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LD DOM Forum notes 26th July 2016

Posted on the 4th August 2016

These are notes (not minutes) and reflect the opinions and understandings of those present

Christine Rowberry opened the meeting.

David started by informing everyone that CPIC will be meeting with Derek Thomas MP every 3 months and that Derek will try to organise a meeting with Kate Kennally (Chief Exec at Cornwall Council). At the previous meeting with Derek, topics discussed include delayed payments, duplication of regulation, and the lack of process for placements which often means Providers are accepting service users without purchase order in place, which often leads to delayed payments.

Mary reported on the Care Association Alliance meeting attended by Mary and Richard. One of the guest speakers was Bev Mayberry, Policy lead for ADASS. ADASS are looking to showcase best practice by Commissioners and Local Authorities across the UK as well as writing a paper for the Government on pricing in the sector.

It was highlighted that small businesses will be adversely affected by the increase in pricing by CQC.

A discussion took place around Simon Duffy’s recent request for information to be included in a report to Parliament. Richard has sent Simon a number of documents, but Simon is looking for a précis of the situation in Cornwall. Elaine outlined Simon’s position and intention which is that Tendering as a process for the Care sector should be thrown out completely as it simply not the right approach. A document by Simon was circulated (and is available online at http://www.sochealth.co.uk/2016/02/16/ending-tendering-in-social-care/).

Christine called for volunteers to spend some time to précis the position in Cornwall. Carol. Tish, Elaine, and Diane volunteered to work with Christine. Tish suggested contacting Healthwatch too. Action: Christine to invite Healthwatch to help with précis. Action: Richard to send documents to the volunteers.

David reported that Maria Harvey highlighted that at a recent meeting, there was some negativity from Providers. Mary has arranged a meeting with Maria (along with David Coleman) on a separate issue, but is happy to discuss this situation with Maria. It was suggested that Maria’s email be forwarded to Kathryn Hudson. The meeting felt that CPIC should reply to Maria (copying Kathryn) to say that the situation is nothing to do with CPIC as it is an open discussion forum. Action: David to reply to Maria Harvey (copying Katrhyn Hudson) stating that the situation is nothing to do with CPIC as it is an open discussion forum.

One provider reported on phone call from the Council regarding a visit by the Service Improvement Team that the Provider knew nothing about.  Underhand tactics like this do not hep the Council to engender a feeling of trust.

Another provider was criticised by the Service Improvement Team over the quality of their Care Plans when CQC had finished their inspection only days previous and were glowing about the quality of the Care Plans. The Council do not seem to be able to justify why the Service Improvement Team is different or needed. 

David reported that when the Council were questions about ‘Outcome Focused Commissioning’, no-one was able to define the outcomes, or how they would be measured.

Peni reported on the Individual Funding Service (IFS) who offer a service to allow personal budget clients that ability to manage their own budget. They have been invited to attend a future Forum to introduce themselves.

Kieran Topping arrived and presented an agenda for discussion.

Kieran started by informing the meeting that business case is being developed on the need for change and the cost of change. Currently in draft form, this is looking to cover both Dom Care and Residential Care at the same time. The business case is expected to be ready by September 2016 and have a 6-9 month delivery period.

A discussion took place around collecting client contributions and that levels of outstanding debt is so low according to the Council. Providers felt that this was primarily because Providers have to be so good at keeping on top of this in order to maintain cashflow, even though the task is onerous and time consuming. It was also felt that the clients and their families would be more responsive to the Council chasing fees owed, rather than the provider.

The point was made that if the Council were to take on all claiming of debt owed, it would make Electronic Call Monitoring more efficient and effective. 

Kieran informed the meeting that due to a reduction in audit checks, the period using Electronic Call Monitoring after 8th August 2016 should be significantly faster. Kieran would like feedback from Providers using ECM to see if payments are quicker. Action: All providers using ECM to report to Kieran regarding speed of payments after 8th August 2016.

One provider reported that the volume of invoices raised outside of ECM has increasing significantly as two thirds of ECM invoices had to be resubmitted as manual invoices.

It was suggested that if Purchase Orders for next month are not available, it makes sense to raise the invoice outside of ECM rather the having it rejected through ECM and then having to resubmit manually.

A discussion took place around the Care Home and Care at Home forum. It was agreed that the meeting was not long enough.

The point was also made that Providers will always raise old issues if they feel they have not yet been acknowledged or answered.

It was also highlighted that the Health section of the meeting was very good and positive. The Council could take Health’s approach to their section of the meeting.

The meeting agreed that for future meetings, it would be useful to be warned in advance of the topics for discussion so that Providers could actually contribute to the meeting. Currently the Council has reverted to its approach of ‘talking at’ Providers rather than engaging Providers in discussion. It was highlighted that it cannot be true co-production is the Council do not listen to Providers, or do not like the comments that are made.

One Provider questioned how much money was being spent on making the Framework work? It was suggested that the money could be better spent on front line services.

The point was also made on how Brexit might affect the situation. Kieran reported that as EU regulation is currently enshrined in UK law and would take years to reverse, no change is likely in the short term.

Some Providers felt that reverting to an ‘Approved Provider’ list would be a sensible and more cost effective approach. Kieran broadly agreed and confirmed that this was one of the options being looked at.

The meeting agreed that there is currently no mechanism in place for Providers to discuss what is going right/wrong and how to resolve them. There is no accountability.

Kieran confirmed that attending these Forums is useful and that it is important to discuss the issues, regardless of how challenging they may be, and he will endeavour to attend future Forums.

Actions

  • Action: Christine to invite Healthwatch to help with précis
  • Action: Richard to send documents to the volunteers
  • Action: David to reply to Maria Harvey (copying Katrhyn Hudson) stating that the situation is nothing to do with CPIC as it is an open discussion forum
  • Action: All providers using ECM to report to Kieran regarding speed of payments after 8th August 2016