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Supporting health and social care providers in Devon

MPS: Supporting Independence

MPS: Supporting independence

What do we want from this area in the future?

We define the characteristics of an effective service as:

  1. A market that meets the needs of all care groups: A sufficient number, range and quality of providers
  2. A range of provision to meet the differing needs of individuals: support that meets the diverse needs of individuals and responds to changing needs
  3. Support that is person-centred and promotes individual independence and personal progression: Outcomes-focused support helping people to access employment, services and facilities, uses technology, develops personal relationships and socialise in a way that meets individual needs and aspirations, allowing a choice of provider to help people achieve their goals and reduce support as they become more independent
  4. Support that is high quality and delivers desired outcomes: Providers that meet quality thresholds set out in the tender and work with Devon County Council’s Quality Assurance and Improvement Team to achieve a minimum level for quality.
  5. Provides support for unpaid carers: involves unpaid carers in care planning as experts in the person’s care and enables them to have an essential break from caring responsibilities.
  6. Different conversations with individuals and their families across the system: Working together for the individuals we support, focused on ‘what matters to you’, achieving their aspirations and supporting them to be and to remain independent.

 

What is the assessment of need?

An assessment of need was provided at launch of the tender, and is published as a supporting document on the Supporting Independence website as Needs Assessment v.2 (original tender document)

We are currently undertaking work to strengthen our profiles of need to support provider business plans. We will publish further data by May 2020, which will include an updated profile of need and future projections.

 

What is the assessment of supply?

People currently receiving a package of unregulated care and support.

The number of people receiving unregulated care and support has remained stable at around 2,700 people at any one time across the framework and historic contract arrangements.

This includes support provided within an accommodation-based environment such as supported living. Our analysis shows people with a learning disability and/or a mental health condition are most likely to need unregulated care and support.

Support provided into people’s own homes:

1 January 201921 August 2019
Older people331352
Older people with mental health conditions2728
People with a physical disability220231
People with a learning disability11641180
People with a mental health condition235255
People with autism112145
TOTAL 2,0862189

 

The number of people accessing group based care through the Supporting Independence contract and historic contract arrangements:

01 Jan 201921 Aug 2019
Older people352369
Older people with mental health conditions32
People with a physical disability8585
People with a learning disability193200
People with a mental health condition1012
People with autism98
TOTAL 651674

 

Market impact:

The framework enables the transition between services and providers to happen more easily than historic contracting methods. Our aspiration for people who need care and support, is the promotion of their independence and achievement of care plan goals through short – term enabling interventions. We are working with providers of both Lots 1 and 2  to focus on reducing dependency on ongoing packages of care as people become more independent.

Future requirements

For future development we would like:

  • greater capacity in the market to deliver skilled and specialist mental health packages that could support people who are
    • ready to leave hospital and residential care settings
    • living in the community through crisis and which reduces the need for hospital admission or residential placement
  • higher volumes of quick responses by the market to referrals across all service user groups for packages of individualised support
  • the market to lead innovation around
    • the challenges of how to deliver services in rural areas where there is significant travel time and few other packages in those locations
    • supporting people to become more independent and achieve their care plan outcomes as their needs change. For example to provide a flexible range of offers related to the number of hours commissioned, particularly smaller units of time for example one hour
  • providers to generate packages that support the development of an individual’s life skills at the point they are transitioning into adulthood and independent living, from as early as 16 years of age. Providers will need to work flexibly with other providers such as those who provide care in Supportive Living environments and Devon County Council’s education department
  • providers of day services that are not already on the Supporting Independence contract to join it at the next opening in 2020.

 

What has worked well to date?

  • The Supporting Independence website to support new providers preparing their entry.
  • New providers have made good use of the tender ‘opening point’.
  • The tender process is establishing baselines of quality, and supporting continuous development in a market that has no regulatory oversight.
  • The pricing mechanism has led to much greater transparency over unit costs, and that has helped everyone to make plans that are more informed.
  • Improved DCC monitoring and reporting resources are helping highlight specific areas for market development.

 

What hasn’t worked so well?

  • A low level of response to referrals across all areas of the county and service-user groups.
  • The Council being clear on the person’s goals to be achieved and Providers working in a maintenance approach rather than progressing the person’s independence.
  • Some providers who need development on specific areas of quality have found it difficult to prioritise the capacity needed to undertake that work. Areas for development include:
    • the lack of safeguarding training
    • not having submitted a tender before and thinking that some of the questions were not relevant to them.
  • It has proved difficult to refresh the originally published needs assessment, and the market needs better information to plan for the future. This work is now under way with a target for reporting of May 2020.
  • The referral process through to providers needs further development, better communication and understanding of pathways is part of work being undertaken to improve this process.

Further work is being undertaken to support market development through a live platform that will provide more detailed information on:

  • providers by post code/geographic location
  • providers delivering packages of care by location
  • care groups being supported by each provider.

What changes are we looking for from this service in the future, including any market opportunities, and what can DCC help to move towards these changes

We are looking for:

What is needed?How will this be achieved?When?Who?
A sufficient market across Devon that supports all care groups and people with more complex needs

·        Understand demand and supply across the County through the development of a data platform and robust contract monitoring processes

·        Work with providers to understand the challenges around delivery and any barriers to joining the framework, and how these can be overcome

Started end 2018, ongoing throughout 2019

 

 

Autumn 2019

Commissioners/ Business Relations Team/ Procurement

 

 

 

Commissioners/ Business Relations Team/ Providers

Ensure the focus is on short-term support that meets people’s outcomes and enables greater independence

·        Work with practitioners to ensure that packages reflect individual needs and are regularly reviewed,

·        Improve the referral process to services available on the SI framework

·        Work with providers to develop plans that promote independence and help them to adopt new delivery models to meet changing needs

·        To work with other parts of the Council e.g. Education and other Providers to develop ‘life-skills’ programmes for young people transitioning into adulthood and independent living.

Ongoing, started spring 2019

Community Teams

 

 

Commissioners/ Business Relations Team/Contract Management/ Providers

 

A market that delivers good quality provision at an affordable cost

·        Build on the current quality assessment for any future framework

·        Work with providers to develop provision that meets minimum quality thresholds

·        Work with providers to understand and agree hourly rates that are viable for the market and offer value for money

By October 2020

 

Ongoing

 

 

 

By October 2020

Commissioners/Contract Management Team/ QAIT and Procurement

Quality Assurance & Improvement Team/ Providers

 

Commissioners/ Business Relations Team/ Contract Management Team / Providers

The Creative Innovation and Growth Business Support package is available to help businesses develop and grow: and includes grant funding with an emphasis on developing new services, increasing sufficiency, developing new products and innovative ways of working.

Market opportunity - Supporting independence

The Supporting Independence contract runs until the 30 September 2021.

The final entry point will open in March 2020 and close in May 2020 with new contracts being awarded before the commencement date of the 1 October 2020.

The opportunity to pick up unregulated packages of care will be greater for providers on the framework as all new business will be offered to framework providers in the first instance.

 

(Return to the Market Position Statement)

Last updated: 29/01/2020


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