Agenda item

HOUSING SUPPORT MENTAL HEALTH SERVICES

Minutes:

Report ACH22-018

 

The Committee considered a report advising Members on the procurement options for the future adult mental health recovery and rehabilitation accommodation-based support and floating support services in Bromley. The report sought Executive approval to replace the existing service model with a new joint adult mental health recovery and rehabilitation support@home service contract in 2024, underpinned by the section 75 agreement between LBB and CCG.

 

The provision of adult mental health recovery and rehabilitation accommodation-based support (residential care and supported living) and floating support services ensured that the London Borough of Bromley (LBB) and South East London Clinical Commissioning Group (SEL CCG) met their dual duties under the Care Act 2014, where there was a requirement for people to be supported to remain in the community; and the Mental Health Act 1983 in relation to hospital discharge.

 

LBB and SEL CCG currently contracted 61 units of accommodation-based support within the borough, and more than 300 hours of floating support per week. The existing budget for these services had a combined annual value of more than £2.94m, split between LBB and SEL CCG (£1.5m LBB / £1.44m SEL CCG).

 

The Associate Director Integrated Commissioning – NHS South East London CCG (Bromley) (“Associate Director”) advised that the procurement of a new joint adult mental health recovery and rehabilitation support@home service sought to deliver some key priorities of the Bromley Mental Health and Wellbeing Strategy:

 

  • Establish a strong mental health and wellbeing offer for people with mental health challenges;
  • Develop an integrated recovery and rehabilitation pathway across all health, care and support mental health community services;
  • Ensure that those who could, were supported to move into more independent settings including, when ready, outside of services all together;
  • Ensure that independence and wellbeing was at the forefront of provision with services shaped by the people that use them; and,
  • Provide good housing options for people who were at risk of homelessness due to mental ill health.

 

Mental Health recovery and rehabilitation accommodation-based support and floating support services aimed to support mental health service users away from reliance on hospital and residential provision towards more enabling and cost-effective services such as supported accommodation, support in the community and targeted support towards independent living. The services supported people who were recovering from a period of mental ill health, which could in some cases include periods in hospital, and/or people who were homeless or at risk of homelessness due to their mental ill health.

 

The proposed service model intended to:

  • end the unnecessary confusion between “supported housing” and “floating support” services and move to a model that supported clients no matter where they lived;
  • enable improved linkages with community mental health (CMHT) and social care teams through a single joint model of support;
  • enable improved joint working with LBB Housing and housing associations to better enable clients, when ready, to move into their own homes;
  • develop a more specialised workforce with a greater focus on particular groups; and,
  • create better value for money through integrated contracting with financial savings for both LBB and SEL CCG.

 

In response to questions, the Associate Director advised that different services were currently provided through different contract. The proposed

new service model would provide everything in a single service which, after assessment, could be better tailored to an individual’s needs – they wanted to ensure that independence and wellbeing was at the forefront of the provision, with services shaped by the people that use them, supported by the Oxleas community mental health teams. It was noted that currently, clients living in residential care homes did not have the same rights and responsibilities as individuals who held their own tenancy, and were also unable maximise the full range of benefits available to them to support their independence. The proposed model would help them gain access and support to ensure they had the rights they were entitled to. The Project Manager – Mental Health – NHS South East London CCG (Bromley) (“Project Manager”) confirmed that changes to rental revenue, including service charges would be met via these increased benefits, such as housing benefit to which clients living in residential care homes were unable to access.

 

Members asked for further information in relation to the waiting lists for services. The Project Manager said that there were waiting list as well as other performance measures such as referrals to the service. The Associate Director said that waiting lists were often not long, as clients in need had a duty to have these needs met – as such alternative provision was identified rather than long waiting times. The Associate Director agreed that recent performance data could be circulated to Members following the meeting. A Member highlighted that paragraph 13.3 of the report indicated that there would be estimated savings of £276k and asked whether this budget had been cut. The Project Manager advised that this related to efficiencies created. The Member highlighted the current cost of living crisis and questioned whether this should be reallocated into frontline services. The Director of Adult Social Care noted the budget item discussed earlier in the meeting, which had highlighted the significant pressures faced. There was a need for contracts to create efficiencies and be managed with the resources available.

 

A Member considered that this was an innovative programme and enquired how it would be managed to ensure that it achieved the best overall benefit, and did not just meeting the needs of a few individuals. The Project Manager advised that the KPIs would be discussed and established in the next steps of the procurement exercise. The current model attached accommodation-based support to a property and floating support to individuals living in their own home. The two services were separate, but structured to work alongside each other. The proposed model would detach support from an associated property so it could move with an individual when they moved on, and allowed more consistency in terms of them receiving support from the same provider in their new home.

 

In response to a question regarding the length of the proposed contract, the Associate Director advised that he worked across the Council and CCG to develop the proposals and balance needs, and the length of contract was similar to others awarded. The Member highlighted that longer contracts with break clauses would be more efficient.

 

RESOLVED that the Executive be recommended to approve the procurement of a new joint adult mental health recovery and rehabilitation support@home service to:

 

i)  replace existing separate LBB and SEL CCG contracts;

 

ii)  be in place by October 2024 with an estimated annual contract value of £2.66m, split 50:50 between LBB and SEL CCG; and,

 

iii)  deliver estimated efficiency savings of £166k per annum to LBB, and £110k per annum to SEL CCG.

Supporting documents: