Why are you doing this now?
We have not previously established a specific commissioning arrangement for Supported Living, and need to do so now to secure quality and value for money across this area of business.
This has become increasingly relevant as Supported Living alternatives to residential care have become more widespread, and the duties towards safeguarding and Fair and Affordable Care Policies remain key priorities for us.
We propose to establish this commissioning arrangement for Supported Living across all care groups, wherever social care assessments validate the option of a shared on-site service as the best way of meeting needs. Work will start with learning disability building-based services, because this is where the evidence of need for shared service is already strongest and where the model is most typically used.
Will there be an opportunity to discuss how the new arrangement is working ?
There is an existing process that enables you or your staff to raise any issues you see developing and this can be copied to firstname.lastname@example.org
Beyond this there will also be a review scheduled, within the first 3 months, or sooner where developmental goals have been set, to assess how the arrangement is working for everyone and is an opportunity for you to raise any concerns.
How do Shared Hours Offer agreements affect clients with Direct Payments?
The Council does not have a contract with a provider for any service that they provide to a person who takes their personal budget as a Direct Payment. As a result, as we are not party to these contracts, any inflationary uplift that the Council awards to its contracts cannot legally apply to the contract between a provider and its other customers.
The client reviews conducted by Devon County Council at each property will result in an agreed number of shared and/or individual hours service required to deliver appropriate outcomes for these clients. The resulting Agreement Schedule provided to you enables discussion of future arrangements with any person who takes their personal budget as a Direct Payment.
What is an Advocates role?
An Advocates role is to support the client with understanding and engaging with the assessment conducted by the Care Manager. An Advocate will not have a role in negotiation regarding the DCC contract with the Provider.
When will new Supported Living Contracts start?
The emailed notice sent confirming the Schedule of Shared and Individual Hours states that the implementation date is 30 days from the date of distribution of the notice, or another pre agreed date.
Why are 2015/16 Framework rates (2015/16 spot rates if not on the Framework) being used for the Shared Hours element of the new Supported Living Contracts?
The nature of Shared Hours is that people are sharing the support provided in the property, unlike other support services involving travel. It has therefore been agreed with individual providers that this is a reasonable holding position for the interim contracts pending further discussion during the coming months that will inform the new Supported Living Framework tender.
In adopting this position for shared hours the Council has acknowledged that additional individual hours for each legacy client’s support will be priced at the current (i.e. 2016/17) spot contract rate, or a negotiated rate aligned with that of the majority of the market.
How do we advise you of vacancies?
DCC has been working with Providers in the past few months gathering information to identify the capacity of properties not under interim Contract arrangements. The list of these potential vacancies is regularly produced for staff, to compliment the information generated through the interim Supported Living contracts.
To provide DCC with information on vacancies please use email@example.com
How will vacancies be advertised?
There has been work completed with our systems that enable staff commissioning Supported Living placements access to this information. The properties where Void payments apply will also be flagged to these staff.
It is important that you continue to advise DCC of vacancies at a property whilst there is no interim Supported Living contract in place.
What happens if the Shared Hours Offer provider does not wish to deliver the one to one regulated hours?
This would be discussed when setting up the Agreement for the property and specific impacts could then be considered.
What happens when the individual hours under the Shared Hours schedule are offered to LW@H prime providers?
Currently LW@H providers are focussed on mobilising non LD services, the further development of the contract for LD services for new and existing clients will include engagement with all LD service providers. The intention is to have a proposal for new LD clients by the autumn.
What happens if the shared hours financial settlement being offered to a supported living provider is felt to be insufficient?
The Council is currently offering what it believes are viable and sustainable interim financial settlements. These are being negotiated with providers on an individual basis, because they involve detailed confidential financial information about each provider’s cost structure and staffing arrangements. In terms of the longer term future, the Council has published a discussion paper about how a more competitive, transparent pricing mechanism might work, and has invited providers to submit responses before July 2016.
Does the Shared Hours Offer cover unregulated as well as CQC regulated support provided?
Do Shared Hours have to be delivered by CQC registered staff?
It depends upon the needs of the people. If nobody within the house needs personal care or prompting for personal care then the SHO can be delivered by non CQC regulated companies. If somebody does need personal care the provider (if unregulated) has to prove that they are able to meet the requirements using sub contracted companies who are regulated. However it would of course be simpler for all concerned, where somebody within the house needs CQC regulated care that the SHO company is regulated.
Can a vacant room that we are invoicing for a Void payment under the Agreement be used for other purposes e.g. Respite?
The preference would always be for a vacancy not attracting a Void payment to be used for respite. The risk is that the space will then not be reflected as available for a new long term placement for this period.
Notwithstanding this then yes it is possible and the Void invoice presented should be adjusted accordingly with ‘Respite use’ noted as the reason for the reduction in days invoiced for, there will be no change to the end date of the Void payments.
DCC would not pay for both respite for a DCC funded client and the Void.
What happens if the client with tenancy does not occupy the room 24/7?
People are more than able to spend time away from the house, we all spend nights away either on holiday, visiting family etc. The shared hours offer remains but obviously no individual hours would be paid unless there is evidence that they have been used during this time (staff support on the holiday for instance).
What if the Provider decides to use a room for other purposes?
You may raise a request to reduce the number of places commissioned under the Shared Hours contract and DCC will enter into discussion with you.
Will Brokerage continue to contact us in the normal way for placements? How do we respond.
For new placements, in the interim whilst not all properties are under contract, Brokerage will refer to the Vacancy register for Supported Living properties and if appropriate ensure inclusion in the tender whilst also meeting client choice directive. This inevitably means that in this interim period you may be contacted for both properties already under contract, and those not. The preference in this roll out period is to continue to use the existing process and forms. This process will be kept under review with the Brokers and any changes made will be advised to Providers.
So currently should you choose to respond to a tendered service need then the response should identify that you are a Supported Living Provider under the new arrangements. The outcomes should identify which will be met by the Shared Hours offer [SHO] and which will require additional individual hours [1:1]. The costs should show the cost of Shared Hours Offer and then the cost of individual hours based on the agreed rate under your Contract Schedule.
As someone moves into a property with a Supported Living contract will they be reviewed and changes made to their package?
Yes as the contracts and process are rolling out there may be a follow up review to adjust the persons My Plan to reflect the outcomes met by Shared Hours and those met by Individual Hours, to finalise their package and enable agreements to be entered onto our systems.
In the future clients seeking Supported Living Accommodation are likely to have already been through this process, in the same way the Supported Living Review Team is currently operating.
If I have a property and there is a medical emergency outside of the Shared Hours agreed, or during the individual hours activity, who is responsible?
This is no different to normal situations, if a medical emergency occurs while the 1:1 member of staff is there or the Shared hour’s staff then they are responsible for supporting the person to access medical help. Otherwise the contingency arrangement made for each individual applies; this can differ person to person, and often includes training for the client by one of the providers in how best to respond.
What hourly rate do you use for your Day Care services?
The Council commissions approaching 100% of all services provided from independent sector providers. There are a few in house Day service centres available at a rate of £85 for a full day / £42.50 half day for Learning disabled clients which may be selected by people to use, however many people are encouraged to focus of developing independence through community based opportunities rather than Day Centres.
Should there be a specific reason for choosing a Day Centre, including DCC Day Centres, then this cost will be part of the persons budget for individual hours.
What notice will be given to the providers and the clients of changes to service under the interim Supported Living contract
We are running Care Act compliant reviews with advocates (either family or independent) to support clients through this process. Each individual’s assessment is sent out in draft before the Schedule, which collates information for all clients at the property, is sent to providers. The Schedule then gives a further two weeks notice of change being made.
Everyone will have been fully involved in the process for some weeks and this additional two weeks is given to ensure that each person (or family or advocate) has given thought to the implications for them and planned in detail how their needs can be met differently using the budget available to them. The Review Team is available to support clients, family and advocates and providers in achieving the right transition plan if requested.
What happens if there is no shared hours offer in my building?
Where the discussion with the potential Supported Living provider does not identify a shared hours offer, but is simply a shared housing solution, then the Supported Living specification will not be progressed.
The client can opt to take a Direct Payment if they want a different solution.
What is Supported Living?
Supported Living is the name of the new commissioning arrangements we are creating to ensure that we are getting quality services and value for money, and that our arrangements are transparent and fair for everybody.
We will start putting the new Supported Living contracts in place from 1 April 2016. Contracts will be rolled out on a provider by provider basis.
Will inflationary uplift be applied to my Supported Living contract?
DCC advised a 2% inflationary uplift for Type 1 and Type 2 Framework contracts and wholly unregulated community-based support spot contracts from 4 April 2016. The award is pending the outcome of recommissioning these areas of activity. A cap of £16 is applied to this uplift.
This uplift applies to Type 1 and Type 2 Enabling contracts. If your organisation delivers Type 3 services email the procurement team at firstname.lastname@example.org to request a spot contract for this service.
What if the cost of providing shared hours exceeds what you are willing to pay?
In the short term, where our discussions identify a requirement for a shared hours offer we will negotiate a sustainable solution, which will be kept under review.
In the longer term, if the person does not require the level of shared hours offer within the building we will look, with the person and their family, at the options available to them so that a choice can be made.
What happens if I also provide regulated care to clients in my building?
Where, over and above the shared hours offer, someone has eligible needs that include any element of regulated care we will expect to put that through our new Living Well @ Home contract. As a Supported Living provider you offer services within that contract either as a primary or link provider.
The service user can choose to have a Direct Payment if they want a different solution.
I offer shared hours, how do I negotiate a Supported Living contract?
We have been conducting workshops and individual discussions since early 2015, and we’ve also written out to providers that have multiple DCC-funded clients in a single building to request basic details to inform us of the potential of any provider as a Supported Living provider. If you have not already been contacted email us at email@example.com and we will send you the submission form to complete and return.
What if I decide to set up a new service?
Email firstname.lastname@example.org to tell us and we will contact you to discuss the process. This will be influenced by your position in the implementation schedule and whether you are an existing Supported Living provider.