Agenda item

[Report of the Director of Adults and Health. To be introduced by the Cabinet Member for Adults and Health.]

This report seeks approval to award a block contract to Priscilla Wakefield House (the Home) for 61 nursing beds from 1st November 2019 to 30th October 2022, with the option to extend for a further 2 years in 12-month intervals at the rate of £950 per week.

The Cabinet Member noted this report sought to secure nursing home provision for local resident’s in-borough for the next three years at a sustainable rate. This block contract would ensure the Council had high quality local provision, offering local employment and opportunities for career progression ensuring older people can remain in their local communities as far as is possible and if they need residential care.

In response to questions from Cllr Connor, on the use of Block contracts to provide care, it was noted that there were incentives in place to providers to provide good care as these arrangements gave them a guaranteed income. Certainty in the market was important and providers knowing they have an arrangement to fund the periods where there is lower demand. Therefore, this was an important mechanism for providers. This was also a negotiated position and arrived at from considering the fair cost of care. The Council were working with colleagues across the NCL boroughs to ensure each were paying reasonable rates with a focus on quality and outcomes achieved. This was also a teaching care home, which was positive for Haringey.

Following consideration of exempt information,

RESOLVED

To approve, pursuant to Contract Standing Order 10.02.1b, the award of contract to Magicare Limited for 61 nursing beds from 1^st November 2019 to 30^th October 2022, with the option to extend for a further 2 years in 12-month intervals, at the rate of £950 per week. The total cost of the contract over 5 years would be £15,412,751.

Reasons for decision

The market for residential and nursing care is very tight at the moment and demand in the sub-region (Barnet, Camden, Enfield, Haringey and Islington) outstrips the supply of nursing beds. Priscilla Wakefield House is one of only two nursing homes in Haringey and the only one, which is currently rated at Good or above. The home is rated ‘Good’ by the Care Quality Commission (CQC), and was recently named as one of the prestigious and innovative new cohort of ‘teaching care homes’ by the Foundation of Nursing Studies: https://www.fons.org/resources/documents/Teaching-Care-Homes/TCH-Yr-3-Teams-Announced.pdf The selection of Priscilla Wakefield House as a teaching care home, is a mark of the confidence placed by the Foundation of Nursing Studies in the quality of leadership and management at the Home.

Councils have a duty to shape their local marketplace and offer choice to local residents. Establishing a block contract with Magicare Limited is an important means of securing local beds for Haringey residents. The only other nursing home in Haringey is currently under a temporary embargo because of concerns notified by the CQC. There is no other home in the sub-region able to provide this number of beds to Haringey Council.

In order to ensure both capacity and flexibility, the Council is keen to have a mixed economy of spot and block purchase arrangements in place. Many placements are commissioned on a spot purchase basis, but the proposal set out here – to continue and expand a block contract – reflects the desire to maintain capacity in Haringey and to ensure best value in commissioning this provision. The Council has been working closely with the provider over a period to sustain improvements in the quality of care provided and will continue to monitor the contract closely to ensure high quality standards and the achievement of outcomes for residents.

As well as securing nursing care in Haringey provision for the future, the arrangement also ensures that commissioning rates for existing and future residents can continue to deliver best value and be maintained at an affordable rate.

The Home is a significant local employer and has participated fully in the development of the North Central London Proud to Care Portal which seeks to attract a more diverse range of people, including young people, to join the care sector and to ensure a stronger focus on skills development and career progression. This has involved working closely with the local further education sector to grow skills and knowledge and to present the care sector as an attractive career routs. As a teaching care home, the only one in London, the potential for the Home to develop the skills of local residents as valued employees in the care sector and to offer a strong social value package is being included in the contract arrangements. In line with the Council’s approach to Community Wealth Building, the Home offers a range of benefits to local residents keen to join the care sector as well as to potential residents and their carers and contributes to the local Haringey economy.

There are 77 Haringey residents currently living at Priscilla Wakefield House, delivered by Magicare Limited. They are all extremely vulnerable and frail and many are very elderly. It would not be possible to find alternative nursing care accommodation in the borough for these residents or in boroughs adjacent to Haringey, where existing residents would be able to live together and to receive the same quality of care.

Alternative options considered

One alternative option is for the Council to ‘do nothing’ which will see the continued reliance on spot purchases and the risk of a significant increase in expenditure over the proposed period of this contract. This would result in the Council having to pay either an increased spot rate to the provider or find alternative accommodation for the residents, which would currently be outside of Haringey, at rates which are not known, but are likely to be significantly increased and in provision which has not yet been identified.

A second option would be to tender for an equivalent scale block contract for the provision of a local nursing home. There is no other nursing home in the sub-region, however, which can put forward a tender proposal at the scale required or close enough to the Haringey borders to be considered local. In addition, there are insufficient grounds for the Council to seek to move any resident from the provision delivered by Contractor A given their level of vulnerability and frailty.