Mears Care is new provider for Marlborough area's Help to Live at Home

Written by Tony Millett on .

From today (September 5) the Marlborough Area will no longer have Leonard Cheshire Disability as Wiltshire Council's main provider of social care in people's homes.

The Mears Group, a housing and social care provider, will be running the area's homecare.  Mears Care now holds six out of the eight area contracts for Wiltshire Council's social care at home scheme - Help to Live at Home.

With Leonard Cheshire Disability's contract set to run out on September 4, they told Marlborough.News: "After careful consideration, as we are coming to the end of our five year contract agreement providing care at home services, we have decided not to take up the offer of a further two year extension to our contract."

Leonard Cheshire rejected the offer of an extended contract on the terms offered by the Council.  Those terms, according to Wiltshire Council, were Leonard Cheshire's original (2011) price bid with "inflationary uplifts...this did not meet their financial requirements."

Wiltshire Council has reported: "The new price for the re-tendered service [awarded to Mears Care] was significantly less than the increased rate which Leonard Cheshire requested."

Apart from their contract for Marlborough and Pewsey areas, Leonard Cheshire had also provided care at home in the Wootton Bassett, Calne, Cricklade and Malmesbury areas.

Mears Group has, their executive director, Alan Long, wrote in the Guardian, "...taken the agonising decisions to hand back a number of homecare contracts to local authorities, especially in the north of England."  He goes on:  "In the homecare world, generally, councils only pay for 'contact time' – the time a care worker spends with a service user."  They do not, he says, pay for sick leave, training, or pensions. He went on to praise Wiltshire's scheme.

Answering questions from Marlborough.News, Mears Care said their staff pay will be "considerably higher" than the National Living Wage and the enhanced pay rate takes travel time into account.

One of the most controversial issues on home care is the length of visits - that 'contact time'.  Leonard Cheshire Disability has been critical of the 18 councils that are still commissioning "flying 15-minute care visits" - when national guidance advises that visits of at least 30 minutes are needed.

Wiltshire has moved away from specifying length of visits in their contracts.  Instead they use 'outcomes-based' contracts for homecare. Outcomes-based service commissioning gets away from the traditional 'time and task' model. Outcomes - or objectives - are used to promote independent living for the service user, so our care workers (and associated health professionals) work with them rather than for them.

Outcomes are set and agreed by the service users, their families and the council - and all outcomes must be achievable...The length and frequency of visits are agreed based on the outcomes, and are assessed regularly to increase or decrease the time needed to complete outcomes - again, agreed with all parties. There is more flexibility in an outcomes-based model.

Critics say these outcomes-based contracts can be a cover for shorter visits - as well as providing a service better answering an individual's needs.

One of the key problems for providers of social care in Wiltshire - and across the country - is recruitment and retention of staff.  It is said that one provider in the county took to bussing in staff from south Wales.  But Mears do not envisage any problems.  They say they have already worked in Wiltshire for a while and have been actively recruiting, and they have experience of recruiting in many difficult areas around the country.

It is assumed that many the Leonard Cheshire staff for the Marlborough area will transfer to the Mears care operation.  Wiltshire Council has told councillors: "Reaction from staff to the change has been positive, particularly in view of the higher hourly rate Mears are able to pay staff."

The Help to Live at Home service has seen some turbulence since it began in 2011.  Two areas were retendered "...due to issues with the incumbent providers."  And for a time in the south of the county, the Care Quality Commission stopped Mears Care taking on new clients because they were not providing a satisfactory service.  They have since been rated 'good' in that area.

More recently the Council decided the Mihomecare contract for the Trowbridge-Melksham area should not be extended.  Last December the CQC found the service 'required improvement', and by April they were told they were still falling short of the required standards.

The two contracts in the north and west of the county held by Somerset Care at Home "have been working well" and have been extended.

[Since it was first published some direct quotations have been removed from this article.]