To ask the Minister of Health for an update on (i) the number of service users awaiting care packages in the Northern Health and Social Care Trust; (ii) changes that have been made to the number of hours of care provision calls; (iii) his assessment of the current challenges for domiciliary care and the sustainability of services; and (iv) the steps he is taking in response to these challenges.

As of 13 June, 1480 service users were reported as awaiting domiciliary care packages in the Northern Health and Social Care Trust, of these 1077 were awaiting a full package of care and 403 were awaiting a partial package of care.

(ii) The table below outlines the total number of hours of care delivered, over the past 5 years, within the Northern Trust area.

Note: This includes independent sector and internal Homecare service provision. Independent sector hours of care are reported in 13 periods throughout the year as opposed to months. The Independent sector hours have been adjusted to months based on manual calculation and the in house hours delivered have been adjusted based on the average hours delivered per month over the entire year to negate the impact of 5 week months.

(iii)I recognise that there continue to be a range of difficulties facing the domiciliary care sector including for providers in retaining their staff, with rising costs being one element of this. There are also continued challenges presented by staff absence due to Covid-19, as well as a competitive wider recruitment environment.

While domiciliary care services continue to experience significant pressures, my Department remains committed to the provision of a high quality domiciliary care service. Trusts endeavour to provide care packages where they are required, however, ultimately there are a range of factors which can impact upon this delivery, including staffing issues.

Where delivery of care packages has been negatively impacted, Trusts have in place mitigation measures to try to ensure delivery of services continues to be provided.

(iv)In regards to action being taken, where a temporary care home placement is accepted for individuals awaiting implementation of a care package, my Department has advised Trusts to waive the usual care home placement fees until a suitable home care package has been developed. Trusts are continuing the messaging of encouraging a timely discharge process wherever possible through the use of care options such as care home placements, or informal support from family and friends.

The Department also reviewed and re-issued the regional Direct Payments guidance, to simplify the process, make it less restrictive (i.e. allowing for the employment of family members where no other workers can be identified) and make the option more attractive to prospective users.

In regards to support to the independent sector, you will be aware that in November last year I announced a support package of up to £23m, which supported independent domiciliary care providers to improve recruitment, employee retention, and Terms and Conditions for staff. This investment has allowed providers to deliver enhanced rates of pay and improve other terms and conditions, which may also include increased mileage rates, at individual employers’ discretion.

Despite a very challenging financial climate I have ensured that sufficient funding was provided to Trusts to ensure this uplift was carried through to the current year and made recurrent. Although the overall demand for care packages continues to increase, I am confident that this funding has assisted in stabilising the sector, and has increased the capacity of providers to deliver care packages.

In recognition of the issues facing the sector in regards to increasing costs and the impact this may have on staffing and delivery of services, I was pleased to recently be able to announce a mileage rate increase for Agenda for Change (AfC) staff, including Trust employed domiciliary care workers and district nurses.

I have tasked officials to continue engaging with the independent sector on ongoing challenges including the travel and other cost of living pressures facing staff. However, given the financial pressures and budgetary uncertainty, the room for manoeuvre in terms of additional funding is limited.

There remains a need to address issues in the long term. The work of the Reform of Adult Social Care will inform the long term strategic reform of the sector, including domiciliary care. As you may be aware, a public consultation recently closed, which sought views relating to long term proposals on the Reform of Adult Social Care. This public consultation set out proposals for reforming adult care and support and making significant system change. However, it should be noted that this reform package will require sustained additional investment and budgetary certainty.