Care Home 22 nd January 2016

AGENDA Welcome and introduction Presentation on the principles of the draft contract Feedback from the engagement sessions Proposed contract principles Proposed timescales Accreditation presentation Draft Quality Assurance Framework presentation Any other business DONM: Thursday 24 th March 2- 4pm Kindle Centre

Engagement feedback Key themes and messages from engagement sessions September to December 2015 Transparency is needed especially to calculate hotel costs as higher costs will be for some and not others. Need to improve communications, no one knows who to contact to resolve issues. Payment system needs to be improved. Process needs to be faster, especially for LD it is a slow process. Increasing costs for providers Keep as close to the CQC standards as possible and keep it simple, providers do not want additional performance target

Key themes and messages from engagement sessions September to December 2015 Would like to see council not commission with providers who are consistently delivering poor quality of care. Outcomes based commissioning, need to work in collaboration on this and keep it simple Work together and not against each other Need operational group to help co-produce outcomes Any procurement activity needs to be clear, simple and easy for the smaller homes. Engagement feedback

Introduction of Common Fee Structure - Background CHC placements should reflect the common cost components of any basic social care nursing placement plus reflect the additional care costs of caring for a client with continuing health care needs Analysis showed that there is no consistency of cost allocation by providers despite the requirement to use a standard template Other areas have introduced either a basic CHC placement cost with a banded / threshold approach to reflect the costs of meeting the additional needs above a basic placement, or adopted a unit of care* * EG Birmingham CCG’s operate with a basic value for money CHC fee and then pay up to 20% above this rate dependent on the clients health care needs whilst Peterborough and Cambridge CCG have a unit of care approach based on the CHC matrix of need

AreaLACCGRecommendation Contract areaLA contract states:CCG contract states:ProposalRisk Suspension of placements Not covered or being applied Yes Suspensions are a useful tool as part of a range of actions for protecting vulnerable clients and allowing time for the provider to resolve issues, however the Council need a clear steer from Legal around risks and mitigations Legal challenge due to loss of income for the provider Payment on the death of a service user The arrangement will automatically end on the fifth day following the death of a resident. 1 day Need to scope the cost for payment of 5 days, recommend reducing the payment period to a maximum of 3 days with clear definition, plus Remittance Notices must be completed by Providers in order that we can claw back any monies Need to scope, Lack of clarity around when 5 days starts and finishes, plus contractually we can claw back monies if the room is filled within the 5 days, this is not being applied. Families have to currently contribute for the full 5 days Shared room rate Was 80% but not in the contract just in the Band rates N/A Need to scope and if required capture within the Contract. If not required we could offer to remove this from the contract as a incentive to providers to sign up. Absence of a resident Hospital stays Absence The provider shall notify the council in writing within 48 hours of a resident being admitted to hospital. Such as hospitalisation the weekly payment recorded shall not be reduced for the first 6 weeks but after the council will pay 80% of the councils contribution less any amount being paid by the resident direct to the provider until the resident is home is the arrangement ended. Need to scope and then clarify whether this is being applied, if not then we could offer to remove this from the contract as an incentive to providers to sign up. This will require Social Workers, etc to ensure they terminate individual agreements if the client is unlikely to return to same setting within a reasonable timescale Need to scope Payment 2 weeks in advance 2 weeks in arrears 4 weeks in arrears, dependant on decision around Third Party Top ups and collecting client contributions Payment increases Contract states The Council will review annually using a number of indices any award is applied from 1 st April each year We will need a transparent and robust methodology to inflationary awards. Plus we could introduce a performance related fee structure to incentivise the market to continuous improvement If we are moving to individually costed care plans then we will need to use a Pricing Tool and appropriately trained staff to negotiate effective and efficient fee’s Termination of agreement Give 12months notice (Individual placements can be terminated by giving a maximum of 4 weeks notice) This seems a reasonable approach Contract areaProposal Suspension of placements In line with the CCG. We would still seek a voluntary suspension in most cases. Payment on the death of a service user Payment on death + 2 days in line with CCG Shared room rate80% of single room rate Absence of a resident 100% in week 1 75% in week 2 50% in weeks 3-6 and beyond Gross payment Payment The council will be seeking approval from cabinet to move to gross payment process. Move to 4 weeks in arrears, CCG will continue as transition period. CONTRACT PRINCIPLES

AreaLACCGRecommendation Contract areaLA contract states:CCG contract states:ProposalRisk Suspension of placements Not covered or being applied Yes Suspensions are a useful tool as part of a range of actions for protecting vulnerable clients and allowing time for the provider to resolve issues, however the Council need a clear steer from Legal around risks and mitigations Legal challenge due to loss of income for the provider Payment on the death of a service user The arrangement will automatically end on the fifth day following the death of a resident. 1 day Need to scope the cost for payment of 5 days, recommend reducing the payment period to a maximum of 3 days with clear definition, plus Remittance Notices must be completed by Providers in order that we can claw back any monies Need to scope, Lack of clarity around when 5 days starts and finishes, plus contractually we can claw back monies if the room is filled within the 5 days, this is not being applied. Families have to currently contribute for the full 5 days Shared room rate Was 80% but not in the contract just in the Band rates N/A Need to scope and if required capture within the Contract. If not required we could offer to remove this from the contract as a incentive to providers to sign up. Absence of a resident Hospital stays Absence The provider shall notify the council in writing within 48 hours of a resident being admitted to hospital. Such as hospitalisation the weekly payment recorded shall not be reduced for the first 6 weeks but after the council will pay 80% of the councils contribution less any amount being paid by the resident direct to the provider until the resident is home is the arrangement ended. Need to scope and then clarify whether this is being applied, if not then we could offer to remove this from the contract as an incentive to providers to sign up. This will require Social Workers, etc to ensure they terminate individual agreements if the client is unlikely to return to same setting within a reasonable timescale Need to scope Payment 2 weeks in advance 2 weeks in arrears 4 weeks in arrears, dependant on decision around Third Party Top ups and collecting client contributions Payment increases Contract states The Council will review annually using a number of indices any award is applied from 1 st April each year We will need a transparent and robust methodology to inflationary awards. Plus we could introduce a performance related fee structure to incentivise the market to continuous improvement If we are moving to individually costed care plans then we will need to use a Pricing Tool and appropriately trained staff to negotiate effective and efficient fee’s Termination of agreement Give 12months notice (Individual placements can be terminated by giving a maximum of 4 weeks notice) This seems a reasonable approach Contract areaProposal Quality assurance Aligned with the CCG Policies and appendicesWill be available online Service specifications Based on outcomes for the service user and will be developed with you over the next year. Communications You will have a consistent contact within the council for ongoing communications. Accredited/approved provider list A simplified and transparent procurement process will be implemented in order to ensure quality and sustainable services. CONTRACT PRINCIPLES

Timescale ActionTarget Date Gross payment decisionCabinet April 2016 Final contract and appendices May ProcurementMay – June Contract start dateJuly 2015

Kindle Centre 22 nd January 2016 DPS- Residential and Nursing Home Overview

DPS Overview Issued online: Light touch procurement – self certifying model Submission deadline 30 days Response comprises a number of mandatory sections: 1.Organisational Information 2.Professional and Business Standing 3.Accreditation 4.Insurance 5.Safeguarding Policy 6.Equality and Diversity Policy 7.Recruitment Policy

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