Agenda item

AWARD REPORT FOR: 1) DOMICILIARY CARE FRAMEWORK AND 2) DOMICILIARY CARE PATCH CONTRACTS (PART 1)

Minutes:

Report ACH21-031

 

The Committee considered a report outlining the results of two tendering processes and sought approval to award Framework contracts to multiple providers for the delivery of domiciliary care, alongside awarding eight domiciliary care Patch contracts.

 

In accordance with its statutory social care function, the Council provided approximately 15,000 hours of standard domiciliary care per week and spent around £14m per annum providing services to adult residents of Bromley. Additionally, children and young people access support services which encompass the wider definition of domiciliary care. The cost of this activity was £0.7m per year (560 hours per week).

 

The current Domiciliary Care Framework commenced in August 2012 as a ‘5 year plus 2 year plus 2 year’ contract and was scheduled to end on 26th August 2021. On 27th November 2019, the Executive agreed to Proceed to Procure for a multi-provider Framework contract for domiciliary care to replace the expiring Framework (Report ACH 19015). The Gateway 0/1 report also outlined the move towards providing a Patch Model of provision with additional support provided through a list of Framework providers. The Borough had been divided into four geographical patches (East, West, Central and South). Each Patch has between 1-3 Patch providers, depending on the number of service hours to be delivered in that Patch. It was envisaged that the Patch arrangements would result in better provider staff recruitment and retention levels due to potentially better contract terms and work conditions and greater knowledge in the relevant geographical patches. In turn it was planned that there would be improved quality assurance arrangements with a smaller group of core providers. The 8 Patch Providers would deliver the primary domiciliary care model. To give greater flexibility and to ensure that all care and support needs would be met, the Patch Provider contract would be supplemented with a Framework (up to 32 providers). The Framework providers would be used only when Patch providers were not able to respond to service requests.

 

In order to ensure that there is a seamless transition for children to adult services, the new Framework incorporated all ages. Children’s domiciliary care would account for approximately 3% of the new business and 11% of the activity was likely to be related to clients that were eligible for Continuing Care support (NHS funded). Including the latter would support the integration agenda, whilst maximising the opportunity for the Council and CCG to achieve economies of scale, more competitively priced joint packages and avoid multiple providers for service users that were eligible for health and social care assistance.

 

The new Framework and Patch arrangements would also supersede the current Discharge to Assess (D2A) Framework contract as planned and confirmed in D2A Framework Award report (ACH20006). This equated to approximately 5% of the domiciliary care Framework activity.

 

The proposed Framework would commence from 27th August 2021 for a four-year period. The Patch contracts would commence on the same date; however, Patch providers would be given six months to mobilise if they so wished.

 

In response to a question which referred to the date of the data that had been referenced (2020), the Head of Community Commissioning advised that this year’s Adult Social Care 2021 survey had been delayed due to pandemic, however it was not mandatory and consequently officers would resume the usual survey schedule in the Spring 2022. The data provided had been collected by the performance team and consequently feedback would be conveyed. A Member noted the reference made to ‘57% domiciliary care respondents stated that the way they are helped and treated makes them feel better about themselves’. It was highlighted that it would be useful to have a comparative benchmark to understand if this figure was acceptable, and an indication of the number of respondents.

 

A Member raised concerns regarding the fourth recommendation to grant delegated authority and therefore the contract would not be brought back to the Committee for scrutiny. The Chairman reminded Members that a huge piece of work to be undertaken to ensure compliance and it was concluded that delegation in this way formed part of the contract procedural rules and, if included in the original Terms of Reference, the contract would not need to be brought back to the Committee. The Head of Community Commissioning advised that the value and full term of the contract had been exposed via the tender process, and providers had bid for the full term. The extension had been agreed at the beginning of the contract, allowing the Local Authority to activate it if required. It was stressed that this was not a waiver. The Chairman highlighted that authority would be delegated to Director of Adult Social Care, subject to agreement with the Portfolio Holder for Adult Care and Health, the Assistant Director Governance & Contracts, the Director of Corporate Services, and the Director of Finance, as determined by the Contract Procedure Rules. The Portfolio Holder for Adult Care and Health noted that a report regarding this had been agreed by the Council’s Executive and requested that a copy be circulated to the new Members of the Adult Care and Health PDS Committee.

 

In response to a question, the Head of Community Commissioning advised that during the tender process providers had been required to demonstrate how they would offer Social Value. This included how they would support apprenticeships for Bromley residents, supported internships for people with learning disabilities and how they would work with local schools and colleges and make a broader contribution to social and economic life in Bromley. Each provider would be monitored on a quarterly basis in relation to this. A Member enquired if the Council’s target to become carbon neutral by 2029 had been considered during the tender process. The Head of Community Commissioning advised that this was also covered under Social Value and was supported through using less providers and their staff undertaking less commuting.

 

A Member noted that the table on page 100 of the report pack indicated savings of more than £0.5m and asked for assurances regarding the quality of the contract and service provided. The Head of Community Commissioning responded that this ambition was based on new modelling and drawing down more new packages from the new domiciliary care providers. There would not be a reduction in the quality of the service – there would be less providers, and therefore less churn of staff, and more local people would be employed. The ‘Wake up to Care’ recruitment initiative had been extended and was built into the contract and they would be working with the Learning and Development team with regards to training and recruiting local people, maximising staffing numbers. Another Member asked for further details of how the blended rates were calculated. The Head of Community Commissioning agreed to request this from the Head of Finance for Adults, Health and Housing following the meeting.

 

RESOLVED: that the Executive be recommended to:

 

i.)  Approve the award to the named Framework providers (as detailed in the Part 2 report) for the period 4 years from 27th August 2021 – 28th August 2025. The Framework contract had an estimated overall annual value of £14.2m total per annum. The overall whole life value is £113.6m (Framework and Patch);

 

ii.)  Grant delegated authority to the Director of Adult Social Care to reopen admission to the Framework, via a compliant process, as required and award further contracts to the Framework, within the estimated contract value as per Recommendation i;

 

iii.)  Approve the award of contracts to the Domiciliary Care Patch Providers (as detailed in the Part 2 report) from the 27th August 2021 for 5 years with the option to extend for a further 3 years (5+3); with the estimated contract value as per Recommendation i; and

 

iv.)  Grant delegated authority to the Director of Adult Social Care to apply the three year extension option for the Patch contracts, subject to agreement with the Portfolio Holder for Adult Care and Health Services, the Assistant Director Governance & Contracts, the Director of Corporate Services and the Director of Finance as determined by the Contract Procedure Rules.

Supporting documents: