Decision Maker: Alison Elliott (Director of Adult Social Services)
Decision status: Recommendations Approved
Is Key decision?: No
Is subject to call in?: No
To approve the approach to sustaining the
market in respect of supporting social care providers with their
extraordinary costs.
This decision would in other circumstances be
taken by Cabinet. However, in circumstances where the Cabinet is
unable to meet to expedite its functions in a timely manner during
the COVID-19 pandemic, this decision is being taken in accordance
with the power referred to under background below in consultation
with Andy Brown, Director of Finance, Terence Herbert and Alistair
Cunningham, Chief Executive Officers. This decision will be
reported to the next meeting of the Gold Command.
Social care providers are facing extraordinary costs due to the
unique nature of their interactions with their clients. These costs
arise from a variety of reasons:
the need to purchase Personal Protective Equipment (PPE) in
significant quantities at currently vastly inflated prices in order
to be able to mitigate the risks of working with sick and/or
vulnerable individuals, both to those individuals, and to the
members of staff
the need to ensure that any staff displaying symptoms of
Coronavirus do not work, so as to protect both themselves and the
vulnerable people they work with
inflated prices for agency staff at this time, in part because of
greater competition in the labour market for comparable paying
roles
In recognition of these extraordinary pressures, the Council made
an offer to providers to meet these additional costs, by submission
of invoice. To safeguard cashflow, any invoice would be settled
immediately, and verified afterwards. Only claims to meet costs
that are unreasonable would be subsequently reclaimed.
In addition to this offer, the Council also undertakes to pay
“on plan” for services, and to also pay 80% of the
normal rate for any undelivered domiciliary care or supported
living hours. This offer from the Council was ratified by the Chief
Executive Officers, and was originally very well received by local
providers.
The letter containing the offer to providers contained the proviso
that if the Government issued guidance suggesting alternative
arrangements, if those arrangements were more advantageous to
providers then the Council would adopt them. Within the last few
days, guidance has been issued by the LGA and ADASS which
effectively recommends uplifting prices by 10% for the period of
the coronavirus crisis.
It is the judgement of the Director of Commissioning and Head of
Finance for Adults the original offer to providers of meeting their
extraordinary costs is a more generous, more targeted, and more
effective method of sustaining the market. However, Older People
care home providers made robust representations to the effect that
an increase in fees of 10% would be a better approach. These
providers are, in particular, in the very front line of the efforts
against the virus.
Therefore Older People Care Home providers were asked, via the
Wiltshire Care Partnership, to state whether they preferred the
offer of a 10% increase in fees, or for the Council to meet their
extraordinary costs – and indicated a preference for the
latter.
The proposal is therefore to continue with the original offer to
social care providers, including for Older People Care Home
providers, with the latter in particular being on the basis of the
expressed preference of providers.
The uplift would apply to any placements made on or before the 19th
March, but not since, as it is assumed that the market has already
priced in the extraordinary costs; would not apply in particular to
any COVID placements, for the same reason; would not apply to void
beds (there are no extraordinary costs related to void beds, as
there is no one in them receiving care). The uplift would initially
apply until the end of July.
1It is not possible to estimate what the costs of this proposal is
with any degree of confidence. By way of comparison, the cost of
putting care home fees up by 10% would cost £1.6m, and would
have left financial risks with providers, so it is likely that the
costs of this, covering all providers of care, will be
significantly higher. This will be monitored closely and reported
on as part of the normal budget monitoring cycle.
I confirm that in making this decision I have considered the
following in line with Wiltshire Council’s
Constitution:
Key decision requirements:yes
Views of relevant cabinet member(s), committee chairman, area
board(s): NA
Consideration of the area boards and delegated decision checklist
for officers on the issue of when and how to involve local
councillors and area boards in decisions about local
services:yes
Implication of any council policy, initiative, strategy or
procedure: yes
Consultation in accordance with requirements and expectations of
consultation with the public:yes
Range of options available:
yes
Staffing, financial and legal implications:
yes
Risk assessment: yes
Involvement of statutory officers and/or directors:yes
Regional or national guidance from other bodies:yes
The council’s constitution: yes
This contract is suitable for execution under the e-signature
process:yes
Other approaches to sustaining the market have
been considered, and the approach is considered the one that most
effectively meets the strategic objective of sustaining the market
through the Covid 19 crisis period. Doing this is a statutory
requirement.
Conflict of Interest: Not applicable
Background: As the Director for Adult Social Services, I am responsible for any matters relating to Adult Social Care in the County of Wiltshire on behalf of Wiltshire Council. Pursuant to paragraph 4 of Part 3 Section D, the Directors of Wiltshire Council are also empowered to take all necessary decisions in cases of emergency. This decision is being taken by Alison Elliott using these powers in circumstances where the Director concerned believes that there is a risk of damage to property, a threat to the health or wellbeing of an individual and/or that the interests of the Council may be compromised if this decision is not otherwise taken.
Contact: Alison Elliott.
Publication date: 02/06/2020
Date of decision: 23/04/2020
Accompanying Documents: