Supported Living – Market Engagement

Aims of Engagement To give the market sight of ECC’s plans within the Supported Living market To outline the proposed procurement activities To get input on key issues still to be resolved For further information on the Commissioning Intentions of ECC, please follow the below link: https://www.livingwellessex.org/working-with-us/supported-living-and-older-people-independent-living/

Supported Living and ECC ECC is committed to carrying out our responsibilities under the Care Act 2014, which requires us to: Ensure accessible information is provided so that Adults (or their deputies if they lack Mental Capacity) can make informed decisions Ensure personalisation, independence, choice and control for vulnerable Adults Develop the market to ensure a range of high quality options are available ECC also takes into account “Valuing People 2001”, and good practise guidance such as TLAP’s “Making it Real: Marking progress towards personalised, community based support”, NdTI’s “Supported Living;Making the Move”, all of which stress the importance of rights, inclusion, choice and independence for Adults with Disability. Essex has a duty to ensure that public funds are used efficiently to achieve best value. ECC’s Vision is to deliver against these three drivers by re-procuring Supported Living in 2018.

Supported Living The aim of Supported Living is to support individuals living in the scheme to function with as much independence as possible to meet their needs and achieve their personal goals and aspirations Support will be provided  where necessary to enable tenants to manage activities of daily living, manage their tenancy responsibilities, to make and sustain relationships, access and participate in their local community  and community events, access training, work and education opportunities and to live a full life. There should be a progression model, enabling Adults with disability to increase their independence and reduce their dependence on social support

Summary of main advantages for supported living over residential (Supported Living – Making the Move, NDTi 2010 10 2) Supported Living Residential support Own home or tenancy, specified security of tenure Licence agreement with no security of tenure. As a tenant or homeowner the person has a right to choose who provides their support and can change support arrangements without moving home or move home without changing support arrangements Support is provided as part of a package with housing and either element cannot be changed without impacting on the other. ... As a tenant or homeowner the person has a right to choose who they live with. Support good practice in residential support dictates that housemates should be well matched as much as possible but in practice many people live with people they do not choose to live with. Tenants and homeowners have rights to full welfare benefits including housing benefit. People in residential support have rights to limited amounts of welfare benefits and most people access a residential support allowance of approximately £20 per week to purchase personal belongings, clothes and holidays Can access Direct Payments, Personal Budget Cannot access most additional funding for support.

Supported Living in Essex Essex County Council currently spends over £50m per annum from within the wider domiciliary support budgets to fund around 900 Adults with Disabilities in Supported Living. The majority have Learning Disability. Adults in Supported Living reported (Feb 2016) that they value: compatibility, integrated planning, location and transport links, visiting and understanding choice of accommodation and support providers, respect, knowing how to access help and advice when needed (esp bills). There are over 450 supported living schemes within Essex and the number is growing as ECC continues to develop knowledge of the market

Types of Supported Living in Essex Type 1 – Self-contained Occupants have their own flat within a block or cluster of the same type of provision Support provided by staff on site, or based nearby Communal areas may be available to be shared by residents Type 2 – Shared property Occupants have their own room, usually with en-suite and kitchen facilities Kitchen, dining, living, and ancillary areas are shared with other residents Support delivered by staff who have a sleep in space within the property

Commercial Challenges All Supported Living placements in Essex are purchased on a spot basis, leading to a broad range of rates for services There are no standardised contractual agreements with providers in the market There is no co-ordinated oversight of the market, and where voids exist There is no formalised process for placing Adults in Supported Living or selecting where they should be placed ECC is seeking to address these immediate challenges through a procurement process designed to give greater oversight of the market and put in place robust procedures for the placing of Adults into Supported Living.

ECC Commercial Aims To promote the supported living model including ‘Increasing Independence’ and ‘Good Lives’ philosophies; ensuring compliance with the provisions of the Care Act To regulate placement costs and reduce variations in prices across the supply chain To ensure compliant and effective contractual arrangements and embed a consistent process for placement of Adults To promote Adult choice when placements are being made To drive and standardise quality provision in the market place To have greater oversight of the market and the challenges for future provision To encourage the development of new capacity in the Supported Living market in Essex

What you told us Feedback ECC Proposal Training and recruitment is costly and there is high turn over of staff A sustainable framework will be put in place to standardise cost and service levels which should help with staff retention It is difficult to get payments from ECC We propose to pay for core support services on a separate invoice to simplify payment and give assurances of regular payment Vacancies are difficult to fill A process for monitoring vacancies within schemes and finding suitable supported living for Adults quicker There is no clear description of quality in the specification A clear shared understanding of what Supported Living should look like and how it is delivered and costed.

Core Core is defined as shared hours between 2 or more Adults within a supported living scheme, designed to meet the assessed needs of all Adults utilising it ECC want to encourage and increase the use of core within supported living schemes The majority of schemes within Essex already have a core provision within them, however ECC have not reviewed all of these schemes to check the suitability and efficiency of the core being delivered Presently core is divided equally between service users within schemes irrespective of voids, but that is not compliant with the Care Act – ECC would like to transition to core being divided equally between all units within a scheme ECC propose to pay for the entirety of the core service on a separate invoice as opposed to the current approach whereby it is charged against each Adult

Neighbouring Authorities Kent County Council Operate a ranked list for the Supported Living services, predicated purely on cost £14.38 paid as standard rates for personal care, with £16.54 paid for enhanced rates Night awake and night sleep paid up to maximum sums per shift Suffolk County Council Framework in place £13.98 is the minimum rate paid, £14.83 is the maximum Norfolk County Council Providers accredited before placements made £12.50 lowest rate payable, up to £15.50 for new packages

Procurement Plans ECC proposes to introduce a framework into the Supported Living market to operate for a period of 4 years and allowing new entrants at regular intervals The framework will operate on ranked list basis, ranking all providers on the framework in order based on quality and cost criteria. This framework will be split into districts with different rates able to be charged in different districts Providers will be required to bring forward schemes to which they have access and at which ECC can place Adults; these schemes must be detailed to ECC and approved prior to placement being permitted and voids being tracked It is proposed that core support hours will be paid on a separate, consolidated invoice to ensure continuity of payment and ease of payment process to the provider Rates submitted by providers to the framework will be between a minimum and maximum, defined in collaboration with the market and different in each district of Essex

Ranked List Operation The ranked list will rank providers in each district on quality and cost criteria It is proposed that social workers would remove schemes that are unsuitable for the Adult based on key criteria Of the schemes that have been identified as suitable for the Adult, the Adult will be first offered the choice of suitable schemes available in their preferred district with the highest ranked provider If the Adult makes a selection from these schemes they will be placed at that scheme, agreeing a tenancy agreement directly with the landlord, and their care package will be placed with the provider at the agreed rates If the Adult does not select any of the schemes offered they will be offered suitable schemes from the next highest ranked provider in that district; this process will continue until the Adult makes a selection or the list is exhausted

Key Questions for Engagement ECC has a number of outstanding issues, and we would like to engage with the market to resolve these questions and issues. These questions and issues are outlined on the next slides. This session will then break out into groups and the issues will be discussed with ECC officers. Further information around each of the questions will be provided by ECC officers during these conversations.

Costs Do you consider the current rates paid by Essex to be reasonable, and if not, why not? Do you think that rates paid for support to Adults with complex needs should be higher than the standard rates payable by ECC? What increase do you think would be reasonable? Aside from complex needs, all other services are proposed to be paid at the same rate irrespective of need – does this pose any problems? What cost pressures are there in different districts of Essex and how should this be reflected in the rates payable? What difference do you think there should be? ECC are looking at how core services are paid and are considering a fixed rate for core services for all providers; what do you think of these proposals? Would there be significant opposition to a rate across Essex for provision of Supported Living services being fixed and applied to all providers?

Quality What do you think of the minimum quality standards outlined? Is there anything you consider to be missing or that should not be included? What key quality criteria do you think could be used at tender stage to identify the highest quality providers? What areas should technical questions be built around to make the most effective ranking of providers? What scope for quality improvement do you see through the framework? What key quality criteria should be measured by ECC to best represent the quality of the service being delivered? What key criteria do you take into account when deciding whether to accept the placement of an Adult? What compatibility criteria is used to inform the decision taken?

Specification / Contract What key elements do you think should be included in a specification? What key criteria do you think should define ‘complex’ needs? Can all homes house those with complex needs or would you prefer to have a separate ranked list for those that come forward with what ECC deems as complex needs? ECC propose that existing packages would move on to the terms of the new framework and the framework rates upon a change to the package. Is there any objection to this? A process needs to be agreed with the market to manage voids and ensure information on the framework is up-to-date. Do you have any thoughts on how this might best be achieved? ECC want to ensure Adults receiving direct payments do not pay more than ECC pay for managed services. Do you foresee any issues in the implementation of this? ECC propose to remove schemes that are unsuitable for Adults at placement stage and offer only schemes that meet their needs. What criteria do you think should be used when making the decision as to suitability of individual schemes to Adults?

Registering for opportunities Essex County Council is adopting a new widely used e-sourcing platform, BiP Delta, to conduct future procurement activities. The new platform is designed to improve accessibility to the authority’s procurement opportunities and enhance the experience of participating in procurement opportunities. This portal will enable providers to: Register for a free account Locate the Council’s current tender opportunities Express interest in relevant procurements Administer clarifications and submit tender responses electronically If your organisation is not currently registered with BiP Delta, it would be advisable to register for an account via the following link in order to gain access to potential business opportunities as they arise and engage in forthcoming procurements: https://www.delta-esourcing.com/ BiP Registration Guidance is available containing screenshots to support your registration. Please email amy.wilson2@essex.gov.uk for a copy

Linked Contracts at ECC / Other Opportunities AWD Residential Day Opportunities OP Residential