Agenda item

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

This report details the outcome of a mini-competition process conducted via the Council’s Dynamic Purchasing System (DPS) Supplier Agreement for Home Support and Reablement Services and seeks approval to award a ‘Call-Off contract to the successful tenderers.

 The Cabinet Member for Adults and Health introduced this item which detailed the outcome of a mini-competition process conducted via the Council’s Dynamic Purchasing System (DPS) Supplier Agreement for Home Support and Reablement Services and seeks approval to award a Call-Off contract to the successful tenderers.

The Cabinet Member was delighted to present this report, which was an important step in a process to transform home support in Haringey, recognising the critical role it plays in enabling people to live in their homes for as long as possible.

The Cabinet Member highlighted that by offering London Living Wage to all front-line care workers, the Council was honouring its commitment to the Ethical Care Charter and recognising the importance of care workers – their status and their value – in the delivery of home support. Likewise, the Council were recognising that for the majority of people the experience of home support was their experience of social care – representing a real opportunity to make the necessary changes when people were at their most frail and vulnerable.

The Cabinet Member closed by thanking Unison and Officers for all of their hard work in achieving LLW for care workers in the borough.

In response to questions from Councillors Ogiehor, the following information was provided:

• There would be no reduction in the time spent caring for people as a result of this contract.
• The rates paid for direct payments would be paid to reflect LLW, which would be monitored. The expectation was that all care workers would be paid at least the LLW.
• Officers noted that the Council would be monitoring the contract closely to ensure that care quality was maintained. If there were concerns with the performance of the contract, the Council would work closely with the contractor to make the required care quality improvements.

Officers would confirm in writing the timescale and procedure for a breach of contract.

Further to considering exempt information at item 38,

RESOLVED

1.  To approve the award of ‘Call-Off’ contracts for bundled hours of Home Support and Regalement services to the successful tenderers (identified in          the exempt appendix of this report) for a period of (3) three years with an          option to extend for further period of up to 2 years, commencing from 1^st         April 2020 to 31 March 2025 (if extended) at the maximum cost of      £12,449,500 inclusive of LLW for financial 20/21 but exclusive of annual      inflationary increase for subsequent years.

2.  To vary the contract price annually in line with London Living Wage (as published by the Living Wage Foundation periodically) inflationary increase     from 1^st April for each and every subsequent year for the term of Service Agreements; and

3.  To note that not all bids received were fully compliant in order to award the       full capacity for each of the localities and that home support therefore will             continue to be covered directly from the DPS

4.  To note where insufficient suppliers are not deemed to be compliant the            Council will go out to tender again

5.  To note that a new tender process will be undertaken as a matter of priority      to ensure the new service model is fully in place

Reasons for decision

All home support & regalement Service Providers currently enrolled on the Dynamic Purchasing System (DPS) were invited to re-enrol for the bundled hours home support and reablement tender (more particularly described at 6.11 below). The tenderers’ proposals were evaluated using a 40% quality and 60% price weighting, on this basis, the recommended Service Providers’ bids were deemed to be the most economically advantageous, representing the best value option to deliver the required service.

Commissioning a locality-based home support and reablement service will bring several benefits as service providers will be able to develop a good knowledge of the area they work in and the community resources available for service users to access. There will be dedicated service providers for each locality, removing the current hard- to- reach area problem. Service providers will be based closer to the people they are serving, reducing travel time for care workers.

By working with a smaller number of providers across three Localities, the new model will provide a unified approach between care providers, social workers, community nurses, therapists and the voluntary and community sector. This aligns to Haringey’s locality-based working with the NHS and particularly primary care.

It is anticipated that the new model will deliver improved outcomes, offer a more sustainable service and create better conditions for the workforce. Features of the new model include:

·         For each Locality, the Council will commit to commission a minimum           number of guaranteed hours from the Service Providers each year. This will     enable the Service Providers to organise and manage their resources

·         70% of home care packages will be through a bundled hours’ arrangement.

·         30% of home care packages would remain as spot purchases to ensure the          opportunity for small/micro, including not-for-profit organisations and        existing Small and Medium Sized Enterprises, to remain in or to enter the   market

·         Providers will be required to pay all care workers LLW bringing Haringey in           line with the higher rates being paid by neighbouring authorities, which are          increasingly affecting the ability of providers operating in Haringey to attract        and retain good staff, thereby impacting on the quality of care we are able       to provide. Employee wage is connected to the service providers’ capacity to recruit and retain care workers, and continued non-payment of London      Living Wage would impact negatively on the quality of service delivery, whilst      payment will support better quality care

·         Providers will operate across a wide range of health and care needs for both         Adult Social Care and NHS Continuing Health Care (CHC) packages.

·         All providers will be required to have an Electronic Call Monitoring system

·         The new model will see improved workforce recruitment and retention         through improved contractual arrangements

·         Career progression pathways through greater skills development, workforce          planning and linking in with NCL ‘Proud to Care’ initiative. Appropriately          skilled care workers will be an essential part of the new model of care. This      will ensure that care workers have career opportunities to develop skills that           will offer a pathway into more advanced social care or health care provision.

Alternative options considered

An option to proceed with an in-house home support service was considered but rejected based on the assessed financial impact, as well as, the scale of the infrastructure required to implement an in-house model.

Implementing an in-house home support service at an additional cost of £3.5m per annum would be challenging, particularly in the context of the significant level of savings already being implemented for the financial years 2019 – 2021 for Adult Social Care, totalling approximately £16m.

In-house services can give greater control over the care that is provided, delivering improvements and minimising risks by ensuring supply and balancing cost and quality requirements against the available budget although quality is not guaranteed through an in-house delivery model. Previously in-house services have, however, been shown to be significantly more costly than external provision, due either to lack of efficiency and/or to better staff terms and conditions. No London borough currently has an in-house model for home support.

An option to continue with the current model of home support was considered but rejected on the grounds that it does not meet the Council’s commitment to delivering London Living Wage, nor does it transform the service to deliver in an integrated way to meet user needs.

An option to deliver the existing model but at London Living Wage rates was considered but rejected on the grounds that this would not deliver the improved outcomes for service users that a high quality, integrative model would achieve.