Agenda item

The Committee considered a report they had requested surrounding the current pressure on domiciliary care and the impact that this was having on hospital discharges.  The report was to provide assurance that patients were being safely supported to leave hospital and outlined the pressures and how Carmarthenshire County Council was responding to those pressures.

This report was the third update the Committee had received which included the latest available data captured up to the end of September 2023.

The Cabinet Member for Health & Social Services highlighted improvements had been seen particularly since August 2023 and that this was aligned to the relaunch of the Domiciliary Care Framework and the addition of 4 new care providers that had built further capacity into the sector.   Consequently, there had been an overall growth in the number of hours commissioned for domiciliary care and a reduction in hours and people waiting across community and hospital sites.

It was noted that while progress had been made, there was still a significant amount of unmet need that necessitated monitoring to ensure that people remained safe whilst waiting for care.

The Cabinet Member for Health & Social Services advised that fortnightly meeting were being held to review long hospital waits to ensure that all options had been considered thus reducing the number of people with a long wait in hospital.  Also, twice weekly hospital escalation panels were being held where all difficult cases were escalated.  These reviews of long stay patients had significantly reduced those with a length of stay of over 100 days which in turn would have a positive impact on social care commissioning.

It was noted that the Authority also offered Delta CONNECT and direct payments to both the person needing the care and also to the carer who provided care to support individuals whilst they were caring for someone waiting for care.

It was advised that the growth in the number of hours commissioned for domiciliary care was approximately 7% for the first 6 months of 2023-2024. The projected overspend for the current year was approximately £1m – assuming further growth in October - March.  This was partially offset by the reduction in hours delivered by our inhouse service.  There was a projected underspend in the inhouse service of £727k (as at August 2023 budget monitoring) due to staff recruitment issues.

In response to a question regarding the re-launch of the Domiciliary Care framework and the fall-back position for the services provided by the commissioning, the Director of Community Services advised that having 4 Domiciliary Care agencies was advantageous as if one went bankrupt there were three other agencies available.  The importance of having an in-house service to provide continuity of care was highlighted and considered to be an essential element of care provision.

In response to reference made regarding the Health Board statistics concerning hospital discharge and those waiting for care, the Acting Head of Integrated Services advised that work was being done at the ‘hospital front door’ to identify the frailer people and to assist with returning them to the community.  Data showed improvement with regards to the number being discharged within 72 hours.

On behalf of the Committee the Chair extended his congratulations to Carmarthenshire’s Home First team who had won the Welsh heat of the Great British Care Awards this year. 

The Committee also expressed thanks to officers for the quality of the report that had been produced.

UNANIMOUSLY RESOLVED that the report be received.