To improve the relationship between the council and external adult social care providers, Havering Council recognised a need to develop a two-way communications model between all providers and the council. The model would support a more equal relationship, focusing on the best possible outcomes for vulnerable residents. This forms part of our adult social care markets and commissioning resource.
The story so far
Information collected from the new communication model highlighted common issues and hurdles faced by our providers. The council identified that to overcome market issues it needed to take a more proactive approach and offer a solution to all providers.
It was quickly established through the improved communication that Havering Council needed to develop a new training offer for all providers.
The council undertook a workshop in 2015 with all providers, who informed it about the challenges they experienced with information sharing and communication breakdowns when key staff left or changed roles within the council. It was clear from discussions that they needed a single point of access for all provider information.
Based on this feedback, the council was able to develop Care Network, an online portal which supports two-way information sharing. Within the portal there are specialist confidential forums that can be booked onto. Each forum has a shared agenda; where issues are recorded, circulated and fed back on to members.
Specialist forums include:
- residential and nursing care
- home care
- learning disability services
- voluntary and community sector
Feedback from residential/nursing care homes and home care agencies in the borough identified that many services faced challenges in sourcing high quality training for new starters at an affordable price. This led to the provider workforce having an inconsistent and uncoordinated level of training and providers’ were facing increased staff training costs, which often involved long distance travelling.
Havering was able to use this market overview as an advantage and identified a niche opportunity to develop providers’ training offer using the Care Network. Further investigation and provider surveys identified the top 10 courses either most in demand and/or those which focused on quality.
For a one year pilot, the council was able to deliver quality-assured mandatory training courses; making such courses available for care homes and homecare agencies to purchase. It was important for providers that training was local and of high quality.
The council now brokers courses from a range of training providers using an online procurement system, with the providers funding the training themselves. This brokerage system allows Havering to negotiate better fees for training based on collective demand and by implementing a ‘community buy-in’ model of purchase, prices per head are determined by the number of providers that have expressed their interest. Members can explore the courses on offer and register an expression of interest through the online Care Network. Although courses are targeted at residential/nursing care homes and home care providers, bookings are open to all Care Network members.
As of July 2018, the council has trained over 200 people on their courses and has a 75 per cent attendance rate.
Through the programme, the council was able to support personal assistants to access quality-assured training and achieve an accreditation. Personal assistants had similar issues to the providers and found it difficult to source training on an individual basis.
The council has since trained over 50 personal assistants which has led to a significant growth in the personal assistant market in Havering.
Courses on offer in Havering include:
- Medication Awareness and Administration Competence
- Managing Challenging Behaviour in Adults with Learning Disabilities and Complex Needs
- Managing Challenging Behaviour in Adults with Dementia
- Moving and Handling of People Practical Skills
- Moving and Handing of Objects Practical Skills
- Stoma care
- Catheter Care
- Pressure Sores
The council is now looking to deliver the training programme sustainably to providers and personal assistants as part of an integral business as usual process, with an administrator managing the programme, whose post is supported by the programme delivery.
Benefits of the council's approach
- Care workers are trained to a high standard and are capable and confident in their role
- Providers have access to high quality training courses locally at an 'affordable' price
- The training programme is sustainable and can be delivered at no cost to the council
- Improved relationships with providers
- Better overview of how providers are developing their staff in terms of learning prospects
- Improved confidence that providers are accessing high quality learning through the training pilot programme
- Reduces the need for the local authority to check training records with providers as part of visits as these are now available via Care Network
- Economies of scale through brokerage and ‘community buy-in’ model of purchase
- Ability to identify if there is a shortfall in a specific skill set
Advertising courses on an ‘expression of interest’ model basis before committing to the course protects the council from being subject to charge. This does increase the risk of no courses being run due to a shortage in sign up, and providers losing trust in the programme, or sourcing learning elsewhere.
To overcome this challenge, we implemented an agreement with neighbouring local authorities and partner organisations to offer places to the wider market, provided only a small additional number are required to run the course, to ensure courses do proceed. A membership fee model was investigated, however was found to be limiting and inflexible for use in Havering, and was without any incentive for providers to buy into it.
A strong communications strategy was built to encourage bookings. Evaluations were held collaboratively with providers to ensure that courses with sufficient demand are run. Providers attend working groups and regularly discussed the programme during forums. Strong relationships were built between the commissioning, contract monitoring and quality assurance teams in order to ascertain future demand and encourage attendance on council-led training. This assisted the council in managing the programme on a quarterly basis, minimising this risk and ensuring productivity.
Impacts of these new approaches
- Providers have said that there is a noted improvement in the relationship with the council since the communications model was implemented; they found previous provider forums were often one-sided and this led to them becoming defensive or wishing to maintain the status quo; the forum now operates on a two-way, partnership basis, enabling open and honest conversations to take place about continuous service improvement and development
- Providers now make a direct and positive contribution to the co-ordination and commissioning of residential and home care services
- The council’s confidence in the quality of care provision to residents is expected to increase due to the quality-assured training being accessed and our understanding of market operations
- Consultation with the local home care market led to a 10% uplift on hourly rates for those on our framework agreement.
- The majority of attendees saw an improvement in their confidence and knowledge around course subjects immediately after the training and after 3 months
- The personal assistants market in Havering has grown and developed to respond to demand.
- Developing and supporting the stability of the provider workforce, including qualifications and a joined-up career pathway
- Increasing the learning prospects available to providers – free, and at a charge
- More shaping of the VCS market to deliver outcomes against three priorities: tackling social isolation, carers support and developing community resilience through peer support.
- Begin by building on what you already have in place; introduce incremental shifts to improve it. Review impact. Learn. Repeat.
- Plan for the whole local system and build on that rather than take a piecemeal approach
- It’s important to ensure that the mind-set in the council enables true partnership working
- Making small concessions to providers can reduce frustration significantly and can contribute to much improved relationships
- Ensure that whatever IT system you use is fit for purpose and meets your needs
- Build relationships with other colleagues in the council including workforce development, quality assurance, commissioning and quality assurance.
- Make sure that providers are interested and committed to this offer and that there will be sufficient demand
- Ask specific questions about what you can realistically offer as part of the programme – we collected too much information initially as part of a survey and needed to find a way to narrow down priorities, which relied on increased resources
- Involve providers in the process from very early on; ensuring that they are on board with the programme and have the opportunity to contribute towards the designs
Contact details for more information
Amy Reed, Commissioner and Project Manager at Havering Council
Phone: 01708 431858