North Yorkshire Council

 

Health and Adult Services

 

Executive Member Meeting

 

13th June 2025

 

REPORT TO Corporate Director of Health and Adult Services (HAS) in consultation with the

Executive Member for Health and Adult Services

 

Procurement of a framework agreement for the provision of Live in Care Services in North Yorkshire

 

 

This report includes a supporting Annex which contains exempt information as described in paragraph 3 (Information relating to the financial or business affairs of any particular person (including the authority holding that information)) of Part 1 of Schedule 12A to the Local Government Act 1972 (as amended).

 

1.0         Purpose Of Report

To provide an overview of Live in Care Services with a view to seeking the Health and Adult Services Executive Member approval, for the procurement of a framework agreement for the provision of Live in Care Services in North Yorkshire.

 

 

2.0         Summary

Health and Adult Services are seeking to procure a framework agreement for the provision of Live in Care Services within North Yorkshire.  The Framework agreement shall have an initial term of 5 years, with the option to extend for a further 2 years.

 

Approval of the recommendation to procure the Service has been obtained via HASLT on 8th May 2025 and at Procurement Assurance Board on 5th June 2025.    

 

Service Definition:

Live in Care (LIC) services can support people with care and support needs to remain in their own homes with the support of a Care Worker who resides with them in their own home, offering care and support as and when needed. A Live in Care Worker can support the person holistically, supporting their health and well-being, encouraging social interaction and providing social and emotional stimulation reducing isolation and can prevent or delay the need for the person to move into residential accommodation.  

 

LIC is a person-centred service which can be used flexibly to provide:  

·         Regular carer breaks or in response to carer breakdown. 

·         As an alternative to residential respite services. 

·         A short-term assessment period following an escalation in care needs for a person being supported in the community.  

·         Intermediate Care as an alternative to a temporary care home bed.  

·         Support for a range of long-term care needs to both individuals and couples

 

 

3.0         Background

Live in Care Services are currently purchased via the Local Authority’s Home-Based Support Approved Provider List (HSB APL).

 

4.0         Detail of Substantive Issues

The current contracting arrangements are vulnerable due to the following issues:

·         Specification within the HBS APL is limited with an unclear definition of LIC.

·         APL hourly costings vary considerably. Many providers submitted high generic hourly rates meaning the Authority pays more than needed for some packages.

·         APL rates are based on the traditional home care model of urban, rural and super rural including travel costs which would not be relevant for this service. Meaning the Authority pays more for some packages.

·         Where examples of poor practice have been identified, there is limited ability to challenge due to the limitations of the current service specification.

 

Legal and Procurement advice has determined that changing the current HBS APL documentation would present a fundamental change to the way the APL currently operates and therefore we are unable to undertake a variation to the APL, due to risk of challenge; in accordance with Procurement regulations. As a result of this, the recommended option is to procure a framework agreement for the provision of Live in Care Services in North Yorkshire.

 

5.0         Performance Implications

The aims of the Service are to:

·         Provide the opportunity for people to remain living at home whilst ensuring all care and support needs are met.

·         Provide person-centred care which supports independence and well-being.

·         Support people to develop their skills to remain as independent as possible preventing escalation of needs.

·         Provide support that enables people to maintain personal choice about everyday life supporting them to make decisions about what they want to do and how they want to do it on a day-to-day basis.

·         Provide high quality care that reflects safe and effective practice.

·         Provide care through well-maintained professional partnerships supported by good leadership.

·         Be integrated into the community as much as possible, to support people to access their local community (and beyond), remain involved in activities they enjoy and that they need for living their daily lives.

·         Help people to build and maintain friendships, relationships and connections where they want to, making sure that connections with friends and families are facilitated as much or as little as people wish.

·         Ensure that the relationship between the person/informal carer and the Live in Care Worker promotes effective communication and positive social interaction.

 

6.0         Alternative Options considered

The following procurement options have been considered:

1.    Continue to use the HBS APL in the current format

2.    Removal of Live in Care Services

3.    Access pre-existing framework agreements

4.    Procure a block contract

5.    Procure a framework agreement

 

Based on the options appraisal contained within Section 4 of the Gateway 1 document a framework agreement is identified as the most appropriate option.

 

7.0         Financial Implications

Please find below the costings for the service. Please note there is no guarantee of business attached to the framework agreement, and costings have been based on current usage (14 Live in Care packages).  We have allowed for an annual incremental increase to the number of packages which may be purchased.

 

We have determined that we may experience year on year incremental growth on the number of live in care packages running at any one time as follows:

v  Year 1 – 25 packages

v  Year 2 – 50 packages

v  Year 3 – 75 packages

v  Year 4 – 100 packages

v  Year 5 – 100 packages

v  Year 6 – 100 packages

v  Year 7 – 100 packages

 

Whilst the funding for this service would come from pre-existing Community Support Budgets, this is a potential budget for the purposes of procurement:

Ø  Total cost for initial term (5 Years):  £27,555,990.00

Ø  Total cost for option to extend (2 years):              £15,746,280.00

Ø  Whole Life cost (7 Years): £43,302,270.00

 

A pricing schedule has been drafted with further work underway with finance colleagues to establish appropriate ceiling and floor rates for the defined Service levels. Providers will be asked to submit rates for services within the defined ceiling and floor rates requiring providers to give a clear breakdown of costs associated with delivering the service.

 

8.0         Legal Implications

Legal framework of the service

The Care Act 2014 determines that where a person is assessed as having eligible needs, the Council must involve the person in the development of the person-centred support plan to meet the needs and achieve the outcomes of the person in ways that work best for them as an individual or as part of a family. The outcomes should be built holistically around peoples wishes and feelings, their needs, values and aspirations. The Care Act defines that a person’s needs may be met in a variety of ways and that what meets the needs of one person may not meet the needs of another person in a similar situation. The Care Act requires the Council to take a diverse approach to meeting people’s needs, in consideration of their wishes and should be defined within the person-centred support plan. 

 

The Legal Framework of the procurement

The framework agreement shall be procured in association with the Light Tough Regime under the Procurement Regulations 2024.

 

9.0         Consultation undertaken and responses

Engagement activities have taken place across North Yorkshire with the aim of understanding the views and experiences of people with lived experience and their families as well as stakeholders and Live in Care providers.

 

The focus has been on:

·         Where Live in Care has been commissioned with benefits and challenges.

·         Barriers to access; and

·         How the service may support the Council Strategic wish to support the home first approach enabling people to remain independent in their own homes for as long as possible.

 

Engagement recommendations to influence Service Outcomes:

·         Education and promotion of what a Live in Care service is and can offer.

·         People wish to remain living independently at home for as long as they can.

·         Families and carers wish for the person to remain at home for as long as possible and would like to be supported to remain in a caring role.

·         The service needs to support people with diverse care and support needs.

·         People would like information about the service to support them to make an informed choice. 

 

Engagement recommendations to inform procurement:

·         Ensure that the specification includes a clear definition of LIC and clarity about what the service is not able to support (e.g. 24-hour care).

·         Create person level and service level outcome statements that will be used to determine key performance indicators and appropriate performance measure to demonstrate the quality and impact of the service.

·         Wider market testing to be completed to provide assurance in relation to the deliverability of the specification and costing model.

 

10.0      Impact on other services/organisations

The Council identified a risk that choosing not to continue to utilise the APL to source Live in Care Services may leave the Council susceptible to challenge.  It was determined that APL gives no guarantee of work and there is no contractual obligation to continue utilising it for this service area.  Existing Live in Care Packages shall remain under the terms of the APL. 

 

11.0      Contribution to Council priorities

The North Yorkshire Council plan 2025 – 2029 sets out the vision, ambition and priorities of the Council over the four-year period. One of the four key ambitions is to ensure the people of North Yorkshire are safe, healthy and living well, through delivering services that are preventative, least restrictive and focused on people’s strengths.

 

The council will support people to live independently in their home of choice, prioritise early intervention, preventing crises before they arise, and embedding an approach that draws on people’s strengths, their relationships and what is going on in their local communities to help them live longer, healthier, independent lives.

 

This service shall support the Council to achieve these priorities.

 

12.0      Risk Management Implications

Number

Risk

Mitigation

1

Impact on the amount of income the Council receives, where a person is in receipt of Live in Care rather than in a Care Home Placement.

The Council will undertake a financial assessment determining the person’s financial contribution, which shall be informed by the Care Act assessment and support planning process.

2

Increased internal system resource required for onboarding Service providers.

Resource already exists within the Council for onboarding new service providers. The systems teams are involved in the project group and are aware of timescales.

3

Limited remote oversight and monitoring of care workers.

Provision made within the service specification and standards and outcomes framework.

4

Potential breach of current Approved Provider List terms by no longer continuing to purchase Live in Care Services from the APL.

The Approved Provider List APL offers no guarantee of work and there is no contractual obligation to continue utilising it.

5

Personal choice .v. cost to the local authority (Live in Care Services may be more expensive than a Care Home Placement).

Clarity provided by the legal requirements under the Care Act. Choice guidance to be completed to supported practice related decision making.

6

There is no national costing model for Live in Care Services.

Work undertaken with the Council’s finance team to design a costing model, considering all relevant factors.

7

Providers may not engage with the procurement opportunity.

Market engagement indicates that there is a viable and interested market for the opportunity.

8

Live in Care Services not being sourced appropriately.

Effective communication with care and support t.eams, to support understanding of the service offer.

 

13.0      Equalities Implications

Equalities Impact Assessment screening tool completed – no adverse impacts identified for people with protected characteristics.

 

14.0      Climate change implications

Climate Change Impact Assessment completed – no adverse impacts identified. 

 

As part of the process to procure a new service, consideration has been made to social value.  Whilst social value considers a wide range of elements, one element is associated with climate change:  

Tackling climate change and reducing waste.

·         This service is delivered from the person’s home, there is limited travel time and mileage impacts compared to generic domiciliary care.

 

15.0      ICT implications

There is no requirement for any new ICT systems. The framework agreement providers shall need to be added to the following HAS systems:

·         ContrOCC

·         E-Brokerage 

Provision for these changes has been built into the implementation plan, with relevant representation on the project group.

 

16.0      Conclusions

This report in association with the appendices, sets out the context for the recommendation to procure a framework for Live in Care Services in North Yorkshire. 

 

17.0      Reasons for recommendation/s

The procurement of a framework agreement shall support the Council to achieve the following service benefits, which are not available under the current arrangements:

·         Clear model and definition of Live in Care

·         Improved choice, quality and clarity of expectations of the service

·         Clearer definitions enabling robust oversight and assurance

·         Consistency of service offer across the County

·         Value for money vs high hourly rates on the APL

·         Consistent costing model

·         Flexibility of offer with rates for standard, enhanced and couples’ packages

·         No upfront investment required

·         Clearer legal framework

 

20.0     Recommendation/s

Recommendation to approve the procurement of a framework agreement for the provision of Live in Care Services within North Yorkshire. 

 

Name and title of report author:            Helen Thirkell, Strategic Service Development Manager

                                                                        Helen Tuckett, Senior Service Development Officer

 

Appendices

v  Appendix A: Gateway 1 inc. Sub-appendix – Service Specification (both documents Exempt in accordance with Para 3)

v  Appendix B: Equalities Impact Assessment Screening Tool

v  Appendix C: Climate Change Impact Assessment