Bradford Cares

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Over the summer of 2012, David Ward as MP undertook a survey which asked thousands of his constituents about the state of social care in Bradford. The object of this survey was to raise awareness of the Draft Care and Support Bill and give local Bradfordians a chance to have their say on its recommendations.

Following a community event on the state of social care in Bradford, David submitted the results of the survey to the Draft Care and Support Bill Committee in January 2013 which was chaired by Rt Hon Paul Burstow MP. The report was also submitted to Normal Lamb as Health Minister. David held a Westminster Hall debate on the report and the conclusions were welcomed by Norman Lamb.

In early 2013, Bradford Council announced its intention to increase the Fair Access to Care Services Criteria from “Moderate” to “Substantial”. David along with the Bradford Disability People’s Forum and the charity Scope, created the Bradford Cares Consortium campaign to fight against the proposed cuts to over 2,000 vulnerable people across Bradford.

David and the consortium launched Bradford Cares http://bradfordcares.org/en/ with Rt Hon Paul Burstow MP and Rosemary Frazer, Community Campaigns Manager at Scope in July 2013. David and campaign met with Norman Lamb in September 2013 and also submitted a petition to number 10 calling for Bradford Council to cancel the Care Cuts.

Unfortunately in October 2013, the Council published their decision to introduce the care cuts and these went live on 1st April 2014.

In November 2014, David and the Bradford Cares consortium held an event with guest speaker Baroness Sal Brinton, in order to gage what has happened 6months after the cuts have been implemented. It was clear from the feedback from carers and those receiving care that access to information about Council services was very poor.

Domiciliary Care Survey

Having been approached by several local care providers about concerns with the Council and the rate that the Council was paying for care, David organised a domically care survey in order to gage how extensive the problems was.

The feedback from this survey as well feedback from a dinner organised with Baroness Brinton and local care providers in November 2014, found that the price that the Council were paying of £12.50 for an hour of care was not only having an impact on the quality of care provided but was having a large impact on the feasibility of delivering care at this price and was forcing providers out of the market.

Investigation by Health and Social Care Committee

Having received feedback from David Ward’s domically Care Survey, Cllr Jeanette Sunderland, Leader of the Liberal Democrats on the Council ensured that the Councils Health and Social Care Scrutiny Committee undertook an investigation into domiciliary care in Bradford it met on the 7th and 9th January to consider the implications of the £12.50 fee for standard domiciliary care per hour set by Bradford Council.

The committee received evidence from the Bradford Care Association, the United Kingdom Home Care Association and the Council’s Adult Services Team.

The Committee made a number of recommendations to the Councils Executive which were presented in draft to them on 13th January 2015. These were:

(1) That Executive be requested to consider:

(i) That the Council undertake a fully comprehensive exercise to establish the actual costs of domiciliary care in the Bradford District in collaboration with the independent private sector and the National Health Service (NHS).

(ii) That the Committee strongly believes that the Council should work towards, through its commissioning process, the reduction in the use of 15 minute care visits and zero hour employment contracts.

(iii) That consideration be given to the Council engaging with NHS partners

to establish joint principles for the commissioning of services in the District.

(iv) That steps be undertaken to progress the adoption of North Yorkshire County Council’s guidance on 15 minute care episodes for staff.

(v) That the transition from Bradford Enablement Support Team (BEST) to domiciliary care providers be reviewed to ensure that there is agreement in relation to the number of hours of care required.

(vi) That consideration be given to the adoption of the recommendation of the Burstow Commission that any decision to pay below the UK Homecare Association calculated minimum cost for domiciliary care be signed off by the Bradford and Airedale Health and Wellbeing Board.

(vii) That the Council ensures that its commissioning practices and its dominant position in the domiciliary care market does not increase the risks to the human rights of older people and those with learning disabilities.

(2) The a report be received back in 6 months.

The terms of reference for the inquiry and the above recommendations were produced by the Liberal Democrat Group. There are 4 key remaining issues that need to be resolved on an interim basis whilst the price review is carried out.

1. The price being used by the Council to purchase 1 hour of basic care to an older person.

2. The impact of the Council not paying for travel time has led to older people not getting their time as travel time is deducted from the call and the reduction in the length of calls.

3. The impact of the extensive use of zero hours contracts.

4. The sustainability of the care market in Bradford

1. The price being used by the Council to purchase 1 hour of basic care to an older person.

The Bradford Care Providers represented approximate 7000 hours of the care delivered per week in Bradford. This represents about half of the 14,200 hours of domiciliary care purchased by the Council per week.

The Council purchases this care at what it describes the “most economically advantageous price to the Council” of £12.50 per hour for basic care for elderly people. In February 2014 the Bradford Care Association raised with officers that this rate was not sustainable. This position was acknowledged by officers. However the price has not been reviewed and officers are using figures from 2011 to base their current price on.

The Council costs its in-house service at a rate of £22.25 per hour a difference of £9.75 an hour. The difference in price is due to the difference in terms and conditions between the Council’s own staff and those it commissions and the rates of pay paid to care workers.

Council rates of pay

Trainee £7.19- £7.30

NVQ trained £7.43-£8.05

Senior £10.50 - £11.51

Private Sector rates of pay in Bradford

£7.10 per hour across the board once they have been through induction is average however some are paid at the national Minimum Ware rate of £6.50

Some providers pay an enhanced rate for weekend working of £7.60-£7.80 however the impact of the national minimum wage compliance has led to a flat rate of around £ £7.15 to £7.20 per hour being paid by most providers.

The Councils dominant purchasing power has kept wages down in the private sector to less than that paid to trainees working for the Council.

In 2001 the Council purchased an hour of care for £12.00 and in 2015 it is paying £12.50.

The UK Home Care Association has calculated that the minimum price for an hour of care using the national minimum wage of should be £15.74.

The impact of the Council purchasing dominance on the domiciliary home care market is leading to a number of Domiciliary Care Businesses refusing to accepting referrals from the local authority.

Private companies charge on average a rate of £11.00 for a half hour call and £15.00 for a full hour.

Where the Council negotiates a care package for a person who is assessed as eligible to pay, they then becoming self-funders it charges the service user £13.75 for the care although it pays the Domiciliary Provider £12.50 and makes a “profit” of 75p on the hour of care.

The Council purchases domiciliary care on spot contract rates as and when it requires them arguing that this method benefits self-funders who can secure better prices. However the reality is that the purchasing dominance of the Council is causing the care businesses to cross-subsidise from self-funders to support the care purchased by the Council. Self-funders are also disadvantaged when their care is purchased for them by the Council and charged back to them at more than the Council pays for it.

2. The impact of the Council not paying for travel time has led to older people not getting their time as travel time is deducted from the call and the reduction in the length of calls.

Council says this does not happen however its own work with care providers produced the comment “Service users don’t get 15 minutes of care as travel is built into the time.” Domiciliary Care Providers have to pay for travel as it is used in the calculation for minimum wage compliance.

The Council has consistently argued that it doesn’t use/record 15 minute calls however evidence produced at the scrutiny committee from just one Domiciliary Care Provider showed the number of 15 minute calls purchased per year as;

Year 1 2008-2009 0

Year 2 2009-2010 4143

Year 3 2010-2011 7451

Year 3 2011-2012 9092

Year 4 2012-2013 11369

The contract was ended so no further data was collected. In March 2012 the provider raised the issue with the Commissioning Officer monitoring the contract the impact of the 15 minute call were having on the quality and delivery of service. The officer agreed to escalate the concerns. All 15 minutes of care are now purchased on a spot contract basis. Requests to Council for information about the number of 15 minute calls have not been answered.

3. The impact of the extensive use of zero hours contracts

The Council has a dominant market position and makes extensive use of spot contracting leading to zero hours contracts being very much the norm for people working in the private domiciliary care sector. It is a direct consequence of the care businesses not having a contract and with it some degree of certainty of hours along with the aggressive pricing of the Council that has led to the increasing use of zero hour contracts. This makes life extremely difficult not only for the businesses but also the workers themselves when trying to make arrangements for child care, arrange finances or their own caring responsibilities. Such low levels of pay mean that most workers are reliant of state benefits to top up their incomes and have not as yet got a pension.

4. The sustainability of the care market in Bradford

Bradford has a growing aging population. The criteria for who gets care has been raised so the needs of frail elderly people entering the care system have increased and the dominance of the councils purchasing policy is putting care businesses under great pressure. At the scrutiny inquiry and in their evidence to the Bradford Care Association described the situation as a crisis and advised Members of the Committee that they were considering pulling out of the providing domiciliary care purchased by the Council.

 

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