Agenda item

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

The report will seek agreement to the award of contract for a PBS provider to provide wrap around care and support to residents who will be living at 10 Linden Road and property management of the property.

The Cabinet Member for Adults and Health introduced this report which sought agreement to the award of contract for a PBS provider to provide wrap around care and support to residents who would be living at 10 Linden Road and property management of the property.

The Cabinet Member was delighted to present this report, which marked the closing phase of the project to bring Linden House back into use. This project offered four Haringey residents with very complex needs the opportunity to live as independently as possible in a building designed to meet their needs with a service which would be flexed as required.

The Cabinet Member closed by noting that, whilst building works on the premises continue apace, there had been a focus on working with the four identified residents and their families to support them to make a successful transition to their new homes. The award of contract to the successful bidder would make this transition a reality over the coming weeks.   

In response to a question from the Leader, the Cabinet Member confirmed that, where other individuals in long term care sought to live more independently, this contract would significantly assist in providing them with that transformative opportunity

Further to considering exempt information at item 20,

RESOLVED

1. To approve the award of a ‘Call-Off’ contract to deliver PBS Service to successful tenderer (identified in the exempt report) for a period of (4) four years with an option to extend for further period/periods of up to 12 months years, commencing from 1st April 2020 to at the maximum cost of £7,000,000 (inclusive of LLW).
2. To approve variation of hourly rate increase for PBS Keyworker to bring in line with LLW inclusive rates. The current and new proposed hourly rates are set out in Appendix 2 - Part B (exempt information) of this report.

Reasons for decision

All five framework participants were invited to tender. The tenderers’ proposals were evaluated using a 50% quality and 50% price weighting and, on this basis, the recommended Provider is deemed to be the most economically advantageous tender representing the best value option to deliver the required service.

Alternative options considered

An option not to proceed was considered but rejected on the grounds that there is a pressing need for local provision for this cohort of vulnerable people.

The needs of the people who will live at Linden Road are highly complex and they will each have spent considerable periods of time in long stay Assessment and Treatment Units in hospitals. In light of this, the future care and support offer must be able to meet their individual needs and to respond to their highly challenging and individualised behaviours. Positive Behaviour Support (PBS) is a person-centred approach to supporting people who display or are at risk of displaying behaviours which challenge. It involves understanding the reasons for the behaviour and considering the person as a whole - including their life history, physical health and emotional needs – to implement ways of supporting them. It focuses on creating physical and social environments that are supportive and capable of meeting people's needs, and teaching people new skills to replace the behaviours which challenge. The PBS approach will support service users who present ‘challenging behaviours’ to live in a community setting. It was felt that using a PBS model would improve life outcomes for our most highly vulnerable service users with Learning Disabilities and autism, those who display behaviour that challenges and those with mental health condition

It was considered that there are two options for delivering this specialist provision: a PBS provider from the Council’s existing framework or an in-house service, also delivering to a PBS model.

An options appraisal was completed to consider how best the service should be provided. It was recognised that in-house services can give the Council greater control over the care that is provided, delivering improvements, minimising risks and balancing cost and quality requirements against the available budget (although quality is not necessarily guaranteed through an in-house model). However, the Council has no recent track record in delivering this type of service successfully and it was also recognised that transitioning this cohort of service users to Linden House will be challenging especially for those who have been inpatients in an acute setting for a long period of time.

Seeking the delivery through the Positive Behaviour Support Framework from an external provider was selected as the optimal way to meet the needs of this cohort both at the outset and over time as it allows for a high level of care (with high staff numbers) when service users first move into Linden Road and start to deal with the new and different environment of a supported living setting.

The Positive Behaviour Support model gives the flexibility to step down service users’ package of care over time. The payment model for a PBS provider on the Framework is outcomes related; 80% of flat weekly fee will be paid monthly in arrears based on sustainment of placement and remaining 20% of flat weekly fee will be paid pro-rata, quarterly in arrears linked to delivery of basket of outcomes. When services are sourced using the PBS Framework agreement, 15% of the Care and Support costs will be paid by the Big Lottery, Commissioning Better Outcomes Fund.

The PBS model will be delivered by a highly skilled workforce and it is built in through the contract that Haringey staff will benefit from direct input to their skills development. This will include training, sharing of best practice, shadowing both management and practice and building strategies and skills to deliver this model of care and support. Such an approach is aimed at ensuring that Haringey’s directly employed staff are in a better position to carry out such specialist and highly challenging work in the future.

The opportunity to pass on and develop in-house skills is reflected in the approach undertaken here to commission this service for a fixed period, when it is planned that users will enjoy Linden Road as their home for the rest of their lives and will therefore have care and support needs too for their lifetimes. This supports the option for an in-house service to be developed.