1. CARE PROVIDER FORUM 30 th January 2015 Welcome

2. JULES GREGORY Market Manager – Bed Based Care jules.p.gregory@birmingham.gov.uk JENNET HARTRICK Market Manager – Home Support jennet.hartrick@birmingham.gov.uk

3. Agenda Quality Ratings Update KPMG Open Book 3 YA Consultation Update SProc.Net Update Birmingham Care Awards Supported Living Update ECMS Update

4. QUALITY RATINGS UPDATE MIKE EWINS Performance Management Officer mike.ewins@birmingham.gov.uk

5. Adapt BCC quality ratings to new CQC inspection framework Review ‘rating’ questions in SAQ Review quality rating bandings and public information Promote public quality ratings dashboard Make better use of feedback from citizens, family/friends & members of the public What do we want to do?

6. Replaces Essential Standards compliance with a Quality Rating Five new categories: Safe, Effective, Caring, Responsive & Well-Led Four possible outcomes: Outstanding, Good, Requires Improvement, Inadequate Ratings for the five categories combined to produce an overall rating using the same four outcomes New CQC Inspection Framework

7. CQC non-compliance deductions currently used: - 3 points for minor concerns - 8 points for moderate concerns - 20 points for major concerns For new CQC inspections we will apply the following deductions for each of the five categories: Requires improvement - 8 points Inadequate - 20 points New CQC Inspection Framework

8. We will analyse provider comments recorded in SAQ over the last 12 months We will work with providers to develop a revised set of ‘Rating’ questions and scoring system We will aim to introduce a revised SAQ and scoring system by Autumn 2015 Review of ‘Rating’ Questions

9. We will review our current public quality ratings dashboard using feedback from providers and the public We will work with providers to incorporate the new CQC quality ratings into the dashboard We will look at how we identify providers with ‘Outstanding’ or ‘Inadequate’ CQC quality ratings Review of Quality Rating Bandings

10. We will continue to promote the dashboard through the media, events, external partners etc. We will promote ‘good practice’ examples where providers have encouraged citizens & others to provide feedback into ‘Healthwatch Birmingham’ We will continue to explore ways in how we can incorporate citizen ‘review’ data and outcomes delivery into the quality ratings process Promoting Quality Ratings

11. KPMG OPEN BOOK 3 CHRIS MacADAMS Strategic Market Manager chris.macadams@birmingham.gov.uk

12. Additional analysis on Open Book 2 to identify and separate out ‘Care’ and ‘Hotel’ costs for both OA and YA bed based care Consult with YA providers to develop alternative pricing models which could include: a price banding structure linked to outcomes; and/or an enablement approach where the price reduces over time; and an assessment of whether to offer a specialist hourly rate Open Book 3 Process

13. To include YA Home Support, Supported Living and Housing with Care (“Extra Care”) Develop a methodology to take into account future changes in the main cost drivers and therefore future proof the process for establishing fees Open Book 3 Process

14. KPMG OPEN BOOK 3 CHARLES WHITWORTH Senior Management Consultant charles.whitworth@kpmg.co.uk

15. Key Principles KPMG have done this before! One of the ‘Big 4’ accountancy firms Professionalism KPMG will work at ‘arms length’ ‘Evidence based analysis’ from data gathered Independence

16. Key Principles We will discuss approach and share output We will have the evidence for every assumption and result Transparency Our tools have been refined through previous work KPMG will support and validate the data Engagement and Support

17. Creation of questionnaire and reporting tool Manage data gathering process Support providers through the process Validate provider responses Consolidation, aggregation and analysis of data Independent report of findings KPMG Role

18. Understand actual local costs of care including staff and non-staff costs Understand local and national context of these costs e.g. What are the challenges and pressures affecting costs, both now and expected in the future? Understand occupancy, capacity and future plans of the local market Objectives

19. Process Stages StageActivitiesTiming 1. Design approach and outcomes (scope) Create questionnaire, pilot with small group of providers Complete by Friday 14 th February 2. Gather DataSend out questionnaire for completion to all providers 3 weeks, complete by 7 th March 3. Perform AnalysisKPMG check data, group data, anonymise, and develop cost structures 7 th March until end of March 4. Validate with marketShare findings with providers (participation rates & ‘aggregated’ data) Early April

20. Cost data should reflect local market dynamics and structure Minimise use of industry/national averages and assumptions – local data is critical! Grouping questions will be asked and used to segment data – home size, care type etc. Maximum coverage – sent to all providers Not a lengthy process – 4 weeks response time Questionnaire Principles

21. We are seeking a small group of providers to assist with: - Tailoring a questionnaire for the local market - Ensuring it is easily understood - Ensuring the process is reasonable - Ensuring the process is relevant - Ensuring the process is comprehensive - Fine tuning to avoid confusion etc. The Pilot

22. The Data Gathering Period Engagement StepProposed Timing Questionnaire sent to bed-based care homes w/c 11 th February Ongoing support, calls, updates, FAQs and visits if required 11 th February to 8 th March Closing of response period8 th March Data analysis and clarification of any outstanding questions with homes 11 th March onwards

23. On receipt by KPMG, your questionnaire is manually validated Your questionnaire is uploaded into a database and all identifying data in the tool is removed (care home names, contact details, second part of postcodes) At the end of the data gathering process all responses (written and email) will be destroyed We will write to all providers to confirm the destruction/deletion of all data Confidentiality

25. This will be transparent – we will share summary information with you A report outlining the costs of care in Birmingham will be shared with all providers This report will clearly state the sample size, approach to data analysis (e.g. averages), any exclusions and assumptions made Sharing the Output

26. There will not be a direct link made between this report and fee levels There will be no reference to individual, identifiable homes in this report Sharing the Output

27. We will provide as much support as is required FAQ’s Calling a sample of Providers on a daily basis Visiting Providers if additional support is required Providing a help number/email for queries In Addition

28. CHRIS MacADAMS Strategic Market Manager chris.macadams@birmingham.gov.uk CHARLES WHITWORTH Senior Management Consultant charles.whitworth@kpmg.co.uk

29. YA CONSULTATION UPDATE

30. Consultation Themes 1.Introduction of a Framework Agreement 2.Introduction of a Micro-Procurement process

31. SPROC.NET UPDATE

32. 814 packages started in last 12 months Jan 14 – Dec 14 (new clients or changes of provider) 50% of packages procured through SProc.Net (last 3 months) Average starting weekly costs - last 12 months Residential Care Fees SProc.NetNot SProc.Net £421£437

33. 538 packages started in last 12 months Jan 14 – Dec 14 (new clients or changes of provider) Over 60% of packages procured through SProc.Net (last 3 months) Average starting weekly costs - last 12 months Nursing Care Fees SProc.NetNot SProc.Net £472£484

34. 120 packages started in last 12 months Jan 14 – Dec 14 (new clients or changes of provider) 92% of packages procured through SProc.Net (last 3 months) Average starting weekly costs - last 12 months Residential Dementia Care Fees SProc.NetNot SProc.Net £425£484

35. 90 packages started in last 12 months Jan 14 – Dec 14 (new clients or changes of provider) 90% of packages procured through SProc.Net (last 3 months) Average starting weekly costs - last 12 months Nursing Dementia Care Fees SProc.NetNot SProc.Net £528£612

36. 3036 packages started in last 12 months Jan 14 – Dec 14 (new clients or changes of provider) 94% of packages procured through SProc.Net (last 3 months) Average blended hourly rate - last 12 months Home Support Fees SProc.Net £11.48

37. Home Support Fees Citizen GroupAverage blended hourly rate Aged 18-64£11.56 Aged 65 Plus£11.47 Dementia£11.25 Learning Disability£11.43 Mental Health Act£11.67 Mental Health£11.53 Physical Disability£11.51 Sensory Impairment£11.24

38. SAFEGUARDING (last 12 months)

39. Safeguarding (last 12 months) Type of AbuseNumber% Neglect73940.4 Physical56530.9 Emotional19810.8 Financial1387.6 Institutional1065.8 Sexual422.3 Other392.1 Grand Total1827100

40. Safeguarding (last 12 months) PerpetratorNumber% Social Care Staff57240.6 Other Citizen28620.5 Health Care Worker 22215.9 Other31623.0 Grand Total1396100

41. Safeguarding (last 12 months) Source of Referral Number% Social Care Staff72652.0 Health Care Worker 21513.7 Family Member1168.3 CQC694.9 Other27021.1 Grand Total1396100

42. Safeguarding (12 months) Location of Incident Number% Care Home99871.5 Own Home21615.5 Supported533.8 Other1299.2 Grand Total1396100

43. BIRMINGHAM CARE AWARDS

44. SUPPORTED LIVING UPDATE

45. ECMS UPDATE

46. CARE PROVIDER FORUM DATES Tuesday 28 th April 2015 Tuesday 28 th July 2015 Wednesday 28 th October 2015

47. JULES GREGORY Market Manager – Bed Based Care jules.p.gregory@birmingham.gov.uk JENNET HARTRICK Market Manager – Home Support jennet.hartrick@birmingham.gov.uk CHRIS MacADAMS Strategic Market Manager chris.macadams@birmingham.gov.uk