Agenda and minutes

Councillor Cheryl Barnard - leave

None.

To confirm the minutes of the meeting held on 09 July 2024

The minutes of the meeting held on 9 July 2024 were confirmed as an accurate record and signed by the Chair.

Report of Interim Corporate Director of Adult Social Care and Health

Cllr Corall Jenkins joined for this item and for the remainder of the meeting.

Helen Johnston, Consultant in Public Health, and Tracey Ford, Changing Futures Senior Systems Change Commissioning Manager, presented the report on the commissioning of Changing Futures services for Nottingham, 2025/26-29/30, highlighting the following points:

a)  the Changing Futures programme aims to improve outcomes for people experiencing Severe Multiple Disadvantage (SMD), working intensively with people who are the most vulnerable and with the most complex needs in our communities. Recipients of support will have a concurrent combination of at least three out of five key sources of disadvantage: homelessness, substance misuse, mental ill health, experience domestic/sexual abuse or violence, and connection with the criminal justice system;

b)  this decision authorises receipt of funding from NHS Nottingham and Nottinghamshire Integrated Care Board (ICB) Health Improvement and Innovation Fund (HIIF) through a Section 256 agreement between the ICB and Nottingham City Council, and approves the outlined service model for the commissioning of Changing Futures services from 2025/26-29/30 against that funding envelope.

During subsequent discussion and in response to questions from the Committee, the following points were made:

c)  Changing Futures is only able to work with individuals with the most complex needs, but through working and learning about what works with the most complex individuals, the programme can highlight system changes and enable improvements throughout the whole network of services, as well as bringing services into closer coordination;

d)  there had been concerns that the Changing Futures programme would not receive funding, despite being remarkably successful in Nottingham. The HIIF funding from the ICB us crucial for enabling that service to continue.

Resolved to:

(1)  approve receipt of £7,346,875 of ringfenced ICS Health Inequalities and Innovation Investment Funding (HIIIF) between 01 April 2025 to 31 March 2030 (£1,469,375 per year);

(2)  to delegate authority to Director of Public Health to;

  i.  enter into a Section 256 NHSA 2006 Agreement with the Integrated Care Board for the transfer to the Council of the HIIIF of up to £7,346,875 (£1,469,375 per year) from 01 April 2025 to 31 March 2030;

  ii.  approve the service model for the commissioning of Changing Futures services against the entire budget available;

  iii.  subject to prior Spend Control / s151 Officer approval:

a.  to spend £1,469,375 per year for the next five years on Changing Futures services and activity to 31 March 2030 as set out in the indicative budget at appendix A, including the extension of four specialist navigator contracts from 01 April 2025 to 31 March 2026;

b.  to procure, award and enter into two contracts for Changing Futures services and activity for three years from 01 April 2025, with an option to extend for a further two years from 01 April 2028 for (i) Main Delivery Service and (ii) Partnership Learning Hub;

c.  to enter into 1-year extensions of four specialist navigator contracts from 01 April 2025 to 31 March 2026.

Reasons for decision

e)  all of the funding for Changing Futures services commissioned  ...  view the full minutes text for item 30.

Report of Interim Corporate Director of Adult Social Care and Health

Cllr Pavlos Kotsonis joined for this item and for the remainder of the meeting. 

Claire Labdon-West, Commissioning Manager, introduced the report on the re-commissioning of Extra Care services in Nottingham City, highlighting the following information:

a)  the report proposes re-commissioning Extra Care services at five existing schemes, with provision in the budget to fund an additional service if needed, depending on demand;

b)  the schemes will be funded from the existing Adult Social Care budget, with a block-funded element and an individual element. This report seeks approval for the block-funded element, while individual care packages will be approved individually;

c)  Extra Care allows people to maintain independence in the community for longer, maintaining social contacts and routines as their care needs change, rather than going into residential care too soon;

d)  the strategic commissioning review of Extra Care conducted in 2023/24 identified demographic pressures, including a large increase in the cohort aged 75-84, and without developing alternatives to residential care that would be the only option for many individuals;

e)  there are risks in the market, due to rising costs and instability of care providers. Providers have advised that the current financial envelope provided for Extra Care is not enough to maintain those services;

f)  consultation with citizens has shown that they want consistency, the ability to get out and about and maintain social contacts, while receiving support around any health conditions and feelings of isolation and loneliness, and this has feedback has fed into the specifications for Extra Care;

g)  the new model includes three new elements: night care and background hours as standard across all the schemes, to make them a viable alternative to residential care, and an expectation that care providers and housing providers will work together to support residents’ overall wellbeing;

h)  an implementation group is being set up to help implement the framework. The contract will be managed by colleagues, with appropriate termination clauses if providers do not accept those with high levels of need;

i)  the revised scheme will help to bolster the market, deal with demographic pressures, and help to reduce the number of people in residential care.

Cllr Pavlos Kotsonis, Executive Member for Adult Social Care and Health, commented:

j)  at the moment Extra Care is not able to provide a consistent offer, with night-care not always available, but the new model corrects that. The new offer is streamlined and flexible enough to meet people’s needs as those needs change. The new model will enable other types of provision than residential care to meeting growing demand;

k)  modelling has been completed to understand the impact on the budget. It is not a saving at this point, but it is an avoidance of cost and may become a saving in time – if the target occupancy of 192 citizens is achieved, it will imply a saving of 0.582m per year;

l)  it is important than residential care and more intensive kinds of care do not grow out of proportion, in the context of  ...  view the full minutes text for item 31.

Report of Interim Corporate Director of Children and Education Services

Charlotte Dodds, Commissioning Lead Officer, introduced the Children’s Advocacy and Independent Visitor Service report, highlighting the following information:

a)  for noting, since the report was published, Nottinghamshire County Council has slightly changed their figures. There will be an additional £28,000 in block funding per annum, on top of the £200,000 outlined in the report, and a further unconfirmed amount which may be available from 2026/27. The updated figures will be included in the tender, so it would be permissible under procurement regulations should they secure that funding;

b)  this report seeks approval for the joint commissioning of a Children’s Advocacy and Independent Visitor Service with Nottinghamshire County Council, on a five-year contract (with an initial three years with the option to extend it to 2030);

c)  the service will provide issue-based advocacy for children in care, with advocates regularly visiting children and young people in residential homes and champion their wishes and views, Independent Persons for secure accommodation review panels, and Independent Visitors who befriend children in care and act as an adult role model;

d)  currently, Nottingham City Council and Nottinghamshire County Council hold separate contracts with the same provider. Both have provision to extend these contracts to 2026, however the incumbent provider does not wish to extend these contracts. The provider has stated that holding the contracts jointly allows for efficiency savings;

e)  the current contract is out of line with government guidance, which recommends that young people aged 16 and 17 who may be homeless should have access to an independent advocate during their Joint Housing Assessment interview process. There is also updated guidance related to advocacy for Looked-After Children, Children in Need and Care Leavers, which the new contract will meet on a payment by activity basis to ensure Best Value;

f)  a consultation was undertaken through a tender process in 2022, including consultation with the Children in Care Council. It is hoped that the contract opportunity will be advertised through an open tender process in late September / early October, ready for the new contract start date in April 2025.

During subsequent discussion and in response to questions from the Committee, the following points were made:

g)  there should not be any risk that Nottinghamshire County Council would not approve the joint commissioning approach, as they have been securing additional funding;

h)  the Nottinghamshire County Council funding element has been updated, but the Nottingham City Council funding element remains as in the report.

Subject to Nottinghamshire County Council’s approval to spend up to £1,190,000 or more for the purposes of a joint Nottingham City Council and Nottinghamshire County Council Children’s Advocacy and Independent Visitor Service, with a maximum contracts value of £1,681,000 (or more, depending on any further approved spending by Nottinghamshire County Council) and appropriate Spend Control Board approval for Nottingham City spend, resolved to:

(1)  approve Nottingham City Council’s spend of up to £491,000 over a maximum 5 year contractual term for the above purpose;

(2)  delegate authority to the Director of Commissioning  ...  view the full minutes text for item 32.

Report of Interim Corporate Director of Children and Education Services

Charlotte Dodds, Commissioning Lead Officer, introduced the Children’s Residential Block call-off report, highlighting the following information:

a)  the tender is for two, two-bed homes for those facing challenges within standard residential services, due to diverse needs often requiring specialist support;

b)  the tender is for a five-year contract, with options for two extensions for two years, under the D2N2 framework. It is part of a series of tenders intended to maintain sufficient places. The initial contract period of five years enables initial investment, but the options to extend provide flexibility and easier contract management;

c)  there is a maximum block element, and additional funding for the second child, and the provider’s profit will be weighted towards this second placement;

d)  the Council is asking providers for details costings, to understand the market better and to introduce more transparency into the market for children’s residential homes. 

Resolved to:

(1)  subject to receipt of appropriate spend control approval, to approve spend of up to £18.72m over 9 years for the provision of up to 4 children’s residential care beds, of which up to £11.262m will be as a guaranteed block payment;

(2)  to approve procurement through the existing D2N2 framework of 2x 2-bed residential care homes for children with complex needs for 5+2+2 years;

(3)  to delegate authority to the Director of Commissioning and Partnerships to approve and award the outcome of the tender process;

(4)  to delegate authority to the Head of Service Contracts, Quality and Personalisation to sign the call off contract, save for any agreement/contract being required to be executed as a deed, which shall be executed on behalf of Nottingham City Council by the Director for Legal and Governance / Head of Legal and Governance.

Reasons for decision

e)  offering D2N2 providers a guaranteed income under a block contract will encourage investment in the development of homes for children in care for whom it is challenging to find placements within standard residential services;

f)  the contract is arranged to allow an initial assessment period for both the authority and the provider to ensure the arrangements are working, with extensions to enable longer-term arrangements;

g)  the Council currently has 11 children placed in unsuitable provision, using unregistered accommodation as a short-term emergency fix, but this would help to move children into registered provision as quickly as possible;

h)  these unregistered placements tend to be costly, set up quickly with high staffing levels and prices reflecting the lack of choice within the market. Indicative costs for specialist 1 and 2 bed homes indicate this decision would provide savings, but to invest providers require the assurance of continued utilisation;

i)  the intention is to limit the block contract element to a cost which would enable a 2-bed home to be run as a solo provision with reduced payment for the second child, which would allow the home to be cost effective if it had to be run as a solo home for a period of time, but enable efficiencies of  ...  view the full minutes text for item 33.

Report of Director of Economic Development and Property

Matthew Wheatley, Head of Economic Development, introduced the NEET Reduction Service report, highlighting the following information:

a)  the report seeks approval to enter into a contract for a NEET reduction service for 2024/25 and to place that contract with Nottingham and Nottinghamshire Youth Services (NNYS), part of the Futures group, under a TECKAL exemption;

b)  the Council has a statutory duty to encourage, enable and assist young people, as well as those between 20-25 with SEN and disabilities, to participate in education and training. It is a priority for the Council in the strategic plan, as the longer a young person spends as a NEET, the more the long-term cost to the public sector;

c)  Futures has performed well, contributing to Nottingham City’s combined NEET and unknown rate being recorded as 5.1% in 2023, the second lowest of all the core cities;

d)  the service will be delivered in three parts: core services, meeting statutory requirements, to be met from the local authority’s base budget; an enhanced service, targeted for those with the highest risk of becoming NEET; and making use of public health grants to undertake activity supporting the wellbeing, including the financial wellbeing, of young people across the city;

e)  the value has reduced by £50,000. The Council is working with the provider to drive efficiencies and savings. An outline Best Value review has been undertaken, which showed that performance was good and cost was comparable with other cities and local authority areas.

During subsequent discussion and in response to questions from the Committee, the following points were made:

f)  the report seeks one-year’s funding, and it is difficult for those working on one-year contracts that is renewed year-on-year. With the development of the East Midlands Combined County Authority, it is hoped that the landscape for skills funding will change positively in the future.

Resolved to:

(1)  Delegate authority to the Corporate Director for Growth and City Development to enter into a new joint contract with Nottinghamshire County Council for the delivery of NEET reduction activity, delivered by NNYS under TECKAL arrangements within Nottingham City for the period 2024/25, with the combined value not exceeding £941,300 (£410,300 LA base budget) and the contract to be reviewed by Legal Services in advance of signature;

(2)  delegate authority to the Corporate Director for Growth and City Development to sign the contract and any subsequent modifications on behalf of Nottingham City Council, subject to compliance with the applicable Public Procurement regime and review by Legal Services.

Reasons for decision

g)  The local authority has a statutory duty under Section 68 of the Skills and Employment Act to support young people in participating in education or training, and implementing a NEET reduction service in Nottingham ensures that the local authority complies with its legal obligations;

h)  reducing the number of NEET individuals is crucial for economic development and is a key metric in the Keeping Nottingham Working strand of the Strategic Council Plan;

i)  young people who are NEET often face multiple  ...  view the full minutes text for item 34.