The report was introduced by the Executive Director, People; the Director of Adult Social Care; and the Director of Transformation.
· There was a discussion around cost of care, and the Commission was advised that there were three main reasons for differences between care costs for older and younger people;
(i) As young people who accessed services tended to have more enduring needs, over a longer term with a higher level of acuity, their care would be more expensive than episodic, short term needs that older people tended to have;
(ii) That the proportion of younger people with disabilities came from lower socio-economic backgrounds which meant they did not contribute to the chargeable element of services, and more chargeable elements were recouped from older people;
(iii) There had been a shift in the proportion of people who accessed services; that in 2018 the proportion of older people and younger people was approximately 70%:30%, and now it had moved significantly, to 60% older people and 40% younger people who accessed serivces. This had increased costs of social care.
· There was a discussion around the Bristol community meals service, and Members were advised that about 350-400 people per month accessed meals via the service; that it had been a good service for communities and had potential for expansion. It was confirmed that self-funders were also able to buy into the service.
· The Cabinet Member for Adult Social Care and Integrated Care Service highlighted the community meals services teams as unsung heroes for the work and support they provided for vulnerable and isolated people, over and above the meals provision.
· There was a question about joint working with planning colleagues to help ensure accessibility and future-proofed accommodation, and Members were advised that the social care team would not have sight of every planning application, although there was close work with colleagues around the design of accommodation and services for people with needs.
· It was noted that the Adult Social Care team sat on the Housing Delivery Board and worked closely with Housing colleagues, for example on Extra Care schemes and supported homes for younger people.
· There was a discussion about direct payments and the Commission was advised that the aim was to have more people with access to direct payments and there was a work stream to improve the process.
· There was a question about Integrated Care Partnerships (ICPs), and where they fit on the ‘Care Ladder’ and the Commission was advised that they were across all it; that the Care Ladder was at the heart of the ICP work, relevant for all organisations and partners.
· There was a discussion around meeting need within the city and across Authority boundaries, and Members were told that neighbouring Authorities worked as a system, across Bristol, North Somerset and South Gloucestershire, as Healthier Together, with the same aims; and so reference to ‘out of area’ was other parts of the country, outside the immediate partnership.
· There was a discussion around the Council’s service provision, and services outsourced, and Members were told that Bristol’s communities had benefited from the provision of community meals and reablement services. There were ways the Council could configure relationships with other sectors so a stake and control in the service provision and activities was retained, for example through strategic partnerships; through that method, investment and expertise could be brought into the city and wider area, and skills and capabilities of the workforce could be built at scale, that could not be achieved as a local authority on its own.
· There was a question around how people were supported after they left hospital, and Members were advised Extra Care housing was purpose built with technology; although older schemes needed modernising.
· The Chair asked about the time it took to complete the digital forms within the time allocated on a Homecare package, and Members were advised that commissioners needed to be constantly aware of, and assess, the efficacy of new developments in technology. It was confirmed that that the system had moved away from that type of data inputting task for the carer within the allocated time.
That the report be noted.