The Deal 2030 Care and Support Ethical Framework
Briefly describe the initiative/ project/service; please include your aims and objectives
Wigan Council and Wigan Borough Clinical Commissioning Group wished to develop an ‘Ethical Framework’ that would deliver a transformed model of ethical, asset-based care, meeting the needs and aspirations of people to live fulfilled lives in their own home avoiding inappropriate admissions to hospital and residential care. To do this we knew that we required providers who were passionate about their service and could help our residents achieve and deliver on the points below:
– That people have real control over their care and support, actively engaging residents, carers, local communities and partners in the co-design and development of support packages.
– The difference that they are making to people’s lives through an asset-based approach celebrating and facilitating people’s gifts, talents and aspirations.
– That they seek solutions that actively plan to avoid or overcome crisis and focus on people within their natural communities, rather than service and organisational boundaries.
– That they enable people to develop networks of support in their local communities and increase community connections.
– That they take time to listen to a person’s own voice particularly those whose views are not easily heard.
– That they fully consider the needs of the family and carers when planning support and care.
– That they ensure that support is culturally sensitive and relevant to diverse communities.
– That they consider a person’s whole life, including their physical, mental, emotional, and spiritual wellbeing.
Commissioners wanted care and support to be delivered by skilled and compassionate workers, employed by providers who offer excellent services to Wigan residents based on responsible and supportive employment practice, in return for a comprehensive reward and support package. Commissioners wanted a way to engage with Wigan’s supply chain as trusted partners to co-design services to meet the needs of Wigan people. The ‘Ethical Framework’ is the foundation of this partnership.
The Lots covered by the Framework are:
– Homecare Services;
– End of life care;
– Complex Health services;
– Extra care;
– Supported Living for people with Learning Disabilities, Autism or Physical Disabilities;
– Supported Living for people with Mental Health needs;
– Day Opportunities;
– Non-personal care;
– Complex Care Including Transforming care;
– Homelessness Service;
– Temporary and supported Accommodation;
– Community Rehabilitation and Specialist services;
– Adult respite;
– Delegated Healthcare tasks Training;
– Community care and support at night;
– Direct payments and Personal budgets;
– Children’s Services.
Service users participated in both the drafting of the specification and in the interview process to select organisations admitted to the Framework. They analysed the market from their perspective as recipients of services. Suppliers fed into the specification and Lots to be advertised. Even the “ethical rate of pay” for certain Lots was co-produced with the market as was the zoning of Wigan into manageable areas to reduce travel costs for staff and providers. This zoning of areas also helps providers and commissioners meet their environmental pledges. Providers highlighted that travel distance between calls could vary, this impacted on the time spent with clients and resulted in complaints from both staff and clients. Providers were assured by the proposed zone model; Wigan is split into 16 zones for homecare and previously this was covered by 19 providers who could and themselves visiting clients across the borough.
The new model is still split into 16 zones, however there are now 12 providers covering allocated zones. Providers contributed to the design of these geographic zones. This in turn has cut down on travel time, increased productivity, improved satisfaction rates and contributed to reducing carbon emissions in the Borough.
Providers had concerns as to whether providing care in Wigan would be cost effective. Providers were advised that the ‘Ethical rate’ for Homecare in Wigan (2019/20) is £15.40p/h. This price includes the National living wage, Travel, NI and pension contributions, Holiday pay and Travel costs. Providers were assured that Wigan wished to co-design an affordable and sustainable pricing model which was respectful of a healthy profit return. Small providers were less confident in using Wigan’s procurement portal and writing bids in general. The Procurement Team took a proactive approach to ensure small providers were not deterred by the procurement process. It is envisaged that approximately £250m of spend will go through the new Framework but this may rise considerably as the CCG uses this resource more. 71 providers gained admittance to the Framework and all successful parties committed to undertaking community wealth
building / social value activities to strengthen the partnership and give something back to the Wigan community.
What are the key achievements?
Ensuring that providers, whether they be small local providers or large multi-national providers, were committed to Community Wealth Building in the borough proved challenging. However, it was crucial that providers understood its importance to Wigan politically and philosophically. Wigan Council has been practising elements of community wealth building for years under the banner of Social Value. We may not have recognised it, or even intended it, but its ethos is one that aligns strongly with what it means to be Wigan. Community wealth Building was embedded throughout the selection process, and not just the 20% evaluation question within the ‘Invitation to Tender’. It was integral to choosing the right partners for our place and people. The interview process was
structured to test interested parties’ commitment. Community Wealth Building aims to reorganise the local economy to put control back into the hands of the local people and places. At the heart of the approach are key strategies for harnessing existing resources to enable local economies to grow
and develop from within:
– Fair Employment;
– Socially productive land and assets;
– Making financial power work;
– Plural ownership of the local economy.
We achieved this through the presentations at the Provider Engagement Event; documents were uploaded within the tender pack that gave providers an understanding of what Wigan wants to achieve by 2030. The questions within the ‘Invitation to Tender’ (ITT) gave providers a chance to give examples of how they have or would contribute to Community Wealth Building/Social Value. Wigan Council’s “Community Book’ website enabled providers to link with community groups and charities. Opportunities during the interview stage, either through the presentation or through response to questions, gave Commissioners an insight to which providers understood the importance of community wealth building and who could deliver on this key priority for Wigan. From the feedback and enthusiasm received from providers who attended the Engagement Event we were confident that the Framework would attract like-minded professionals who were committed to working in an asset-based way which aligned with Wigan’s 6 Core Deal Principles (photo uploaded) and behaviours; we were not disappointed.
In total we received 327 expressions of interest, 122 applications, of which 4 bids were non-compliant, 117 providers were moderated and 87 providers were invited to interview. Following interviews 71 providers were successful in gaining admittance to ‘The Deal 2030 Care and Support Ethical Framework’. These figures have been a measurable increase from the previous Framework where far fewer applications were received and only 45 providers joined the Framework. We believe the Provider Engagement Event was pivotal in Wigan receiving a high number of quality bids and is reflected in the only non-compliant bids being from providers who did not attend the event or engage with the Procurement Team prior to submitting their bid. The success of this procurement process will mean our Borough’s residents will receive the highest standard of care from ‘the best of the best’. The consultation with providers and service users (I-Statements of what service users want from providers) fed into a wealth of data that will be used to shape specifications for ‘call offs’ from the new Framework and ensure that the right services are put in place for Wigan people. This consultation has only just begun. The Framework is a tool to facilitate more open conversations with Wigan’s providers. Feedback from bidders has been overwhelmingly positive saying that the procurement exercise was well managed. Weekly summaries of questions submitted via the procurement portal were shared openly to assist. The opportunity was advertised for 51 days across OJEU to give organisations an opportunity to apply..
What are the key learning points?
Wigan’s Senior Management Team have shared the benefits of this approach with our Association of Greater Manchester Authorities (AGMA) colleagues, speaking to the AGMA Directors of Adult Social Care Group. One of the Greater Manchester Combined Authority (GMCA) single commissioning strategy priorities is the commissioning of a rapid improvement in homecare services across the region. The transformation of homecare in Wigan informs development
and shaping of this important work and is seen as leading practice in designing a new Greater Manchester Ethical Framework. Wigan Councillors are being paid to speak to other Local Authorities nationally about Wigan’s improvements to Adult Social Care, including the benefits achieved by this ground-breaking approach. To progress our ambition for further radical re-design of homecare, we have developed a partnership with ‘Helen Sanderson Associates’ (HSA), an internationally recognised Social Enterprise, leading innovation in Social Care. HSA are working with us to move away from a reductive approach of time and task, to be one of the first areas to develop asset based, outcome focused homecare at scale.
We will also be testing out a Wigan version of the Buurtzorg model, introducing the concept of integrated Wellbeing teams, able to provide a fully integrated health and social care offer of homecare. Working for ethical providers among the care workforce is increasing the quality of recruitment and standards of provision enhancing the subsequent letting of contracts from the Framework such as Extra Care and Supported Living. The commitment to Community Wealth Building has been shared across Wigan Council and Wigan Borough Clinical Commissioning Group. A workshop was held with the Centre for Local Economic Strategies (CLES) with the senior management from both organisations. Wigan has a conscious focus on Community Wealth Building and has utilised progressive procurement techniques to reinvest Wigan money in Wigan.
The Framework won a “Highly Commended” award at last year’s ‘GO Awards’, PROCUREX 2020. It is a resource that is being utilised by Wigan Council and Wigan Borough Clinical Commissioning Group (CCG) in their response to the pandemic and in their approach to market shaping and service delivery.