Portsmouth City Council Home Care Re-Commissioning Consultation

Current Service Requirements

Domiciliary care is the most common means by which the Council's Adult Social Care delivers its statutory duty to meet people's care needs. Clients typically access domiciliary care following an assessment of need by either a community social work team, the Adult's Intermediate Care Team or the Community Reablement Service. The level and type of support required is determined in line with each individual's support plan.

The purpose of the domiciliary care service is to compliment the Councils priorities by ensuring:

• People live longer and have healthier lives.
• People are safeguarded in vulnerable situations.
• Independence is promoted for older people.
• People are enabled and healthy lifestyles are promoted.
• Independence for people with disabilities are promoted.

Providers are provided with an assessment, which will detail the wishes, needs and outcomes required by the individual service user. Support packages vary in size based on the individual needs and range from minimal support up to highly specialised and complex needs.

Service users are ordinarily a resident in the city of Portsmouth and/or the responsibility of the Hampshire and Isle of Wight Integrated Care Board (HIOWICB). The service user will be assessed as requiring health and/or social care services.

Background

The Council established a Dynamic Purchasing System (DPS) on 1st February 2020, with 3 separate lotting options under the light touch regime of the Public Contract Regulations 2015 to meet the existing and future demands for Domiciliary Care.

The DPS is constructed as follows:

• Lot 1 is for those providers accepting the Councils' standard rate for domiciliary care.
• Lot 2 is for providers offering services at a rate determined by the provider.
• Lot 3 is for awarding contracts for complex cases and is usually negotiated on a case-by-case basis between practitioner and provider outside of the brokerage process (principally Continuing Health Care placements).

The DPS was initially awarded on the basis of a 5-year term, with the option to extend beyond the initial term by a minimum of 1-year intervals for an indefinite period. At the point of establishment 39 suppliers were successful with their application onto the DPS, with some suppliers on multiple lots.

The DPS was advertised with an anticipated annual value of £9.2M a year and spend of £46M over the initial 5 year-based term of the DPS.

By October 2023, the Council was in a situation where the number of providers on the DPS was exceeding the demand, with the risk of destabilising the market for existing providers by winning less call-off contracts, threatening the business models as well as creating a risk to the Council.

Following a review of the DPS capacity (see II.2.14. Additional information for further details), the Council issued a modification notice on the 17 November 2023 to close the DPS for new applicants following a 30 day application period.

The Council received a further 45 number of applicants by the 18th December 2023 when the DPS was closed, with 23 new suppliers being successfully award a place the DPS.

Ongoing and predicted spend

The original advertised contract value was forecast to be in the region of £9.2 million per annum.

However, the Council have spent the following within the first 5 years of the DPS -

2020/21 - IRO £12.5 million

2021/22 - IRO £13.5 million

2022/23 - IRO £14.5 million

2023/24 - IRO £17.6 million

2024/25 - IRO £19.7 million (forecast)

The reasons behind the increased levels of spend include - annual uplifts, allocation of unexpected grants during Covid, and increase in demand. The result of this has meant the estimated spend over the initial 5 years exceeded the estimated value included within the original contract notice.

Known current supply and demand

There are currently 62 providers on the DPS. Supply of domiciliary care in the City currently exceeds demand, resulting in multiple offers of care for most referrals.

The situation is not unique to Portsmouth and seems to be a picture found in many urban areas. It is a recent development, which has emerged gradually over the past 3 years or so.

To ensure fairness and transparency with providers that are on the DPS, packages of care are allocated to those achieving 100% via the brokerage portal and then filtered to the provider that has been awarded the least number of hours during the current month. The average number of bids achieving 100% per package of care is between 5 and 15. Client preference may apply to Tier 1.

As of July 2024, there were 1089 clients in receipt of 19,500 hours of domiciliary care per week. This includes standard domiciliary care, sitting services, social inclusion and sleeping/waking nights.

Future

The Council needs to address the current situation with regard to market saturation and review the commissioning model in the most cost-effective manner possible. The Council have conducted research with other Local Authorities to explore different models of commissioning home care, and now need to engage with providers for their input. The Council are are holding an in-person event at Portsmouth Guildhall on 12th February to explore the future for home care in Portsmouth.

At this stage, the Council are restricting attendance to one person from each provider as the Council can only accommodate 100 places at the event. The event will be on a first come first serve basis. In the event that the Council exceeds the maximum occupancy for the event, the Council reserves the right to run an additional online event to engage further with providers who could not attend the in-person event.

Places for the event can be reserved using the following link - www.eventbrite.co.uk/e/portsmouth-city-co… ↗

In addition, providers can find the link to the event and details of the SMT event on the Councils e-sourcing platf…