SOCIAL SERVICES

Contract ComplianceFramework

.

The Way Forward

Contract ComplianceFramework

Contents Page

  1. Introduction
  1. Vision
  1. Context

3.1 What is contracting?

3.2 Contract Monitoring

3.3 Reactive and Proactive Monitoring

  1. Contract Compliance- Components

4.1 Who monitors the Contract?

4.2 Contract ComplianceResponsibility

4.3 Contributors

4.4 Priorities – Which services should be monitored

4.5 Route - Reactive or Proactive

4.6 Collecting Monitoring Information

4.7Analysis of Monitoring Information

5Managing Poor Performance

6Strategic Fit of Service

7Dependence on a Service Provider

8Conclusion

Appendix 1 - Risk Assessment Tool

Appendix 2 - Contract Compliance Good Practice Model

1Introduction

Thisdocument is the first stage towardsthe provision of a more comprehensive approach to evidencing the quality and performance of all the care and support services that Clackmannanshire Council's Social Services purchase from care providers within the independent sector.

What follows is a framework which will provide the foundation for a consistent approach to contract complianceand thus improve further the quality of care services procured by Clackmannanshire Council's Social Services on behalf of their clients.

In considering the wide range of Social Services' client groups, theirdiverse needs and the variety of care provided,there is a crucial need for planned contract compliancewith the ability to assure care management that systems are in place to secure the most appropriate care services, at the best quality and within available financial resources to support their clients' needs.

2Vision

The Social Services Business Plan 2009/2012 sets out the key aims and objectivesthat Clackmannanshire Social Services is striving to achieve.

“Our aim is to provide people who live in Clackmannanshire with the best possible social work services, with an emphasis on the protection and support of individuals who are at risk. We want to ensure that the people and families in Clackmannanshire who need social work support are able to make the most of the opportunities they have and to realise their potential."

Key Objectives of Clackmannanshire Social Work Services

•To meet legislative duties and requirements.

•To achieve positive outcomes using a needs-lead approach.

•To use resources effectively, getting value for money from services we

provide and pay for.

•To build a learning culture and a competent workforce.

•To work in partnership to ensure services are coordinated, flexible andresponsive.

•To seek people’s views and involve client and carers in decision making.

•To monitor, evaluate and manage performance - always checking thequality of our services and continually working to improve them.

•Providing services that listen to what people say, are open to new ideas and welcome challenge.

The Contract ComplianceFramework will contribute to meeting Clackmannanshire Council's Social Services Business Plan Aims and Objectives by:

Enabling Social Services through the planned implementation ofcontract complianceprocesses to:

  • Secure Best Value
  • Improvethe quality of procured care services
  • Resolve issues of sustainability and continuity of care
  • Better target resources
  • Contribute to the social and economic wellbeing of the residents living in the Clackmannanshire Council area
  • Commission and deliverthe best care services possible within the available resources

andmost importantlywill contribute to the achievement of the Aims of GIRFEC, which are:

Child at the centre

Improved partnership with families

Shared understanding of wellbeing-with children having a right to be safe seen as paramount

Holistic and preventative value base linked with practice

Improve partnership between agencies

Support for early intervention

Identify additional needs

Reduce bureaucracy and duplication of effort

3Context

3.1What is contracting?

Contracting can be defined as:

"The process of securing or buying specified services and contracting is the means

bywhich that process is made legally binding"

Contracting covers a wide range of activities, from agreeing a contract with a Provider to delivering aspecified service at an agreed price,through to monitoring the performanceof the contract with the evaluation and review of the provision of the service.

All contracting activities need to be undertaken within the context of an overall commissioning strategy if they are to contribute to the achievement of the provision of efficient and effective services that meet clients' needs.

To help demonstrate where the contract compliancefunction lies within, and how it contributes to, the process of securing a service on behalf of a client a diagram now follows, the three areas that feed contract compliancehighlighted as key activities.

Note:The outcome of the monitoring process should always be fed back into the strategic commissioning cycle.

1

Working Effectively to Improve Outcomes

Contract Compliance - Commissioning and ContractingLifecycle

Service Need to Service Delivery

BEST VALUE
EVALUATE MONITORING REPORT
ADDRESS SERVICE FAILURE
(consult, contract, breach, etc)
REVIEW CONTINUING APPROPRIATENESS OF EXISTING SERVICES
EVALUATE NEED FOR CHANGE
(legislation, policy, client driven, funding, unmet need etc)
REPORT FINDINGS TO MANAGEMENT
FINDINGS RATIFIED?
FEED BACK INTO PLANNING PROCESS / / PRIORITISE PURCHASING INTENTIONS
SPECIFICATION OF SERVICE
(what, when, how, cost guideline)
IDENTIFY MARKET OPTIONS
(providers, location etc)
ACCREDITATION (fit for purpose)
ADOPT APPROPRIATE TENDERING MODEL
SECURE PROVIDER
/ MANAGEMENT INFORMATION
CORE BUSINESS (statute, policy)
AUDIT OF EXISTING PROVISION
AUDIT OF AVAILABLE RESOURCES
(financial, staff)
IDENTIFY FUTURE RESOURCES
ASSESSMENT OF NEED (purchasing intentions)
PRIORITISATION OF NEED
(consultation, policy, resources)
PLAN OF ACTION
(who, when and how) /
ESTABLISH MONITORING PLAN
based on risk assessment
GATHER FEEDBACK (complaints, spot checks, regular review, comments, audit trail, , etc)
IDENTIFY PROBLEMS / GOOD PRACTICE
REPORT PERFORMANCE / IDENTIFICATION OF CLIENT NEED
IDENTIFY FINANCIAL RESOURCES
IDENTIFY POTENTIAL PROVIDERS
(resource directory)
SEEK APPROVAL (client, management, etc)
COMMIT RESOURCES (individual need contract) / DEVELOP CONTRACT ACTION PLAN
AUDIT OF EXISTING PROVISION
COMPILE CONTRACT (terms/spec/ISC)
CONTRACT APPROVAL (legal, purchaser, etc)
CONTRACT ACCEPTED
UPDATE RESOURCE DIRECTORY (SSID)

To secure appropriate quality care services for individuals, all of these activities need to be undertaken, continuous monitoring of contract performance will inform

future commissioning plans and contribute to the improvement of care service provision

1

Working Effectively to Improve Outcomes

3.2Contract Monitoring

Systematic monitoring is vital in ensuring that a contract is appropriate in relation to its terms, meets the purchasing intentions of commissioners andmost importantly delivers the quality of care services that meet the needs of clients whilst providing value for money. Furthermore, the contract monitoring outcomes have the potential to provide a significant contribution to current commissioning plansand influence future commissioning and procurement decisions.

Definition of Contract Monitoring1
Contract monitoring aims to ensure as far as possible that each client receives the highest quality of service, which demonstrates value for money, meets contractual standards and is continuously improving.
It involves:
  • the collection of consistent and measurable information about the service specified in terms of
  • quantity
  • quality
  • effectiveness (achievement of outcomes)
  • the collation of information from a variety of sources
  • analysis, consideration and making judgements about collated information
  • the use of such information and judgements in order to:
  • Identify and resolve any shortcomings in the service provided, at individual, provider and whole service levels.
  • Review and raise contractual standards.
  • Support service-purchasing decisions, including those involving suspension or termination of contracts because of continuing unsatisfactory performance.
  • Achieve optimum efficiency of the operational arrangements that enable the service to be set up, delivered and reviewed.
  • Support and stimulate wider market management and strategic commissioning.

3.3Reactive and Proactive Monitoring

There are two basic approaches to contract monitoring:

(i)Reactive
(ii)Proactive.

Reactive methods refer to contract monitoring instigated as a result of responding to a concern, complaint or matter raised about a contracted service. They tend to be individual case focussed.

Contract monitoring staff use proactive methods to collect information about specific issues or the whole service, often through getting the views of a sample of clients and/or information from a range of other sources.

4Contract compliance- Components

4.1Who monitors the Contract?

Contract monitoring will be conducted by a variety of individuals based on the method of monitoring being undertaken with a "Designated Officer" taking responsibility for managing the overallcontract complianceprocess, which includes review and evaluation.

It is important everyone involved in the contract compliance process has a clear understanding of why we are doing it and what we hope to achieve and conducts the process in a manner that will provide a clear and accurate picture of the service that is being monitored.

CODE OF CONDUCT
  • Contract monitoring staff will behave in a courteous, professional and straightforward manner.
  • Contract monitors will share concerns about service quality with all relevant parties at appropriate time.
  • Provide guidance on how any notifications, anonymous or vexatious, will be treated.
  • Contract compliance outcomes will be clearly communicated by the Council with the Provider

4.2Contract ComplianceResponsibility

Due to the breadth of information to be collated, analysed, judgements reached and recommendations made,there is a need to discuss further the operation of how to ensure these monitoring processes are undertaken and evaluated to establish whether the service provider is meeting their contractual obligations. The overall contract compliance responsibility at present lies with the commissioning officer who is usually the budget holder for the care services being procured.

Theoutcome of the contract complianceprocess should provide a clear overview of the service provider's ability to deliver care services to Clackmannanshire Council's clients.

It is important everyone involved in the contract complianceprocess has a clear understanding of why it is being done and what Social Services aim to achieve.

In establishing the priorities of contract compliancetwo elements need to be considered: the resources available and the assessment of risk of current service providers.

Resources – It is essential with limited resources that monitoring becomes ‘smarter’,therefore it is important to link available resources against the risk assessments of care serviceproviders. (Appendix 1)

Resources allocation is fundamental to laying the foundation for good practice contract compliance. See attached Appendix 2.

Effective contract complianceshould be able to answer the following questions:

  • Has the service changed or improved since the last monitoring?
  • Do the concerns raised about the service show any pattern or suggest particular problems?
  • Is the service delivered of an acceptable standard?
  • If an outcome focussed service- to what extent are outcomes achieved?
  • Is there any difficulty with the day-to-day working relationships that affect the operation of the contract?
  • Is there a need to put any corrective action in place?
  • Strategic Fit -does the purchased service fit within the commissioning strategy ?

4.3Contributors

Each stakeholder will have different hopesfrom the contract complianceprocess and it is important that these expectations are understood and can be met by laying down the most appropriate contract complianceframework.

Stakeholders

There are individuals who have an interest in, but who are not usually involved in, contract monitoring. Examples include elected members, senior managers, legal, health, education, housing, audit, finance and procurement services within Clackmannanshire Council.

Client and their relatives, friends and advocates, regulators, Social Services and the service provider are key stakeholders, who can contribute directly to contract compliancein various ways.

4.4Priorities - which Services should be monitored?

The use of a Risk Assessment Tool to assign levels of risks to each Provider will prioritise and identify the areas of care service provision that should be proactively monitored. (see Appendix 1 based on the ADSW model)

Based on the scoring received, the provider will be assigned a level of monitoring (low-medium-high). The basic principle is that the level of monitoring applied to a particular provider or service should be proportional to the assessed risk.

Risk assessments are not static and need to be reviewed regularly as the risks may change over time.

4.5Route - Reactive or Proactive?

As previously mentioned contract monitoring includes two different approaches - reactive and proactive This is not only about monitoring methods but also about how the whole process operates and is managed.

  • Reactive methods are where another person notifies there is a problem or concern or unsatisfactory service.
  • Proactive methods involve planned collection and collation of information and visits on a routine and regular basis.

Reactive Approach

Reactive monitoring mostly deals with circumstances where things go wrong, or appear to go wrong. It can produce three important types of outcomes:

  • Issues are resolved and the customer is satisfied with the service.
  • Provider performance improves and changes in relation to the issue/complaint.
  • Provides overview of the service delivered.

The information from this reactive monitoring must be linked back into the overall contract complianceframework and be considered as part of future risk assessment processes. At any point reactive monitoring information can trigger increased levels of monitoring activity.

Proactive Approach

The level of proactive monitoring applied will be proportional to the level of risk associated with the Provider. The table below indicates the typical types of monitoring methods that can be applied to a Provider within each level of risk.

Types of Monitoring applied depending on risk

Assessment of Level of Risk / Monitoring methods applied
Low
Baseline monitoring activity / Routine returns
Annual Checklist
Review of Care Commission Inspection reports
Annual site visit & monitoring meeting.
Medium
Active monitoring activity / Baseline + plus internal feedback with focus on specific problems
6 monthly monitoring meetings with possible site visit.
High
Close monitoring activity / Baseline + short life working group to specifically work with Provider.
All sources of monitoring maybe used at this level

This gives Providers an idea of the scope of monitoring input they should expect given their level of assessed risk. It also provides those officers monitoring contracts with a defined list of methods that can be applied. There may be times when more or less monitoring is applied at each level depending on specific circumstances.

These levels of monitoring will be applied to all care services

4.6Collecting Monitoring Information

Below are the methods that can be used to gather information to evaluate the quality of service delivered and promote good monitoring practice. These methods will be used to monitor the Provider's adherence to a contract's service specification, integral to contract management and ensuring quality care services for Clackmannanshire Council's clients.

1Case Reviews

At each individual Client's case review, his/her care plan will be considered, matched to the actual provision of services, and decisions made about the acceptable level of quality of services. Any discrepancies or concerns will be identified, together with appropriate action or remedy.

A record will be taken of any concerns and each Clackmannanshire Council Care Manager will keep a record of concerns and the remedies. These records will be kept for annual review and aggregation by the appropriate Clackmannanshire Council Care Manager.

Any patterns of sub-standard performance will be noted and the reason discussed with the Provider. The Provider will be given a fixed number of days, in which to satisfy the Council that the appropriate standards have been attained (the Council being the sole judge of such satisfaction), failing which the Council will be entitled to deem that there has been a material breach of contract on the part of the Provider.

2Provider - Annual Review

Each year the Provider’s performance will undergo a self review. Within some contracts, (mainly care at home contracts), the Service Specification is designed to form a working document which enables the Provider to carry out a self assessment of their ability to meet the Care Standards, and make comment about future standards and developments. The Provider will go through each Standard and detail whether or not each Standard is met and the degree to which it is met, or the degree to which the Standard has not been met.

The Provider's documentation of their annual review will be provided to the Council for assessment.

3Spot Check by Council

The Council’s staff will undertake visits at various times as part of their assessment or care management duties. These visits are to clients of care services. The Council’s staff will take note of any issues or concerns arising from the visits, and take the appropriate action (eg report to the Care Commission, the Provider, Contracts , Service Manager - Adult Care, etc)

4Spot Check by Provider

As part of the Provider's system of quality assurance, the Provider will undertake spot checks to satisfy themselves of the ongoing quality of their service delivery. The result of these checks will be recorded, and made available to The Council for the annual review of the Provider's service. They should specify any remedial action taken as a result of the checks.

5Individual Client and Carer Feedback

The Service is in the process of developing Carer and Client feedback survey questionnaires which will record individual comments about service quality, suggestions regarding service improvements, etc.

This information should be gathered and analysed to contribute towards the picture of the effectiveness of the Provider's service and the Council's ability to achieve the specified outcome for the Client.

6Care Commission Reports

The Council will review Care Commission inspection reports and where appropriate attend Care Commission Feedback Sessions.

7Complaints

A record will be kept by the Provider of any complaints, including verbal complaints, the details of the investigation, and the outcome. The Provider’s complaints procedure will form part of Clackmannanshire Council’s complaints procedure for Social Work Services, as required by the NHS and Community Care Act, 1990.