Issue - meetings

Report of the Corporate Director of Adults, Housing and Health. To be presented by the Cabinet Member for Health, Social Care & Wellbeing

DECLARATIONS OF INTEREST RELATING TO THIS ITEM:

None

RESOLVED:

That Cabinet:

1.    Approved the commencement of a procurement for Home Care and Reablement services as separate lots.

2.    Agreed a contract term of up to eight years, with appropriate break clauses at year four and year six.

3.    Approved a commissioning mix that increased guaranteed hours from around 50% in Year?1 to around 70% by Year?3, with the remainder procured via the Dynamic Purchasing System (DPS). Appendix?A listed the indicative maximum number of hours per service agreement.

4.    Approved a Council?defined sustainable pricing approach, including a rate range and annual uplift mechanism, with flexibility to respond to exceptional circumstances.

5.    Agreed to an increased number of contracts and a cap on awards per provider to improve resilience and avoid over?concentration.

6.    Noted and approved the mobilisation approach, including TUPE where applicable, Electronic Call Monitoring (ECM), and phased transition arrangements.

7.    Delegated authority to the Cabinet Member for Health, Social Care and Wellbeing, in consultation with the Corporate Director of Adults, Housing and Health, to award contracts for Home Care and Reablement following completion of the procurement process.

Reasons for decision

Haringey supported around 1,500 people per year with Home Care and Reablement. Home Care provided support such as personal care and dressing, helping residents remain in their homes for longer. Reablement supported residents who had experienced, or were at risk of, hospital admission to regain skills lost during illness.

The proposed approach to retendering these services sustained and strengthened what was already working well in Haringey’s model while addressing current pressures. The locality?based, guaranteed?hours arrangements had improved responsiveness, workforce stability and hospital discharge, and enabled greater oversight of providers, supporting quality assurance and relationship?based practice.

A re?procurement was required to preserve these gains and update the model for current market conditions.

Separating Home Care and Reablement into distinct lots emerged as a key learning from the current contract. Establishing Reablement as a separate service ensured clarity about its short?term, outcomes?focused role and allowed ongoing support to be commissioned and measured differently.

Introducing Council?defined sustainable rates with transparent uplift rules aligned with the Council’s fair?pay commitments and the requirement to consider the actual cost of care, reducing the risk of provider exit or failure. Increasing the share of guaranteed hours to approximately 70%, distributing awards across more providers with caps per provider, and using ECM for billing and assurance collectively improved resilience, continuity and contract oversight.

Delegating contract award decisions to the relevant Cabinet Member enabled timely implementation following the conclusion of the tender process, ensured proportionate political oversight, and supported safe continuity of care for residents while complying with Contract Standing Orders.

Alternative options considered

Do nothing / rely solely on the DPS
Rejected. Without call?off contracts, Brokerage would have needed to place all packages on the DPS, which was slower, offered less certainty for residents and providers, and would have weakened market stability and oversight.  ...  view the full decision text for item 438

The Cabinet Member for Health, Social Care and Wellbeing introduced the report.

It was explained that the report set out plans to initiate the procurement of Adult Social Care Home Care and Reablement services, as the existing contracts approached their end. Home care supported over 1,000 residents in Haringey, and reablement services played a key role in supporting hospital discharge and helping individuals to regain and maintain independence over time.

The Cabinet Member noted that the Council sought to maintain and build on the existing approach, including the use of blocks of guaranteed hours. This model had provided greater oversight of service delivery, improved continuity of care and workforce stability, and supported manageable contract administration. The separation of reablement and home care into distinct service lots represented a change intended to improve service outcomes. This approach enabled clearer parameters to be set for reablement, focusing on time?limited support with defined outcomes, distinct from longer?term home care provision.

It was explained that a resident focus group had been involved in shaping the service specifications and outcomes to ensure they reflected the experiences of people using the services.

Following questions from Councillors Carlin and Cawley-Harrison, the following information was shared:

• It was explained by officers that the reason for the splitting of home care and reablement care was to ensure it would be easier to better set outcomes for users. It was stressed that the aim would be to ensure more independence wherever possible. It was stressed that this had been identified as best practice based on other comparable authority’s experience.
  
  
• It was noted that reablement was aimed to support people to be independent as soon as possible. It was stressed that the assessing professional was the one to determine independence in all cases. It was additionally noted that reablement was a part of the overall relationship between the Council and the service user, which could include district nurses, social workers and others.
  
  
• It was explained that having a defined set of outcomes would improve quality for service users and that the Council had changed the way that it reports visits as a result.
  
  
• It was explained that the Council retained an in-house reablement service to be an interface between external providers and the Council, which would help define goal setting.
  
  
• It was noted that the Council would use more electronic monitoring data to quality control care visits and contact with staff. It was also noted that the council sought to increase the volume of block hours to improve quality and better build relationships with providers.

RESOLVED:

That Cabinet:

1.    Approved the commencement of a procurement for Home Care and Reablement services as separate lots.

2.    Agreed a contract term of up to eight years, with appropriate break clauses at year four and year six.

3.    Approved a commissioning mix that increased guaranteed hours from around 50% in Year?1 to around 70% by Year?3, with the remainder procured via the Dynamic Purchasing System (DPS). Appendix?A listed the  ...  view the full minutes text for item 438