PAPER B
SCRUTINY COMMITTEE FINAL REPORT
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RESPONSIBLE BODY Scrutiny
Committee |
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ENQUIRY NAME WIGHTCARE |
REFERENCE NUMBER SC06/06 |
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1 OUTLINE OF ENQUIRY AND PROPOSED OUTCOME 1.1
To enquire into the financial circumstances of Wightcare, and to
examine if the proposal to transfer this Council service to a private-sector
provider is in the best interests of service users and the local economy. 1.2
The proposal is of
significant public interest and should be examined to ensure the right
decision is made for service-users and the local economy. 1.3
To ensure that any transfer decision is the right one for service-users
and the local economy. |
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2 RECOMMENDATIONS 2.1.
The Scrutiny Committee task group are agreed that
Wightcare provides an excellent home care service. Wightcare are not able to provide a service to private
self-funded clients or direct payment clients and therefore often operate
with clients who are less economically attractive to private providers.[1] Wightcare provides a service that
employees are proud of - leading to much flexibility and immeasurable
goodwill, which is valued by service users. 2.2. However, the task group recognise that this service is expensive compared to private providers, though they would question the calculation of some of the elements of the in-house unit cost. Consequently they consider that an intensive analysis of the costs of an in-house service is undertaken, perhaps with a view to establishing an (arms-length) social enterprise (potentially in tandem with the local Health care trust). This could be beneficial in terms of retaining the value added elements of this service, for example responsiveness and flexibility, and one able to accept private payers. 2.3.
It is therefore recommended that the decision to transfer Wightcare
to a private provider should be deferred during this financial year,
to allow a fuller Review of the financial circumstances of Wightcare
and its ability to compete more favourably with the private sector providers,
and for an extensive consultation with service users and their
families/carers. 2.4.
The task group believe that the £420,000
identified saving accruing from a transfer this year can be found by
retaining this as a short-term priority of this Council. Hence, the required
efficiency savings will reduce to £2 million rather than £2.4 million, and
£400k will be deducted from planned new priorities spending. The task group
have received no compelling argument to support the planned new priorities,
in particular the seeming targeting of considerable extra resources to adults
and young people with learning disabilities and older people with mental
illness; although of course they recognise how vulnerable all Adult Services’
clients are. 2.5. It is further recommended that:
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3 PREAMBLE 3.1. This investigation has concentrated on the Home Care elements of the Wightcare operation. The task group are aware that there are other functions within Wightcare that fall within the Safer Communities Directorate. However, they understand that the proposal to transfer to a private provider is founded principally on the 2006/7 budgetary efficiencies required in the Adult Services Directorate. 3.2. The ‘task & finish group’ appointed by the Scrutiny Committee to enquire into this decision was pleased that a decision around the proposal was deferred by Cllr Cousins until the enquiry was concluded at the end of May 2006. 3.3.
The group decided to interview a range of
stakeholders in private, but ‘on the record’. They were also pleased that the Cabinet Member for Care, Health
& Housing and Interim Director of Adult & Community Services, and
three Wightcare Home Care Organisers were willing to appear before formal,
public Scrutiny Committee meetings in May and April 2006 respectively. The task group would have liked to
directly involve service-users, but lack of time prevented this. However,
they did receive letters supporting the in-house operation. 3.4. Cllr Anne Bishop was invited to undertake some financial investigation for the group. |
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· 4 WHY THE PROPOSAL WAS MADE TO TRANSFER 4.1. The Council has decided that as part of its 2006/7 budget the Adult Services Directorate needs to make efficiencies of £2.4 million. 4.2. As part of that efficiencies requirement a proposal was made by the Cabinet Member for Care, Health & Housing that Wightcare should be transferred to a preferred private provider due to the high unit cost of the operation - £21.46 per home care hour – and the predicted potential savings of £420,000 this financial year. 4.3. Once the total efficiencies are made the Cabinet Member then proposes to reinvest that money, plus new monies, to the tune of £4.4 million – with the focus turned on people with learning disabilities, older people with mental illness, and increases in care home fees. |
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5 WIGHTCARE PRIOR TO MAY 2005 5.1 As
part of our evidence gathering the task group received a great deal of
information from all stakeholders about the way Wightcare had had to adapt to
changing and challenging circumstances in recent years. What became apparent
was that some of these changes had not been managed as well as they could
have been. [2] |
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6.1
Wightcare home care is managed by a Community
Services Manager and through her a Service Manager. He reports to the Head of
Adult Services, who reports to the Director of Adult & Community
Services.
6.2
Wightcare is set up to care at home for
high-dependency, vulnerable service users – children and young people, older
people, people with mental health problems and people with disabilities. They
also provide an extensive out of hours service. They do not deal with service
users who have opted for Direct Payment of care packages, and are prevented from
taking on private-paying service users.
6.3
The home care staff are highly flexible,
well-trained and earn an hourly rate of £7.20 per hour, plus premiums. The stated overall unit cost of Wightcare
homecare is £21.46 per hour (excluding corporate recharges).
6.4
Home care organisers manage groups of about 20
Home Carers each and are responsible for work rotas, picking up emergencies,
training and visiting new service users to determine the home care package.
6.5
Wightcare currently employs about 140 members of
staff, mainly female and part time. Many are on contracted hours; but some
are on zero hours, without a retainer fee. There have been numerous
variations to their conditions of service in recent years.[3]
6.6
The operation is based at Bugle House, High Street,
Newport. This is prime office property, costing the service over £30,000 per
year.
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7.1 Service users with lower dependency are supplied home care though a Council contract, mainly by two private providers – Two Counties and Wight Homecare Services. We have received evidence that Two Counties have become the ‘preferred provider’ should Wightcare be transferred to the private sector, though that is not yet confirmed.[4] Both these companies are regulated, as are Wightcare, by the Commission for Social Care Inspection (CSCI). 7.2
Rates of pay with these companies are much less than
Isle of Wight Council employed home carers (below £6 per hour for carers).
Additionally they do not guarantee any working hours for their care staff.[5]
However, at this stage we cannot comment in detail as we have no substantive
evidence. However, it is clear from the documentation that the hourly unit
cost within the existing contract with both companies can be as low as £13.90
per hour. What is not clear is whether this lower unit cost reflects the
lower dependency of the service users they generally deal with. 7.3 We have been advised that TUPE will apply if Wightcare staff are transferred to a private provider, though we understand from past experience that in reality TUPE protection of terms and conditions is generally only in the short-term.[6] |
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The following are headlines that have steered our subsequent recommendations: In favour –
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Due to contractual
shortfalls the private providers also pick up high-dependency cases without
many problems.
Against -
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9.1 That this proposed transfer has not been effectively communicated to or consulted with service users and their families. There is a great deal of support for the Wightcare service and the task group received a number of supportive letters.[10] 9.2 That after any transfer the Council will still have to provide an out-of-hours home care service to deal with emergencies and breakdown of care arrangements. 9.3 Having an ‘all our eggs in too few baskets’ homecare arrangement on the IW could be detrimental both operationally and financially in the future. 9.4 A transfer will lead to a detrimental affect on the IW’s local economy, due to downward pressure on wages. 9.5 The recent Health White paper ‘Our Care, Our Health, Our Say’ is being cited as the reason for the need to transfer Wightcare to a private provider, at a time when the full implications of this White Paper are still the subject of debate. 9.6 An early decision to transfer without discussion with local Health agencies may be short-sighted given the evolving and changing priorities, including those set out in the White Paper ‘Our Care, Our Health, Our Say’. 9.7 Wightcare homecare unit cost suffers from: Bugle House costs, appropriations to Council reserves (£78k last year), high postage costs (£10k pa) due to poor IT systems and high mileage costs. |
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1. Scoping
document as approved by the Scrutiny Committee on 20 April 2006. 2. Notes
of an informal meeting with Homecare organisers held on 19 April 2006. 3. Documents
supplied for the informal meeting on 19 April 2006 by Homecare organisers. a) Letter from Homecare Organisers – Wightcare Services dated 18 April 2006. b) Wightcare Services memorandum to all Homecare staff from Kim Dueck dated 18 March 2004. c) Wightcare Services memorandum to Care staff from Kim Dueck dated 4 October 2004. d) Letter from Glen Garrod, Strategic Director of Adult and Community Services to Wightcare staff. e) Director’s Bulletin February 2005 issue. f) Wightcare Services memorandum to staff from Mr Keith Mitchell, Services Manager dated 16 March 2005. g) Wightcare Services memorandum to staff dated 27 March 2005. h) Wightcare Services memorandum to staff from Mr Keith Mitchell, Services Manager dated 21 April 2005. i) Summary of discussions held between Wightcare Services Homecare staff and Managers – 12 May 2005. j) Letter from Councillor Andy Sutton, Leader of the Council, to Mrs Sandy Weller, Associate Director of Adult and Community Services dated 18 November 2005. k) Confidential letter to staff from Mr Keith Mitchell, Services Manager dated 22 November 2005. l) Job Opportunity flyer regarding Emergency Response Team – November 2005. m) Wightcare Services memorandum to Childcare Home Care from Mr Keith Mitchell, Services Manager dated 23 January 2006. 4. Background
information on Wightcare from the Council’s website. 5. Budget
book details for Wightcare services 2005/06 and 2006/07. 6. Role
of Councillor Bishop in Wightcare inquiry. 7. Formal
minutes of the Scrutiny Committee on 20 April 2006 with attendance of
Homecare Organisers. 8. Notes
of evidence given in formal session of the Scrutiny Committee on 20 April
2006 by Homecare Organisers. 9. Notes
of an informal meeting on 26 April 2006 with Interim Director for Adult and
Community Services and Cabinet Member for Care, Health and Housing. 10. Notes of an
informal meeting on 3 May 2006 with UNISON representatives. 11. Notes of an
informal meeting on 11 May 2005 with Councillor David Williams, former
Chairman of the Homecare Task Group. 12. Documents in
relation to the work of the Homecare Task Group. a) Report of the Chairman of the Homecare Task Group and the Portfolio Holder for Social Services, Housing and Benefits Select Committee held on 18 March 2004. b) Minute of the Social Services, Housing and Benefits Select Committee on 18 March 2004. c) Report of the Chairman of the Homecare Task Group to Adult and Community Services Select Committee held on 26 October 2004. d) Minute of the Adult and
Community Services Select Committee on 26 October 2004. 13. Notes of an
informal meeting on 12 May 2006 with Wightcare care workers. 14. Adult and
Community Services Contract Monitoring Grid – Wightcare (confidential) 15. Adult and
Community Services Contract Monitoring Grid – Two Counties Community Care Ltd
(confidential) 16. Adult and
Community Services Contract Monitoring Grid – Wight Home Care (confidential) 17. Wightcare
summary of PSS User Experience Survey 2005/06 18. Wightcare
Services Organisational Chart 2006 19. Letters relating to Wightcare services. a) letter from Ms Wigman dated 18 April 2006 b) letter from Mr and Mrs Glynn dated 23 April 2006 c) letter from Mr and Mrs Yeoman dated 9 May 2006 20. Business case
for externalising Wightcare Homecare – Report of the Cabinet Holder for Care,
Health and Housing. 21. Commission for
Social Care Inspection – Inspection report of Wightcare – 25 August 2005. 22. Commission for
Social Care Inspection – Inspection report of Wight Home Care Ltd – 17
November 2005. 23. Commission for
Social Care Inspection – Inspection report of Two Counties Community Care – 6
July 2005. 24. e-mail from Cllr
Anne Bishop to Cllr Geoff Lumley dated 16 May 2006 together with financial
details relating to Wightcare. 25. Formal minutes
of the Scrutiny Committee on 18 May 2006 with the attendance of the Interim
Director for Adult and Community Services and the Cabinet Member for Care,
Health and Housing. 26. E-mail dated 4
April 2006 from Kerry Hubbleday to Cllr Geoff Lumley regarding expenditure
priorities. 27. Documents
supplied by Unison. ·
Letter from Mr Mark Chiverton, Branch Secretary of
Unison to Mrs Sandy Weller, Head of Adult Services dated 2 March 2006. ·
Letter to Wightcare staff from Mr Keith Mitchell,
Service Manager dated 7 March 2006. ·
Letter from Mr Mark Chiverton, Branch Secretary of
Unison to Mr Andrew Williamson, Interim Strategic Director of Adult Services
dated 9 March 2006. ·
Letter to Mr Mark Chiverton, Branch Secretary of
Unison from Mrs Sandy Weller, Head of Adult Services dated 28 March 2006. |
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Prepared by: Date: |
Cllrs Lumley, Gardiner
and Mosdell April West & Paul
Thistlewood, Overview & Scrutiny Team 26 May 2006 |
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[1] Notes of an informal meeting with Homecare organisers held on 19 April 2006, p2
[2] Notes of an informal meeting with Homecare organisers held on 19 April 2006
[3] Documents supplied for the informal meeting on 19 April 2006 by Homecare organisers
[4] Notes of an informal meeting on 26 April 2006 with Interim Director for Adult and Community Services and Cabinet Member for Care, Health and Housing
[5] Letter from Homecare Organisers – Wightcare Services dated 18 April 2006
[6] Notes of an informal meeting on 3 May 2006 with UNISON representatives
[7] Letter from Cllr Sutton to Sandy Weller, Associate Director, Adult & Community Services dated 18 November 2005
[8] Letter from Homecare Organisers – Wightcare Services dated 18 April 2006
[9] Formal minutes of the Scrutiny Committee on 20 April 2006 with attendance of Homecare Organisers
[10] Letter from Ms Wigman dated 18 April 2006; Letter from Mr and Mrs Glynn dated 23 April 2006; Letter from Mr and Mrs Yeoman dated 9 May 2006