Report ACH22-035

This Committee considered a report which sought Executive approval to commence the procurement of the adult mental health recovery and rehabilitation support@home service.

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 LBB Mental Health Flexible Support Service contract would expire on 30^th September 2024. The current contract had been in place since 1^st October 2019 and had an estimated value of £319k per annum. The contract had no further options to extend and had a cumulative value of approximately £1,890k over the 5-year term.

The South East London Integrated Care Board (SELICB) Adult Mental Health Residential and Supported Accommodation Services contract would expire on 30^th September 2024. The current contract had been in place since 1^st April 2019 and had an estimated value of £1,432k per annum. The contract had no further extension options remaining and had a cumulative value of approximately £6,963k over the 5-year term. In addition, the Local Authority held individual placement contracts for clients placed into SELICB contracted provision. In 2021/22 the combined annual value of these placements was estimated to be approximately £1.12m per annum. In total these two services had an estimated combined value more than £2.94m per annum.

The Gateway 0 report (ACH22-018), presented to the Executive on 29^th June 2022, advised Members on the procurement options for future housing support mental health services in Bromley and gained 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 the Local Authority and SELICB, and with a combined total contract value estimated at £2.66m per annum, split 50:50 between the Local Authority and SELICB. The report presented to Members set out the actions relating to stakeholder engagement and co-production.

A Member considered that the proposals seemed logical but asked how staff would be impacted and if they would spend more time travelling to visit service users than delivering care. The Project Manager – Mental Health, South East London ICB (“Project Manager”) said that these were elements that would be built into the specification. It was emphasised that this was not a flat procurement of the same services and was instead a part of the wider transformation of the housing support pathway. Some of the current residential services were de-registering in order to become a supported living environment – a benefit of this was residents could gain their own tenancies, essentially living in their own homes. This was a change to the model and the way in which client groups were supported.

A Member asked what safeguards were in place to ensure that the appropriate service was provided for each service user, rather than the provider delivering what was best for them financially. The Project Manager advised that the service provided should be in line with the assessed needs of an individual. As part of the wider transformation programme additional capacity had been provided by the Social Care Team at Oxleas NHS Foundation Trust to work with the provider to undertake reassessments of all individuals who were currently receiving services to ensure they were the services required. It was highlighted that the opposite was often seen, with the provider wanting the service user to move on to a more independent setting, but the current model did not necessarily have the capacity to provide this. Looking that the services wholistically it would ensure that the right level of support was available to service users in the community rather than filling beds. It was about getting the model right and ensuring that up to date assessments were undertaken. In response to a further question, the Project Manager said that where individuals were living in a co-located building with their own tenancies and just receiving community support – when they reach a point in time where they no longer required this level of support the oversight dropped away. Having a provider overarching all services and facilities there should be a better connection between them and the individual, and contact would not automatically be lost when support stopped.

A Member enquired as to what other London boroughs were doing in relation to this service. The Project Manager advised that this proposal was moving in the same direction, both locally and nationally. It was noted that providers were used to delivering this model of service.

RESOLVED that the Executive be recommended to:

i.)  Approve the commencement of a tender process for the housing support mental health services ‘support@home’ contract:

-  for an initial period of 5 years from 1^st October 2024 to 30^th September 2029;

-  with two options to extend for a further period of 2 years from 1^st October 2029 to 30^th September 2031 and 1^st October 2031 to 30^th September 2033;

-  at an estimated total contract value of £23.4m; and,

ii.)  Delegate authority to the Chief Officer in consultation with the Portfolio Holder to approve the contract extension period(s) on satisfactory achievement of the contract performance indicators.