Management of the current contract identified the opportunity to make better use of staff time by moving to an outcomes-based commissioning model where care provision could be more responsive to the health and wellbeing needs of service users. This view was reinforced by a review of Fair Work practices within the care at home sector undertaken in response to a Trade Union enquiry and concerns raised by staff representatives. To inform their approach The Partnership conducted an audit of current care at home providers asking for information, including whether they pay care workers from the start of shift to the end of shift.
It was established that only 50% of providers paid care workers from start to end of shift (6 out of 12 providers).
This was attributed by providers to the policy of paying on actual care hours provided and not full shift hours. Providers indicated that it would not be affordable under the current contract/s to pay their care workers for full shift hours as The Partnership paid them based on actual contact time. Typically, care workers were not paid for downtime such as gaps in the rota, cancellations of visits to service users or travel time to/from and between visits, causing their pay to fluctuate.
Following the audit, it was decided that the existing contract for care at home would be redesigned to amend the terms and conditions of the workforce to facilitate payment of full shift hours (where workers were not already being paid on this basis). The additional cost of this was estimated at 14% for the duration of the test of change (6 months). This was covered by The Partnership.
The contract was amended for the duration of the test of change to facilitate the move to pay full shift hours:
‘A Test of Change has been introduced from 10 October 2022 to 31 March 2023 to improve fair work terms and conditions for care staff in order that they are paid for full shifts worked rather than just actual hours of service delivery. Payments to the Provider for the period from 10 October 2022 to 31 March 2023 will be based on the deployed shift hours of service in line with the guidance supporting the Test of Change. Any overpayment made, due to advance payments being made at the block contracted level of hours via the Payment Schedule and the deployed shift hours of service being lower than this, will require to be repaid to the Council.
The Provider is required to ensure they pay care staff from 10 October 2022 to 31 March 2023 based on the shifts worked rather than actual hours of service delivery in line with the guidance supporting the Test of Change.’
The Annex includes the full results of the analysis.
