Short breaks & other services for disabled children and their families Targeted services

1. Short breaks & other services for disabled children and their families Targeted services Provider-commissioner event 25th June 2014 The right help, in the right place, at the right time

2. What are short breaks? Short breaks are activities and family support services for disabled children and young people who are unable to access mainstream activities and clubs To give disabled children an enjoyable break from their families To give parents and carers a break from their caring role The short breaks covered by the plan are funded by Bristol City Council and NHS Bristol Clinical Commissioning Group.

3. Who has short breaks • Children and young people aged 0-18 years • With a life-limiting or long-term health condition or disability • With multiple needs because of emotional or physical difficulties and /or affected by issues in their family • Specialist services are for those with more severe and complex needs (about 300 children) • About 780 activities / holidays / sessions of targeted • About two-thirds are boys

4. Why need to change • Not about saving money – but making money go further • Child population is increasing • Numbers of disabled children are increasing • Currently spend more than half of the total short breaks budget of £3.3M on residential short breaks for 85 children (costing about £450 per night) • Compare costs of overnight short breaks • Vision • Help greater numbers of children and families • Give children, young people and their parents/carers more choice • Make sure services are targeted at those who most need them • Services help people to step up and down through services as needs change • Short breaks are enjoyable for children and young people • Parents get a real break and better quality of life • Invest in the most cost effective services

5. We are consulting on a draft commissioning plan Until 30th June Workshops and focus groups with parents/carers, practitioners and providers Questionnaire In July we will consider all consultation feedback and revise the plan Final plan to be adopted by the Mayor in September Consultation

6. What we’re changing Targeted services Community care & palliative care Foster-based short breaks Short breaks for more children & families Increase availability of a range of options More flexibility & choice Residential short breaks Residential holidays Direct payments

7. What we’re changing Targeted servicesNot known 527 Community care & palliative care5972 Foster-basedshort-breaks5682 Summary of proposals Providing specialist short break services for 469 = 57 more children & young people Residential holidays4464 Residential overnight Short breaks85 63 Direct payments 168 188

8. Outcomes for children and young people • We will fund services to achieve these outcomes • For disabled children and young people • Have safe and stable lives • Improved physical health through physical activities • Improved emotional health and well-being • Enjoy their short breaks • Less dependent on their parent or carer • Learn and develop skills and abilities • Young people develop skills that help toward • independence in adulthood

9. Outcomes for parents / carers & strategic outcomes • And for parents / carers and families • Improved quality of life for parents/carers/siblings • Improved emotional well-being • Have more time to do other things (e.g. leisure, work, study, spend time with other children) • Family is able to lead a more ordinary life • Family environment is less chaotic and more sustainable • And strategic outcomes • Fewer CYP become looked after because • of their disability • Reduced need for unplanned placements • in residential units • Families have increased choice & control • over the short breaks they get

10. Consultation feedback so far

11. General • Providing transport is necessary for some families – otherwise their child is unable to attend, or they will not get a meaningful break • Parent/carers would like more stay and play opportunities • Need more places for befrienders and PAs to take children • Parent/carers would like more chances to network with each other – do would personal assistants • Need contracts that maximise collaboration between providers (including role in upskilling and coordinating the workforce) • Importance of trust to parents/carers • Lack of information about what is available • Personal budgets coming . . . Specialist BME service • South Asian and Somali families said would welcome a service open to all communities with focus on their cultural needs and workers who speak their language. • Some practitioners concerned KHAAS may lose the reach it has achieved

12. Special schools holiday playschemes • Often the only targeted service accessed by CYP with more complex needs • Parent/carers say it works for their child because of familiar surroundings and staff (& feels safe for the parent) • Highly valued, but not enough available and is being reduced • Parent/carers would like it to be available not just at beginning of holidays • Not available to CYP who do not attend the four schools • Some schools face challenges staffing the schemes • VCS are saying they could offer services from the schools premises Mixing children • Some parents say they are happy for older children and younger to mix • Other parents say mixed activities are not suitable for their teenage children • Some parents whose children have significant physical needs and/or complex health needs are concerned about mixing with children with more challenging behaviour • Very little accessible provision for above CYP

13. Proposed evaluation criteria for bids • How well proposed services will meet outcomes • Number of children and young people who will benefit • Breadth and range of activities and their suitability for different ages and impairment groups • Providers’ ability to work in partnership with the council, health providers, schools and other local providers • Providers’ ability and track record of meeting the needs of children who are hardest to reach • Plans to bring added value, e.g. use of volunteers, making premises available to other groups, helping to develop pool of workers in the city • How well the services will respond to changes in demand and provide choice to children and families (and enable increased “personalisation”)

14. Residential holidays

15. Residential HolidaysProposal +46% Total current children = 44 Total proposed children = 64 Total value after = £75,000 Residential Holiday Contract Action for Children

16. Residential holidaysIndicative procurement timetableWhich is best?

17. Targeted services Afterschool, holiday & weekend activities Befrienders

18. Targeted services – currentPlay, leisure and sport activities and befriending Total value = £235,000 6 contracts 3 council services Special Schools Consortium WECIL Consortium Playbus New Fosse-way National Autistic Society Briar-wood KHASS Kings-weston WECIL Clare-mont Bristol Autism Project Befrienders Time 2 Share Families in Touch Time 2 Share KHASS Bridging workers & inclusive play

19. Targeted services proposalPlay, leisure and sport activities and befriending +15% • Re-commission all services with increased funding Total value = £270,000 Total children = min 400 • Plus keep council-run bridging and inclusive play service

20. Targeted services original proposalPlay, leisure and sport activities and befriending Competitive tender for two city-wide contracts – preferably consortia Consortia B Consortia A Be-friending BME

21. Alternative proposal – preferred option 2 lots – ideally 2 consortia A - holiday play schemes in special schools Joint working befrienders BME targeted B – Weekend, after-school and holiday activities

22. Alternative proposal – not preferred • One city-wide lot – ideally one consortium holiday schemes in schools other holiday activities Weekend & after-school activities BME targeted service befrienders family fun days

23. Targeted servicesIndicative procurement timetableWill this work?

24. Introduction to Collaborative ArrangementsKirsty BarrettProcurement SpecialistStrategic Commissioning & Procurement Service

25. Targeted Services Collaborative Bids • Consortium Members MUST take their own legal advice • http://www.supporthub.org.uk/resources/collaboration-agreement-template • Council has sight of draft agreement at PQQ (in this case, Open Tender) stage • Sight of final agreement at award • Consortiums formed at start of process

26. Models of Collaborative Arrangements • Lead partner consortium • Joint and several liability consortium • Sub-contracting

27. Lead Partner Consortium • Consortium of providers working together to bid for/deliver services • One provider (Lead) contracts with the Council • Lead Provider SOLELY liable for delivery of contract • A fail for one member at minimum standards (e.g. Insurance Levels) may constitute a fail for the entire organisation. See Invitation for full details. • Technical capability • Financial capacity

28. Joint and Several Liability Consortium • Contractual relationship with ALL members of consortium • May appoint ‘Lead Organisation’ • ALL members of consortium equally responsible • Cumulative strength assessed • All members joint and severally liable

29. Sub-contracting • Council contracts with one provider (Prime Contractor) • Provider enters into sub-contracting arrangements • Subcontractor performance responsibility of Prime Contractor • At tender stage (minimum requirements), details of proposed sub contractors given • Minor/specialist elements only – Prime Contractor responsible for core. • Payments & Intervention

30. Multiple Bids • Bid as member of more than one consortium • Comply with http://www.oft.gov.uk/OFTwork/competition-act-and-cartels/competition-lawcompliance/ • Legal advice • Certificate ‘regarding involvement in other bids’

31. Consortiums & Collaboration • Check the Invitation to Tender & Terms • Ask collaboration questions early on • If in doubt - Legal advice Any Questions?

32. Table top discussion A How should the lots for targeted services be split? • Which outcomes should be monitored to measure service quality?

33. Table top discussion B How can providers be encouraged and enabled to collaborate and what are the benefits?

34. Table top discussion C How can we make sure the right children get services? Should we define categories of need and/or age groups? What should be the key features of the services and how should they be reflected in the specs?

35. Target group – current services • Varies across all contracts • Some refer to Group A and Group B • Group A - children and young people with ASD or those children and young people whose challenging behaviour is associated with other impairments such as severe learning disabilities • Group B - children and young people with complex health needs including those with a disability and life limiting conditions, palliative care, cognitive or sensory impairments or have moving/handling needs or require special equipment adaptation. These groups include where relevant, those with: • ASD • complex health needs, including the technology dependent child and those requiring palliative care; • moving and handling needs that will require equipment and adaptations up to age 18 • challenging behaviour as a result of their impairment; • severely disabled young people 14+

36. Target group – new services • New SEN “areas of need” • Communication & interaction • Cognition & learning • Social, emotional & mental health difficulties • Sensory and/or physical needs Who might miss out? 1 3 2

37. Next steps • Revise commissioning plan • Mayor adopt revised plan on 2nd September • Provider event second week September • Advertise tenders • Any questions contact: • ann.james@bristol.gov.uk • joanna.roberts@bristol.gov.uk • mark.hamilton@bristol.gov.uk