Decision details

The County Council spends around £70 million on specific supported living arrangements across the County. The model is based on several people living in rental accommodation, sharing 24 hour formal paid support. This has been a popular model for over 30 years, with up to 1,830 people supported in around 700 schemes, these range from single tenancies to larger flat let schemes. Support is provided countywide by 49 domiciliary providers. This involves a significant workforce.

The County Council developed a specific Learning Disability Preferred Provider Scheme in 2007, which was revised in 2010 but cannot be extended beyond June 2015. There is ongoing transformation work to ensure citizens currently living in supported living schemes can have a personal budget, a personalised support plan and more choice of housing and support options.

A review of the current scheme commenced in October 2013, which has included formal consultation with existing providers of supported living, self-advocates, family members and a range of other stakeholders, with a focus on what has worked well in the existing scheme, what has not worked well and what needs to change going forward.

The engagement and feedback has had a significant impact on the option appraisal and final recommendations for ensuring the effective commissioning and procurement of good quality and affordable domiciliary care for people with a learning disability in Lancashire from June 2015.

The procurement and implementation is challenging and complex and will take time to implement safely and effectively. This will require the commitment of additional interim capacity to manage the safe and efficient transition from the existing to the new configuration of Learning Disability Supported Living (Domiciliary care) services.

This is deemed to be a Key Decision and the provisions of Standing Order No 25 have been complied with.

County Councillor Tony Martin, the Cabinet Member for Adult and Community Services:

(i)  Approved proposals for Re-commissioning and Procuring Learning Disability Supported living (Domiciliary care) services over a 3 year period with the option of a further 2 years under a revised Framework from June 2015 which place an emphasis on:

·  Commissioning Supported living (Domiciliary Care) Services which:

o  Promote Personalisation;

o  Become more outcome focussed and maximise independence;

o  Support integrated working with other Health and Social Care services and organisations;

o  Ensure the dignity of individuals and safeguards those who are vulnerable;

o  Incorporate human rights and Mental Capacity Act obligations into decision making and commissioning and contracting practices;

o  Supported living providers who wish to secure places on the revised Framework will need to sign up to the Driving Up Quality Code and Lancashire Values;

o  Promoting co-production and federating to maintain and develop Lancashire's Learning Disability Supported Living workforce.

o  Have a strong commitment to a range of monitoring of their service including

o  – Self Monitoring

o  – Peer Monitoring with other providers

o  – Self Advocate & Family Monitoring

·  Changing the Council's approach to contracting so that:

o  Providers are expected to support the principles of Self Directed Support and take greater responsibility in supporting individuals to exert choice and control over the use of their Personal Budgets;

o  There is the adoption of a clear and robust approach to quality based on citizen derived standards, the co-produced 'Lancashire Values' and Key Performance Indicators, reliable monitoring and incentives to continually improve;

o  A clear expectation that providers will work in partnership with the County Council to deliver Remodelling of Supported Living and reduce the reliance on formal paid support;

o  The length of contracts offered for 3 years with the option to extend for a further 2 years. This will be  subject to satisfactory progress and performance;

o  Internal County Council arrangements for quality and contract management are redesigned to ensure consistently high performance is rewarded, mediocre or poor performance is swiftly challenged and consistently poor performance leads to contract termination.

·  Shaping the Market including:

o  A culture of co-production and partnership working with Learning Disability Supported Living providers, operating under contracts from the County Council allowing for a more collaborative approach to working with commissioners and other providers.

o  Offering contracts for future and recommissioned Supported Living (Domiciliary Care) business in specified geographic 'zones' to promote more efficient working across the system and closer integrated working.

o  Allocating of new business to a smaller number of providers who achieve the higher quality threshold.

·  Flexibility is built in to design of the contracts to enable the introduction of new approaches and innovations in service delivery and payment mechanisms;

·  Investing in and developing Lancashire's Learning Disability Supported Living workforce by: 

o  Ensuring all Supported living providers are contractually obliged to follow compliance guidance from Her Majesty's Revenue and Customs (HMRC) on paying National Minimum Wage (NMW);

o  Endorsing the principles contained in Unison's "Ethical Care Charter for Home Care";

o  Working with local workforce and employers' representatives to draft a 'Lancashire Charter for Learning Disability Supported living',

o  Detailing annually updated commitments to:

§  National Minimum Wage Compliance at all times;

§  Minimising the use of Zero Hours contracts;

o  Hourly wage rates which converge towards the 'Living Wage'.

(ii)  Noted the details of the consultations undertaken with supported living providers, Self-advocates and Family Members and Stakeholders and the main findings set out at Appendices  'A' - 'D', the options considered as set out at Appendix 'E' and the Equality Analysis set out at Appendix 'F';

(iii)  Approved the establishment of a Learning Disability Supported Living Business Transitions Project Team to ensure the efficient, safe and timely management of changing from the current configuration of services to thoseset out in recommendation (i) above. This will be one Grade 10 post and one Grade 6 post for a period of 12 months.