Archived decisions

HAMPSHIRE COUNTY COUNCIL

Decision Report

1. Executive Summary

1.1. The purpose of this paper is to seek approval for a tender for supported living services for three young people in transition. The total contract value will be £1.68 million on three two-year contracts with an option to extend for a further two years, one year at a time (2+1+1). This represents good value for money and a cost effective model that supports the personalisation agenda.

1.2. Executive Member approval is required due to the value of the services and the complex nature of the project.

1.3. This report provides details on the tender for support services and on the housing provision (see attached Briefing) for three young people in transition. The project aims to reflect the ambitions of the young people involved and reflects the themes that are central to Valuing People Now and the Hampshire Model;

a) Personalisation - The three young people have very complex needs, a great deal of work has been undertaken to understand their wishes. We must ensure that support services are provided in a way that helps the individuals to make choices including when, how and from whom they receive support. The support provider will be expected to work with the young people to develop their independence and over time reduce their support requirements. This project aims to create opportunities for the individuals to have the same experiences as other young adults and to live in and play a part in the local community.

b) Self Directed Support - It is intended that payments will be made to providers to hold as Individual Service Funds (ISF's).

ISF's will be awarded on a block contract basis. A full tender process will be used to appoint the provider. The young people will have the opportunity to contribute to the service specification and their representatives will have the opportunity to be involved at appropriate stages of the tendering process. The young people will be supported to work with providers to implement their person centred plans and to write and review their support plans. A notice period will be included in the contract which will allow for a change of provider and transfer of the ISF if their needs are not being met.

c)Market Development -It is anticipated that the value of the contracts will attract new providers. As well as working with the successful provider on this project, we will use the tender process as an opportunity to identify new providers who could be involved in the Self Directed Support roll-out Countywide.

d)Carers - Many carers find the constant demands of their caring roles impact on their interests, activities, mental and physical health. The carers in this project have expressed their desire to have less involvement in a caring role as the young people enter adulthood. They look forward to working on their family relationships with the young people involved.

e)Value for money and efficiency - This report summarises the financial implications and makes cost comparisons with alternative support models. This analysis suggests that if the service users settle down well in their new environment then it is highly likely that ongoing savings can be obtained compared to the more traditional care pathways. Indicative support costs are £2300 per person per week, rather than £2500 in residential care.

2. Contextual Information

2.1 Adult Social Care Services are faced with rising numbers of people with increasingly complex care needs. The system for providing social care for adults is being transformed so that the emphasis is on the individual's dignity, right to self-determination, choice, control and power over the support services they receive. This report describes a landmark project to provide housing and support for three young people in transition.

2.2 The support provider will provide a service that reflects the young people's choices. They will work with the young people to help them achieve their goals and develop independence. The tender process will stimulate market development and the value of the contract has the potential to attract new providers to Hampshire.

2.3 ISF's are seen as being an integral part of provision for people with a learning disability in the future.

3. Key Issues

3.1 The proposed deadline for completion of the project is June 2010, the deadline allows time for a full tender process to be completed, it also takes into consideration the needs of the carers involved.

3.2 Due to the transition from children's to adult services, the financial implications are complicated. Cost estimates are based on a traditional commissioning model of hourly rates and all costs fall within the boundaries of the transition social workers' budget forecast. Providers will be required to work to reduce costs and will participate in 6 monthly service reviews.

3.3 To secure personalised support for the young people an open tender process will be conducted to commission a provider who will manage Individual Service Funds (ISFs). Three separate block contracts will be awarded to one provider.

4. Decision Making

4.1 Mental capacity assessments have been completed for all three individuals and show that none of them have the capacity to manage their financial affairs. A referral has been made to Hampshire County Council Client Affairs team to make an application to the Court of Protection for Deputies to be appointed to manage the individuals financial affairs.

5. Support Provision

5.1 A National tender process will be conducted to appoint a single provider on three 2+1+1 yearly block contracts, one contract for each young person. The block contracts will be to provide support within an annual budget rather than being for a fixed number of hours.

5.2 The process of awarding a budget to provide support is also known as Individual Service Funds (ISFs). In an ISF:

- The money is held by the provider on the individual's behalf

- The appointed Deputy will be responsible for authorising the spending plans from the ISF's

- The provider commits to only spend the money on the individual's service and the management and support necessary to provide that service.

5.3 The individuals will be supported by their families and care managers to work with providers on their individual service plans.

5.4 The award of three block contracts will give the individuals security but ensure that support is not accommodation based. If any of the young people decided to move house their block contract could follow them.

5.5 Adult services will lead the tendering process. Advocates, Person Centred Planning facilitators, the young people and their families will have the opportunity to be involved at appropriate stages of the tender.

6. Legal Implications

6.1 The proposals are compliant with the County Council's Standing Orders.

7. Financial Implications.

7.1 All three young people are being assessed for continuing healthcare contributions (CHC). The PCT have been asked to agree to this model of support, should it be determined that the PCT are in any way responsible for providing care. As the assessment results are not yet known the budget has been prepared assuming that there are no CHC contributions and the full cost lies with Adult Services.

7.2 The ongoing costs of support are dependent on how well the young people develop and settle into their home. It is anticipated that savings of between £55,000 - £231,000 will be made, against the transition budget of £1.68million available for this project. The level of saving is dependent on how successful the provider is in supporting the young people to develop their independence.

8. Risk Assessment

8.1 Risk: Although a staged move-in is planned the individual's support needs may increase for a brief time as they adjust to a new environment.


Resolution: The worst case scenario budget £1.68million accounts for this.

8.2 Risk: Although compatibility assessments have been completed and the individuals meet regularly there is a risk that they won't get on when living together.


Resolution: The contracting model allows each individual to retain their support and move to alternative accommodation. If one individual decides to move out consideration could be given by the relevant Deputies, as to whether it would be in the best interests of the remaining individuals to increase their Support for Mortgage Interest (SMI) claim and still be under the individual £200,000 limit. .

8.3 Risk: A meeting with the head of home ownership from Advance UK is outstanding. Risks relating to the housing option are unknown and we await confirmation of the detail.


Resolution: If shared ownership is not considered appropriate, the long-term contingency is to identify suitable social or private rented accommodation, the same contracting model can be applied to those housing options. If the project runs over-time the short-term contingency is for two of the individuals to access alternative accommodation where places are being held and for the third and youngest individual to live with her family.

8.4 Risk: High quality providers will not tender for the service


Resolution: By offering a block contract we are providing security for prospective providers. A nationwide advert will be placed and we hope to stimulate interest among new providers who could also enhance the local Learning Disability market.

8.5 Risk: The services commissioned will not meet the outcomes of one of the parties involved.


Resolution: The interview process will seek to identify providers who have the structure, experience and desire to deliver services to this highly personalised model.

9. Conclusions

9.1 The housing option and support services proposed will provide personalised support that enables three young people with very complex needs to have the same opportunities as other young adults.

9.2 The project timelines reflect the transition process for the young people and allow sufficient time for the full tender process to be completed.

9.3 This project will provide a valuable learning opportunity for the department and will help to identify new providers who could be involved in the SDS roll-out County-wide.

10. Recommendations

It is recommended that:

10.1 The Executive Member approves the full tender process for the support services and to award three two-year contracts with the option to extend for a further two years, one year at a time (2+1+1) to the combined value of £1.68 million.

CORPORATE OR LEGAL INFORMATION:

IMPACT ASSESSMENTS:

1. Equalities Impact Assessment:

a) In preparing this report, account has been taken of the requirements of the Corporate Equalities Plan and Race Scheme. The contract ensures that the provider will perform their duties with due regard, to eliminate unlawful discrimination and to promote equality of opportunity for all people and to promote good relationships between different racial groups.

2. Impact on Crime and Disorder:

a) The County Council has a legal obligation under Section 17 of the Crime and Disorder Act 1998 to consider the impact of all decisions it makes on the prevention of crime

No Impact

Climate Change:

b) How does what is being proposed impact on our carbon footprint / energy consumption?

The proposals to move people into ordinary housing should have a positive impact on the carbon footprint.

c) How does what is being proposed consider the need to adapt to climate change, and be resilient to its longer term impacts?

There are no specific proposals for this particular scheme but the need to adapt to climate change will be considered for future schemes.

Briefing

Housing Provision

1. Most people with learning disabilities do not own their own homes and sometimes they are living in unsatisfactory housing. Valuing People says people should have more choice and more of a say about their housing. The Government wants more shared ownership for people with a learning disability and the Homes and Community Agency has funding especially for this.

2. Work so far has identified Shared Ownership as potentially the best housing option offering the mix of choice, control, independence, security and flexibility. The young people would be supported to jointly purchase a property of their choice through the Advance Shared Ownership scheme. Decisions on finance and property would however be for the Deputies to make once they have been appointed.

3. Work has been done with the individuals and their families to determine whether living together is in the best interests of the young people and to test whether they would be compatible housemates. The social workers and families involved feel that living together is in the best interests of the young people.

4. The families feel strongly that a non-residential housing option would be best for the young people. The benefit realisation model (Appendix 1) was used to explore the range of housing options. Shared Ownership emerged at this stage, as the best choice for this group.

5. Shared Ownership is the most secure form of accommodation insomuch as the individuals will be homeowners. This model of accommodation reflects the County's strategic approach to meeting the National Indicator for settled accommodation.

6. All three young people would like to live in the same area. They will require a detached four bedroom property with a garden and good public transport links. A search has shown a good choice of properties in the relevant area with these attributes.

7. Shared Ownership options, if considered by the Deputies to be in the best interests of the individual person, would involve them purchasing up to 70% of the property using a 99year interest only mortgage. The mortgage payments would be met through Support for Mortgage Interest (SMI), a benefit payment available on mortgages up to £200,000. Advance Housing buy the remaining share of the property and rent it back to the young people. The rent is paid by Housing Benefits.

8. The scheme allows a person claim up to £200,000 SMI against their mortgage. If one individual decides to move out the remaining two could increase their SMI claim and still be under the individual £200,000 limit.

No capital implications have been identified for Adult Services Department

Benefit Realisation Model for Transition Project

Housing Options

_ Yes

- Partly

X No