FOI 3656 data
Review of care home provision for adults with learning
disabilities
Through robust contract management activity the Joint Commissioning Team
is undertaking work to ensure current care home provision for adults with
learning disabilities, purchased by Birmingham City Council, is on a
sustainable basis and with pricing based on a better understanding of care
costs to meet needs.
This will support future work to consolidate an array of different contractual
arrangements currently in place with providers, as well as underpin further
work around personalisation. This will be with better alignment of resources
linked to service user needs as we move towards service users taking greater
control over their services through greater use of personal budgets. This
activity comes at a time when the financial challenges for learning disability
services are substantial, both nationally and here in Birmingham, with
numbers requiring care support rising through demographic pressures, at a
time when public sector investment is expected to tighten significantly.
What work is the Joint Commissioning Team undertaking?
A programme of reviews of the highest cost residential care placements of
adults with learning disabilities made by the City. These reviews (not
assessments) will determine if the current care plan for the individuals
concerned remains appropriate. Since we are already delivering services to
the service users, FACS eligibility has previously been established we do not
envisage that reviewing eligibility will form a major part of this review although
whether an appropriate contribution from health partners is in place will be
considered.
Additionally we are reviewing the pricing of packages by using the care
funding calculator to ensure care packages demonstrate best value to the
Council. Part of this activity includes determining the number of care hours a
person needs. This is also an intrinsic part of the review of care packages
being delivered to service users.
Why are we using the Care Funding Calculator (CFC)? The CFC has been developed by various stakeholders including provider
groups as it offers the Council a robust way to:
* Analyse in detail the level of staff support required to meet an individual’s
needs as well as identifying objectives for the service user and report on
progress
* Determine a price based on market knowledge, which is appropriate to
the needs of the person but with a understanding of providers’ services and
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cost pressures
This approach is open and transparent with the provider facilitated to
contribute to the CFC thus enabling a dialogue and contractual negotiation.
For additional information on the CFC see the SE Improvement & Efficiency
Partnership website or following web address:
http://www.southeastiep.gov.uk/newsstory.asp?PageRef=7&NewsRef=277
As well the contract negotiations based on the CFC, the Joint Commissioning
Team is offering meetings direct with providers to discuss future business
plans. This enables both commissioners and providers the opportunity to
discuss the development of future provision required for personalised services
of people with learning disabilities here in Birmingham.
What can be expected at the reviews?
If the service user has not had a recent review of their care plan then the
Reviewing Team will carry out a care management review which the CFC will
form part of. The information collected will determine if the current care plan
remains appropriate to meet the needs of individuals including identifying the
level of care hours required to support an individual. This information will be
used to inform the care funding calculator. The information gathered will be
used for legitimate purposes in accordance with our statutory obligations.
In all care management reviews the Local Authority will ensure that any
information that needs to be shared in advance will be, and that adequate
time will be allowed for any information that needs to be collated prior to the
review. It is not normal for the local authority to supply forms beforehand and
it is not considered to be necessary. The process of review is an ongoing one
and if any service user (or his/her family/carer) wishes to supply information
after the information or have any matter clarified then this is quite acceptable.
The Local Authority leads the review process and will coordinate the process
appropriately including identifying (where appropriate with the service user)
who attends and when. The reviewing officer (and where appropriate in
consultation with the service user) will determine who attends interviews and
review meetings accordingly. In some instances attendance may be restricted
as a result of concerns raised by any party.
Which care packages form part of this initiative?
We are currently looking to apply the CFC to residential care packages over a
threshold of £1149 per week. This threshold is determined by the highest
level of our current contracted fee under our Adults with Specific Needs (ASN)
Contract and pricing framework. It represents just under 260 residential care
packages.
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Response to Freedom of Information Request - FOI 3656
1. A list of the names of the largest 5 providers by value of the contracts
with them being reviewed as part of this project/initiative.
The five largest providers determined by costings of relevant contracts are:
• Care Tech
• Autism West Midlands
• Jaffray Care
• Robina Care
• Care Through The Millennium
2. The total number of providers that are being reviewed under the part
of the project to scrutinise high cost placements.
The total number of providers being reviewed under the project is 85.
3. The total number of providers with more than 3 placements funded by
Birmingham City Council that are to be or are being reviewed as part of
the project/initiative to scrutinise high cost placements.
There are 19 providers with more than 3 placements.
4. The names of providers with more than 3 placements being reviewed
as part of the project/initiative to scrutinise high cost placements.
The providers with more than 3 placements are:
Alphonsus
Maple Leaf Lodge et al
Autism West Midlands
Platinum Care
Birmingham Institute for the Deaf
Robina
(bid)
Care Through the Millennium
Selborne
CareTech SENSE
Craegmore Trident
Elizabeth Fitzroy Support
Trevanion House
Forest Grange
United Response
Friendship, Care & Housing
Jaffray
Voyage
5. The number of providers that have been contacted by 1 December
2009 to review the current contract and/or scrutinise high cost
placements.
96 providers were sent a letter in August 2009 detailing the ‘New Approach to
Contracts’ and there were two provider forums (2 June 2009 and 15 Sept 09)
in which approximately 250 providers were invited.
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6. The definition of a high cost placement. This definition should include
the monetary/cost (in terms of the weekly fee paid to the provider of
care) above which a placement is defined as a high cost placement for
the purposes of the initiative/project being undertaken.
The definition of a high cost placement is a placement costing equal to or
more than £1149.29 p/w. This figure is the ceiling to the current ASN contract
(residential).
7. The number of providers who have agreed to a review to:
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
The Joint Commissioning Team is working jointly with the Learning Disability
Service to ensure the high cost packages continue to meet the needs of
individuals whilst offering best value. Review activity is a requirement for
Local Authorities under community care so it will fulfil this obligation
regardless of provider agreement. However all providers to date with varying
degrees have understood the need to undertake this work and have
cooperated. It is intended that the continued appropriateness of the
placement and the fee level that the Local Authority feels is reasonable will be
reached with full engagement with providers. We have not received any
correspondence to refuse a review to date.
8. The names of providers who have agreed to a review to:
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
See response for 7
9. The number of providers who have confirmed that they do NOT agree
to a review to
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
We have not received any correspondence to refuse a review to date.
10. The names of providers who have confirmed that they do NOT agree
to a review to
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
We have not received any correspondence to refuse a review to date.
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11. The number of providers who have neither agreed to nor disagreed
to a review to
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
See response for 7
12. The names of providers who have neither agreed to or disagreed to a
review to
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
See response for 7
13. The Total Annual Value of placements that Birmingham City Council
intends to review as part of this review to
a) review the current contract
b) to scrutinise high cost placements as at 1 December 2009
The full year value of residential placements above the threshold £1,149 per
week is £22,828, 317 as at July 2009.
14. The Total Annual Value of placements that Birmingham City Council
intends to review as part of this review to
a) review the current contract
b) to scrutinise high cost placements that providers have
confirmed that they agree to a review as at 1 December 2009
See above and response to Q7
15. The Total Annual Value of placements that Birmingham City Council
intends to review as part of this review to
a) review the current contract
b) to scrutinise high cost placements that providers have
confirmed that they DO NOT agree to a review as at 1 December
0209
See response to Q13 and Q7
16. The Total Annual Value of placements that Birmingham City Council
intends to review as part of this review to
a) review the current contract
b) to scrutinise high cost placements that providers have
confirmed that they have neither agreed to or disagreed to a
review as at 1 December 2009.
See response to Q13 and Q7
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17. For EACH provider that has NOT agreed to the carrying out a review
of either
a) the current contract or of
b) the scrutiny of high cost placements as at 1 December 2009 -
please provide the specific reasons communicated to you by each
provider for not agreeing to the reviews.
No providers
18. For EACH provider who has NOT agreed to a review – provider by
provider please provide your responses to them.
See above
19. The number of providers (and the value of the contracts being
reviewed) who have been contacted to carry out these reviews by
Birmingham City Council but with whom no agreement has been
reached after 60 days of your first oral (ie phone call to arrange reviews)
communication with them on this matter to arrange the reviews
No providers
20. Please provide copies of the minutes of the meetings held with
providers where they have NOT agreed to a review to a) review the
current contract b) to scrutinise high cost placements as at 1 December
2009.
No providers
21. A list of the names of the largest 5 providers by value of the
contracts with them being reviewed as part of this project/initiative.
See response to Q1
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