Agenda item

To seek approval to proceed with procurement exercises for the award of contracts for care homes provision for all client groups (older people, learning disability, mental health and physical disability).

Cabinet received a report seeking approval to proceed with procurement exercises for

the award of contracts for care homes provision for all client groups (older people,

learning disability, mental health and physical disability).

The Care Act 2014 gave local authorities, the NHS and the CQC (Care Quality Commission) clear legal responsibilities for managing different elements of the adult social care market. These included developing the quality and range of services that local people wanted and needed and integrating commissioning of services from the care market with key partners, including the NHS and housing, and ensuring a diverse range of services, so people had choice.

The Authority currently commissioned a range of adult social care services from the independent sector to meet the needs of individuals deemed to be eligible in accordance with the Care Act 2014 following a Care Act assessment.

The Authority did not deliver these services internally and needed to have robust and proper arrangements in place for services to be procured and available.  There were arrangements in place at present for these services and these had come to an end.  There was, therefore, a need to put new arrangements in place and the report set out proposals for new contracts to be put in place to ensure there was sufficiency and continuity of supply to ensure the needs of eligible individuals and the wider population could be met.

New contracts would put in place a range of services and providers to support individuals and ensure there was sustainability of supply and provision over the period the contracts were in place.  The contracts would also need to ensure value for money was achieved, and also that client outcomes were deliverable and that this was a key focus of the service to be commissioned.

All contracts would be in line with the strategic objectives and the commercial context in which the services operated, these were set out in the Cabinet report on 29 June 2020.  For Adult Social Care, these stemmed from the Our North Tyneside Plan which set the Authority’s priorities for supporting vulnerable people to be healthy and well and also that they were cared for, protected and supported.

There were currently 31 homes in the borough for older people, with 1482 beds.  There were currently 14 homes in the borough for those with a learning disability, working age mental health and physical disability, with 182 beds.  The Authority did not fund all of the beds in these care homes; placements in these homes included private funded placements, placements funded by other Local Authority areas and placements funded by the Clinical Commissioning Group.

The proposed procurement process would allow the Authority to contract with any care home provider in the borough that accepted the fee structure proposed by the Authority and which met the standards set out in the contract and service specification for personal care, funded nursing care and NHS continuing healthcare. 

All care homes were required to be registered with the Care Quality Commission (CQC) and would be subject to the CQC regulatory process and this included undertaking inspection visits and publishing inspection reports.  The Authority would work closely with the CQC on all matters relating to service quality and delivery.

Whilst Adult Social Care must seek to ensure Best Value in terms of the procurement of residential and nursing care, the structure of the existing market in the Borough, the use of a pre-agreed pricing mechanism and the choice of placements afforded by the Choice of Accommodation Direction meant that it had not been previously possible to competitively procure this service.  The current contract had ended in 2015 and had been extended as a waiver since then due to ongoing fee negotiations.  In accordance with the Public Procurement Regulations 2015, a procurement exercise must be undertaken. Extensive engagement was currently being undertaken to ensure providers were ready to contract with the Authority. Engagement was being undertaken in relation to pricing, placement strategy and contract duration. Arrangements would be put in place to ensure that the Authority complied with its duties contained within the Care Act and provided a commercially robust approach for the Authority. If approved, the final terms of the contract and offer to the market would be determined in accordance with the recommendations as set out at paragraph 1.2 of the report.

The Authority was seeking to procure and operate a new contract and framework agreement for care homes provision in the borough from 2021, for a term of four years to 2025.  The procurement arrangements would allow for new providers to the market to be added during the contract’s lifetime.  All individual services would be commissioned on a spot purchase basis.

The report sought authority to procure a care home service and to award contracts to providers that met the required criteria.

Cabinet considered the following decision options: to accept the recommendations as set out in paragraph 1.2 of the report, or alternatively, to not approve the recommendations and propose that officers consider other options for delivering this provision.

Resolved that the Head of Health, Education, Care and Safeguarding, in consultation with the Head of Commissioning and Asset Management, Head of Law and Governance, Head of Resources, Cabinet Member for Adult Social Care and Cabinet Member for Finance and Resources, be authorised to:

(i)         finalise the commercial arrangements to secure the delivery of residential and nursing care home services from providers operating across North Tyneside

(including the procurement of nursing and continuing health care services on behalf of North Tyneside Clinical Commissioning Group);

(ii)        undertake a procurement exercise to procure a range of providers to deliver the identified services, as outlined in section 1.5.2 of the report; and

(iii)       proceed with the award of contracts to the preferred bidders following the procurement exercise carried out in accordance with (i) and (ii) above.

(Reasons for decision: Current contracts and contracting arrangements have expired and are subject to annual carry forward and could be leaving the Authority subject to financial risk, new arrangements will need to be in place to ensure continuity of service for individuals accessing those services; need to ensure compliance with procurement regulations, undertake competitive procurement exercises; and to ensure commissioning arrangements are current, effective and ensure value for money is in place with those contracts and framework agreements.)