Suffolk Home Care and Support

July 2018

Market Engagement Events

Welcome to today’s session…Purpose of today;

• Feedback on Market Engagement

• A Potential Model

• Based on what we have heard so far

• An opportunity to hear what you think

• We don’t have all the answers

• Break and table discussions

• Procurement

• Next Steps

What do Customers Want? Customer consultation in 2014 informed the Home Care and Support Principles:-

1. Care available when I need it

2. Good quality and reliable care

3. Focus on independence and what I can do

4. Care and support plans that include all the resources available to me and how they can be used to retain my independence

5. Able to cope with a wide range of my needs

Background Support to Live at Home contract started September 2015 - one main provider in a geographical area to meet all the care needs

◦ Proved to be too ambitious

◦ Too disruptive for customers

Not able to deliver the Home Care and Support Principles

Contract ends in September 2019 so needed to think again

New approach based on the following:-

◦ More information on customer views

◦ Provider and stakeholder feedback

◦ Data analysis

◦ Contract management information

Customer Views – Health Watch Survey

Recommendations from the survey included;◦ No missed visits

◦ Do not change the carer with short notice, or no notice

◦ Send accurate rotas to the customers

◦ Ensure consistency of carers

◦ Ensure replacement carers have access to the customers care plan

To address this the locality service specification;◦ Will cover the Healthwatch recommendations

◦ Will include Key Performance Indicators – i.e. no missed visits

◦ Be contract managed focusing on customer concerns

Summer 2018

.

Health Watch Survey with

home care customers

started

Spring 2018

Market Events –

Shaping the Future

4 x sessions across the

County to share what we

had heard and consult on

our proposals.

85 providers and

stakeholders attended

5 x Service Development

Themes identified

Initial Visits

Obtained views on a

number of issues to

inform our future plans.

120 responses from

providers & stakeholders

Talking to the Care Sector

Winter 2017

Market Events -

Proposed New

Operating Model

Informed by;

Health Watch survey,

Market Engagement

events, data analysis,

and contract management information

Summer 2018

We Need More than a Contract

• Customer Journey – Timely and good customer

assessment information that is passed to care providers

• Service Development – longer term improvements that can

assist all providers of care and support

• A New Operating Model – how we propose to deliver the

Home Care Principles

Themes x3

Customer Journey

Improve understanding and consistency re outcome and enabling focus

• Felixstowe pilot testing outcome focused delivery with SW and provider partnership

• Ongoing contract management.

• Link with OT’s to build on enabling ethos with providers

• Expand training offer to SPOT providers

Improve ACS processes

◦ Area action plans x 4

◦ Work ongoing to improve handovers to providers

Service Developments

GOOD EMPLOYMENT

PRACTICE, STAFF WELL

BEING AND SATISFACTION

Draft Code of Practice

RECRUITMENT &

TRAINING

These 2 forums have now been

merged into one. First session to

be arrange in July

COMMUNICATIONS

Develop Website

Provider Forums

Newsletters

RECOGNITION

Care Awards

Promote Good Practice

Potential Operating Model

Responsive ServiceRedesign existing services into one Responsive service that can flex across the health and care system

Aim to develop an integrated approach with health that includes the acute, community health and GPs.

Key Aspects ◦ Provide rehabilitation and reablement

◦ Access to therapy staff is integral to the model

◦ Fluctuating need between health and care and needs to be stabilised

◦ Short term that ranges from a few days to up to 6 weeks

◦ Available 7 days a week for referrals

◦ Urgent response - within 4 hours

An Integrated Approach

Health Care

Including Community Response

Responsive fills the gap using available resources

Long term care Locality services

Community Health

Therapy Staff EIT

React CAT+ etc

GP’s

Home First

Provider of Last Resort (POLR)Care Act 2014 - Suffolk has a duty of care to ensure that all vulnerable adults are given the support they require when they need it, this also includes continuity of care where there is provider failure.

This duty will continue to be delivered by SCC ‘in house’ service; ◦ This will ensure that support is available at very short notice or where there is no

capacity in the market at the current time

◦ only short term emergency intervention

◦ All hours available to transfer to the market when there is capacity.

◦ Includes access to ‘Crisis Care’ - the ability for SCC to call on carers from outside of Suffolk if necessary.

Bespoke Service OutcomeTo have a countywide service that delivers appropriate support to customers whose longer term needs cannot be met by the Locality service.

ObjectivesWork with Stakeholders to:-

• Achieve a common understanding of what care & support needs cannot be met by

the Locality service

• Develop a service model that is focussed specifically on those unmet needs, and is

flexible and available in all areas of Suffolk

• Deliver a service model that is cost effective and sustainable, and

• Commission a service that meets the strategic aims and financial targets of SCC

Bespoke Service – Progress to Date Reviews were carried out for a sample of customers that had previously remained with their current provider on a spot contract for a variety of different reasons as it was not appropriate for them to transfer to the preferred provider or to take an ISF or DP.

Potentially a significant proportion of these customers have support needs that could be met by a generic provider.

We are aware that there is no consensus on what is constitutes ‘Bespoke’ and this need to be discussed in more detail with stakeholders.

There is an awareness that ‘Bespoke’ may not be the best name for this service and it is therefore a working title.

Bespoke Service – Next StepsSet up a wider Stakeholder network to help co-design the service model

Plan and deliver a series of engagement events across the county

Ensure effective comm/s & alternative engagement process for stakeholders unable to attend events

Time FrameIt is currently planned to implement this service in April 2020 but the engagement process will commence in Autumn 2018 to allow 18 months to develop and deliver the model.

Key Principles for the Locality Home Care Model• All providers will need to be accredited with Suffolk County Council

• This will be for new customers only

• Existing customers can remain with providers who are successful in entering the Framework.

• Limited transfers – only where necessary

• No requirement to transfer staff

• No Delays in requests for care

• Care available across the county when we need it

Initial thoughts are SCC will be a price setter and have a methodology to provide varying levels

of rates across the county on a parish level

Locality Home Care ModelOpen Framework on Connect Area /Locality Area (North) which gives you the ability to trade with us but does not guarantee work.

There is then the ability to apply for a Call off contract for each area. There is no restriction on the number of providers that can work in a connect/locality area.

Also a county wide call off contract that gives providers the opportunity to deliver care in any area. (this contract will be used if those providers in the connect/locality areas are unable to take the care packages in the first instances).

Providers can apply for the connect/locality area call off contracts and the county wide call off contract.

Locality

Areas

Connect & Locality Areas

Connect

Areas

Existing Providers

Accredited

after 1st

Oct 2017

Need to have an

Accreditation Health

Check

SCC will complete

Accreditation

Process

Accreditation PassUnable to join

Framework

Accredited

before 1st

Oct 2017

Accreditation Fail

Can reapply for

Accreditation at

any time but can

only apply to join

the Framework

when it opens

again

Accreditation Process

for Existing Providers

New Providers

A Pre-Accreditation

needs to be approved

by SCC before tender

return date

SCC will complete

Accreditation Process

Accreditation PassUnable to join

FrameworkAccreditation Fail

Can reapply for

Accreditation at

any time but can

only apply to join

the Framework

when it opens

again

Accreditation Process

for New Providers

Pricing Methodology

Through the previous market engagement there was no consensus as to whether SCC should

be a price setter or taker.

The model has to be affordable within the Councils budget constraints.

In order to recognise the differences of delivering care across Suffolk our initial thoughts are

there will be 5 price bands across the county set at parish level, the bandings recognise factors

such as:

• Availability of care staff

• Deprivation

• Rurality

Therefore this recognises the varying difficulty in providing care in some areas compared to

others

This methodology is still being worked through and has not yet been approved, however we

wanted to share the principles with you before going forward for approval.

Overview of the requirements of the Service◦ Service will be for all people over the age of 18 within the Suffolk County

Council boundaries.

◦ Delivered 7 days a week 6am to 11pm

◦ Referrals to be responded to 6 days a week

◦ All care to be delivered in an enabling way focussing on outcomes and promoting independence

◦ Responsive to opportunities of new ways of working e.g. assistive technology

◦ Work collaboratively with all partners to deliver best outcomes for people.

◦ Focus on working in partnership to build a strong homecare market within the connect/locality areas

Contract Management

• There will be proportionate contract management for all providers that

are successful in entering the Framework and Call off Contract Areas.

• We will be measuring providers performance against KPI’s and

management information.

• We will be managing poor performance through contract management.

• We will work in a collaborative way to raise quality and standards of care

West SuffolkClinical Commissioning Group

NHS Continuing Healthcare (CHC) – Home Care• Ipswich and East Suffolk and West Suffolk Clinical Commissioning Groups are currently exploring the

opportunities to continue to work jointly to procure home care in Suffolk alongside Suffolk County Council

• To become eligible for CHC an individual must have been assessed as having a "primary health need",

meaning that the main need for care is because of a health need as opposed to social care needs. Where

this is the case, the NHS is responsible for providing and funding all of that individual’s assessed health and

social care needs.

• In the majority of cases, the care needs of individuals in receipt of CHC packages are generally the same

needs of individuals receiving social care packages – therefore, it is felt that a majority of packages could be

arranged through the locality based home care element of the proposed model.

• Approximately 70% of CHC packages are allocated as fast tracks for end of life care requiring immediate

provision of NHS CHC and an urgent package of care. Often, end of life care can be seen as more

complicated, however, this is not always the case. Fast track packages need faster pick up times, knowledge

of end of life care but the same high quality care that is required for any other health or social care package.

• We would like to understand your views on delivering care to CHC funded customers and your ability to

quickly respond to requests for care.

Table DiscussionKey Areas to discuss:

◦ Comments on the Locality Service Model

◦ Comments on the key areas of the requirements of the service

◦ Comments on the draft KPI’s (what’s deliverable or not)

◦ Comments on difference between CHC and Social Care packages, methods of prioritisation

◦ Any areas of support/clarity needed/What does this look like for you?

What is an Open Framework?• It is a phrase for agreements with providers that set out terms and conditions under which

specific purchases can be made throughout the term of the agreement.

• It is not a guarantee of work

• It can be set up for other organisations to use the providers

• An Open Framework duration is normally for 4 years

• It can be opened to allow more providers to be accepted on to the agreement at determined

intervals

Call Off Contracts from the Open Framework• A Call Off is a competition to the providers on the Open Framework to bid for an area of work

to enable you to provide care for customers

• Direct Awards can be made to providers without opening a competition under certain

circumstances

• The Call off Contracts can be for longer than the Open Framework

• Providers do not have to bid for all Call-off Contracts

Provisional Procurement Draft Timeline

Tender Available30th Nov 2018

Submission Date23rd Jan 2019

Evaluation 4 Feb – April 2019

Provisional Award1 May 2019

Final Award10 May 2019

Tender Clarifications

Evaluation Clarifications

10 days54 days

Provisional Procurement Draft Timeline

Framework

How the Open Framework potentially may work

Successful Providers

Successful providers

No customers with SCC Customers with SCC

Providers continue working in Connect / Locality Areas with current customers

Direct Award Call Off Contracts for current providers in Connect / Locality Areas

Providers tender for Call Off contracts for Connect / LocalityAreas. Providers can tender for any amount of Areas

YesNoAgreed planned

re-provision with new provider in Connect /

Locailty Area

Requests for care in Connect / Locality Areas

How the Open Framework potentially maywork

Unsuccessful Providers

Unsuccessful Providers

Customers with SCC

Re-apply to Framework when open

No customers with SCC

Continue with customers for transformation period until Framework

re-opens

If current providers are unsuccessful again customers will be re-provisioned to successful providers

Work with the providers to achieve Framework standards

Any safeguarding or quality issues the customers will be re-provisioned immediately

Help with your Tender❖Tender Training Sessions

https://www.suffolk.gov.uk/business-jobs-and-careers/tenders-and-supplying-us/our-tendering-process/#tab3

Next dates are 14th September & 26th November 2018

❖Any specific concerns and questions we can offer targeted training sessions

❖Read all instructions and questions carefully

❖Only send back the information that has been requested

❖Check the e-tendering system regularly for messages, we will post answers to your clarifications and

may ask questions

❖If you ask a clarification and it is not answered immediately, please do not send it again, there is a time

limit we have to reply in the ITT document

❖Do not assume that those on the evaluation panel know what you mean

❖Answer the question being asked

❖Use appropriate examples

❖Do not go over the stated page limits

Don’t leave it till the last minute to upload documents and submit your tender

The tender will be published on our e-portal

You must be registered on this system to apply for the tender

www.suffolksourcing.uk

Instructions on registering and getting help or technical assistance from the helpdesk

Email - Suffolk.sourcing@suffolk.gov.uk

Telephone: 01473 260232

Liquid Logic - Context

• The system we’ve purchased includes a provider portal, with direct

links to financial and customer information

• The system will replace our existing case management system which

will feed information through to the Provider portal for payment

• All Providers to be paid via automatic payments

Liquid Logic - Functionality

• To view and accept Individual Service Contracts

• To edit and amend ‘actual’ delivered hours/sessions in an automatic

payment (instead of invoicing)

• To view upcoming payments, as well as historic payments

• To update your contact details and business information

Liquid Logic – Roll out • Current Homecare Providers on automated payments are expected

to go-live September 2018

• Contract managers will be working through information packs with

these providers over the summer

• These providers will need to attend training which will run over the

summer

• Homecare Providers not on automated payments will follow from

November onwards (no date set as yet)

What Happens Next?

• The New Operating Model has to be approved by SCC Cabinet in

September 2018

• Informal market engagement will now end prior to procurement

process

• Any further comments by end of August.

Please email

ACSHomeCareandHousingSPARTeam@suffolk.gov.uk