Adult Social Care Supplier Engagement

Welcome & Introductions Helen Coombes – Interim Director Adult Wellbeing Wayne Welsby – Head of Commercial Services Amy Pitt – Adult Social Care Commissioning – Copies of the slides will be available on the Business Opportunities page of the Council’s website – Exit in case of emergency

Transforming Adult Social Care in Herefordshire Supplier Engagement

Supplier Engagement Events? Short, medium and longer term commissioning activity Changes to our arrangements with Wye Valley NHS Trust Better VFM Accelerate Personalisation Market Development New Care and Support Bill

Where are we today? The majority of adult social care provision is provided externally through managed budgets, block contracts, Direct Payments etc The council currently commissions Wye Valley NHS Trust and 2gether Foundation Trust to manage and provide a range of adult social care services on its behalf These services include our social work assessment and care management function as well areas of direct service provision such as day opportunities, community equipment and sheltered accommodation Adult social care budgets remain at just over 1/3rd of total council budgets (34%), rising demand and reducing budgets make a very challenged financial environment.

Why is it changing? The current arrangements with Wye Valley NHS Trust are about to come to an end on 13th September 2013 so we need to find alternatives ways of delivering services The Adult Social Care budget has overspent for many years and we need to ensure we can deliver services within a budget we can afford We want to encourage and support people to live independently and stay healthy for as long as possible We want to enable more people to take control of choosing and purchasing their own services under the national personalisation agenda as service users are the best people to decide what they need

What and when is it changing? Assessment and Social Work functions ( currently in Wye Valley) will return to the council from September 2013 and we have a new operational structure aligned to community health services All “direct service” provision will be commissioned rather than directly provided by the council in the future (by March 2014) The services are: – Integrated Community Equipment Store (ICES) – Adult Placement Scheme – Norfolk House sheltered accommodation – Reablement Services – Day Opportunities – Sensory Impairment

What will this mean to service users and carers? Where services change, we will work with existing and new providers to make sure transition plans are in place The council will make sure that those who are assessed as vulnerable* (i.e. people with substantial and critical needs) will be regularly reassessed to make sure their needs continue to be met appropriately Service users and their carers will get an improved and more responsive service Working with the market we hope to deliver more flexible direct care and in some cases increase capacity

What will this mean to those who wish to provide services? These changes create opportunities for all of us to think differently We are interested to hear from a range of providers, communities, voluntary groups and staff (who may wish to become sole traders or set up small businesses) who want to offer some of the activities people might be interested in purchasing “Personalisation” is about choice, but to create choice, we need to work with providers to ensure a range of services are available Complete the process by the end of March 2014

Other Commissioning Tasks Home and Community Support Information, Advice, Advocacy and Brokerage Telecare Rapid Response

Commissioning Principles Broadly looking at framework approaches User and Carer experience and involvement Proportionate tendering exercises and qualification criteria dependent on complexity Safeguarding and Quality Outcome based with a strong focus on enablement Supplier Diversity and Support Local Economy where we can Promote Choice and Control – range of access for Personal Budgets Encourage partnerships and joint ventures to maximise benefits of volume linked price reductions and capability of market Flexible contracting

2013 Plan Specific Procurement Activity Completed Market Position Statement and Intentions 2-3 year Procurement Plan shared to enable market planning Including e- market place, pre paid cards, ISF’s, retail model’s Integrated Pathways commissioned with the NHS

What is a Direct Payment? The Direct Payments scheme is a key part of the UK Government’s national personalisation agenda to give service users greater choice and control over their care and support. This approach gives service users money directly to pay for their own care, rather than the traditional route of a Council providing care for them (typically at set times for set tasks). Direct Payments promotes user choice, independence and flexibility which in turn supports greater well-being and quality of life.

THE SERVICES

The Services Looking for a rich mix of services provided by Personal Assistants, care agencies, private sector and voluntary sector. May include help with practical daily living tasks, such as: – washing and dressing – shopping and cleaning – getting up and going to bed – cooking and eating meals Also may include: – at college or classes – Leisure – Specific events (H. Art events), Museum visits, talks on topics of interest.

Examples Example 1: Jim is a 30-year-old with learning disabilities and autism who for the past four years has used direct payments to fund fair trading (selling fair trade goods at events to local customers) and to organise charity music gigs that raise money for education projects in South Africa. He also employs two personal assistants who have a specific interest in fair trade and the music he likes. Example 2: Josephine had to cut short her career as a graphic designer due to the severity of rheumatoid arthritis. Her individual budget gave her £324 per week of care. This is partly spent on massage, acupuncture and pedicures which help relieve some of the symptoms of the condition. Of most significance though is the employment of three personal assistants 30 hours a week to provide care and take her out on shopping trips. Finding PAs that could drive was hugely important giving Josephine regular contact with the outside world, whereas previously she'd been unable to get out much.

Examples Example 3: Mrs N, a 69-year-old music teacher from West Sussex, has a number of health difficulties including spondylitis, arthritis and glaucoma. She was allocated £203 per week to meet her needs through an individual budget and decided she wanted to be the one in charge of how this would be spent. She changed the care agency providing domiciliary care to a local one, saving her money that was then spent on funding a car cleaner, gardener and chiropodist. She also employed her grandson, who was a student, as a personal assistant to take her on weekly shopping trips. Example 4: Fatima is a 33 year old mother of three affected by Post traumatic stress disorder and temporary intermittent physical paralysis. Fatima receives a Direct Payment and uses that to employ an assistant for 14 hours a week. In addition to helping her with household chores, her Assistant looks after her children so that she can attend a local out-patients clinic. At the clinic Fatima is able to get the support that she needs from others who are in a similar situation to herself. Fatima is able to live an independent life and look after her children. She has employed a Somali language speaker and this helps to ensure that her children develop their own cultural identity

Examples Example 5: Maria has a learning disability. She has 24-hour package of care using a team of four personal assistants. She has a trusted circle of support to help her decide and get what she wants. Her package of support is funded through Direct Payments and the Independent Living (1993) Fund. An independent living trust was set up to look after and manage her money on her behalf. Example 6: Jill is a two year old with Glycogen Storage Disease type 1A. Jill is attached to a feeding pump, which has to be monitored every 2 hours, day and night. Jill's mum provides 24-hour care 7 days a week. She is a lone parent with two other young children. Her only source of support was Jill's grandfather, who would spend time in the home every evening. When the grandfather fell ill, Jill's mum found herself in the position of having to send the other two children to bed when Jill went to bed, or to leave them downstairs alone while she sat with Jill. Direct Payments were arranged for 14 hours a week. This enabled Jill's mum to spend some time with her other two children whilst a personal assistant sat with Jill until she went to sleep.

Examples Example 7: John is a middle aged man who is living with HIV. He is unable to work and spends most of his time at home. He gets very tired and so finds it very difficult to go on outings. He barely manages to get to the local shops to buy food. John applied for a DP and now he has a Personal Assistant who comes to his house twice a week. It has made his shopping trips much easier and he now enjoys social outings. Example 8: Judy and Mick are a young couple with 4 children under the age of 6. Mick has a physical impairment and Judy has to take the kids to school every day. She doesn't drive so this entails a lengthy journey across town with 2 toddlers 'in tow' as Mick cannot cope with kids in his wife's absence. They own a car but Judy doesn't have a license. They're not receiving services within the home because neither of them want what they feel would be an intrusion into their home. Judy is trying to meet all of Mick's personal care needs. A carers' Direct Payment funded the cost of driving lessons. Judy passed her test and is now able to use the family car, which tremendously eases some of the burdens of caring for both Mick and her four children.

Examples Example 9: Bill is deaf and blind and lives alone. His father previously assisted him with many tasks; dealing with correspondence, communication, and acting as a communicator guide when accessing community services, socialising and shopping. His dad found this extremely difficult and Bill was assessed as needing a communicator guide for essential access needs. Due to the limited number of professionally trained communicator/ guides in the community, Direct Payments where set up to enable Bill to purchase such a service from an organisation that the local Social Services would not normally contract with. This also allowed more flexibility for Bill as the days and times for requiring this support would vary from week to week.

Sensory Impairment After assessment completed, training/equipment/support/advice is given to the service user to maximise their independence and safety. Enables people to remain in their own home for as long as possible and prevents them needing more costly long term social care in the future. Reduces social care formal provision by supporting the preventative agenda by assessing and providing specialist enablement equipment for people at home. Needs to provide a cost effective service and offer special advice and information for those affected by sensory impairment Supports drop-in clinics in the Market towns.

Day Opportunities Aim: Increase the range of services vulnerable adults can access via personal budgets cf. traditional day centres. Eligibility: Critical and substantial needs assessment (FACS) offered a personal budget accessed through range of mechanisms. Outcomes: 1.Choice of quality support services which meet an individual’s needs and wants 2.Ensure everyone is protected from risk and harm and able to live a full, independent life.

Reablement Short term, home based intensive support  6 weeks Gives individuals the skills and confidence to live independently at home. Assists hospital discharge. Outcomes: 1.Promote independence 2.Prevent deterioration of well-being due to ageing, illness and disability 3.Delay need for more costly and intensive services.

Adult Placement Scheme Supports carers who can provide accommodation and support in their own homes for adults with disabilities, learning disabilities, health problems, mental health issues and older people. Sources additional carers Individuals encouraged to live as independently as possible and undertake everyday living tasks. Opportunity to share in family and community life. Short term and long term care. Outcomes: 1.Promote independence and choice 2.Person centric 3.Opportunity to live an ordinary life.

ICES Provides equipment to enable people to stay at home and maintain their independence. Provides advice to carers to enable them to continue domiciliary care. Short term or long term loan of items from special mattresses to walking frames. Outcomes: 1.Gives individuals increased independence, choice and control and supports safety. 2.Helps carers reduce the amount of support, reduces the risk of injury and ill health.

Norfolk House 30 unit sheltered housing scheme for over 60’s with 24 hr. care. The scheme provides: Self-contained, easy to manage, non-institutional accommodation A supportive community with support staff and other residents Peace of mind and help in an emergency Promotion of social inclusion, involvement, participation and active citizenship An alternative to residential care Prevents hospital admission, depression, loneliness and anxiety.

Home Care Supports people with daily tasks on a long term basis in their homes after a decline in health / illness/ or following an accident. Available to all client groups and provides respite for carers. Following a needs and eligibility assessment, a personal budget is created and individuals choose how they spend this through a range of mechanisms. Can include: personal care, preparation of meals and drinks, cleaning and house care and general household management. – Outcomes: - To maintain independence, health and wellbeing, to receive personalised care, and ensure a safe service which treats people with dignity and respect. – To enable people to remain in their own homes for as long as they wish and be a part of their local community, and support carers in their role.

Proposed Commissioning Approach Services to be commissioned via 5 – 6 procurement processes will be conducted concurrently during September 2013 – January Service delivery is planned to commence 1 st April The aim is to conclude all processes by 1 st February 2014 to allow for a minimum of 8 weeks mobilisation of each Service. Consultation with potential service providers to be carried out during August 2013 to gather comments on the proposed commissioning approach. This will include an opportunity to complete a questionnaire, as well as feedback provided at these events.

Proposed Commissioning Approach The procurement processes to be used will be shaped and informed by the feedback gained from consultation. Feedback on the results of the consultation will be published on the council’s website. Feedback will be presented, the tender processes to be used and the commissioning approach to be confirmed at supplier events scheduled for 28 th August th September 2013.

Proposed Commissioning Approach In particular, the council is interested in exploring a commissioning approach which seeks to capture and concentrate the expertise of specialist service providers across the range of Home and Community Support services via one procurement process. This procurement for ‘Home and Community Support’ would be seen as encompassing such services such as: Day Opportunities Home Care Norfolk House Sensory Impairment These could be on a framework agreement with a range of suppliers such as domiciliary care agencies, leisure activities, social activities, clubs and even holiday provisions.

Proposed Commissioning Approach These package of specialist services would be tendered for alongside more traditional approaches to the provision of care for example Integrated Equipment Adult Placement Scheme Reablement which would be commissioned via a block contract.

Proposed Commissioning Approach It is planned that this will enable the commissioning of more innovative services, which will better meet the needs of service users and offer increased choice. In addition to commissioning by the council, the plan is for these services to be able to be commissioned directly by service users as part of their personalised budget. However, to enable this it is likely that the contractual framework for the provision of these services will be structured differently to that for the more traditional services.

Proposed Commissioning Approach These ‘Home and Community Support Services’ would be packaged into smaller lots, making accessible to a wider range of potential providers. The specification for these services would also be less prescriptive, focusing on satisfying overall commissioning objectives, in other words more ‘outcome’ focused’. To this end, the council is particularly interested in understanding the range of services which are available in the marketplace, to make sure that the scope of the procurement is broad enough to encompass these.

Wayne Welsby Head of Commercial Services

Where can I find Tender Opportunities? Register on Proactis, our e-Tendering Portal:- Its free to register Easy to search for Opportunities Technical Support is available The core communication channel for procurement

Proposed Procurement Processes Two Procurement process options: Restricted (two stage) process involves the completion of a Pre-Qualification Questionnaire (PQQ) which will be scored. Only the highest scoring shortlisted providers are invited to tender for the services (likely shortlist providers of 5 – 8). Open (single stage) Process involves submission of a selection questionnaire at the same time as a tender for the services. Process used will be influenced by number of factors including, potential tenderers and number of suppliers required.

PRACTICAL TIPS WHEN TENDERING FOR PUBLIC SECTOR CONTRACTS

What is a Invitation to Tender (ITT)? An ITT is a formal document issued by the Council which sets out the detailed requirements of work to be done. Complies with the EU Treaty principles of.. transparency, proportionality, equal treatment and non-discrimination. Questions asked within the ITT gives the Council confidence that organisations are suitably qualified for the opportunity and asks questions around how the requirements will be fulfilled. The objective is to identify a bidder with whom to contract.

Don’t be put off – if in doubt ask! (via Proactis) Read the documentation thoroughly and understand what is required. Understand the Council; aims, priorities, commissioning principles. Do answer in full, do not assume anything is obvious or “goes without saying”, particularly if you are a current supplier as we can only evaluate what’s in the Tender. Make it clear which question your answer refers to – clearly number and cross reference. Help the evaluation team to make the right decisions. Note the evaluation criteria and weightings and ensure extra care given to key questions. Be clear on your pricing model - state any assumptions you made when pricing (e.g. availability of resources, timing etc) Complete and return the documents by the date and time given. Check that you have signed everything you should have. Don't include publicity or promotional material in your submission unless you are asked to do so. Do ask for feedback if you are unsuccessful, it will help you with the next tender. Ten Top Tips on How to Tender

What is asked in a Tender (1)? “BASIC DETAILS OF YOUR COMPANY” – We want to know who we are dealing with e.g. company name, parent company details, VAT registration. “REFERENCES” – Purchasers need to validate claims. References are a test of capability and capacity. – Proof often sought from more than one client. “INSURANCE” – We seek (proportional) insurances for our protection should something go wrong. “FINANCIAL INFORMATION” – We need evidence of solvency and to evaluate financial risk including over reliance.

What is asked in a Tender (2)? “EQUAL OPPORTUNITIES”, “ENVIRONMENTAL MANAGEMENT” AND “QUALITY ASSURANCE” The Council operates these policies and it seeks to work with organisations sharing same values and controls. “HEALTH & SAFETY”, “EQUALITY & DIVERSITY” The Council complies with H&S and E&D legislation. Through its policies and procedures, it seeks to contract with organisations matching its aspirations. “BUSINESS AND COMPANY STANDING” These are statutory questions which all public bodies must ask. Public Services Contracts Regulations 1993 (

Responding to Tenders PLAN YOUR RESPONSE Early on thoroughly read tender documents (including T&C’s). If the tender is unclear, seek clarification. Know the tender timetable and deadlines. Plan for sub-contractor input to your tender response. Determine the evaluation methodology as early as possible. Know how to respond (labelling, formats, attachments and templates).

Responding to Tenders PREPARE AND SUBMIT YOUR RESPONSE Tenders are evaluated based on content not ‘gloss’. Keep responses concise and to word limits where specified. Use affirmative language not conditional phrases (“subject to”, “however”, “might” etc.). If you guaranteeing an aspect of delivery – clearly say so. Prepare your own checklist and tick-off what you have completed. Keep up-to-speed with buyer’s messages (e.g. tender amendments).

How Buyers Will Evaluate Bids Whilst a standard approach is followed to evaluate tenders, this will be adapted to meet the needs of each procurement process. For this set of tenders: Tenders will be first checked to make sure that they are compliant. Compliant tenders will then be evaluated individually by specialists who will then meet to agree a consensus score. There will be a scoring regime against which evaluators will mark tenders - this will be shared with bidders. Tenders will be evaluated on a MEAT (Most Economically Advantageous Tender) basis combining quality and price. Evaluator comments are captured throughout the process and bidders will be fully debriefed on the reasons for the scores.

NEXT STEPS

Supplier Events – 29 th July at the Kindle Centre – 2 nd August at the Kindle Centre Consultation Questionnaire How to Tender Workshops – 28 th August at the Kindle Centre – 12 th September at the Kindle Centre

QUESTION AND ANSWER SESSION

Thank you for coming