Agenda and minutes

Claire Labdon-West, Commissioning Manager, presented a report on semi-independent accommodation and support for looked after young people to the Committee, highlighting the following points:

(a)  the previous framework had issues with not meeting young people’s needs, and has now come to an end. A new framework will be set up to provide additional capacity and extra flexibility;

(b)  6 self-contained units will be available across 1 or 2 properties. They will be staffed 24 hours to provide support for the residents;

(c)  this will present an opportunity for forward planning and improved outcomes, with an initial period of intensive support to assess needs and develop a support plan. This will provide greater consistency of support, and greater consistency of cost;

(d)  over a year, there is a potential saving of up to £80,000.00, with the main risk being under-usage. There has been a recent reduction in the number of young people placed in semi-independent supported accommodation upon leaving care; the latest figures show 17 young people were receiving this type of support in December 2015. The small number of units is designed to mitigate this risk. Occupancy would have to fall below 60% before it would result in an increase on current expenditure;

(e)  providers will be obligated to demonstrate how they will work in partnership to support young people, to ensure that their transition beyond supported accommodation goes smoothly;

(f)  feedback as a result of the  consultation has been positive, and the Children in Care Council will be involved as  the proposals move forward.

Following questions and comments from the Committee, further information was provided:

(g)  the decrease in children requiring semi-independent accommodation support has mostly come about from more children being placed in foster care rather than residential care. Fostered children are more likely to remain with the foster family or go straight into independent accommodation than those who have lived in residential units;

(h)  the tendering process will go out to all providers. Given the vulnerability of the young people, the tender process will be quality driven, not driven by cost savings.

RESOLVED to:

(1)  procure a block contract for 6 units of Semi Independent Accommodation for 3 years with an option to extend for a further 3 years (at the discretion of the Council) with a maximum annual contract value of £206,824.80, with an option to expand the number of units should the demand for the service grow (at the discretion of the Council) via an open and competitive tender process;

(2)  procure through an open and competitive tender process a Framework to provide further capacity in addition to the units in the block contract for times when that provision is not suitable for a specific young person’s needs. This contract is to be for 3 years. The annual value of the Framework is estimated to be a maximum of £723,175.20. This is the forecasted spend for 2015/16 spend minus the value of the proposed block contract;

(3)  delegate authority to the Assistant Chief Executive to  ...  view the full minutes text for item 47.

Antony Dixon, Strategic Commissioning Manager presented the report to the Committee and highlighted the following points:

(a)  Currently only 62% of homecare in the city is being delivered through the Care at Home framework with the remainder being delivered via spot contracts or under the old framework. Spot contracts are very resource intensive and give limited control over quality and price.

(b)  The dynamic purchasing system will manage the delivery of homecare outside of the framework. It will be compliant with EU Procurement rules, will simplify the process, will enable the Council to better control the price of care, and will be a quality assurance mechanism.

(c)  The funding is contained within current spend. There is an issue around the need to establish prices for providers, but there is currently such variance with spot contracts that it is anticipated that it will prove to be less expensive, and will not be more costly.

RESOLVED to

(1)  Approve the establishment of a Dynamic Purchasing System for homecare purchased outside of the existing Care at Home Framework. Contracts awarded through the framework will run until 31st December 2017 with the potential to extend these contracts for a further 2 years.

(2)  Delegate authority to the Head of Contracting and Procurement to award and sign contracts to the successful providers identified through this process.

Reasons for Recommendations

The establishment of a Dynamic Purchasing System will ensure that care

purchased outside of the Care at Home framework will be procured through

an EU compliant process, with all Providers having passed basic qualification

criteria and delivering to the same contract terms, providing a mechanism for

responding to quality and delivery concerns.

Other Options Considered

(1)  Do nothing: Current contracting arrangements would be continued as they are with the Framework being the first choice of option for services and then previous framework and non-framework providers. This option is not recommended due to the fact that a large amount of services risk being purchased outside of the EU procured Care at Home Framework, the resource requirements needed to manage such a system and because of concerns that spot contractual arrangements are not delivering value for money and quality concerns cannot be managed satisfactorily or to the required quality.

(2)  Re-open Existing Framework: The framework would be re-opened through a repeat tender to increase the number of providers within it and therefore its capacity. This option is not recommended due to risk of increased costs, potential risk of legal challenge, the timeframe required for implementation and doubts of whether required resource would actually result from doing so.

(3)  Transition All packages to Lead Framework Providers: All packages currently outside the Framework would be transitioned to the new framework. Depending on how this is done, TUPE may or may not occur. Where it occurs Service Users will take their carers with them and experience little disruption to services. Very careful planning around how to transfer packages would be essential to making this work and ensuring a smooth transfer for  ...  view the full minutes text for item 50.

Antony Dixon, Strategic Commissioning Manager and Kate Lowman, Procurement Category Manager, Care and Support introduced the report to the Committee and highlighted the following issues:

(a)  The Care Support and Enablement framework was established in 2013 and runs until 2017. Providers are struggling to cope with the complexity of needs arising as a result of the transforming care agenda.

(b)  Nottingham and Nottinghamshire are a transforming care fast track site, testing the implementation of a new national model of care. There is an assumption from NHS England that needs will be managed in a community setting rather than a residential setting.

(c)  There is a projection that the programme will apply to around seven individuals, all of whom require high cost packages of care. The average cost of each placement is £2000 per week and one package is in the region of £5000 per week. The intention is that when contracts are re-tendered in 2017 both frameworks will be combined.

(d)  Funding of these placements is a matter of debate with NHS England. It has been suggested that a ‘dowry’ could accompany individuals on resettlement from acute care but this has not yet been resolved. Individual packages will continue to be approved through normal process. This report covers establishing the framework of providers.

During discussion with the Committee the following points were raised and responded to:

(e)  There is no budget to commission a service but when people come out of key care, the Council has budgetary responsibility for their care packages. With enhanced care, traditionally people with such complex needs have gone into residential or acute care settings. The existing framework was not designed to meet such complex needs. The new framework aims to manage particularly complex needs.

(f)  An advantage of going down the community care route is that it will reduce the number of out of area placements. The new framework will enable work to be done with local providers for to achieve a better controlled price. It is also hoped that the reduced use of institutional settings will reduce the frustration experienced by service users.

(g)  The number of individuals in institutional settings  changes frequently. Many have been in hospital settings for a long time and it is difficult to monitor. The current approach is to encourage providers to manage challenging behaviour in a community setting, rather than in institutions. Some individuals are still in institutions at Home Secretary’s discretion.

RESOLVED to

(1)  Approve the proposal to establish a Framework Agreement for Enhanced Care Support and Enablement, with the capacity of meeting the complex needs of citizens in the community. The framework will run for two years from inception.

(2)  Delegate authority to the Director of Procurement and Children’s Commissioning to award the outcome of the tender.

(3)  Delegate authority to the Head of Procurement and Contracting to award contracts.

Reasons for Recommendations

To develop a mechanism for swiftly identifying suitable providers with the tenacity experience, skills and robust processes required to deliver Enhanced Care Support  ...  view the full minutes text for item 51.

RESOLVED to agree to the following changes to future meetings dates:

(1)  Change the date and time of the February meeting from Wednesday 17 February 2016 at 2pm to Wednesday 10 February 2016 at 3pm.

(2)  Change the date and time of the March meeting from Wednesday 16 March at 2pm to Thursday 10 March 2016 at 10am.