How approved care provider regime delivered more choice and value

Under Cheshire West and Chester Council's learning disability provider framework, practitioners no longer negotiate prices, meaning they can focus on identifying the right service for their client, says Joanna Zlocinska.

Even in times of austerity service users should and can receive a good quality service. With this in mind, Cheshire West and Chester Council overhauled its approach to commissioning all learning disability services with the introduction of a provider framework in January this year.

Developed in partnership with the learning disabilities partnership board, carer representatives and health professionals, we have found that it has improved choice for families, freed up social workers to focus on quality, and improved value for money, as well as relationships with providers.

The framework covers all services, including day care, supported living and residential care, includes a set of quality standards and a list of providers assessed as having met them, and caps prices for services. We have now approved over 80 providers through the framework.

The council now sends approved providers information about clients including their needs, what their aims are and, most importantly, about them as a person. The providers will be asked to give information on how they will support the person and why the support they will offer will be good. Service users and their supporters will then be involved in choosing which provider is best for them.

Care managers freed up

From social workers and care managers’ perspective, the framework relieves them of the burden of having to negotiate prices, which often equalled compromising on the quality of care. Having a database of approved providers and a capped rate for care enables them to concentrate on developing the support plan and identifying the right provider who can meet the person’s needs within their indicative budget.

Existing and new providers were invited to sign-up to the framework, which involves a self-assessment against quality standards followed by an audit, in order to verify that the service meets the standards.

Depending on resources, audit visits are carried out by up to three people – the council’s contract manager, an operational member of staff and a social worker. The aim is to gather evidence regarding service delivery; it is a mix of written evidence, practical examples and observations.

Social workers auditing services

One of the social workers, who took part in two audits, said: “I was part of two audits. I found the experience invaluable. It gave me insight into how companies manage their employees, the value they place on them as assets and the company view on training and development. I visited the homes of some of our clients and was able to ask the clients open questions about their home and the staff that support them without causing conflict.”

The audits have truly enabled us to identify the key areas for development. Those were mainly concerning evidence of good person-centred planning,  investment in staff training and support, written evidence in relation to updated policies, complaints and a truly outcome-focused approach to support.

The intelligence we have gathered through audits means that we are better able to offer support compatible with an individual’s needs and personality without having to compromise on quality. The framework also provides an opportunity to identify and disseminate best practice between providers.

Positive feedback from providers

Providers told us that they found the audit and general preparation for the visit a very helpful process and some of them want to use this to develop their own audit systems and general working practice.

We believe that since the introduction of the learning disability framework, the relationship between the council and providers has improved. It has given the providers a much greater clarity of what is required from them. It also gives a much greater assurance to carers and service users, and helped to build a more open relationship between all parties involved in supporting an individual.

Joanna Zlocinska is graduate trainee in the council’s supplier management team

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