LIVE AT HOME PROPOSED 2021 FRAMEWORK - MOIRA MCGRATH DIRECTOR OF COMMISSIONING, ADULT SOCIAL CARE CLAIRE FELTON CATEGORY AND SUPPLIER RELATIONSHIP ...
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Live at Home Proposed 2021 Framework Moira McGrath Director of Commissioning, Adult Social Care Claire Felton Category and Supplier Relationship Specialist July 2020
Introduction
• We would like to thank the Essex Care Association (ECA) and Providers for the
support and collaboration that has taken place to date
• Your views and suggestions gathered through the Strategic Provider forums, the
ECA led workstreams and the market wide event have shaped our proposals on
how domiciliary care will be commissioned from February 2021
• The purpose of this webinar is to present our proposals, so that you can continue
to collaborate with usBackground
• The Council commissioned, on average, 113,000 hours of domiciliary care per
week, supporting around 6,300 Adults, as at June 2020
• The annual budget spend for 2020/21 is £99.9m (excluding Supported Living
and Extra Care)
• Demand is projected to increase for a number of reasons, including Adults living
longer and initiatives / technology to support Adults to remain at home for longer
• Since the implementation of the current framework in 2017, the proportion of
domiciliary care sourced through the framework has increased from 40% to 70%
• The volume of framework providers has increased from 65 to 125, reducing the
Council's reliance on the spot market, but creating challenges in terms of strategic
market management
• Unmet need has remained low over the past one to two years, although there are
still pockets across the county where it remains hard to source
• Covid-19 paused the co-production of a new way of working; the development of
the various models and the Test and LearnsDirection of Travel in 2021 and Beyond We want to see: • Joined up health and social care • Solutions that enable people to gain, regain and maintain independence • Personalised support, based on individual choice and control • Flexible support and outcome focused support that can meet both generic and specialist needs • Increased uptake of Direct Payments This will be enabled by: • Consistency of care provision in smaller geographical areas to enable alignment and integration with other community services • A skilled workforce who feel valued and enabled to deliver good quality support • Active promotion and use of digital technology • A better and closer relationship with a smaller number of providers • Financial sustainability • Better quality solutions; favouring good and outstanding Providers • Joint commissioning of services
Localised Test and Learns
Following engagement with the market through the Essex Care Association, and at the
market wide event in October 2019, as well as with our Health colleagues, we have
identified a number of potential delivery models that align with our direction of travel.
In the short term we plan to trial the following approaches in specific localities:
▪ Guaranteed hours arrangements in Primary Care Network pockets in both
urban and rural areas or a combination, where it's difficult to source and
unmet need / spot usage is high, as well areas of good supply
▪ Digital platform trials to stimulate the creation of individual circles of
support around people using self-employed Personal Assistants and
an Individual Service Fund (ISF) model
▪ Dengie Neighbourhood Team (integrated health and social care team using a
guaranteed hours arrangement)
▪ Community micro provider development using an ISF / Direct Payment model
to increase choice and control stimulated by guaranteeing hours in
an area where there is a large oversupply
▪ Integrated commissioning with CCGs for Continuing Health Care and / or
neighbouring local authorities who have similar sourcing challengesFramework
• In tandem with developing and testing various new delivery models, we will implement
an improved framework
• Having a framework in place allows us to maintain a diverse market, supporting choice
for Adults and develop localised solutions in a managed way
• Over time we envisage that volumes procured through the framework will reduce as the
successful ‘Test and Learn' solutions are rolled out
• Current demand modelling indicates that, post-Covid, demand will increase over the
longer termProposed Framework – Structure
• Four year, two-tier framework - 13 lots (12 districts and HM prison)
• Closed and may only be opened where additional capacity is required
• Ranked lists - service type: this will remain the same: Personal Care; Night Awake; Night
Sleeping; 24hr Care; Carers Break; Carers Support.
• Ranked list – client type: reduce to 2 lists:
- Older People including Mental Health and Physical and Sensory Impairment
- Learning Disability
• One 24 hr care ranked list across the county
• Price matrix reduced to 5 price points (6 in Epping)
• Target Supply Area rates – reduced to 3 rates
• Enhancements removed and an alternative to be co-producedProposed Framework – Key Selection Criteria
• Tier 1 - Providers must have published CQC ratings of Good / Outstanding overall and
be Good / Outstanding for Key Lines of Enquiry - Safe and Well Led
• Tier 1 - specific tender questions e.g. advanced dementia training for carers;
increased social value to the local community e.g. local people employed, good
Community and Voluntary Services and community health connections
• Learning Disability ranked lists – specific tender questions e.g. around a LD focussed
service, staff training
• 24 hour care ranked list - specific tender questions e.g. process for matching potential
carers to Adults
• Tier 2 – Providers must be CQC rated Outstanding / Good / Requires Improvement
• Providers CQC rated as Inadequate will not be permitted to join / remain
on the Framework
• Unrated Providers may bid but will only become active once CQC rated
• Unregistered Providers will not be permitted to bid, even if there is a registration in
progressFramework Mechanics
• Providers will be ranked in descending order of total score (price and quality)
• KPIs to manage performance – aim is to use validated data and minimise Provider
time spent on reporting:
- Call punctuality – standard calls / time critical calls / missed calls / calls outside time
- Carer continuity
- Package hand-backs
- Service user survey
- Volume of packages accepted
• Lists will be re-ranked – quarterly, then monthly once Electronic Homecare Monitoring
(EHM) data feed is automated, based on price and quality score for that period
• Annual refresh of tiers 1 and 2 across all districts, based on price and average KPI
score from that year
• Framework will be opened to new entrants at the end of year 2, only in districts
where the ratio of care sourced through spot arrangements increases above the pre-
determined levelElectronic Homecare Monitoring (EHM)
• Looking to mandate EHM across the domiciliary care service
• Objectives are to improve the safeguarding of our most vulnerable Adult; improve
risk management; support the performance management of provision
• Proof of concept phase is due to start, running from July – December
• Switch on to be during the first year of the Framework
• In the interim, Providers will be required to upload EHM reports to a portal
(continuity of carer, time windows, transparency of time spent especially when Adult
pays for, or towards, the cost of care)Proposed improvements
We want to collaborate with you on the following:
• Updating the Information for Service Provider (ISP)
• Building in tolerance for package changes
• Building in Trusted Assessor initiative
• KPIs – agree metrics
• Embedding a personalised enabling approach, focused on increasing independence
to become business as usual in the specificationHigh Level Timeline Key Milestone Key Date Decision Paper sign off 21/9/20 Tender Issued End September 2020 Tender Close End October 2020 Contract Award End January 2021 Go Live 12th February 2021 The authority will not be bound by this timeline. We are building in the option to extend the overall time frame by up to 6 months if there is a need.
Live Q & A Session Live at Home Proposed 2021 Framework Claire Felton Category and Supplier Relationship Specialist Jo Rogers Commissioning Manager July 2020
Live Question & Answer Session
• A live Q&A session, hosted by members of the Live at Home project team, will take
place on Thursday 9th July commencing at 10 am
• The questions and answers will be made available on the Provider Hub, if you are
unable to join us on the day
• Slido details for this event are: https://www.sli.do/
• Enter code: 30225
• Slido will be open for questions and feedback after the webinarFinally....
• We are looking for providers to collaborate with us on the areas for improvement
• This work will take place during July 2020
• If you would like to work with us on these areas, please contact us
at: LiveatHome@essex.gov.ukThank you for joining us
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