market position statement final - bathnes · 2018. 3. 27. · a market position statement (mps) ......
TRANSCRIPT
Market Position
Statement for Adults with
Learning Disabilities
and/or Autism 2018-2020
Help us develop the right care and support
services for Adults with Learning Disabilities
and/or Autism living in Bath & North East
Somerset
1
Contents
Section Page
1. What is a Market Position Statement 2
2. A Sense of direction 2-3
3. National Context 3
4. Population and Demographics - March 2018 4
5. Future Needs – demanding times 5
6. How are services delivered in Bath & North East Somerset
6-9
7. Housing needs going forward 9
8. Assistive Technology 10
9. How we check the quality of services 11
10. Direct Payments and Individual Service Funds going forward
12
11. What people do during the day 12
12. How we are spending the budget on Learning Disabilities Services
13
13. What providers are telling us
14
14. Commissioning Intentions and development opportunities
15- 17
15. A summary of key market messages 18
16. Information sharing and opportunities for networking
19
17. We want to work with providers who are… 19
18. Conclusion 19
2
1. What is a Market Position Statement?
A Market Position Statement (MPS) is a market facing document that sets out information for care and support providers about how the Council and the Clinical Commissioning Group (CCG) intend to facilitate and shape the market over the coming years, based on information about anticipated volume and demand, knowledge and national legislation and guidance.
This MPS will set the direction of travel and outcomes to be achieved that allows the market and others to develop new, innovative and different ways of doing things to support people with a learning disability and/ or autism as well as providing the opportunity to review the suitability of existing services already in the market. The MPS is a starting point for further consultation and partnership working to enable the market to develop appropriately over the coming years. The MPS aims to support current organisations to review what they are providing in Bath & North East Somerset (B&NES) and inform new organisations that are not currently delivering services in the area and that may want to think about entering the market in the future.
2. A Sense of direction
The needs of people with a learning disability and/or autism are changing and
becoming more diverse. People have higher expectations of an independent life in
their community, and want more control over their lives with good quality support
built around their individual needs. The relationship between the Council and the
social care market is changing, with the Council in the role of facilitating and
developing the social care market, rather than providing services.
Both the Council and the CCG face severe financial pressures, and there is a need
to make sure services provide the best value so people can get the most from the
available resources. We need a range of good quality care and support services to
meet people’s highly individual needs and ensure real choice. We also need culture
and practice to change so that support builds on individual, family and community
resources, empowering individuals and their families. We need strong partnerships
to make sure the ‘whole system’ helps people with a learning disability and their
families stay independent, healthy, well, and fully included in community life.
We want to facilitate a market in which services are person centred, support individual choice and maximise independence of individuals. We will measure our success and progress against the nine core principles set out in the national service model Building the Right Support:
• I have a good and meaningful everyday life.
• My care and support is person-centred, planned, proactive and coordinated.
• I have choice and control over how my health and care needs are met.
• My family, paid support and care staff get the help they need to support me to live in the community.
• I have a choice about where I live and who I live with.
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• I get good care and support from mainstream health services.
• I can access specialist health and social care support in the community.
• If I need it, I get support to stay out of trouble.
• If I am admitted for assessment and treatment in a hospital setting because my health needs can’t be met in the community, it is high-quality and I don’t stay there longer than I need to.
3. National Context
3.1 Building the Right Support Building the right support is the national service model, published in October 2015, as a result of Winterbourne View and the national Transforming Care Programme. It articulates the need for a change in culture, a shift in power to individuals and a change in services. We need to see people with a learning disability and/or autism as citizens with rights, who should expect to lead active lives in the community and live in their own homes just as other citizens expect to, supported by the right community based services. Building the Right Support, although primarily targeted at people with behaviour that challenges, proposes a whole system response as the key to delivering high quality services and support for people. For this to be a reality, services need to demonstrate a strong commitment to a shared value base which places individuals and their quality of life at the heart of all they do. This value base should reflect the ‘golden threads’ and be evident on the basis of the capable environments within which care and support is delivered. Capable environments are characterised by: positive social interactions, support for meaningful activity, opportunities for choice, encouragement of greater independence, support to establish and maintain relationships and mindful and skilled family/carers and paid support and care staff. A full copy of Building the Right Support can be found here: https://www.england.nhs.uk/wp-content/uploads/2015/10/ld-nat-imp-plan-oct15.pdf
3.2 Local Transforming Care Partnership
Local Transforming Care Partnerships have been established across the country in
response to Building the Right Support. Bath & North East Somerset is part of the
B&NES, Swindon and Wiltshire (BSW) Transforming Care Partnership. The
partnerships have been developing Service Models to set out their plans for
implementing community based models of care concentrating on prevention of
hospital admission, early intervention, and enabling people with learning disabilities
and/or autism who have behaviours that challenge, including those with a mental
health condition to remain in their local communities. A copy of the BSW Service
model can be found here:
http://www.wiltshireccg.nhs.uk/wp-content/uploads/2018/01/Transforming-care-plan-
v3.pdf
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4. Population And Demographics - March 2018
The total population of people with learning disabilities and/or autism living in B&NES is estimated to be 5,051 (population predictions from Projected Adult Needs Service, Institute of Public Care, 2017 predictions). Over 500 adults with a learning disability and 152 adults with autism currently receive care and support funded and arranged by the Council and the CCG through a joint commissioning and funding arrangement. Services are provided to the population of adults with learning disabilities and/or autism assessed as eligible for social care services in accordance with the Care Act 2014 national eligibility criteria. Health services are provided to patients registered with a Bath and North East Somerset GP who have a diagnosed learning disability using the criteria adopted by the learning disabilities service. People with learning disabilities and /or autism have a wide range of needs, with a range of backgrounds, they include people with lower level needs for support and people with significant additional needs - including people with dementia, physical disabilities, sensory impairments, mental health problems, profound and multiple intellectual disabilities and those who have behaviours that challenge services.
The diagram below shows the predicted numbers of people with learning disabilities and/or autism in B&NES (population predictions from Projected Adult Needs Service, Institute of Public Care, 2017 predictions ),
52 people predicted to have behaviours that can challenge services
744 people are predicted to have moderate to severe learning disabilties and be in reciept of services.
1479 people are predicted to have autism
3572 people predicted to have learning disabilities
182100 is the population of Bath & North East Somerset
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What do we know about
people who receive
services?
• 510 people with learning
disabilities currently
receive an adult social
care service.
• 152 people with autism
currently receive an adult
social care service.
• 92% of people receiving a
service are aged between
18-64 years old, while 8%
are aged 65 years old and
over.
• 42% of people who
receive a service are
female and 58% are male.
• 593 people with a learning
disability are registered
with a GP in B&NES.
• In 2016/17 84% of people
with a learning disability
received an annual health
check from their GP.
• 74.9% of people with
Learning Disabilities live in
settled accommodation
(not registered care) within
B&NES
• 11.3% of people with
learning disabilities are in
paid employment.
5. Future Needs – Demanding Times Looking forward, estimates of the number of people with learning disabilities and /or autism in B&NES are predicted to steadily increase year on year until 2030 with an overall 6% increase (Projected Adult Needs Service, Institute of Public Care).The most noticeable increase is among the population aged 18-24 and those aged over 65 years old. This is in line with local evidence, that suggests there is an increasing number of younger adults living with multiple and complex health needs, often life limiting, which require specialist services when moving through adulthood. We are also aware of an increasing number of children with a diagnosis of autism who will require an adult social care service over the next five years. In the next two years we expect 33 young people to move into
adulthood that are likely to require a service from the learning
disabilities or autism teams. We are working closely with
children’s commissioners to ensure a smooth and joined up
transition into adult services.
We are also aware of an increasing number of young adults
with borderline learning disabilities and a history or risk of
offending behaviour that are at risk of falling into crisis; repeat
offending, hospital admission who require specialist support.
At the other end of the adult spectrum there are an increasing
number of older adults with learning disabilities, often
developing conditions associated with older age and in
particular dementia.
We currently have 42 people with a learning disability that are
over 65 years of age and receive a service. We need to
ensure that learning disabilities providers are able to support
and meet the needs of people with learning disabilities who
are becoming older and more physically frail. We also need
to work with specialist older people’s services such as
dementia services to ensure that they can respond to the
needs of people with learning disabilities.
5.1 What this means for the future of services?
We need to commission services that can meet the changing
needs of our local population of people with learning
disabilities and/ or autism, including those with profound and
multiple learning disabilities, people with learning disabilities
and/or autism who have behaviours that challenge services
and for those people with learning disabilities and dementia.
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6. How are services delivered in Bath and North East Somerset?
The relationship between the Council and the social care market is changing, with
the Council taking on the role of facilitating and developing the social care market,
rather than providing services.
Following an extensive two year review, in April 2017 Virgin Care Services Limited
became the prime provider of community health and care services in B&NES. Under
this model, the CCG and the Council entered into a contract with a single prime
provider. This organisation has overall responsibility for the delivery and coordination
of services but it can also sub-contract with specialist, third sector providers and
small and medium-sized enterprises (SME). For more information on the review of
community services see: http://www.yourcareyourway.org
6.1 Learning Disabilities and Autism services provided by Virgin Care
Community learning disability services are provided by Virgin Care Services Limited.
Services include specialist learning disability community nursing, physiotherapy,
occupational therapy, speech and language therapy, psychology, psychiatry, day
services, shared lives service and supported living service, supported employment
service. Social work and case management is also undertaken by Virgin Care and
includes an Autism social work service for people with autism across the spectrum.
6.1.1 Learning Disabilities and Autism services sub-contracted to Virgin Care
Virgin Care sub-contact with a small number of community support providers that
provide services to people with learning disabilities and /or autism in the community.
These services provide low level support with a focus on enabling individuals to
develop independent living skills and be active members of their local communities.
6.2 Inpatient facilities and hospital admissions in Bath & North East Somerset
In B&NES we have a strong track record in working collaboratively to drive better
outcomes for people with complex support needs and as such have already
decommissioned Assessment & Treatment and learning disability specific inpatient
beds. People with learning disabilities and/or autism are supported via a range of
community services, and where indicated, as appropriate, have access to
mainstream physical and mental health inpatient care. This includes access to
specialist commissioning placements for those individuals who may be subject to
forensic pathways and Ministry of Justice restrictions. We recognise the need to
continue to develop local services to meet the needs of people with learning
disabilities and /or autism who have behaviours that challenge including those with
mental health conditions.
6.3 Autism diagnostic service
The Council and CCG jointly commission the B&NES Autism Spectrum Service
(BASS) to provide a specialist assessment, diagnostic and post diagnostic support
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service for adults with autism. We recognise the need to continue to develop the
range of service available to people with autism.
6.4 Services directly commissioned by the Council
We commission a broad range of services to meet the needs of people with learning
disabilities and/or autism from the independent and voluntary sector including:
6.4.1 Registered Care and Nursing Homes
We have contracts with 14 local care homes that are registered to provide learning
disabilities and/or autism services, providing 121 beds. The care homes are provided
by eight organisations. Of the 121 beds 40 are purchased by B&NES for B&NES
funded people and 81 are purchased by other local authority areas. We have two
registered residential respite services, provided by two providers who between them
provide 7 respite beds.
94 B&NES funded people live outside of B&NES in out of area registered care
placements. Many of these placements are long established placements.
Historically, a number of people were placed outside of the area when we were
unable to meet their needs locally. Where placements are made we aim to place in
neighbouring authorities or as close to B&NES as possible. We are keen to continue
to identify and seek options to bring people back into the area.
This year we have worked with a provider to develop a new local registered care
service primarily to support people with complex needs and behaviours that
challenge including those with forensic needs. We hope this will reduce the need for
out of area placements traditionally made for this cohort of people and will enable a
more robust locally coordinated approach for individuals.
6.4.2 How we commission registered care and nursing home placements going
forward:
The Council has been committed over the past decade to reducing the overall
proportion of people with learning disabilities living in registered care and developing
more supported living options.
The Council continue to support registered and nursing care placements where it is
the most appropriate option for people. Wherever possible the Council will view
registered care as an interim step and seek to promote re-ablement and
rehabilitation models which support people to have their own tenancy and support
people to return and live in the community.
We will continue to improve and maintain quality in services with a focus on enabling
people to achieve their personal outcomes. From April 2018 we will be issuing all
registered care homes with a new contract and outcome based specification. The
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specification has been co-produced with people with learning disabilities, their
families and service providers.
We want to work in partnership with our current registered care and support
providers and providers of older people’s services to further explore how we are able
to respond and meet the needs locally of adults with learning disabilities and
dementia who are increasing in prevalence. This may be achieved through service
re-modelling, staff training programmes or awareness raising.
6.4.3 Community Based Care and Support Services
We are committed to ensuring that people with learning disabilities and/or autism are
able to live wherever possible in accommodation of their choice and receive the
support they need to live as independently as possible based on their assessed
needs and preferences.
We commission a broad range of community based care and support services. This
term describes a wide range of support models but is defined as non-residential
care. It is delivered to people in their own homes and aims to support people to be
as independent as possible. This means that someone could be living in private
rented accommodation, social housing, a shared house, a home owner or part of a
supported living scheme. The amount of support a person has is based on their
assessed needs and could be as little as a few hours support a week or as much as
a 24 hour, 7 days a week package of support to enable them to live as independently
as possible.
The majority of packages are commissioned on an individual spot purchased basis
using personal budgets, which allows for bespoke, person centred support
arrangements. We have contracts with 15 providers of community based care and
support services. All providers have been through the Council’s accreditation
process to ensure that they meet the required standards of quality.
We commission ten accommodation based supported living schemes from six
providers. These are typically clusters of self-contained flats or a shared house, on a
single site with communal facilities and onsite support available up to 24 hours a
day. Supported living schemes offer the optimum combination of freedom and
support by sharing some support hours across tenants in their own accommodation.
For example a scheme of 6 flats with a mix of tenants with varying support needs
offer the opportunity where staffing can be shared across the scheme at certain
periods of the day or at night. Additional one to one support can be provided during
the day at specific time as required. This option ensures a balance of costs and
needs which allows a viable proposal for the provider, an economy a scale for the
commissioners and a personalised approach for people receiving the service.
6.4.4 How we commission community based care and support going forward:
We are preparing to renew our framework agreement during 2018 for all supported
living and community based support services. We will have a modified accreditation
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process that we will be inviting all current and new providers to complete before they
are able to be entered onto the framework. We recognise that we have a gap in our
community based care and support provision in being able to meet the needs of
people with learning disabilities and/or autism who have behaviours that challenge
services and those people at risk of/or with forensic backgrounds. We will be
including this as an area of specialism within the accreditation and inviting providers
to evidence their experience in supporting this cohort of people.
All procurement to renew the framework will be undertaken via the Council’s
procurement system via the the Supplying the South West portal
(https://www.supplyingthesouthwest.org.uk/). We therefore encourage all new and
existing providers to register on the portal.
7. Housing needs going forward
We are aware that proposed changes to benefits legislation has had an impact on
the development of supported living models, rendering it less attractive to registered
landlords and leading to a reduced amount of development opportunities. Whilst the
precise future of housing benefit is still uncertain, the recent decision that the
housing benefit cap will not be applied to supported housing will hopefully provide
the required assurance to registered landlords and build confidence in the sector.
We want to ensure that a range of housing options are available, including housing
for those with complex needs and physical disabilities. We will continue to work in
partnership with our collegues in the B&NES Council Housing Enabling Team and
local Registered Landlords to identify any new development opportunities.
We will be reviewing the supported living schemes that we commission to ensure
that we have the correct mixture of provision to meet the changing needs of people
with learning disabilities and/ or autism living in B&NES.
HOLD Homeownership Five people are being supported to purchase their own home using the HOLD shared ownership scheme. The HOLD scheme will meet the complex needs of a group of individuals who were identified as needing bespoke accommodation and support. The scheme has been developed following a bid to the Department of Health Housing and Technology Capital Fund 2016-2017. The bid built on a successful programme in B&NES of developing shared ownership for people with learning disabilities using the HOLD scheme in partnership with Advance Housing. The scheme is being funded by a combination of Department of Health Capital bid funding, Homes and Community agency grant and capital grant from the Council. All of the people identified for the scheme have complex needs and require bespoke housing to enable them to live as independently as possible. The individuals, their families and existing or future support providers are involved in the process of searching for a property on the open market that will best meet the person’s needs. One of the great benefits of the scheme is that individuals can find a property of their choice in an area of their choice in a community they feel familiar and supported in. It is anticipated that all property purchases will be completed by April 2018.
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8. Assistive Technology Project
We were able to secure funding in the bid to the Department of Health’s Housing and
Technology fund in 2016, to support a project to develop the use of assistive
technology for people with learning disabilities and autism living in B&NES.
Assistive technology plays a part in supporting independence for people with
learning disabilities and/or autism. It can reduce some of the risks associated with
living independently and reduce the amount of supervision required. For instance
door sensors that alert staff to a person’s movements can reduce the need for
constant supervision, cut offs for electrical equipment and medication prompts can
all assist in enabling someone to become more independent, enabling them to be
less reliant on paid staff and have time alone and in control of their own home while
maintaining safety. Other options to enhance independence vary from environmental
controls such as the means to open and close doors or curtains independently to
enhanced communication through technology.
We hope that the project will demonstrate that assistive technology can meet
individual outcomes and demonstrate some potential savings in support packages.
We will be sharing our evaluation and findings from the project in June 2018.
8.1 Developing the use of Assistive Technology
Moving forward we want to continue to expand and develop the use of assistive
technology for people with learning disabilities and/or autism. We would like to see
the potential use of assistive technology considered as standard practice within the
care and support planning process.
We want to trial the use of activity monitoring equipment as a mechanism to assist in
identifying the appropriate levels of support. Activity monitoring systems are
discreet, wireless sensors that are placed in a person’s home to monitor activity, for
example a bedroom door monitor can measure how many times someone may be
leaving their room at night or send an alert if they have not returned with a certain
amount of time. The monitoring can be put in place for a time limed period to provide
an insight into a person’s daily routine and assist in identifying the appropriate level
of support.
We want to work with providers who are willing to support individuals to utilise
assistive technology, and also to share their experience and learning of where they
have supported people to use assistive technology. We are also interested in
understanding how providers are themselves using new forms of technology within
their business to support service provision.
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9.1 Snapshot into the quality of local services
We gather intelligence about our local services from a
range of sources which includes sharing information
with the Care Quality Commission (CQC).
The charts below provide a snapshot of the outcomes
of the most recent CQC inspections of the services we
commission in B&NES.
Where a service is identified as requiring improvement
we work with the provider and CQC to support the
provider to improve the quality of the service.
We have a strong track record of providing good
quality services within a stable local care market.
Going forward we would like to improve on this by
supporting providers to achieve an ‘excellent ‘rating.
73%
14%
13%
Registered care homes - outcomes of CQC
inspection
Good
Requires
improvement
newly registered or
change in provider
93%
7%
Registered community based care and support
providers - outcome of CQC inspection
Good
Requires
improvement
9. How we check the quality
of services
The Council currently aims to carry out
as a minimum an annual contract
review on all commissioned services.
The contract review process is
designed to ensure that the services
meet the quality standards set out in the
contract terms and conditions. The
process consists of visiting the
service(s), talking with relevant people
including staff, individuals who use the
service, families and other professions
involved and a review of relevant
information.
The Council has previously
commissioned a team of experts by
experience to carry out quality checks
as part of the contract review process.
We are currently reviewing this process
and considering how to best continue to
commission this service and review
how we engage with people with
learning disabilities and/or autism and
their carers and families.
We have an ongoing process for
gathering feedback on contracted
services. Professionals working with
individuals and providers within the
area are encouraged to feedback any
good practice or areas of concern to the
Commissioning Team throughout the
year.
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10. Direct Payments and Individual Service Funds going forward
We are committed to promoting and encouraging the use of Personal Budgets and
Personal Health Budgets, particularly combining the two to deliver integrated
personalised support. We have seen a year on year increase in the number of
people choosing to take a direct payment and manage their own support, currently
100 people with learning disabilities and/ or autism have a direct payment.
Going forward we want to look into the feasibility of commissioning Individual Service
Funds as an alternative model to run alongside Direct Payments and the Council
Managed Service. An Individual Service Fund (ISF) is when a provider commits to
helping an individual make the best use of their Personal Budget to meet the
outcomes in their support plan. Key features are that:
• The money is held by the provider on behalf of the individual.
• The person decides how to spend the money
• The provider is accountable to the person.
• The provider commits to only spend the money on the person’s service and
the management and support necessary to provide that service (not into a
general pooled budget).
• The provider can deliver some or all of the services required to meet the
individual outcomes in the person’s support plan.
• The provider may choose not to deliver any services but to commission them
all from other providers with the individual’s agreement
We will be looking for providers to pilot the use of individual service funds within the
next 12 months.
11. What do people do during the day?
We have worked in partnership with Virgin Care and previously Sirona to redevelop
the way that day services are provided within B&NES. We continue to commission
two buildings based services from Virgin Care, these services are focused on
providing a timetable of activities, and employment related projects and therapeutic
support for those with complex needs. A number of community based care and
support services also provide day time activities and employment services that
people can purchase using their personal budget.
11.1 What people do during the day going forward:
We want to continue to work with providers to promote flexible day opportunities that
offer a range of community based activities. In particular, focusing on promoting a
greater use of mainstream services to decrease dependency on traditional health
and social care services. We have had continued success in B&NES of supporting a
small number of people into employment and we want to build on this and work with
day services, employment agencies and the voluntary sector in order to improve
access to employment opportunities.
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12. How we are spending the budget on learning disabilities and
autism services
A fundamental challenge for the Council is that as part of the Governments drive to
tackle the national debt, all Councils are receiving progressively less grant funding
from central government each year, at a time where we are seeing an increased
demand for social care services.
In B&NES social care services (adults and children) currently account for almost 75
pence out of every pound spent by the Council. By next year 2018/19 it is forecast
that this will rise to 80 pence in very pound (net).
We operate a pooled health and social care budget for adults with learning
disabilities (including those with learning disabilities and autism), the total pooled
budget for 2017/18 is £28.2million of which approximately £25million is spent on
residential, community and Continuing Health Care Placements.
The main budget pressures that are currently facing the learning disability budget
are:
• The impact of changes to overnight support costs and the impact of the
introduction of the National Living Wage.
• Demand led pressures i.e.: from young people coming through transition from
children’s services and changes in individual needs; people living longer
• Efficiency programmes to deliver savings from Council purchasing budgets
In addition, we currently spend approximately £833,000 on social care support for
adults with Autism who do not have a learning disability.
We want to work in partnership and collaboration with all stakeholders to identify
opportunities for efficiencies in service delivery, whilst still maintaining quality
services.
22%
2%
35%
1%
40%
Budget breakdown of purchased services - learning
disabilities Virgin Care services
Continuing health care
Personal budgets
support to live indepenedently
Nursing home placements
Registered Care
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13. What Providers are telling us
In a recent survey we asked providers what are
the two main areas that are impacting on the
delivery of quality services in B&NES?
We were told:
Uncertainly
about the future
Social Work
turnover and lack
of Social Workers
Do not feel the
impact of the
National Living
Wage and
Sleeping in has
been properly
addressed Time and energy
unpicking finance
problems
Some people are
over supported.
The principle of
‘just enough
support’ and
outcomes
monitoring
should be
Staff
recruitment
Recruitment and
retention of staff
Rates of pay Local completion
for staff
13.1 The Local Workforce
Skills for Care 2017 - Adult social care
workforce supporting people with learning
disabilities and/or autism data estimates that
there are 1,075 workers supporting people with
learning disabilities and /or autism across the
statutory and independent sector, which can be
broken down as:
All services 1,075
Adult residential 400
Adult domiciliary /supported living
500
Other 25
Overwhelmingly providers tell us the most
common issue impacting on the delivery of
quality local services is staff recruitment and
retention. With some of the reasons given
being: low rates of pay within the sector and
local competition among providers.
Several shared recruitment fairs took place over
the last eighteen months organised by Virgin
Care and previously Sirona. Between eight and
ten local providers were represented at the fairs
which took place in in number different locations
across B&NES. The benefit of the fairs was that
providers could come together to share
communication, advertising and venue costs.
We do acknowledge the impact of changes to
overnight support costs and the introduction of
the National Living Wage are having on our
local providers and the potential risk to the
delivery of good quality services.
We will continue to work closely with providers
to develop shared solutions and encourage
providers to develop local opportunities to share
best practice and resource, with particular focus
on recruitment and retention, training and skills
development of the local workforce.
Finding staff
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14. Commissioning Intentions and Development Opportunities
Our commissioning intentions have been developed based on our need to consider
more flexible approaches to commissioning. That can create a market which is more
responsive to individual needs and can meet the needs of a population of people
with learning disabilities and/or autism with increasingly complex needs, at a time
where we are under severe financial pressure.
14.1 Develop a range of good quality community services that can meet the needs
of people with learning disabilities and/or autism.
We will do this by:
• Renewing our open framework agreement for all supported living and
community based support services with a modified accreditation process.
• Ensuring that the needs of people with learning disabilities and/or autism who
have behaviours that challenge services and those people at risk of/or with
forensic backgrounds are included within the provider accreditation.
• Ensuring that the needs of older adults with learning disabilities and /or autism
and particular those with dementia are included within the accreditation and
that we are able to contract with providers who have the skills and experience
to support individuals with these needs.
• Scoping the needs and identifying local services that can meet the needs of
the increasing number of young adults with borderline learning disabilities and
a history or risk of offending behaviour that are at risk of falling into crisis;
repeat offending and hospital admission who require specialist support
• Working in partnership with providers to review the current supported living
schemes that we commission to ensure we have the correct level of provision
to meet the changing needs of people with learning disabilities and/or autism
with particular focus on services that have on-going voids in services.
• Working with supported living providers to pilot the use of Individual Service
Funds (ISFs).
14.2 Ensure good quality registered care services can meet the needs of people
with learning disabilities and/or autism.
We will do this by:
• Issuing new contracts to registered care home providers, with increasing
emphasis on quality and a focus on the achievement of individual outcomes.
• Working in partnership with providers of registered care services to review
their services, particularly services that have ongoing vacancies or where the
needs of the current residents are changing: for example becoming
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increasingly elderly, and to ensure that we have the correct level of provision
to meet the changing needs of people with learning disabilities and/or autism.
• Working in partnership with learning disabilities providers and providers of
older people’s services to further explore how we are able to respond and
meet the needs locally of adults with learning disabilities and dementia.
• Continuing to explore the possibility of de-registration where appropriate.
• Undertaking a review of the contract monitoring process for out of county
registered care placements.
14.3 Ensure that there is a range of housing options available to people with
learning disabilities and/or autism that are suitable and will meet future needs.
We will do this by:
• Identifying future housing needs and likely gaps in housing provision.
• Continuing to work with the Council’s Housing Enabling Team and Registered
Providers to identify any new housing development opportunities particularly
for people with complex needs and physical disabilities.
• Continuing to develop the use of HOLD homeownership.
14.4 Develop the use of assistive technology for people with learning disabilities
and/or autism so that it becomes a standard part of the support planning
process. We will do this by:
• Completing an evaluation of the learning disabilities assistive technology
project and share our learning.
• Developing an assistive technology pathway for people with learning
disabilities.
• Trialling the use of activity monitoring equipment as mechanism to assist in
identifying appropriate levels of support.
• Working with providers to understand how providers are themselves using
new forms of technology within their business to support service provision.
14.5 We will continue to improve the transition from children’s to adult services.
We will do this by:
• Developing a better understanding of the profile of young people in transition
and the likely timescales for service demand.
• Adult and children’s commissioning teams working more collaboratively
across transition and work with operational care management teams to
identify services and options at an early stage in the process.
• Continue to work with children’s commissioners on the roll out of multi-
disciplinary Education Health and Care plans (EHC).
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14.6 Ensure that there are systems in place that enable us to engage with people
with learning disabilities and/or autism, their Carers and family members.
We will do this by:
• Working with Virgin Care to re-establish the learning disabilities partnership
board.
• Producing an accessible easy read version of this plan that we can consult on
with people with learning disabilities and/or autism to show what we are
working on and what we think are the main areas for action.
• Working with the Autism Partnership Group to establish how best to engage
with people with autism.
• Reviewing the future role of the quality checkers and how we commission the
service.
14.7 Develop an all age autism pathway.
We will do this by:
• Reviewing our current care pathways for people with Autism.
• Renewing and updating the Autism strategy.
• Reviewing the specialist health and social care support for those who may be
at risk of or have come into contact with the criminal justice system.
• Working with the Autism Partnership Group to identify our priorities for the
next twelve months.
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15. A summary of key market
messages:
The key market messages contained within this
MPS and development opportunities are:
• We will be reviewing our framework
agreement for all supported living and
community based support services with a
modified accreditation process. Please
ensure your organisation is registered on the
Supplying the South West portal
(https://www.supplyingthesouthwest.org.uk/)
• We want to work with existing and new
service providers to ensure that the needs of
older people with learning disabilities and
dementia and those people who have
behaviours that challenge services can be
met within B&NES.
• We will be issuing all care home providers
with a new contract and outcomes focused
service specification.
• We want to work with service providers to
review existing services in B&NES with a
view to having the correct mix of provision to
meet the changing needs of the local
population of people with learning disabilities
and/or autism.
• We want to develop the use of Individual
Service Funds and we will be looking for a
provider to trial this with.
• We want to increase the use in assistive
technology and we want to trial the use of
activity monitoring equipment.
• We will continue to identify new housing
opportunities to enable people to live
independently.
• We will work in partnership with providers to
identify opportunities for efficiencies in
service delivery.
• We want encourage providers to facilitate
local opportunities to share best practice
and resource, with particular focus on
recruitment and retention, training and skills
development of the local workforce.
15.1 Where we see ourselves in 2020
• We will have a framework of local
providers that are able to meet the
needs of people with learning
disabilities and/or autism including
older people with learning
disabilities and dementia, those
people who have behaviours that
challenge services and those
people at risk of/or with forensic
backgrounds.
• We will have a reduction in the
number of registered care
placements being made outside of
B&NES.
• We will have worked in partnership
with existing providers to review and
remodel services within B&NES to
reflect the changing needs of the
local population to ensure the future
sustainability of services.
• We will have supported the
predicted 33 young people in
transition to (where required) meet
their housing and support needs in
B&NES.
• We will have delivered at least five
new units of supported living
accommodation.
• We will have supported 9 people to
purchase their own home using the
HOLD scheme.
• We see at least a 5% increase in
the use of assistive technology
across support packages.
• We will be able to offer people an
Individual Service Funds and have
at least three providers who are
able to provide this service.
• We will have an all age Autism
pathway and a renewed Autism
Strategy in place.
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Market opportunities
16. Information sharing and opportunities for networking
• Learning Disabilities and Autism Provider Forum
A bi-annual forum for commissioners and providers to meet to discuss existing issues, new
working practises; legislation impact and share information.
Commissioner monthly e-bulletin
A monthly e-bulletin containing updates on important and useful information relevant to
providers. This will include local, regional and national information.
• Commissioner’s Good Newsletter
A bi-annual newsletter aimed at all members of staff and service users. It contains useful
information as well as provider’s good news stories. We are always looking for new stories
so please share them with us.
• Vacancy Bulletin
Each month we provide the Care Management Teams with a vacancy bulletin which tells
them which service has vacancies. We ask providers to notify us of the vacancy with a
description of the vacancy.
If you would like future information on joining our distribution list please contact us
17. We want to work with providers
who are:
• Committed to placing the person at the
centre of support and can demonstrate
how they are active in shaping the
design, delivery and quality assurance.
• Willing to work with us to develop ways
of measuring the quality and the benefit
of the service they provide.
• Want to innovate and develop
approaches which reduce dependency
over time.
• Flexible and skilled providers who can
provide support for people with very
challenging behaviour in supported living
settings.
• Willing to build extra capacity and
effectiveness of models of support
through the innovative use of assistive
technology.
• Willing to review current services and
ensure that they will meet future demand
and the changing needs
• Willing to work with us to achieve our
commissioning intentions
18. Conclusion
We are committed to giving people with
learning disabilities and/or autism choice and
control about where they live, who they live
with and the support they receive. We want
people with learning disabilities and/or autism
to lead lives that are fully integrated within the
community they live in.
This market position statement commits us as
commissioners to helping people get involved
in their care, set the outcomes they wish to
achieve and realise their full potential as
citizens.
Our next task is to produce an easy read
version of our plans for the future as outlined
in the MPS so that we can share this plan
with people with learning disabilities and/or
autism.
We have checked this MPS against the
Institute of public care (IPC) Learning
Disability Market Position Statement Good
practice checklist.
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Where to view the MPS
This MPS is available on the Council website at
http://www.bathnes.gov.uk/services/care-and-support-and-you/learning-disabilities
Alternative formats
If you require this information in alternative formats, please contact
Please let us know what you think
If you would like to discuss anything contained in this MPS in more detail please contact the
Learning Disabilities and Autism Commissioning Team at: