This case study forms part of the publication, Bespoke support for people with learning disabilities and autistic people, an evaluation on the impact consequence for local authorities and councils of delivering bespoke support to autistic people and people with a learning disability, including people who have been detained under the Mental Health Act (or at risk of being detained).
In this case study, we spoke to Jon Blackburn, the commissioner in Lancashire who is responsible for developing the Small Supports programme locally.
His journey started about 18 months ago. The local authority had received a sum of money under the Community Discharge Grant fund. As a Transforming Care Partnership, they represented a large area, and approximately 60 Lancashire people who were on their local ‘Transforming Care’ list.
He saw this as an opportunity to do something creative with the funding and began speaking to others on a similar journey to explore ideas. He was recommended to attend a ‘Small Supports’ webinar being hosted by NDTi to find out more information about the programme. He admits to going into the webinar with quite low expectations about what the programme could achieve; however, he left feeling very excited and hopeful.
He knew he would need to convince senior leaders within health and social care about the idea and set about developing a business case for creative use of the Community Capital Grant to kick start a Small Supports programme locally."
This made it easier to ask for their commitment at a senior level to proceed because he already had a source of funding to cover the costs of leading the programme.
His initial thought as a commissioner was that he would not have time to lead this project in addition to his full-time job role. Alongside asking for approval to proceed with the programme, he also sought approval to recruit a programme lead with the express function to develop and manage the project. He was clear that he did not want to restrict the role internally to the local authority, wanting to bring in somebody new with creative and different ideas; so he shared the opportunity on ‘LinkedIn’ platform and received a number of really promising responses.
From this, interviews were held, and a project manager was selected. They began the process of engaging with the provider market to identify a small number of providers who would be interested in engaging with the project. Again, LinkedIn proved to be a helpful platform for stimulating discussion and attracting interested providers. To date, three providers have been selected, using the nine ‘Small Supports’ criteria as a filtering process. They received many responses and had to turn down more providers than they eventually accepted to the project.
The door is not closed completely, but they are being carefully selective with the providers they are choosing to work with.
The commissioner had a procurement background and was aware of the barriers it could bring to the process, so from the beginning he was clear that this programme would need to sit outside of any usual procurement process."
He set up a project group which included the procurement lead from the local authority and was clear that this would be separate from the usual approved provider process. This meant that new/small providers were not restricted from applying even if they were new to the area or unable to provider financial data/references etc.
The procurement team were involved in developing a separate formal process for approving Small Supports providers, opening up the opportunity for new smaller providers who could meet ‘Small Supports’ criteria to be involved in the project. The entire approval process was coproduced with experts by experience.
There were lots of qualitative questions in the process, designed to tease out organisational values, ability to individually tailor support and highlight what makes them different to other providers.
This has enabled new providers who are just starting out and going through CQC due diligence to apply and ‘walk through’ the process with the project team to move towards formal approval as a Small Supports provider.
Each provider has a development plan in terms of where they are now, and where they are aiming to get to.
The three providers selected are all very different.
- Provider 1: Locally established. Supporting less than 10 people
- Provider 2: Set up, but not yet CQC registered. Currently going through registration and supporting approximately three to four people
- Provider 3: Setting up and going through CQC registration. Not yet supporting anyone
The commissioner commented that it would be difficult to use a Dynamic Purchasing System or other formal procurement processes for approving Small Supports providers due to the limitations and restrictions imposed by a typical tendering process.
In terms of the progress of the project, the first individual has been identified to match with one of the providers to commence the process of support planning and building bespoke housing and support provision, ready for them to leave hospital.
The project team have also invested some of their funding in providing bespoke training to the social workers and providers who will be involved in the project, enabling them to explore how to develop creative and bespoke support plans, utilising statutory funding, housing options and community assets to create bespoke solutions for individuals which will enable them to safely transition from hospital into the community.
Two key elements for Jon as a commissioner would be:
- to appoint a dedicated project lead to be able to effectively develop the programme
- don't avoid procurement entirely but work with them to develop an alternative approach which enables small providers to engage in the process
Jon’s team asked the three providers in the project what they valued must about working as part of the Small Supports programme, and the overwhelming response was about the openness of communication within the team."