Stockton-on-Tees Borough Council

Big plans, bright future

Adult Services and Health Select Committee Minutes

Tuesday, 16th December, 2014
First Floor Committee Room, Town Hall, High Street, Stockton, TS18 1AU
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed (Chairman),Cllr Evaline Cunningham, Cllr Elliot Kennedy, Cllr Mrs Sylvia Walmsley, Cllr Norma Wilburn, Cllr Mrs Mary Womphrey and Deborah Miller.
L Hanley, G Irving and R Papworth (CESC); P J Mennear, R Smithson(LD).
In Attendance:
Stuart Dryden (Community Integrated Care); Emma Sword, Andrew Lees (Comfort Call).
Apologies for absence:
Cllr Kevin Faulks, Cllr Ray McCall, Cllr Paul Baker, Deborah Miller and Michelle Savage.
Item Description Decision
AGREED that the minutes of the meeting held on the 30 October 2014 and 18 November 2014 be approved.
AGREED that the information presented be noted
AGREED that the information be noted
AGREED that the Work Programme 2014-15 be noted
5:00pm - 6:00pm


The evacuation procedure was noted.
There were no declarations of interests.
The minutes of the meeting held 7 October 2014 were signed by the Chair as a correct record.
Consideration was given to the draft minutes of the meeting held on the 30 October 2014.

An updated version of the draft minutes of the meeting held on the 18 November 2014 was tabled for consideration in place of the previously circulated draft.
Representatives from Homecare providers Community Integrated Care and Comfort Call were in Attendance to provide Members with evidence towards the Scrutiny Review of Home Care.

Each of the providers gave background information to the Committee:

• Community Integrated Care is a nationwide provider of Care Services with 21 years of operating in the North East. They were one of the largest providers of learning disability services and over the last 10 years had provided domiciliary care. with 18 clients currently cared for in the Stockton area. CiC also provided day time activities in the Borough.
• Comfort Call is a family run North East business based in Durham. Currently 40,000 hours of care were provided per week by 2000 employed staff in over 20 Local Authority areas. A range of services were provided including Domiciliary Care, and extra care, with other developments including Evening Services, Through the Night services and respite care. The provider had been operating in Stockton since 2010 with a good working relationship with the Local Authority. Comfort Call operated extra care and outreach from the Aspen Gardens Extra Care scheme. A career progression structure was in place for employees with paid for training and qualifications, though new recruitment remained difficult. Clients were referred to Comfort Call via Stockton Social Services with plan put in place particular to the Client's needs and wishes.

In response to Members' questions the Comfort Call representatives explained that:

• Staff were paid for the travel time between visits in Stockton. The relative compactness of Stockton allowed for effective zoning of visits with the same member of staff dealing with 3 or 4 clients within the same street or estate. Occasionally there may be some significant travel time between clients for the Care worker but this would not be typical.

• It was noted that training covered areas such as dementia, palliative care, and reablement. It was felt that over time the home care sector was increasingly taking on tasks that would have previously been undertaken by health workers.

• Comfort call did have some employees on zero hour contracts. Due to the nature of the care industry with the lack of guarantees over the amount of work the business would receive from local authority referrals, it was felt by Comfort Call they could only provide zero hour contracts to its care workers.
There were many factors outside of the business's control such as mortality rates and hospital stays. Total hours per week could vary between 600 and 900, for example.

• Staff retention rates were reported as being good in Stockton., with staff usually being given the hours per week that they request. For extra care shift work there were employees on contract.

• Staff on zero hour contracts did have pension and national insurance contributions made by Comfort Call. Staff were automatically enrolled on the pension scheme and had to choose to opt out. Comfort Call stated that they believed that providers should commit to passing on any fee uplifts to staff.

• Comfort Call would look at the minimum hours of care work they had received from Stockton Council over the last 6 months and noted the suggestion made by Members that a contract for some hours work a week should be offered to care workers to provide some form of job security rather than totally being on a zero hour contract basis. It was noted that originally Comfort Call had not originally put in a bid for domiciliary care in Stockton but had taken the contract on at a later stage in addition to the extra care work. It was explained by the Adult Services Lead officer that the Council no longer used block commissioning due to the need to give clients choice. It was noted that the Council could work with Comfort Call on the issue of zero hours.

• Stockton Council currently paid just under £11 per hour with the highest rate paid by local authorities serviced by Comfort Call £13 for equivalent care services. The higher amount per hour was usually in local authority areas where they insisted on living wage being paid to staff over and above the statutory minimum wage.

• The 2000 employees of Comfort Call were based in the North East, North West and Yorkshire and were paid on a 4 weekly period basis. Minimum wage was only paid in 3 local authority areas including Stockton. A higher wage was paid in other areas.

• The QCF training was provided by LIFETIME with staff paid for the hours they were receiving training.

• Comfort Call didn’t require any experience or qualifications for entry level staff. Basic numeracy and literacy tests were in place, although Comfort Call had found that some of their best care workers did not necessarily have good literacy skills. The main criteria was to want to work in care and to be prepared to work anti-social hours.

Both the Community Integrated Care and Comfort Call representatives highlighted difficulties in attracting new staff. The current focus was on retaining existing staff and keeping them happy in their jobs. CiC noted that they had a cost of around £4000 to replace a member of staff due to training and administration. There was a tendency if new staff lasted more than the first 3 months they would stay with about 50% of new recruits doing so. One problem was delays with obtaining DBS disclosures as potential recruits would take jobs elsewhere if the disclosures did not arrive promptly.

In terms of continuity of care, both representatives highlighted that it was not practical for a client to only ever have one care worker throughout their period of care due to staff sickness, holiday, leavers and new starters. It was appreciated that clients wanted to see the same person in order to allow a trusting relationship to be built up. It was also noted that some clients had up to four visits per day.

Community Integrated Care noted that they provided for a different client group and there were longer sessions of support up to four to six hours which enabled a greater level of interaction and relationship buiding.

With a new client CiC would, from the start, have 3 or 4 members of staff in the team they would have contact with in order to allow the client to have continuity of care with the same few faces. Expectations did need to be managed carefully in regard to continuity of care.

The Chair expressed the view that employees in the care profession did need more job security than zero hour contracts represented. Greater job security would attract more recruits in to the care service and help those vulnerable people who needed that care.

The representatives from Comfort Call and Community Integrated Care were thanked for their attendance and presentations.
The Committee considered information from Regional Health Scrutiny

An update from the Tees Valley Joint Health Scrutiny Committee included:

- A presentation on Winter Preparedness from the NHS England DDT Area Team

- An update on Seasonal Flu Vaccination Programme

- An update on Securing Quality in Health Services (SeQIHS)

An update from the NE Regional Health Scrutiny Committee included the draft minutes from the North East Joint Health Scrutiny Committee held on 20 November 2014.

Members expressed concerns over difficulties with the North East Ambulance service recently reported. It was noted that problems with recruitment and the volume of calls needed to be addressed. It was noted that NEAS were due to attend the January meeting of the Tees Valley Committee.
Consideration was given to the Work Programme 2014-15

The Committee was informed that there was now an 'All about me' booklet used in North Tees Trust for in-patients with dementia, and these booklets outlined individual preferences and needs in order to help keep patients safe in hospital.

Queries raised by Members over community-acquired infection rates were still being pursued.

The Committee was also informed about an Ageing Dental Care Event taking place on the 27th January which Members were welcome to attend.

The Chair had nothing further to update.

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