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Policy for purchasing domiciliary care

In May 2008, the Care Quality Commission (CQC) published the quality ratings of all care homes on their website. Medway Council considers the rating system a welcome development for the commissioners or purchasers of services to support families, and for the wider community in choosing a residential or nursing home for themselves or a loved one.

CQC’s quality ratings

CQC has introduced quality ratings to indicate whether a care home or care service is 'excellent', 'good', 'adequate' or 'poor'. These ratings tell people simply and clearly how well a registered service is doing against the national standards.

Following a key inspection for a care service, CQC awards stars (a rating) to show how well the care service is performing against the national standards. The ratings are as follows:

  • Three stars *** = Excellent
  • Two stars ** = Good
  • One star * = Adequate
  • No stars = Poor

Useful CQC links

Medway Council’s purchasing policy for domiciliary care (home help)

This policy sets out how Medway Council’s decisions to buy domiciliary care will be influenced by the introduction of this independent and transparent rating system. From 23 June 2008, Medway Council and its commissioning partners began applying the following criteria when purchasing care from all domiciliary care agencies (DCAs):

DCAs that are part of the home care contract

Home Care contracted providers are the preferred DCAs for all new referrals when purchasing domiciliary care. Medway Council will not purchase from providers outside of this contract unless the following circumstances are satisfied:

  • The prospective service user is already receiving a service from a DCA that is not a primary provider of the home care contract. For the purposes of continuity of care, the service user would prefer to stay with that provider.
  • The prospective service user requires specialist services that cannot be provided through the home care contract.

DCAs that are not part of the home care contract

Where either of these scenarios is applicable then the following criteria will apply in purchasing services:

DCAs rated ‘excellent’ or ‘good’

Medway Council is keen to continue a productive relationship with providers rated as ‘good’ or ‘excellent’. Its resources should be focused on developing a relationship with these providers and will manage them in the same way that it manages Home Care providers.

More importantly, these opportunities will be offered and implemented with the intention of incentivising DCAs to aspire to, and attain, such ratings.  

DCAs rated ‘adequate’ or ‘not yet rated’

DCAs rated as ‘adequate’ could be described as having room for improvement,These agencies form a minority of the provision available to the council. In making a purchase from a such a provider, the council must ask itself: “How can we be sure that this purchase is sound, and offers best value?”

Therefore, the council will be reluctant to purchase care from a DCA that has the rating of ‘adequate’ or ‘not yet rated’ unless it can meet the following criteria:

  • the DCA has the rating of ‘good’ for management or safety domains; and
  • the contract price offers best value when compared to the Home Care contract rates.

DCAs rated ‘poor’ or ‘suspended rating’

The council will not contract with DCAs that have these ratings. It has a duty of care to prospective service users and a duty to ensure best value. Both of these duties are reflected in the council’s guiding principles:

  • Putting our customers at the centre of everything we do; and
  • Giving value for money.  

Promotion of this policy

Medway Council will, of course, raise awareness among its staff about this policy and ensure that it is applied consistently and transparently.

The council also has a duty to self-funders (private individuals who pay for their care without the direct participation of the Council). It will perform this duty by confirming in the Adult Social Care Guide that the council has a policy for purchasing domiciliary care, which we are happy to share on request.

 

For more information contact Adults and Children's Services Team by telephone: 01634 334466 / TextRelay 18001 01634 334466 or by email: ss.accessandinfo@medway.gov.uk

Write to: Adults and Children's Services Team, Medway Council, Gun Wharf, Dock Road, Chatham, Kent ME4 4TR

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