Decision details

The Cabinet member for Adult Social Care is asked to approve the variation to the Virgin Care Block contract to expand the Supported Living Service for people with a learning disability.

The Cabinet Member agrees to vary the Virgin Care Block contract to expand the Supported Living Service for people with a learning disability in two ways:

Proposal 1: Increase the non-accommodation-based care to support people in their own tenancies or family homes by 10% each year over the next 3 years. This will enable the recruitment of 5 additional care staff each year, including a registered manager in the first year. The focus will be on young people with more complex needs transitioning from children into adult services where there is currently a gap.

Proposal 2: Increase accommodation-based provision with the development of two four-bed properties with care and support provided by Virgin Care onsite.  This would enable 6 adults who have already been identified by social care to return to B&NES from out of area and /or step down for residential care or prevent further placements out of area or into residential care (unless this the individual’s choice). Additional staff would be recruited to provide care in the 2 properties including staff to sleep-in. Support is also request for the proposal of these units being purchased directly by the Council if considered appropriate and agreed through internal capital governance procedures.

Currently there are 574 adults with a learning disability and/or autism who receive a care and support package or placement commissioned by B&NES.

Residential placements make up the biggest spend from the Learning Disability purchasing budget. Of the 130 adults currently placed in residential care, 82 (63%) are placed out of area. The residential care spend is £12,711,303 per annum, of which the out of area spend on residential care is £8,902,237 (which is 70% of the residential care spend).

The Virgin Care Supported Living Service supports 46 people with a learning disability (figures included in 3.1 above), 30 in Bath and 16 in North East Somerset in a mix of accommodation-based and non-accommodation based supported living.

The Virgin Care Supported Living Service is currently 8% of provision commissioned by B&NES. Other than the Virgin Care contract for the Supported Living Services, all packages, and placements for people with a learning disability are individually contracted on a spot purchase basis. There are no other contracted services in B&NES for this client group that we can expand or develop within procurement rules because we contract for individual packages and not services. In addition, B&NES providers are understandably not willing to risk expanding at the level required with no guarantee of future commissioning and funding.

We are therefore planning to change how we commission and move away from the spot purchase model to a more planned and strategic approach where we commission local community services. We are developing a rolling 5-year commissioning plan which will identify new demand each year over the next five years. This will enable better planning for:

•  young people who will transition into adult services from children’s each year

•  adults who are still living with family carers, especially ageing carers who may not be receiving any care or minimal support but who will require a care package or move at some point

•  those whose needs change especially as they age as people with a learning disability are living longer now. 

We are currently engaging with the local market about the future  procurement of community services which can grow iteratively  each year to meet new and changing demand as part the plan. We  are also engaging with people with lived experience and their

carers as part this process.

The first phase of this procurement is planned to commence in

March 2022 which means any new supply will not start to come

online until after the first new contracts have been awarded and

services mobilised, which realistically will be after October 2022.

Varying the contract with Virgin Care for the Supported Living Service

allows us to expand and mobilise community provision now ahead of

the wider procurement of services which is still 12 -18 months away

and will address some of the immediate supply issues.

The Supported Living Service is registered with the Care Quality

Commission as a domiciliary care provider. There is no quality or

performance concerns about the delivery of this service. It is

performance managed by the Senior Commissioning manager

through quarterly service level performance meetings as part of the

Virgin Care Contract Quarterly Performance process.  It performs

well and is always fully utilised. The service is ready to mobilise for

the first year as it has been increasing is bank staff in anticipation of

the decision being made.

Three options for increasing capacity urgently in the market have been considered:

• Do nothing and continue to spot purchase. This was discounted because it would not provide the increase in capacity required. It would not give providers any security about future growth, and they have indicated that they are not willing to risk investing in wider expansion based on spot purchase only with no guarantee of future funding. It is also not possible within current procurement rules.
• Procurement of new supply from the wider market. Planning and engagement with the wider market is underway but will take at least another 12 -18 months before any new supply becomes operational.
• Vary the Virgin Care contract. This option was selected as we have a contract already in place and close partnership. By agreeing to vary it, care and support can be mobilised quickly ahead of the wider procurement due to commence next year.