Transcript Presentation title - Welcome To Cumbria County Council

Health & Care Services
Supplier Engagement Session for
the Procurement of Care and
Support Services in Cumbria
16th March 2015
Serving the people of Cumbria
Procurement of Care and Support
Services in Cumbria
Care and Support Services today refers to:
• Home Care
• Supported Living
• Extra Care Housing Support
• Mental Health Active Rehabilitation and
Recovery Pathway
• Night Services
Serving the people of Cumbria
Panel available for your questions
today
• Pete Woodhouse, Senior Manager - Service
Development
• Mike Farren, Senior Procurement And Contracts
Manager
• Anne Phillips, Service Development Manager
• Zoe Cowgill, Service Development Manager Specialised Commissioning
• Donna Story, Service Development Manager
Serving the people of Cumbria
Procurement of Care and Support
Services in Cumbria
The purpose of this session is to:
• outline our proposed approaches based on earlier
consultations with ASC operational staff, active
providers in Cumbria and feedback from 3rd Nov
event;
• Provide context: Cumbria County and the Social
Care Market
• Listen and respond to questions and comments
Serving the people of Cumbria
Cumbria Background
• Second largest County in England – 2,635 sq. miles
• Second most sparsely populated – 489,100, with
50% living in rural communities
• Population expected to decrease by 1,400 by 2017
• Older population profile than the rest of England –
65+ age group increased by 15% since 2001 (11%
nationally)
• Lower proportion of people in younger age groups –
decreased by 9.6% since 2001 (0.6% nationally)
Serving the people of Cumbria
Local Context
• Council Plan Objective: To support older and
vulnerable people to live independent and
healthy lives
• Council Plan Delivery Plan aspiration to
encourage suppliers to adopt the Living
Wage
• Financial context - £80m savings over the
next 3-years
Serving the people of Cumbria
Cumbria, Districts, NHS and ASC
Teams
• 6 District Councils
• 6 Adult Social Care Team Areas
• Divisional (3) Occupational Therapy and Learning
Disability Teams
• Integrated Community Mental Health Teams (6)
• Cumbria CCG – Single NHS Commissioning Body
• Cumbria Partnership Foundation Trust
• 2 Acute Trusts – 3 Acute Hospitals
Serving the people of Cumbria
Trends/Patterns nationally
England
Cumbria
Allerdale
Barrow-in-Furness
Carlisle
Copeland
Eden
South Lakeland
35
% Population 65+
30
25
20
15
10
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
Serving the people of Cumbria
2021
Trends/Patterns nationally
• Increased potential demand
– 1 in 3 people over 65 will develop dementia
– Life expectancy:
• Medical advances – older age
• Medical advances – learning disability, transition
– Care Act
• Nationally less residential care homes but those remaining
are larger so slight increase in places but significant
increase in nursing places in last few years.
• Home care decreasing – changes in eligibility?
• Day Services decreasing
• Extra Care increasing
Serving the people of Cumbria
National Context -Drivers
– People living longer/more complex needs
– National social care agenda:
• choice and control/independence – along with
personal responsibility
• Integrated services – health/housing/social care
• Prevention/early intervention – avoid, reduce,
delay
• Tools – Care Act
Serving the people of Cumbria
Trends / Patterns Locally
Serving the people of Cumbria
Context
• Demographics – pressures and challenges of an accelerating
growth in numbers of older adults, and increased life expectancy
of people with complex disabilities
• Ongoing need for CCC to make savings whilst maintaining
quality services that are best value
• Personalisation – support choice and control through ISFs, DPs
and brokerage
• Prevention - focus on prevention and proactive support for
people living in their communities
• Partnerships – to streamline the Customer journey and avoid
duplication in service delivery
• Hospital pressures – facilitating discharge and preventing
admission
Serving the people of Cumbria
Local Context - challenges
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Workforce
Market stability - Quality
Infrastructure – geography of Cumbria
Demographics
Savings
Cultural shift – internal and external
Serving the people of Cumbria
Where we want to be in 2020
• More care and support in people’s own homes
including extra care housing
• Adequate supply in county of quality care for
people with complex needs including respite
• Market/Communities supported/influenced to
offer alternatives
• Communities in a better position to support
prevention/delay of needs, meet more lower
level social care needs
Serving the people of Cumbria
Current Frameworks
Framework 1 (block contracted services):
• Extra Care Housing
• GDC Night Services
• SP Short Term Support
• SP Longer Term Support
Framework 2 – Support At Home (spot purchased –
call-off):
• Support at Home (Domiciliary Care) including
Supported Living
• Supporting People Floating Support
Serving the people of Cumbria
Current Frameworks
Framework 3 – Day Opportunities and Employment
Support
• Buildings based low level service
• Building based higher level services
• Community Based Day Opportunities
• Employment Support Services
Serving the people of Cumbria
Domiciliary Care Services - Hours
• Approximately 50,000 hours a week, including
Supported Living, are currently being ordered
• Some 6,000 of these hours are delivered by Cumbria
Care – the remaining 44,000 hours are with the
independent sector
• Of these Supported Living are just under 22,000 hours
a week and Support at Home are approximately
25,000 hours
• More detailed breakdown for individual service lots
later in the presentation
Serving the people of Cumbria
Support at Home
Serving the people of Cumbria
Supported Living
Serving the people of Cumbria
Local Market Analysis – Home Care
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47 providers, 25,000 hours / week - £17.9m p.a.
6 Districts, 7am – 11pm
Group A / Group B providers
No restriction on provider numbers
Competition for staff and work
Recruitment / retention / staff turn-over issues
Difficult for providers to offer availability and coverage
Off-framework purchasing to meet demand
Provider failure and transfer of work
£11.74 - £13.80 urban (£12.99 - £16.30 rural)
Serving the people of Cumbria
LMA – Night Services / ECH
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Night Services – 2 providers (11pm – 7am)
£0.9m p.a. – approx. 1,500 hours/week
Staff work in pairs / block contract
Recent analysis demonstrated that alternative
provision would cost significantly more
No significant issues
Extra Care Housing £1.8m p.a. – 4 providers
Currently 12 schemes, 2,800 hours/week approx
Services usually provided on-site, 7-days a week
Serving the people of Cumbria
Extra Care Housing
• Nationally increasing against decline of sheltered
housing – increase in mixed tenure developments
• Cumbria – 376 properties across 12 schemes
• 4 schemes under development – 168 properties
• Proposals for 6 further schemes – 200+ properties
• Savings – 47% of (property numbers) x £5,000 p.a.
• Partnership – ASC / Housing / Districts
• Supported by HCA Capital and CCC capital programme
Serving the people of Cumbria
LMA – Supported Living
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11 providers (range from 1 – 53 packages)
SL Day, 13,800 hours/week, £11.6m p.a.
SL Night, 670 hours/week, £1.5m p.a.
Current max hourly rate £13.80
Some recruitment and retention issues
Some providers are paying the living Wage as
evidenced in their recruitment advertising
• No need to purchase off-framework – existing
providers are able to meet local demand
Serving the people of Cumbria
LMA – Mental Health Rehabilitation
and Recovery Pathway
• Historically limited choice – improved under current
framework
• Seeking improvement in recovery approach / moveon focus
• Some recruitment and retention issues
• No provider failure
• No off-framework activity
• Services clustered around acute ward locations
leaving gaps in S.Lakes, Eden and Allerdale
Serving the people of Cumbria
New Contracts – Key Factors
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Recruitment and retention
Capacity / availability / rural coverage
Market stability
Encouraging providers to pay the Living Wage
Quality and cost effective services
continue to provide care managed domiciliary care /
Supported Living
• Likely use of Brokerage – in-house / outsourced?
• increase take up of Direct Payments
Serving the people of Cumbria
ERSH
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Electronic Recording of Support at Home
Pilot over the past 2-years hasn’t gone as
planned
Looking at alternative approaches
Report for Council outlining pro’s and con’s
Will be clear about requirements in tender
documentation
Serving the people of Cumbria
New Framework Contract Structure
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F1 – £17.9m - Home Care, 25,000 hrs/week
F2 – £13.1m - Supported Living 14,470 hrs
F3 – £ 1.8m - Extra Care Housing
F4 – £ 5.0m - Mental Health Rehabilitation
and Recovery
• F5 – £ 0.9m - Night Services, 1,500 hrs
• 12,000 people supported - £38m p.a.
Serving the people of Cumbria
Frameworks for Care and Support
Services in Cumbria
Frameworks 1,2,3 & 5 will include all Adult Social
Care customer groups (but not Framework 4)
and all Frameworks may include some services
which are jointly commissioned with health
partners:
• Winners of F1, 2 & 4 are pass-ported through
to F3 Extra Care Housing (mini-competitions)
• Winners of F1 are pass-ported through to F5
Night Services (mini-competitions)
Serving the people of Cumbria
Proposals for Framework 1:
Home Care
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Framework Agreement – 4 years
Districts – split into 2 /3 zones (17 zones in total)
1 provider or consortium of providers per zone
Providers can bid for as many zones as they want
Max 3 zones per provider / consortium
Must be at least 2 providers per District
All zones offer around 1,000 hrs per week or more
Millom / fewer hours – guaranteed 500 hrs/wk block
Collaborative working by providers as required
Serving the people of Cumbria
Serving the people of Cumbria
Serving the people of Cumbria
Snapshot of Hours on Order for Home Care:
Hours on Order
Home Care Zone
1A
2,802
1B
1,156
1C
1,723
2A
987
2B
1,284
2C
1,033
3A
1,372
3B
2,419
4A
1,050
4B (includes Millom)
TOTAL
644
4C
1,100
5A
1,255
5B
1,377
5C
1,655
5D
1,663
6A
1,635
6B
1,347
24,502
Serving the people of Cumbria
Home Care - Purchasing
• 3 hourly rates – urban / rural / extra rural
• Initial payment of 500 hours x urban rate after 28
days to support cash flow
• Thereafter, payment by invoice on a direct call-off
basis for individual care contracts.
• Invoicing every 28 days with payment within 30 days
as per standard Council procedure
• Initial reconciliation against the block payment
• Single provider per zone – aiming for level of
business stability / income stability
Serving the people of Cumbria
Supported Living
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Providers to bid per District based on County
Council boundaries; Carlisle, Eden, Copeland,
Allerdale, Furness and South Lakes
Can bid for one or multiple Districts
Supported Living Providers will support
individuals with disabilities; predominantly
learning and/or physical disability but the model
may also be appropriate to others
(Individuals with a primary need of Mental
Health would be supported via Framework 4)
Serving the people of Cumbria
Supported Living
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Providers to have the ability and capacity to
deliver a range of support hours to meet
assessed need from 24 hour to lower levels of
support within group and individual services
Packages will be spot purchased with shared
hours an option where appropriate
All services and support will be based on a
progression model for individuals
Serving the people of Cumbria
Snapshot of Hours on Order for Supported
Living:
Supported Living District
Hours on Order
Allerdale
6,473
Copeland
3,548
Furness
2,447
South Lakeland
2,391
Eden
1,537
Carlisle
5,263
TOTAL
21,659
Serving the people of Cumbria
Supported Living - purchasing
• 4-year Framework Contract
• Individual packages will be based on call off to Providers based on
vacancies and capacity
• Group Services or schemes will be procured via mini –competition
• Successful incumbent Providers will maintain their Services and
packages
• We will be asking for a single hourly rate to cover all packages on the
Framework
– The hourly rate will be fully inclusive of all Provider costs, transport,
on-call system
Serving the people of Cumbria
Extra Care Housing
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4-year Framework contract
Providers on F3 Extra Care Housing will be made up of
the successful Providers appointed on F1, F2 and F4
Mini-competitions (Oct/Nov) will be used to select
providers for each contract expiring March 2016
Individual scheme contract durations may vary around the
Framework
The contracts will be based on a combination of block and
spot purchase arrangements depending on individual ECH
scheme requirements
Serving the people of Cumbria
Extra Care Housing
Schemes in Cumbria
12 Operational
4 Development
Serving the people of Cumbria
Extra Care Housing
Current Framework contracts = block purchase of hours from
200 to 380 hours/week. New Framework contracts will be
based on the individual requirements of the Scheme.
Current ECH in Cumbria
updated 09/03/2015
New
Number of contract end Fwk 3
District
location
Scheme
ECH units
date
2016
Carlisle
Carlisle
Burnside Court
44
Mar-16
Y
Carlisle
Carlisle
Sycamore House *
8
Mar-17
Y
Carlisle
Carlisle
Lister House *
15
Mar-17
Y
Copeland
Whitehaven
Monkwray Court
46
Mar-16
Y
Eden
Penrith
Lonsdale Court
29
Mar-16
Y
Eden
Appleby
Rampkin House
19
n/a
?
Copeland
Millom
Duddon Mews
14
Mar-16
Y
Furness
Barrow
Station view
41
Mar-16
Y
Carlisle
Carlisle
Heysham Gardens
60
Sep-15
N
S Lakes
Kendal
Jenkins Cragg
37
Y
Mar-16
S Lakes
Ambleside
Rowan Court
18
Y
S Lakes
Windermere Birthwaite
45
Y
* These 2 schemes are supported via ECH contract but have specialist focus towards
younger adults with disability.
Serving the people of Cumbria
Extra Care Housing
• New Schemes 2015-2017
Developing ECH schemes
Scheme
Eden
location
Kirkby
Stephen
Allerdale
Keswick
Greta Gardens
Opening
date
Spring
2015
Spring
2015
Fairview Court
Autumn
2015
District
Allerdale
Carlisle
Wigton
Brampton
Mill Gardens
Irthing Centre
contract Tender
type Schedule
April/May
non Fwk
2015
non Fwk Complete
non Fwk Complete
late Spring
Jan/Feb
2016
new Fwk3 2016
Serving the people of Cumbria
Mental Health Rehab & Recovery Pathway
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4-year Framework Contract
Providers can bid for 3 Lots to deliver on a
Division basis; East (Carlisle and Eden), West
(Copeland and Allerdale) and South (Furness
and South Lakes)
Can bid for one or more Lots
Plan to award to a maximum of 6 Providers per
Lot
All provision is on a Supported Living basis with
a pathway to promote Recovery and facilitate
step up/step down
Serving the people of Cumbria
Mental Health Rehab & Recovery Pathway
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Providers to have the ability and capacity to
deliver the full range of provision; High end 24
hour SL, Step down SL, Slow stream SL.
Step down SL to cover individual needs from 24
hour support down to minimal hour packages in
the community (current Support at Home
packages)
Option, where appropriate, to purchase shared
Scheme Coordinator hours at Step down SL
multiple tenancy schemes
Close working with Providers within the Division
to facilitate move on
Serving the people of Cumbria
Mental Health – Current provision
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Individuals under CPA;
East Division – 1683, West Division – 1081,
South Division – 1315
Of which 1265 individuals currently receive a community
based or residential service (age 18-64) via Health or
Social Care
297 individual Support at Home packages through Social
Care at 2126 hours per week
Supported Living Services to be included under new
Framework, approx. 100 places, mix of 24hr and lower
hours of support
Current Providers; East = 4, West = 3, South= 4
Serving the people of Cumbria
Mental Health - purchasing
• Individual packages will be based on call off to Providers within the
Division, with all Providers approached for capacity and choice then
offered to Service User. If no preference the lowest hourly rate will be
chosen
• Group Services or schemes will be procured via mini –competition
between the Providers within the Division
• Successful incumbent Providers will maintain their Services and
packages
• We will be asking for a single hourly rate (or 2 rates) to cover:
– The full range of Service models from high end to minimal hour
packages and slow stream
– The hourly rate will be fully inclusive of all Provider costs, transport,
on-call system
Serving the people of Cumbria
Night Support at Home Services
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4-year Framework contract
Providers on F5- Night Services- will be made up of the
successful Providers appointed on F1 Homecare
Likely to be procured in 5 districts of the county (excludes
Furness) depending on demand
Will run between 11pm and 7am at night.
Will involve delivery of a combination of health and social
care tasks.
See next slide for indicative core geographical areas for
night service block contracts (inside the blue areas)
Serving the people of Cumbria
Indicative Core
Geographical AreasNight Support at
Home Service.
(Geograhical core areas and hours
purchased may be subject to
change for future procurement.)
Serving the people of Cumbria
Night Support at Home
• Will be procured via mini –competition when the main Support at Home
tender process is complete- i.e. October/November 2015.
• Providers will initially be offered the opportunity to compete for these block
contracts with other successful Framework 1 providers in their own area,
e.g. Eden/Carlisle etc.
• If Framework 1 providers in the night service District do not wish to bid for
night services in their own area, the opportunity will be offered to all other
successful Framework 1 providers in Cumbria.
• We will be asking for a price for:
– A core number of delivered hours within the core area per District.
– An additional spot price in the core area - for when the block is full
– A spot price outside the core geographical area which we will pay by
mutual agreement.
Serving the people of Cumbria
Transition
• 5 months set aside to manage the changes
required. October 2015 – February 2016
• Support and co-operation of providers
involved to help reduce staff and service user
concerns will be appreciated
• Communications: - CCC will develop a
message for staff and service users
Serving the people of Cumbria
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Key Performance Indicators and
Default
KPI’S focus on
Response times to requests for support
Staff training levels
Care packages refused or handed back
3 defaults may lead to withdrawal of
contract
Serving the people of Cumbria
Quality Monitoring
• KPI Data collected by Corporate Procurement
• CQC – Close working with Council via
Safeguarding Team and Quality Monitoring Officers
• QMO role to support improvement
• Aiming for a supportive approach and for the
council to be a ‘responsible commissioner’ that
works alongside providers to resolve issues, e.g.
support with recruitment and retention
Serving the people of Cumbria
Welcome
Mike Farren - Senior Procurement And
Contracts Manager in
Commissioning, Procurement and Contract
Management (CPCM)
Email [email protected]
Serving the people of Cumbria
Procurement Principles
All procurements should be fair, open and
transparent
• This is based on the European Union procurement rules, about
not favouring or putting any potential supplier to a disadvantage.
All contracting authorities should be seen to be acting in a fair
manner.
• “ensure a degree of advertising and follow a procedure leading
to the award of the contract which is sufficient to enable open
and fair competition and meet the requirements of the principles
of equal treatment, non discrimination and transparency.”.
Serving the people of Cumbria
Rules and Procedures
Expenditure by local authorities is governed by EU Procurement
Directives as enforced by the Public Contracts Regulations
(2015). This legislation sets out clear detailed procedures for the
award of contracts whose value equals or exceeds specific
thresholds. Contracts which fall below the EU financial thresholds
must comply with the Council's own Contract Procedure Rules
which form part of the Constitution. These rules provide formal
procedures for all contracting and tendering and regulate the
processes used by the Council when seeking to procure goods,
works and services.
Serving the people of Cumbria
Draft Tender Timetable
Event
Date
Advertise and release Invitation To
Tender
April 2015
Deadline for receipt of submissions
29/05/2015
Evaluation of bids
June - July 2015
Clarification meetings
TBC July 2015
Cabinet
24/09/2015
Intention to award
October 2015
‘Standstill Period’ and Final Award
October 2015
Contract start date and
implementation period
October 2015
Serving the people of Cumbria
Esupply Portal
www.the-chest.org.uk
Serving the people of Cumbria
Open Tender Process
Open tender process (Single stage)
• All companies who express an interest will be invited to submit a tender. This is a single
stage process.
What will you receive in the Tender Pack ?
• ITT – Invitation To Tender – This will include some important information including
Legal clauses, TUPE, tender timetable, award criteria and general instructions
• Questionnaire 1 – This will be ONLINE and allow you to save in draft form. If applying
for multiple Frameworks then The Chest will save your answers on ‘like for like’
questions.
• Questionnaire 2 – This will be a Word document to complete and will include technical
questions on service delivery, contract management etc.
• Certificate Of Non Collusion - To sign and return
• Form Of Tender – To sign and return
• Specification – For information
• Maps – Zoning for the different Frameworks
• Pricing Schedule – To be completed and returned
• Terms and Conditions / Framework Agreement – You will have to accept in order to
upload your submission
• Bidder Confidentiality TUPE Letter – To be discussed under TUPE section.
Serving the people of Cumbria
Online Questionnaire
Serving the people of Cumbria
0-10 Award Matrix
Scores
10
Assessment
Excellent
Interpretation
The approach has been tailored specifically to suit the contract’s objectives
and the requirements of the specification, uses innovative approaches to deal
comprehensively with the main management and service risks, and is likely to
maximise performance and deliver continuous improvement.
8
Good
The approach demonstrates a good understanding of the contract’s objectives
and the requirements of the specification. It deals fully with the main
management and service risks and provides for delivering continuous
improvement over the life of the contract.
5
Acceptable
The approach demonstrates an adequate understanding of the contract’s
objectives and the requirements of the specification. It covers the main
management and service risks to an acceptable standard.
2
Weak
The approach meets the specification but fails to demonstrate an adequate
understanding of the requirements of the specification.
0
Fail
The approach does not meet the requirements of the specification or no
answer provided.
Serving the people of Cumbria
Example Award Criteria
Criteria
Maximum Score
Reference
1
2
Total Score
Quality – 60%
600
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100
250
50
50
150
Safeguarding
Service Delivery Plan
Recruitment and Retention
Contract Reporting
Joint Working and Governance
Price – 40%
400
• Urban
• Rural
• Extra Rural
200
150
50
Serving the people of Cumbria
Award Criteria
Section
Maximum
Total Score
Weighting
Provider A
Provider B
Organisation
Profile
For
Information
0
Completed
Clarification
Required
Grounds For
Exclusion
Pass / Fail
P/F
Pass
Pass
Compliance / Pass Fail
Standards
P/F
Pass
Pass
Technical
Capacity
Q1 100
Q2 400
Q1 10
Q2 40
Q1 80 (8)
Q2 200 (5)
Q1 50 (5)
Q2 320 (8)
Social Value
100
10
100 (10)
50 (5)
Totals
600
N/A
380
420
Serving the people of Cumbria
TUPE
Transfer of Undertakings (Protection of
Employment) Regulations 2006
• Does TUPE apply ?
• TUPE process during the Tender
Serving the people of Cumbria
Contract Management
• Tender responses / Social value
• Key performance indicators
• Auditing and monitoring arrangements
• Allocation of work and recording
Serving the people of Cumbria
Tendering Tips 1
1. TIME. Check the deadlines for requesting and then returning tender
documents/completing online Questionnaire. Zero tolerance on late bids !!!
2. HELP. Don't be put off by tender documentation. Ask for help. Go to ‘Discussion’ Section
on The Chest and submit your questions.
3. READ. Read the specification and other documentation carefully so that you fully
understand what is required.
4. INTRODUCTION. Treat us like aliens from the planet Zog !!!
5. INFORMATION. Ensure you supply all information requested and in the correct format. If
you cannot supply all the information then send a clarification question via ‘Discussion’ on
The Chest.
6. RELEVANCE. Do not include general publicity information with your tender unless you
have been specifically asked to do so.
7. LOCALITY. Look at the question and think ‘as a local/national supplier, how can I gain
points over the competition?’
Serving the people of Cumbria
Tendering Tips 2
8. SCORING. Look at the points awarded to each question and answer accordingly. Prioritise !
9. EVALUATION. Check the criteria that will be used to evaluate the tender and ensure that
your submission covers all necessary criteria adequately.
10. CLARITY. Be clear on the pricing model you are submitting and the assumptions you have
made i.e. you can hold the price for required period.
11. ADDED VALUE. Consider what added value your company may offer e.g. environmental,
social or community benefits.
12. EXPAND. Don’t rely on one sentence answers. Look at the scoring and expand including
relevant information.
13. SIGN. Ensure you sign all documentation that it is necessary to sign and provide clear
contact details.
14. DEBRIEF. If you are unsuccessful, you may ask for debrief in order to learn lessons for
next time.
IF IN DOUBT ASK
Serving the people of Cumbria
Contact Details
Mike Farren - Senior Procurement And
Contracts Manager in
Commissioning, Procurement and Contract
Management (CPCM)
Email [email protected]
Serving the people of Cumbria
Framework Design - Aims
• Reliability of service with coverage for all
areas i.e. urban and rural
• Ability / flexibility of providers to meet orders
• Appropriate quality to meet outcomes
successfully for Customers
• Procurement method minimising impact
against provider failure
Serving the people of Cumbria
Framework Design - Aims
• Guaranteed business for sustainability
• Realistic hourly price for urban / rural
• System that supports recruitment and
retention
• Appropriate financial reward especially in
rural areas
• Consideration for 15 minute calls
Serving the people of Cumbria
Questions and Answers
Serving the people of Cumbria
Contact Details
Any questions after today should be sent to
[email protected]
Information from today will be available on
the website below
http://www.cumbria.gov.uk/scprocurement
Serving the people of Cumbria