and 17% of providers rated as ‘outstanding’ compared to the 5% national average. Council staff worked closely with the 3 providers requiring improvement, and monitored performance against their improvement plans;

g)    It was recognised that care providers often had contracts spread across the city, which was not always the most efficient approach, or good for relationship building. The new Commissioning Plan sought to develop Locality Hubs to stimulate a sense of community, with providers leading within their ‘local patch’;

h)    The Commissioning Plan would likely be taken to Cabinet in the Spring, with the ambition of securing contracts by end of 2024; 

i)     PCC was frequently approached by agencies from outside of Plymouth looking to establish within the city however, this often did not increase care capacity, with staff often moving from one provider to another;

j)     The Commissioning Team welcomed feedback from all parties involved in Domiciliary Care, which would feed into the new commissioning process.

In response to questions from the Committee, it was reported that –

k)    Spot contracting did not commit the Council, or agencies to fixed provision. While these worked well for many providers, PCC sought to offer longer term contracts to give providers security and sustainability, as well as building relationships;

l)     PCC had established a domiciliary care agency, @PlymouthCare during the pandemic to support the failing market. The new commissioning model would aim to improve the viability and resilience of care agencies, using the lessons learnt from his project;

m)  PCC gave notice to care providers before carrying out an inspection, unless there was sufficient cause for concern to carry out an unannounced visit. CQC inspections were largely always unannounced.

The Committee agreed-

1.    To review the Domiciliary Care procurement methodology and new Commissioning Plan at a future meeting, following its publication at Cabinet;

2.    To note the report.