By John Wimperis, Local Democracy Reporter: The Bath and North East Somerset is facing a “three-fold” challenge as its aims to bring adult social care in house.
As the council prepares to take over the running itself of services currently contracted to the HCRG care group, it faces challenges over finance, workforce culture, and the sheer number of staff transferring to the council, a council scrutiny panel has been told. Approximately 240 people will be transferred to the council under the plans.
The upcoming transfer of services was a main theme throughout a meeting of the council’s scrutiny panel on children, adults, health and wellbeing on October 9.
Clare Thorogood, (pictured) the council’s assistant director of strategy transformation and governance, told the meeting: “It will be about making sure that workforce is transferred safely but also about recognising there will also be a period of cultural readjustment for a workforce that has actually been with another provider for seven years, in line with the future ambition of adult social care and how we want to move and the way we deliver our services in the future.
“So for me the challenges are two-fold — three-fold if you add in the finance challenge.”
She added: “At the point of transfer, on the first of April 2024, our work is not done; in many ways our work is just beginning to make sure we are delivering the services in the way that we want to as [Bath and North East Somerset Council] and doing it within the financial budget and doing it effectively.”
The decision not to renew the contract with HCRG and to bring the adult social care services in house was taken at a council cabinet meeting in November 2022. But the contract with HCRG care group was extended by another year into 2025. Laura Ambler, director of place for Bath and North East Somerset on the area’s integrated care board, said it allowed them to “maintain the current service safely” and work with the group on the transformation plans.
The council is working with the HCRG care group and trade unions on their plans, as well as holding regular briefings for the staff transferring over. When staff are transferred to the council they will keep their current pay and conditions. Services will be reviewed once they have transferred to the council.
Ms Thorogood said: “There’s a huge amount of work underway to ensure the transfer runs as smoothly as it can.”
She added: “Thank goodness we have two recent transfers to learn lessons from.”
But previous recent transfers of care homes to the council have led the authority to be mired in scandal. Last year, Charlton House care home — which was transferred to the council in 2020 after Sirona announced it was handing back the contract — was the subject of a damning Care Quality Commission inspection.
It found that one resident was left sitting in urine overnight while records another had not eaten or drunk anything for two days. The council apologised for the conditions in the now council-run care home, with council cabinet member for adult services Alison Born telling a council scrutiny panel on January 17: “We are extremely sorry that we have let people down and have not provided the consistently high quality of care that residents and their families expect and deserve.”
A report on staffing levels which went before the recent scrutiny panel on October 9 warned that staffing levels were behind the issues. It stated: “On transfer, with an already depleted and exhausted workforce, the in-house services relied heavily on agency staff to ensure safe levels of staffing.
“This agency usage severely impacted both budget and quality of service, and has been a significant factor in two care homes rated by CQC as “requires improvement” and one “inadequate” in October 2022 (this has subsequently been rating improved to [“requires improvement”]). New approaches in the last year have started to make an impact on this and overall use of agency staff has reduced, however staying on-top of recruitment and retention remains an on-going challenge.”
- Harry Mottram adds this: Adult social care and health covers a huge range of services from helping those with challenges to live independently, to providing care homes, support for carers, help for mental health and creating activities for older people – the list is endless is some ways – and will continue to grow as the population ages and the cost is a substantial chunk of local authority spending.
HCRGbegan life in 2006 as Assura Medical working with GPs in Surrey and Devon.
In 2012 they gained a contract to provide community services in Surrey and won a contract with BANES in 2017 to provide social care.
In 2021 Assura became part of the HCRG Group (formerly Virgin Care) a private equity group with contracts across the UK worth an estimated £2bn, established to not only provide health and care services but to make a profit for its shareholders.