Joint Commissioning Unit. Contract Management Framework

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1 Joint Commissioning Unit Contract Management Framework

2 If you would like this information in large print, audio tape or in any other format or language please contact the public information officer on Version Date Approved Approved by Review Date 1 19 th May 2011 Core Strategy Group May

3 Contents Page Introduction 5 Our Priorities 5 Chapter 1 Monitoring and Proportionality 6 Monitoring and Proportionality 6 Section A Contracts Under 50, Section A Service Review Process 8 Strategic Focus 8 Risk Management 8 Stage 1 Risk Management 8 Stage 2 VFM Assessment 9 Stage 3 Service User Consultation 9 Review Outcomes 9 Section B Contract Over 50, Section B Service Review Process Strategic Focus Risk Management Stage 1 Risk Management Stage 2 CQC and QAF Stage 3 Desk Top Analysis Stage 4 Strategic Contract Review Stage 5 Validation Visit Stage 6 Service User Consultation Review Outcomes Section C JCU awarded contracts who are signed up to Walsall Council or NHA Walsall Initiatives Section C Service Review Process Risk Management Stage 1 Risk Management Stage 2 VFM Assessment Stage 3 Service User Consultation Review Outcomes Chapter 2 Performance Management Aims 19 Performance Indicators 19 Outcomes 19 Monitoring 19 Performance Management Process Contract Management Enforcement Action 21 Chapter 3 Strategic Contract Review 21 Aims 21 Assessment Process 21 a) Strategic Relevance 21 b) Quality 21 c) Performance 22 d) Value 22 Assessment Tool 23 Assessment Outcomes 23 3

4 Chapter 4 Decommissioning Conduct 24 Definition 24 Decommissioning Process 24 Exit Strategy 24 Communication Protocol 25 Monitoring Arrangements 25 Evaluation 25 Chapter 5 Defaults 25 Aims 26 Default Notices 26 Default Situations 26 Submission of Information 26 Breach of Contract 26 Serious Default 26 Persistent Default Suspension Chapter 6 Appeals 28 Appeals Procedure 28 Appeal Criteria 28 Exceptions 28 Stages of Appeal 28 Stage 1: Submission 28 Stage 2: Appeal Consideration 29 Stage 3: Appeal Panel 29 Stage 4: Local Government Ombudsman 30 Further Information 31 Feedback Form

5 Introduction The development of the Joint Commissioning Unit (JCU) provides an opportunity to better coordinate working between Adult Social Care, Walsall Council and NHS Walsall. This framework outlines how the JCU will manage its contracts supporting our strategic priorities and financial modelling. Our aim is to: Improve health, wellbeing, life chances and independence of Walsall citizens. Our Priorities: This framework is integral to the JCU achieving our priorities over the next three years ( ) to: Put our citizens at the centre of commissioning, giving them greater choice and control, Provide good quality services which will be outcome focussed and innovative, Promote health and well-being by promoting access to a range of universal services and commissioned primary services (achieved by delivering practical services, promoting health and active lifestyles and supporting safer neighbourhoods), Reduce dependence on services and promote independence and self directed support by offering secondary services to meeting changing needs and expectations (achieved by demonstrating a halting or slowing down of deterioration, active improvement in individual situations and by identifying people at risk e.g. falls prevention to prevent occurrence), Prevent citizens from becoming socially excluded and needing more intense and costly support from social and health care agencies by providing a range of tertiary services (access to services will have a demonstrable benefits including; minimising disability or deterioration, maximising functioning and independence, increased uptake for rehabilitation and enablement services, and joint case management of people with complex needs). Help citizens to access mainstream services e.g. procuring disabled showers in Leisure Centres. We want to: Continue to improve our services to meet outcomes locally and nationally for Prevention, Adult Social Care and Health, Improve access to information and services; Focus on early intervention and prevention services for vulnerable people, including the development of a prevention and intervention strategy. We will: Make sure that contract management processes and activities are fair, open and transparent; Identify opportunities to work with other stakeholders and local authorities in the development of service provision; 5

6 Involve service users, their carer s and families, our stakeholders and partners in the processes for managing our services. Procedures will be reviewed annually, taking into account the JCU business plan. This is an evolving document which will be reviewed on a regular basis due to the contracts in the JCU being subject to change/tender. Chapter 1 - Monitoring and Proportionality Monitoring is about collecting information and assessing it, it is an element of good management practice. The JCU is seeking to promote good practice in the monitoring process by minimising the monitoring and inspection burden on providers to a level proportionate to the level of funding and risk, whilst evidencing the outcomes for Walsall citizens. The JCU will follow good practice around proportionality and risk management in both monitoring and evaluation, while maintaining proper control of use of public money. Contracts awarded by the JCU will be monitored using three specific monitoring processes, as described in Sections A, B and C (pages 6 to 8). Section A - (Flow chart see p7) Section A will be for all JCU contracts awarded by the Council equal to or under the annual value of 50,000. Section B (Flow chart see p10) Section B will be for all JCU contracts awarded by the Council over the annual value of 50,001. Section C (Flow chart see p15) Section C will be for all JCU awarded contracts signed up to Walsall Council or NHS Walsall initiatives e.g. Working Smarter Pilots. 6

7 Section A Contracts UNDER the Annual Value of 50, Stage 1 Service Review Strategic Relevance Determined from the JCU priorities. Risk Management / VfM A risk assessment inclusive of Value for Money Assessment is conducted to identify any potential risks and to determine the frequency of each service review. At least once in the lifetime of the contract. Stage 2 Desk Top Review Service Self Assessment (SSA) Providers are asked to complete SSA covering: Staffing Health & Safety Notifiable Incidents Safeguarding Case Studies Equality Impact Assessment Business Continuity Plan Assessment of Outcomes These are reviewed with performance returns by the JCU. Case studies to be submitted with the SSA depending on the capacity of the service/s, providers are required to submit a 2% sample (maximum of 10) demonstrating outcomes achieved by service users and an annual SU satisfaction survey Stage 3 Strategic Review Peer Assessor Review Peer reviews are conducted independently from the JCU and Provider. Peer Assessments can be carried out in various formats including: Questionnaires Mystery Shopping Consultation Stage 4 Outcome of Service Review JCU will agree 1 of 3 recommendations: Continuation of service/s with no change Continuation of service/s but with minor changes to comply with VfM Service ends 7

8 Section A Service Review Process Strategic Focus The financial climate has placed greater emphasis on preventative services with a change from outputs to outcomes; prevention influences all areas of service provision. Risk Management A risk management approach is linked to the service review timetable (web link) to identify any potential risks e.g. complaints, under performance etc, this may in turn determine the need to change the published timetable (see Stage 1 below Risk Management). The review process is conducted in several stages depending on which section you will be monitored against (Sections A, B or C) these consist of: Annual service self assessment (web link) VfM assessment (inclusive of benchmarked data against West Midlands Regional Information Group (WMRIG) Validation visit, Citizens consultation. Stage 1 Risk Management A risk assessment is conducted for each individual service to identify any potential risks to citizens, service quality or misappropriate use of JCU funds. The assessment will measure the level of risk and determine the frequency of service reviews for each individual service. Performance information taken from the last 12 months is used to inform a risk assessment of 3 areas: Quality QAF/CQC scores, progress with improvement/action plans etc. Performance and Contract Compliance National and Local indicators, returns (accuracy, on time and performance against targets) and exception reports or default notices served Financial Risks Value for Money (VfM) assessments and overall contract values of individual providers The assessment will produce a traffic light risk rating of Green, Amber or Red. Green 12 to 19, overall risk is low and will be subject to a lighter touch approach to contract management. All services will complete an annual return of a SSA for desktop review with a full review being completed within the lifetime of the contract, unless there is a significant change to the delivery of the service. Amber 20 to 27, overall risk is medium and will be subject to a lighter touch approach to contract management. This will involve an annual return of a SSA and one or more elements of the QAF/CQC for desktop review a validation visit, interviews with staff and consultation with service users, with full review being completed within 2 years. 8

9 Red 28 to 36, overall risk is high and will be subject to a comprehensive approach to contract management until the risk rating is reduced to an acceptable level. This will involve the return of a SSA and QAF/CQC, a desktop review, a validation visit, interviews with staff and consultation with service users completed within 12 months. All services are subject to a full service review at least once within the lifetime of the contract. If there is a substantial variation in performance or a critical incident occurs for example safeguarding or health and safety concerns, a comprehensive approach to contract management may be required and the service may be considered as high risk. The risk ratings and suggested timetable will be reviewed and agreed by the JCU governance arrangements to ensure services are effectively managed. Providers will be given details of their risk assessment and the factors considered in determining the final score (web link). Providers will be given the opportunity to discuss the risk matrix score with the JCU. Stage 2 VfM Assessment The third stage of the review process requires a VfM assessment of the service. The assessment considers five criteria and is not based on costs alone. The criteria are: Strategic relevance, Quality, Performance, Value, Service user consultation. Stage 3 Service User Consultation The provider will carry out an annual satisfaction survey with the service users as identified in the service specifications in Schedule 3 of the contract. Review Outcomes The outcome of the review process could be: continuation of contract and services with no changes, continuation of contract and service but with minor changes e.g. service specification, outcomes etc; to comply with changing agendas, service ends. Where the completed review recommends remodelling, re providing or ending a service, a report will be presented to the Lead Commissioner, who will consider the outcome of the review and the impact on citizens and service provision and make their final recommendation to the VAEB, who have the final decision on the outcome. At any time in the review process, providers have the right to appeal against any decisions or recommendations made by the JCU (web link) 9

10 Section B Contracts OVER the Annual Value of 50, Stage 1 - Service Review Strategic Relevance Determined from the JCU priorities. Risk Management A risk assessment is conducted to identify any potential risks and to determine the frequency of each service review. Stage 2 Desk Top Review Service Self Assessment (SSA) Providers are asked to complete SSA & Quality Assessment Framework (QAF) /Care Quality Commission (CQC) workbook providing evidence against 1 of the following objectives: Assessment & Support Planning Security, Health & Safety Safeguarding & Protection from abuse Fair Access, Diversity & Inclusion Client Involvement & Empowerment Assessment of Outcomes These are reviewed with performance returns by the JCU. Case studies to be submitted with the SSA depending on the capacity of the service/s, providers are required to submit a 2% sample (maximum of 10) demonstrating outcomes achieved by service users Strategic Contract Review This assessment is conducted in line with Walsall JCU Methodology and will compare: Strategic Relevance Performance Indicators, outputs & outcomes achieved QAF/CQC scores Value Citizens Consultation Stage 3 Further Evidence / Service Review Investigation / Validation Visit Issues Raised from QAF/CQC or Outcomes The JCU will visit the service to address concerns. An improvement plan will be issued, following completion; the review process will resume starting from stage 2. Failure to achieve level C in stages 3 or 4 will result in a breach of contract and a Default Notice will be issued. Issues Raised from a VfM Assessment The JCU will meet with the Provider to develop the service to comply with VfM requirements. This may include re-modelling of the existing service/s. Stage 4 Strategic Review Peer Assessor Review Peer reviews are conducted independently from the JCU and Provider. Stage 5 Outcome of Service Review Issues Addressed / Resolved JCU will agree 1 of 3 recommendations: Continuation of service/s with no change Continuation of service/s but with minor changes to comply with VfM An agreement to remodel service, working with the Provider Issues Not Addressed / Resolved JCU reports to the Governing Board issues that have been identified from the review and request they decide to agree 1 of 2 recommendations: Changing the Provider and retaining the existing service, or Closure of the service 10

11 Section B Service Review Process Strategic Focus The financial climate has placed greater emphasis on preventative services with a change from outputs to outcomes; prevention influences all areas of service provision. Risk Management A risk management approach is linked to the service review timetable (web link) to identify any potential risks e.g. complaints, under performance etc, this may in turn determine the need to change the published timetable (see Stage 1 below Risk Management). The review process is conducted in several stages depending on which section you will be monitored against (Sections A, B or C) these consist of: Annual service self assessment (web link) Desk top analysis by the JCU VfM assessment (inclusive of benchmarked data against West Midlands Regional Information Group (WMRIG) Validation visit, Service user consultation. Stage 1 Risk Management A risk assessment is conducted for each individual service to identify any potential risks to citizens, service quality or misappropriate use of JCU funds. The assessment will measure the level of risk and determine the frequency of service reviews for each individual service. Performance information taken from the last 12 months is used to inform a risk assessment of 3 areas: Quality QAF/CQC scores, progress with improvement/action plans etc. Performance and Contract Compliance National and Local indicators, returns (accuracy, on time and performance against targets) and exception reports or default notices served Financial Risks Value for Money (VfM) assessments and overall contract values of individual providers The assessment will produce a traffic light risk rating of Green, Amber or Red. Green 12 to 19, overall risk is low and will be subject to a lighter touch approach to contract management. All services will complete an annual return of a SSA for desktop review with a full review being completed within the lifetime of the contract, unless there is a significant change to the delivery of the service. Amber 20 to 27, overall risk is medium and will be subject to a lighter touch approach to contract management. This will involve an annual return of a SSA and one or more elements of the QAF/CQC for desktop review a validation visit, 11

12 interviews with staff and consultation with service users, with full review being completed within 2 years. Red 28 to 36, overall risk is high and will be subject to a comprehensive approach to contract management until the risk rating is reduced to an acceptable level. This will involve the return of a SSA and QAF/CQC, a desktop review, a validation visit, interviews with staff and consultation with service users completed within 12 months. All services are subject to a full service review at least once within the lifetime of the contract. If there is a substantial variation in performance or a critical incident occurs for example safeguarding or health and safety concerns, a comprehensive approach to contract management may be required and the service may be considered as high risk. The risk ratings and suggested timetable will be reviewed and agreed by the JCU governance arrangements to ensure services are effectively managed. Providers will be given details of their risk assessment and the factors considered in determining the final score. (web link) Providers will be given the opportunity to discuss the risk matrix score with the JCU. Stage 2 CQC and QAF Providers are required to complete and submit with relevant supporting evidence a CQC/QAF workbook (web link) Supporting evidence is required in hard copy format and should be clearly cross referenced with the CQC/QAF. If it is not submitted in this format it will be returned to the provider for re-submission, and failure to comply may result in a default notice being served. The JCU will continue to use the principles of the CQC/QAF to monitor quality through the providers SSA. Guidance on the completion of the QAF and the evidence required is available on request from the JCU service and on the Prevention Services pages of the Walsall Council website. (web link) Stage 3 Desk Top Analysis The JCU will review and analyse the provider s SSA/CQC/QAF and the evidence submitted to support the assessment (inclusive of the Equality Impact Assessment (EIA) and Business Continuity Plan) and conduct an analysis against one or more elements of the CQC/QAF, agreed between the Commissioner and Provider. The JCU will determine if the provider s SSA/QAF and the evidence supplied supports the CQC/QAF score. During the desk top analysis, if the JCU feels that insufficient evidence has been supplied to demonstrate the provider s self assessment standard, the JCU will give them a further opportunity to supply this information before the date of the validation visit. 12

13 Stage 4 Strategic Contract Review The third stage of the review process requires a strategic contract assessment of the service. The assessment considers five criteria and is not based on costs alone. The criteria are: Strategic relevance, Quality, Performance, Value, Service user consultation. Stage 5 Validation Visit The JCU will conduct a validation visit in order to assess any outstanding evidence not submitted for desk top analysis. The JCU will also interview staff to ensure quality standards are being met. Stage 6 Service User Consultation Service user consultation is an essential part of the review process. A peer assessors (PA) programme has been developed to assist the JCU in consultation. PA s consist of current, potential and former service users, carers or advocates. They have been specifically trained to conduct interviews as part of the review process. This usually takes place on the same day as the validation visit, if not soon after. Occasionally, it may be appropriate to offer a different method of consultation e.g. by means of a telephone interview or a postal survey. The outcome from the peer assessor interviews will be considered as part of any feedback by the JCU and may affect quality score ratings. Translation, interpretation and transport are provided to enable service users to participate in all consultation processes. The JCU will constantly review its consultation processes to make sure they are user friendly. To enable a broad range of service users/carers and/or advocates to be involved and engaged in our work irrelevant of their level and complexity of need, condition or disability. Review Outcomes The outcome of the review process could be: continuation of contract and services with no changes, continuation of contract and service but with minor changes e.g. service specification, outcomes etc; to comply with changing agendas, decommissioning of contract and/or start the tender process for a replacement service if required. Following completion of the service review and agreement of actions to be taken, a report and improvement plan will be issued to providers. The provider has 28 days to comment on the report and to return the completed improvement plan. 13

14 The agreed final report and an executive summary will be issued to the provider who is expected to share the executive summary with citizens, relevant boards and stakeholders. Where the completed review recommends remodelling, re providing or decommissioning, a report will be presented to the Lead Commissioner. They will consider the outcome of the review and the impact on citizens and service provision and make their final recommendation to the VAEB, who have the final decision on the outcome. At any time in the review process, providers have the right to appeal against any decisions or recommendations made by the JCU (web link) 14

15 Section C JCU awarded contracts who are signed up to Walsall Council or NHS Walsall initiatives e.g. Working Smarter Pilots Stage 1 Service Review Strategic Relevance Determined from the JCU priorities. Risk Management / VfM A risk assessment inclusive of Value for Money Assessment is conducted to identify any potential risks and to determine the frequency of each service review. At least once in the lifetime of the contract. Stage 2 Desk Top Review Service Self Assessment (SSA) Providers are asked to complete SSA workbook covering: Staffing Health & Safety Notifiable Incidents Safeguarding Case Studies Equality Impact Assessment Business Continuity Plan Assessment of Outcomes These are reviewed with performance returns by the JCU. Case studies to be submitted with the SSA depending on the capacity of the service/s, providers are required to submit a 2% sample (maximum of 10) demonstrating outcomes achieved by service users and an annual SU satisfaction survey Stage 3 Strategic Review Peer Assessor Review Peer reviews are conducted independently from the JCU and Provider. Peer Assessments can be carried out in various formats including: Questionnaires Mystery Shopping Consultation Stage 4 Outcome of Service Review JCU will agree 1 of 3 recommendations: Continuation of service/s with no change Continuation of service/s but with minor changes to comply with VfM Service ends 15

16 Section C Service Review Process Strategic Focus The financial climate has placed greater emphasis on preventative services with a change from outputs to outcomes; prevention influences all areas of service provision. Risk Management A risk management approach is linked to the service review timetable (web link) to identify any potential risks e.g. complaints, under performance etc, this may in turn determine the need to change the published timetable (see Stage 1 below Risk Management). The review process is conducted in several stages depending on which section you will be monitored against (Sections A, B or C) these consist of: Annual service self assessment (web link) Desk top analysis by the JCU Value assessment (inclusive of benchmarked data against West Midlands Regional Information Group (WMRIG) Validation visit, Service user consultation. Stage 1 Risk Management A risk assessment is conducted for each individual service to identify any potential risks to citizens, service quality or misappropriate use of JCU funds. The assessment will measure the level of risk and determine the frequency of service reviews for each individual service. Performance information taken from the last 12 months is used to inform a risk assessment of 3 areas: Quality QAF/CQC scores, progress with improvement/action plans etc. Performance and Contract Compliance National and Local indicators, returns (accuracy, on time and performance against targets) and exception reports or default notices served Financial Risks Value for Money (VfM) assessments and overall contract values of individual providers The assessment will produce a traffic light risk rating of Green, Amber or Red. Green 12 to 19, overall risk is low and will be subject to a lighter touch approach to contract management. All services will complete an annual return of a SSA for desktop review with a full review being completed within the lifetime of the contract, unless there is a significant change to the delivery of the service. Amber 20 to 27, overall risk is medium and will be subject to a lighter touch approach to contract management. This will involve an annual return of a SSA and one or more elements of the QAF/CQC for desktop review a validation visit, 16

17 interviews with staff and consultation with service users, with full review being completed within 2 years. Red 28 to 36, overall risk is high and will be subject to a comprehensive approach to contract management until the risk rating is reduced to an acceptable level. This will involve the return of a SSA and QAF/CQC, a desktop review, a validation visit, interviews with staff and consultation with service users completed within 12 months. All services are subject to a full service review at least once within the lifetime of the contract. If there is a substantial variation in performance or a critical incident occurs for example safeguarding or health and safety concerns, a comprehensive approach to contract management may be required and the service may be considered as high risk. The risk ratings and suggested timetable will be reviewed and agreed by the JCU governance arrangements to ensure services are effectively managed. Providers will be given details of their risk assessment and the factors considered in determining the final score (web link). Providers will be given the opportunity to discuss the risk matrix score with the JCU. Stage 2 VfM Assessment The second stage of the review process requires a VfM assessment of the service. The assessment considers five criteria and is not based on costs alone. The criteria are: Strategic relevance, Quality, Performance, Value, Service user consultation. Stage 3 Service User Consultation The provider will carry out an annual satisfaction survey with the service users as identified in the service specifications in Schedule 3 of the contract. Review Outcomes The outcome of the review process could be: continuation of contract and services with no changes, continuation of contract and service but with minor changes e.g. service specification, outcomes etc; to comply with changing agendas, service ends. Where the completed review recommends remodelling, re providing or decommissioning a service, a report will be presented to the Lead Commissioner. Who will consider the outcome of the review and the impact on citizens and service provision and make their final recommendation to the VAEB, who have the final decision on the outcome. 17

18 At any time in the review process, providers have the right to appeal against any decisions or recommendations made by the JCU, (web link) Chapter 2 Performance Management Aims This chapter describes the processes used to monitor contracts within the JCU. It: details the performance indicators used to measure services, describes the performance monitoring processes, explains the stages of the performance management process. We are committed to continually improving services to ensure they offer quality, value for money and improve health, wellbeing, life chances and independence of Walsall citizens to live as independently as possible. Performance Indicators Performance Indicators (PI s) are a way of measuring the effectiveness of service delivery and identifying how well a service is performing. Performance is monitored against a set of national and local service indicators to help measure citizens outcomes, service delivery and to continue to work towards achieving excellence. National indicators 1 (NI s) are used to monitor the levels of independence achieved by citizens. At least one indicator will apply to every prevention service in Walsall and are identified in the service specifications (Schedule 3 of the contract). Service indicators (SP s) are used to monitor the levels of service delivery; these are identified in your service specifications (Schedule 3 of your contract). PI s form part of the providers service specifications and inform the risk assessment process informing the timing of the contract reviews. All services will be reviewed at least once within the lifetime of their contract. Outcomes An outcome is a benefit achieved by a citizen as a result of the support they receive from a service. All services will demonstrate how they link into one of 3 national frameworks Every Child Matters, Adult Social Care or Health. These outcomes will be identified in the service specifications (Schedule 3 of the contract). Providers in partnership with the citizen need to appropriately identify needs and agree outcomes. Planning the necessary support activity to achieve the outcomes through appropriate mechanisms as determined in the contract schedules. 1 From the National Indicator Set for Local Authorities, CLG, October 10 th

19 Monitoring Providers are required to complete quarterly performance returns (eforms) for each service they deliver. Information collected as part of these returns includes: National and service performance indicators, Outcomes data, Complaints, Safeguarding, Exclusions. To verify data validity, a 2% sample (maximum 10) of services achieving positive performance is validated each quarter. Performance Management Process There are several processes in place for the management of performance data. These range from processes for the non receipt of eforms, to the actions taken for under performance. These processes include: Under performance (web link) Non receipt of monitoring information Information quality Domiciliary care concerns (web link) Exception reports (web link) As a requirement of the JCU governance an annual performance report is presented to the Vulnerable Adults Executive Board (VAEB). Where services are under target the JCU will report by exception outlining the actions and progress towards improvement. Written details of the actions and monitoring arrangements to be taken are agreed with providers detailing timescales for implementation. Should Providers not agree with the decision made by the JCU they can refer to the Appeals Procedure (Chapter 5). Contract Management The JCU have a duty to ensure that services are delivered in accordance with the terms and conditions of their contract. The JCU will adopt a supportive approach in helping service providers raise standards and/or commit to continuous improvement where required. Enforcement Action 19

20 There may be instances where, even with additional support, service providers fail to meet their contractual obligations, enforcement action such as suspension, default or termination will then be taken. The JCU will take enforcement action against providers transparently and fairly in accordance with the terms and conditions of the contract. Chapter 3 Strategic Contract Review (SCR) Aims The current methodology considers factors associated with a specific service area of the Local Authority (LA) conducting the assessment and does not provide the ability to determine the strategic impact on anything wider than medium term financial strategy. Assessment Process There are five elements to the assessment, these are measured and contribute to the overall SCR assessment score as follows: 1. Strategic Relevance, 2. Quality, 3. Performance, 4. Value, and 5. Service user consultation a) Strategic Relevance The proposed changes will allow a holistic assessment to consider the contributions the services makes to (if applicable). Medium Term Financial Plan (or equivalent), Long Term Financial Strategies (or equivalent), The contracting Service Area strategic plans, Directorate or Divisional strategic plans, Corporate strategic plans, Strategic plans of partner agencies, Strategic plans of other external (non partner) agencies, Contribution to regional agendas, Contribution to national agendas. b) Quality The current methodology uses a single specific quality assessment to determine the level of quality a service is offering. The proposed changes to the methodology will widen this assessment to include local quality measures along with assessment outcomes produced by alternative agencies, such as regulatory bodies. Different organisations have different processes for determining the quality level of a service therefore the revised SCR assessment will allow for this and consider timescales involved in quality review periods and comparisons of multiple quality assessment applications, i.e. CQC ratings and LA reviews. 20

21 The review of quality will also include considerations of specific service related measures, such as safeguarding of vulnerable adults and children, health and safety and an organisations financial viability (quality vs risk approach). c) Performance Measure of performance has traditionally focussed on quantitative methods which focus on numbers and frequencies, such as KPI s and SPI s rather than qualitative methods which focus on meaning and experience, such as outcome measures. There are also many varied methods used by organisations for the assessment of performance and the SCR assessment will need to review these holistically and in combination, if multiple approaches apply. It is proposed that the performance measure of the SCR assessment will consider (if applicable): local/service performance indicators, key performance indicators, partnership arrangement indicators (such as Local Area Agreements (LAA) or equivalent), partners indicators, other external agency indicators, regional indicators, national indicators. The performance measure of SCR assessment will also consider qualitative measures, including (if applicable): achievement of specific service outcomes (i.e. choice and control, emotional health and wellbeing), outcomes of complaints, citizens feedback, outcomes of surveys, outcomes of relevant research. Compliments or concerns d) Value The current methodology concentrates on the comparison of cost per hour of a service compared to that of similar services elsewhere. It fails to account for the actual cost of delivering the service after considerations for demographic, geographical and commercial influences are made. It also uses input based comparisons only, such as hours, citizens etc, and does not identify the value associated with the achievement of outcomes. The proposed changes to the value assessment of SCR would include: the ability to calculate the cost of delivery of a service in terms of hours, citizens, units, tasks, outcomes, etc; the ability to utilise a wider set of benchmarking data, including selections from specific comparator organisations where delivery is influenced by similar demographics, geographic, budgets, population trends, need and demand levels, information from other agencies who may have commissioned similar services, 21

22 a combined comparison of the above to provide an overall financial value offered by the service being assessed. Assessment Tool To accommodate the proposed changes to the methodology, the format of the assessment will change from a simple data input sheet into a detailed questionnaire. To conduct the new SCR assessment, a more detailed preparatory exercise will need to be undertaken to gather the information required to answer the questions effectively. As value for money assessments are usually conducted as part of a round of assessment of all services in a specific field or sector, and the outcomes are only as informative as at the time at which they were conducted, this preparatory information should only need to be gathered once for each round, rather than for every single assessment. Specific service information will still need to be obtained, including relevant performance information, quality review outcomes and financial data. The current tool produces an evaluation table scoring matrix. It is proposed that the revised tool produces detailed recommendations against each key theme alongside a range of scored comparisons, (i.e. a score based on contributions to partnership s objectives, etc). The outcomes based on the use of the current tool are used only as part of the wider contract review process undertaken on existing contracts and services. The revised SCR assessment has the potential to be used as the primary facility in determining the overall performance and value of a contract and in turn providing the most effective single recommendation for re-provision or decommissioning. The tool is available to download from the Walsall Council website for providers and stakeholders to use; to assess their current services or test new service delivery models against the SCR criteria. (web link) Assessment Outcomes The SCR assessment tool provides three potential outcomes. The outcomes are only recommendations and are based on the SCR assessment alone. SCR assessments are conducted as part of the service review process and alongside regular performance monitoring processes. The recommendations of the SCR assessments will be considered along with the outcomes of service reviews and performance management. For an example of a SCR assessment (web link). Outcomes of SCR assessments will be reported as part of the overall service review report, which is issued following completion of the whole review process and in agreement with the Provider. Chapter 4 Decommissioning All relevant information is considered together with consultation with service users, advocates, stakeholders, referral agencies, additional funding agencies and the provider, before a final decision is made to decommission a service. 22

23 Conduct All stakeholders, including the outgoing provider involved in the closure of any service are required to behave professionally throughout the process to ensure a smooth closure of the service and/or handover to any new provider. Definition Decommissioning is the withdrawal of funding and termination of a contract with the JCU in accordance with the terms and conditions of the contract. The end of a contract may result in an alternative service being provided, should this be appropriate and available. The JCU will ensure stakeholders are kept informed about the actions being taken throughout the process. Everyone involved in the decommissioning process will be informed in a timely, transparent and professional manner. A clear record of all decisions and actions inclusive of an equality impact assessment to demonstrate a robust process will be kept by the JCU. Decommissioning Process The decommissioning process consists of four stages: exit strategy, communication protocol, monitoring arrangements, evaluation. Flowchart summarising the decommissioning process (web link) Exit Strategy The service provider will develop an Exit Strategy agreed with the JCU. It is important that all parties involved in the decommissioning process are aware of the plans, activities, resources and that timescales are clearly stated. The Exit Strategy will cover all aspects of the service re-provision or closure, including: staff redundancy, Transfer of Undertakings (Protection of Employment) Regulations 2006 (TUPE) issues, risks to and needs of citizens, impact on partner agencies, referral arrangements, organisational issues for the provider, information sharing and communication, compliance with regulation, conduct (expected behaviours by all parties involved in this process). Communication Protocol The JCU is responsible for ensuring prompt and accurate communication between all parties involved in the decommissioning process. A communication protocol will be agreed as part of the Exit Strategy, detailing what and how information will be communicated and within what timescales this will take place. 23

24 The JCU will assist the provider in drafting letters, (jointly if appropriate) to staff, citizens and stakeholders. The JCU will attend meetings with staff, citizens, representatives, or other stakeholders to explain the action being taken. The JCU will outline the work being done to decommission the service and minimise disruption to citizens. In order to protect the confidentiality around this process, the JCU and the provider will seek to meet with citizens, their advocates and carers on an individual basis, where necessary. These meetings may also incorporate individual needs assessments and support planning exercises, to ensure that citizens are appropriately housed or supported through and following the decommissioning process. Monitoring Arrangements An appropriate protocol, detailing the expected code of conduct to be adopted by each party, will be developed as part of the exit strategy process. During the period of notice before closing a service, the decommissioning exit plan will be closely monitored by the JCU governance structure. Regular meetings (at least monthly) will take place between the provider and the JCU to monitor the exit plan and update the governing bodies and other stakeholders and citizens. Evaluation The decommissioned provider, new provider (if appropriate) and key stakeholders involved in the process, will be invited to give feedback on their experience and views. The decommissioning exit plan will detail a period of evaluation where the JCU will seek to gain the views of the people involved in the process. This will be formally reported through the JCU governance structure to revise and update our practices as appropriate. Chapter 5 Defaults A default is any failure to carry out contractual obligations based on the terms and conditions of the contract. The JCU ensure services provided to vulnerable people are of the highest quality and are delivered to the best standard. In order to ensure quality standards are maintained, there may be situations where the JCU needs to issue a default notice. A default notice sets out the nature of the default committed, if the default can be rectified and the action required to correct the default within defined timescales. Aims The aims of the default process are to: 24

25 provide clear information on situations where a default notice may be issued, detail the process taken in the issue of default notices and the potential outcomes. Default Notices Default notices are served as a result of three potential situations. These are: if the provider continues to under perform in the same area for a second continuous quarter, failure to submit or the submission of inaccurate information for a second continuous quarter, instances where there is a breach or breaches of contract terms. Default Situations The default notice will clearly specify what the provider must do to rectify the issues raised within defined timescales. This will normally be within 20 working days but will vary depending on the nature of the concerns. An action plan is to be returned by the provider within 14 days. Submission of Information The JCU require providers to submit specific information e.g. quarterly eform returns, and/or a four weekly amendment declarations to process payments and SSA s (where appropriate). This information has a direct impact on the administration of the programme and must be submitted within the timescales specified. Failure to provide any contractual information required by the JCU will result in the provider being requested to submit the information within 5 working days. If the provider fails to provide the information, a default notice will be issued. If a provider fails to submit performance monitoring information the JCU can suspend payments until information is submitted. Breach of Contract A default notice will be issued where a provider has breached the terms and conditions of the contract. For example, failure to have sufficient insurance cover, failure to comply with the QAF minimum requirements, or failure to provide performance information on time. Persistent Default A persistent default is where the provider has committed more than two defaults during any consecutive period of six months, whether or not they are the same or different defaults. If the provider fails to resolve the third default, the decommissioning process will be initiated. The decommissioning process will be followed and the service will be either reprovided or decommissioned. Serious Default 25

26 A serious default means the provider places the health and safety or welfare of a citizen at risk. The provider will be served with a serious default notice requesting immediate action to resolve the default within 7 days. If the default is not resolved the service may be suspended. Suspension The Council may serve a suspension notice where it considers that it is not appropriate for the provider to continue to deliver any or all of the service because: the persistent default or serious default, in the reasonable opinion of the Council, is of such seriousness to warrant a suspension notice; or there, is likely to be a continuing threat of health, safety or welfare of any or all of the service users. If the Council serves a suspension notice upon a provider, the provider shall stop delivering the service or adhere to the conditions as set out in the suspension notice from the date specified in the notice. Conditions imposed whilst the suspension is in place may include: no new placements, restricted numbers of new placements (e.g. 2 new people per week), restricted number of units/limit on total number of care hours/limit on total number of service users, restricted to taking less vulnerable service users e.g. older people only and not including older people with dementia or LD or mental health clients. Following an investigation of the suspended service(s), the Council may decide: that the provider is to resume provision of the suspended service. The Council will serve a Resumption Notice in accordance with the terms and conditions of the contract that sets out the service to be resumed, the date which it or they are to be resumed and the conditions relating to the provider s resumption of the service(s), it is not suitable for the provider to resume provision of the service(s). The Council will service an immediate termination notice, terminating the contract to which these services relate. This decision will be taken in partnership and consultation with: CQC (Advising about defaults and actions taken) Alternative suitable provision Local Authorities input Chapter 6 Appeals Appeal Procedure The aim of the appeals procedure is to provide an open and transparent process where an appeal may be made against a decision of the JCU, for example; following a commissioning decision, an outcome of a service review, 26

27 the issue of a default notice. Criteria for Appeal An appeal can only be submitted to the JCU if it has: failed to adhere to published policies and/or procedures, not taken account of wider strategic considerations for the service, failed to consider all the relevant facts while carrying out various activities, for example during a service review or a commissioning exercise. Exceptions Appeals will not be accepted if the decision is to: amend a service in line with VfM requirements, remodel or reconfigure a service against changing, new or emerging strategic priorities, allow the council to discharge its requirement to continually improve services having regard to a combination of economy, efficiency and effectiveness as required under the Local Government Act 1999 section 3, withdraw funding where incidents of fraud or gross misconduct are revealed, where contractual defaults have occurred or where child/adult safeguarding investigations have been instigated. The VAEB will be informed of all appeals and their outcomes at scheduled meetings. Stages of Appeal Stage One: Submission The provider must submit an appeal within 20 working days of being formally notified in writing of the JCU decision. The appeal must be submitted in writing, using the JCU Appeal form (See appendix 5.1) together with any supporting information. The completed appeals form, covering letter and any supporting information should be marked as Private and confidential and sent to: 27

28 Lead Commissioner, Joint Commissioning Unit 1 st Floor Goscote House Goscote Lane Walsall WS3 1SJ Any request to extend the appeal date, must be in writing to the JCU and can only be agreed and authorised by the Lead Commissioner services or delegated independent officer. Stage Two: Appeal Consideration The Lead Commissioner or delegated independent officer will confirm receipt of the appeal within 5 working days. Within 15 working days of the appeal request, a written response will be sent to the provider confirming whether or not there are grounds under the appeals criteria for the appeal to be supported. The Lead Commissioner or delegated independent officer will then take the necessary actions to address the issues raised and submit recommendations to the governance structure. Written confirmation of the VAEB s decision will be issued to the provider within 10 working days of its meeting. Stage Three: Appeal Panel If the provider is not satisfied with the outcome of Stage Two, an appeal must be made within 20 working days from the date of the written decision made by the governance arrangements of the prevention services. The completed appeal form and any additional supporting information must be sent to the Lead Commissioner or delegated independent officer. The Lead Commissioner or delegated independent officer will confirm receipt of the appeal within 5 working days of receiving it. The Head of the JCU will consider the appeal and write and advise of the outcome within 15 working days of the date of the appeal. The Head of the JCU s address is: Head of the Joint Commissioning Unit Joint Commissioning Unit 1 st Floor Goscote House Goscote Lane Walsall WS3 1SJ If the provider is not satisfied with the Head of the JCU s decision they can appeal against it in writing within 10 working days of the date of the outcomes letter. The Head of the JCU will arrange for an appeals panel to consider this within 20 working days. The panel is made up of one VAEB member, one JCU member one independent 28

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