Agenda item

To consider a report which provides the committee with an update on progress in relation to Care at Home commission, emerging risks and their direct impact on Care at Home services and commissioning work, and the rationale for the recommendation to Direct Award Care at Home contracts to support and maintain market sustainability.

The committee considered a report which provided the committee with an update on progress in relation to Care at Home commission, emerging risks and their direct impact on Care at Home services and commissioning work, and the rationale for the recommendation to Direct Award Care at Home contracts to support and maintain market sustainability.

It was noted that engagement had taken place with residents, carers, operational teams and providers which had identified that a full procurement at this stage would come with several risks. The engagement had identified that the service had a number of providers who have a significant proportion of international employees which could case issues due to upcoming changes to legislation, which could lead to package hand-backs, a loss of workforce, and emergency spot purchasing. Therefore, the intention remained for a recommission which would continue to deliver a stable service to over 1400 residents who currently receive over 22,000 hours per week of care at home.

Members were updated that, since July 2025 officers had met with a number of providers, however, the provider forum had not met for at least 6 months due to low levels of engagement, but engagement days in Crewe and Macclesfield would be held in due course. During Stage 2 of the procurement process, officers would be stating their expectations and requirements and would be working with legal officers to ensure robust wording regarding hand-backs. 

It was noted that there was an aim to work towards a neighbourhood model and microenterprises to assist with care levels in rural areas.

Members were updated that it was not the intention to use the full 36 months extension proposed, however this was added in following procurement and legal advice. It was noted that officers were working alongside the Care at Home Task and Finish Group which was meeting regularly. It was noted that there were a number of changes to process which would take significant time to implement; the growth in the number of international recruits and legislation changes would take time to adapt to.

It was noted that the intention was to carry out a full procurement with a new model at a later stage and that through a reduction of providers, the service was looking to ease contract management and move towards an “outcome based model” with fewer trusted providers and reducing the number of providers would enable the service to make more strategic relationships with providers, and options for consolidated hours. It also provided an opportunity for providers to collaborate. It was noted that there was currently no incentive for providers to reduce their care packages

Members noted concern regarding residents who live on the boarder of Cheshire East, where it may be more beneficial for their care to be provided by the neighbouring authority due to travel and access issued.

Members requested further details on the CQC rating of providers. Officer committed to provider a written response.

The Chair proposed two amendments to the recommendations which were accepted by the committee as friendly amendments:

1.    To add the words “in consultation with the relevant Portfolio Holder / Cabinet Member” to recommendation two.

2.    To add an additional recommendation to read “Authorise an update report to the relevant Overview and Scrutiny Committee in six months’ time on the formation of the new model”.

RESOLVED: (By majority)

That the Adults and Health Committee:

1.    Approve the Direct Award for framework Providers for Care at Home for a period of up to two years plus an option to extend for one year; noting that before proceeding with this measure the Council will need to first await the outcome of the Transparency Notice.

2.    Delegate authority to the Executive Director Adult Health and Integration to take all relevant decisions for the recommissioning of Care at Home Services to include without limitation the generality of the foregoing to execute (or authorise the execution of) of contracts encapsulating the direct award arrangement referred to above, in consultation with the relevant Portfolio Holder / Cabinet Member.

3.    Authorise a report to the relevant Overview and Scrutiny Committee in six months’ time on the formation of the new model.