Agenda Item No
The Vale of Glamorgan Council
Social Care and Health Scrutiny Committee : 10th February 2014.
Report of the Director of Social Services
SEWIC Adult Brokerage Hub
Purpose of the Report
1. To update elected members regarding the work of the regional adult placement procurement hub established by the South East Wales Improvement Collaborative (SEWIC).
1. That members note the work of the SEWIC adult placement procurement hub.
2. That members note the proposed work programme for 2014/2015.
Reasons for the Recommendations
1. To ensure members have oversight of the work being undertaken to ensure that long-term placements are procured in a cost effective way and meet service user needs.
2. To ensure members are aware of the forward work programme.
2. The South East Wales Improvement Collaborative (SEWIC) was formed by the Leaders and Chief Executives in each local authority, supported by ten Directors of Social Services (Vale of Glamorgan, Bridgend, Cardiff, RCT, Merthyr Tydfil, Blaenau Gwent, Caerphilly, Torfaen, Newport and Monmouthshire). Through SEWIC, work is being undertaken to improve the provision and commissioning of social services in the region.
3. One of the improvement projects managed through the Collaborative is the Adult Brokerage Service; Cabinet approved the involvement of the Vale of Glamorgan Council in this initiative in October 2011. The regional "high cost/low volume" adult procurement hub was established to provide direct intervention in the social care market and to rationalise new placement procurement activity across the region, thereby ensuring transparency of costs, better matching of needs and placements and, increasing placement choice for service users. The service is used mainly for individual placements that cost over £600per week for clients with a Learning or Physical Disability.
4. Much of social care provision in Wales is now purchased externally. The 'social care market’ is not homogenous but is comprised of many markets which are often highly complex mixed economies that have developed organically over many years. Intervention in social care markets is in itself a complex process which requires attention at a number of levels – local, regional and national.
5. The aims and expected outcomes of this collaborative arrangement were developed by the SEWIC Programme Board and later confirmed via an independent review:
To develop a single, streamlined, point of access for placement choice and fee negotiation – changing culture and practice in local authorities/health boards.
To develop a thorough understanding of provider costs for existing and new placements.
To achieve better outcomes for individuals.
To gather information and intelligence to influence local and regional commissioning.
To develop a greater understanding of the local and regional provider markets.
To reduce the workload of social workers / local authority / health boards’ commissioning units for high cost placements.
6. This development has been independently reviewed and places the participating Local Authorities and the South East Wales Regional Collaborative at the forefront of collaborative service development.
Relevant Issues and Options
7. The Adult Brokerage Service went live in June 2012. Since that time, it has received 151 referrals. 11 of them from this Council.
8. The use of a regional brokerage service and the commissioning intelligence that this generates has enabled commissioners in SEWIC to identify a series of service user needs that are not being met comprehensively or locally in all cases. These service gaps include:
Respite care - especially for adults with a physical disability;
Specialist substance misuse services;
Services for individuals with Korsakoff's Syndrome;
Specialist services regarding Autistic Spectrum Disorder; and
Services for those with multiple / complex needs.
9. Work is now ongoing to identify the level of shortfall regarding these services. If the volume of demand is sufficient, work will be undertaken to consider the feasibility of commissioning these services on a regional basis to ensure a local provision for individuals within the SEWIC areas.
10. The collaborative arrangement has developed positive and productive working relationships and dialogue with a wide range of accommodation service, care and support providers. The aim of this work has been to gauge the appetite of all stakeholders to engage in developing local, cost effective and flexible specialist services as an alternative to the current provision, which is often located far from the service users' home and does not always represent value for money.
11. To progress this work, the proposed work programme for the Adults Brokerage Service for 2014/2015 is as follows :
Align Telecare, Accommodation & Adult Brokerage Service work streams to ensure that both accommodation and care are considered together;
Continue and conclude the programme of regional/national fee negotiations with large care providers;
Build on market engagement initiatives with Registered Social Landlords and care providers – there are now examples of providers changing practice in response to regional market engagement initiatives and these will require further encouragement and support;
Explore potential options for regional and sub-regional commissioning for specialist services and make recommendations to the SEWIC Programme Board;
Research new and novel service responses that support independence and move-on;
Analyse new ways to "incentivise" providers to provide alternatives to 'full occupancy’ model;
Work with local authorities to produce Regional Market Position Statements.
Resource Implications (Financial and Employment)
12. The staffing and day-to-day management of the brokerage hub is undertaken by Rhondda Cynon Taff. The cost of the service is allocated on the basis of usage. On current usage levels, the cost of participating in this project for the Vale of Glamorgan is £6,600 per annum. This cost will be more than covered by the savings that are anticipated to accrue from adopting a regional approach to securing high cost adult placements.
Sustainability and Climate Change Implications
13. The work programme for SEWIC is looking at the options for providing specialist placements on a regional basis which will enable clients to be placed closer to home, therefore maintaining family and community links.
Legal Implications (to Include Human Rights Implications)
14. SEWIC is taking legal advice from Cardiff Council about issues involved in the collaborative procurement of social care services.
Crime and Disorder Implications
15. There are no crime and disorder implications as a direct result of this report.
Equal Opportunities Implications (to include Welsh Language issues)
16. This service will be used for all individual placements that cost over £600 per week for clients with a Learning or Physical Disability.
17. This proposal will help social services to meet the following corporate objective:
Citizens of the Vale of Glamorgan are healthy and have equality of outcomes and,
Through appropriate support and safeguards, the most vulnerable members of our community maximise their life opportunities.
Policy Framework and Budget
18. This is a matter for executive decision by Cabinet.
Consultation (including Ward Member Consultation)
19. Stakeholders have been engaged in in the ongoing development of this service. This has included care providers, registered social landlords, local authorities and appropriate NHS bodies.
Relevant Scrutiny Committee
20. Social Care and Health
Cabinet Report 19th January, 2011
Carys Lord, Head of Business Management and Innovation
Corporate Management Team
Philip Evans, Director of Social Services