TO: EXECUTIVE Director: People, EXECUTIVE Director: Resources, Executive Member for Adult Services, Health and Housing
16 July 2021
Contract Award Report: Heathlands dementia nursing Care & HotEL serviceS
1.1 Heathlands Care Home is a major new build 66-bedded care facility in Bracknell Forest. The facility encapsulates a health and care partnership approach and is based on the Frimley Clinical Commissioning Group (Health) and Bracknell Forest Council’s (Social Care) aspiration to deliver integrated care to meet growing dementia and nursing need in Bracknell Forest.
1.2 This report seeks approval to award a contract for the provision of dementia nursing care and hotel (facilities management) services at the new integrated Heathlands facility. This award is following a robust and collaborative procurement process, with the Council as the lead commissioner.
2.1 That a contract for the Service, commencing on 3 January 2022 (dependent on building completion), is awarded to Tenderer B, for an initial period of five years, with the option of a further three- and two-years extensions to a maximum of ten years (5+3+2 years) subject to satisfactory performance.
3.1 To complete the procurement process for a provider of:
a. dementia nursing care services across 46 beds (of which up to 36 are to be block purchased by the Council) and
b. the hotel services across all 66 beds (dementia nursing care on lower two floors and intermediate care service (ICS) on the second floor which will be operated by Frimley Health NHS Foundation Trust).
3.2 The anticipated benefits delivered through awarding the contract to Tenderer B will include:
a. improved local availability of dementia nursing care,
b. seamless experiences for the service users through integrated care arrangements and
c. savings to the Council from block contracting for dementia care and the wider system through more efficient local integrated care provision.
4 ALTERNATIVE OPTIONS CONSIDERED
4.1 When developing the business case for Heathlands, partners explored the options of Frimley Health NHS Foundation Trust (FHFT) delivering the whole care offer at Heathlands (e.g. ICS, dementia nursing and hotel services), or ICS and hotel services on the second floor. However, these options were not pursued, which meant that an external provider for dementia care and hotel services needed to be tendered, with the Council as the lead commissioner.
5 SUPPORTING INFORMATION
Commissioning Ask
5.1 Heathlands Care Home is an integrated care partnership between the provider, GPs, Health and Social Care professionals, voluntary agencies, the person/family members/carers and significant others.
5.2 The home should promote independence and person-centred care through the provision of 20-bedded intermediate care service (ICS) offering reablement and rehabilitation aimed at helping people return home or preventing hospital admission and specialist dementia and nursing residential care across 46 beds.
5.3 The intermediate care service will be provided by Frimley Health NHS Foundation Trust (FHFT) on the second floor and aims to:
a. Support the early transition from hospital for a period of care, assessment and rehabilitation in the community.
b. Enable adults to improve, maintain or manage changes in levels of independence, health and wellbeing, through a process of care, reablement and/or recuperation.
c. Achieve better outcomes for people to remain independent and in their own homes for as long as possible and reduce the high levels of dependency on long term care.
d. Prevent hospital admissions and attendances supporting the provision of care pathways allowing people to seamlessly step up or down levels of care and support – ensuring continuity of care, swift discharge and enable return home where appropriate.
5.4 The dementia nursing care service will be located on the ground and first floors and should:
a. providing environment that is homely and where individuals have control over their own life, personal space, privacy and security;
b. support the individual to engage in everyday activities of daily living and developing new skills;
c. provide access to social activities outside the home, facilitated by the Service Provider.
d. The provider should have effective mechanisms for liaising with other agencies to ensure that assessment of need and allocation of service provision results in achieving the individual’s identified outcomes.
5.5 Both ICS and dementia nursing care service will be supported by hotel services, which will, amongst other elements, include:
a. Meals and Nutrition,
b. Laundry consumables,
c. Gardening and building maintenance,
d. Admission – coordination and room set up,
e. Minimum offer on core elements such as linen, soap, towels etc.
5.6 Frimley Clinical Commissioning Group (CCG), FHFT and the Council seek to collaboratively work with a provider who:
a. is committed to working as a system partner within a wider health and care system to deliver the national and local vision of Integrated Care;
b. values an open and collaborative culture;
c. strives for excellence;
d. delivers safe, high quality, value for money and person-centred services;
e. has a commitment to continued improvement alongside Care Quality Commission (`CQC`) standards and person feedback.
Tender
5.7 The procurement was subject to a full tender process in accordance with the Public Contracts Regulations 2015. The procurement was undertaken in accordance with the Strategic Procurement Plan which was approved by the Council’s Executive in December 2020.
5.8 The opportunity was advertised on the Find a Tender Service, South East Business Portal (SEBP) and Contracts Finder in March 2021. The deadline for tenderers to submit their tender was 16 April 2021.
5.9 The procurement included three evaluation stages:
(1) a selection questionnaire, reference review and financial checks to determine providers’ suitability and compliance,
(2) the scoring of pricing and quality method statements and
(3) a clarification presentation, where tenderers outlined their tender and responded to specific questions. See Confidential Annex for more detail.
5.10 The Tender Evaluation Team was drawn up from the Council’s Community Mental Health Team for Older Adults (CMHTOA), Strategic Commissioning, Finance, the Programme Office, and our health partners including Frimley Health Foundation Trust and Frimley Clinical Commissioning Group. Carer volunteers also helped to assess tender responses relating to the user experience.
5.11 Following the evaluation process, the Tender Evaluation Team conducted a final moderation on 22 June 2021, at which stage Tenderer B was identified as the successful tenderer, subject to approval.
5.12 It is recognised by the Tender Evaluation Team that, as a new service, flexibility and collaborative working will be essential in the mobilisation and implementation of the contract. It is recommended to closely monitor the contract scale up period and make provisions for any contingencies. Also, it is planned that the voice of the service user will continue to be included through the involvement of carer volunteers during the embedding of the new service.
6 ADVICE RECEIVED FROM STATUTORY AND OTHER OFFICERS
Borough Solicitor
6.1 The legal implications of the procurement process undertaken prior to contract award are considered fully in Annex 1 to the Executive Report dated 10 November 2020.
6.2 The procurement process undertaken is compliant with the Public Contracts Regulations 2015 and the decision to appoint the chosen provider was made in accordance with the PCR 2015.
6.3 Para 1.15.2 of Supplement C to the Procurement Manual (which supplements the Council’s Contract Standing Orders) and forms part of the Council’s Constitution explains that where a procurement has been the subject of an approved SPP, then further approval at contract award stage is only required where cost and scope as stated in the SPP is exceeded or the SPP states that such approval is required. Neither of the above is the case here, however 1.15.3 explains that a report to the Director is optional but recommended where a matter is complex or high risk. As this is a complex and high value procurement, then it is appropriate that Director approval is obtained for contract award by way of a written report.
Borough Treasurer
6.4 Estimated revenue savings have been set out in the confidential Annex. There are risks to the realisation of these savings, such as unforeseen costs (particularly in respect of the placement of complex clients) and the bed utilisation rate.
Equalities Impact Assessment
6.5 An Equalities Impact Screening and full Equality Impact Assessment was completed at the outset of the procurement, as part of the Strategic Procurement Plan. It is anticipated that awarding this contract for the delivery of dementia nursing care and ICS will have a beneficial impact on those with health and care needs particularly in the protected characteristics of age and disability / long term conditions.
6.6 As part of the tender submission, Tenderer B demonstrated a robust Equality & Diversity approach which will continued to be monitored throughout the contract.
Strategic Risk Management Issues
6.7 In the awarding of the contract following strategic risks will need to be managed and mitigated
|
Risk |
Mitigation |
|
Delay to the building (currently due to complete November 21) requires providers to be flexible – might incur additional costs and or limited capacity to scale up as planned |
Close monitoring of building delay
Ongoing partnership work with providers to plan for contingencies
Contingency budget to cover additional costs during implementation and scale up |
|
Actual demand in terms of volume and complexity of need proves to be different from assumed modelling during scale up (for ICS and or dementia services) |
Plan for operational and pricing implications of activity variance with provider, including impact on any hotel elements
Close monitoring during scale up of incoming placements / level of complexity and impact on service delivery model
Contract review built in after year 1 to allow for contract variation (for dementia & hotel elements)
Risk sharing between commissioners to be agreed through legal framework (e.g. lease agreement) |
|
Covid19 – uncertainties about the development of the pandemic through winter and any additional costs and available funding streams |
Applies to all local providers and will be managed through existing arrangements to support (Commissioning Team to lead) |
7 CONSULTATION
Principal Groups Consulted
7.1 The development of the ITT was completed in close collaboration with the Heathlands partners: the Council, Frimley CCG and Frimley Health and Foundation Trust. Officers from CMTHOA, commissioning and safeguarding were included in the design of the specification and performance management framework for the dementia nursing care service. The Council also worked closely with Frimley CCG and FHFT to ensure that the hotel service ask was fully captured in the specification. The Council, Frimley CCG and FHFT’s finance and estates teams, and external legal partners contributed in the drafting of the ITT including pricing schedule and draft contract.
7.2 Good practice advice and examples from other local authorities and the CQC was also sought. A visit to an integrated care home model in London in 2019 helped to direct the thinking for the Heathlands commissioning ask.
7.3 Discussions during the design of the specification were held with the local Dementia Forum to ensure the voice of the service users is reflected in the commissioning ask. A team of volunteers with lived experience as an informal carer of those with dementia co-produced the tender questions and assessed tenders around user experience.
7.4 Soft market testing during the design of the specification also ensured that the providers’ voice was reflected to ensure the commissioning ask was feasible and would deliver the anticipated benefits.
7.5 The Heathlands Project Board provided governance and steer on the delivery of the project and was regularly updated during the procurement process. The Executive Member for Adult Services, Health and Housing was also regularly briefed throughout the process.
Representations Received
7.6 None
Contact for further information
Thom Wilson, Assistant Director Commissioning, thom.wilson@bracknell-forest.gov.uk
Jo Alderson, Head of Corporate Procurement, jo.alderson@bracknell-forest.gov.uk