Agenda item

RESOLVED:

To award Agudas Israel Housing Association (AIHA) a contract to deliver the Orthodox Jewish mental health accommodation based support service for a term of two years. This follows a direct negotiation as approved by the Committee in September 2018.

REASONS FOR DECISION/OPTIONS APPRAISAL

The report seeks to gain approval for the award of a contract following a direct

negotiation process which was approved by the Cabinet Procurement Committee in September 2018.

This award is in relation to Key Decision CACH P9, Recommendation 2: ‘Agree to the competitive procurement, with multiple lots, for a mental health accommodation based housing related support pathway. The term of contract will be 5 years with an option to extend for a further 2 years (5 +1 +1 years). The annual contract value is £1.2m; equivalent to a total contract value of £8.4m with some additional East London Foundation Trust (ELFT) funding, the value of which is to be confirmed. This will include direct negotiation of a contract for mental health accommodation based housing related support specifically for the Orthodox Jewish community. On completion of the negotiation, a Single Tender Action will be submitted to the Cabinet Procurement Committee for approval’.

The service will provide culturally specific housing related support to people from the Orthodox Jewish community and who have been referred by the mental health housing panel.

The service will be flexible and responsive to the multiple needs of service users with diagnosed mental health problem and some of who may also:

? Have very chaotic lifestyles, including those displaying anti-social behaviour;

? People at risk of offending;

? People with substance misuse issues who may or may not be engaging with substance misuse services;

? People with such needs may occasionally engage in illegal activity and the service is expected to work with the police and probation to explore enforcement options where appropriate.

7.1  The Commissioner, Mental Health and Prevention introduced the report highlighting the following points:

·  The report covered a request for a two year contract which would be for payment by activity as opposed to a fully commissioned service;

·  One of the dilemmas involved with this work was that the provider had indicated increased costs over the preceding years and there was a growing gap between the funding and the costs;

·  An agreement was negotiated by the Council whereby payment would be by activity based on the occupancy of Hackney residents;

·  The service covered non-Hackney residents. Moving to a transition would be a cost neutral arrangement and would allow the provider to be more sustainable over the next two years when the Council moves to a fully payment by activity model.

  7.2  Councillor Kennedy thanked officers for their work on this report. He highlighted paragraph 6.2 in the report which stated that; ‘The arrangement whereby Hackney has to pay for non-Hackney residents will come to an immediate end. AIHA will be enabled to sell a limited number of bed spaces to other funding authorities or for privately funded placements’. Councillor Kennedy sought reassurances that the Council would not be entering into such arrangements again where the Council ended up paying for non-Hackney residents.

7.3  The Commissioner, Mental Health and Prevention replied that the service being provided was very specific to the Orthodox Jewish community. Some of those demands were coming from outside Hackney and were increasing. The contract was sustainable for the provider, as they were receiving referrals from other areas which the Council had previously put limits on the numbers that could be taken. The hybrid model that was now being taken forward would mean that the cost effectiveness for the Council was improved and it was more sustainable financially for the provider. The negotiated agreement would work for both parties, firming up the arrangements and would also help the provider to serve their community beyond the borders of Hackney.

7.4  Councillor Woodley sought clarification on whether those who were receiving the payments in accommodation were still to be taken care of. It was understood that what was proposed was a more efficient commissioning process, however it was a unique neighbourhood in Stamford Hill and the Councillor wanted to ensure that the community involved had co-production in these arrangements.

7.5  The Commissioner, Mental Health and Prevention replied that the Council had engaged with the provider as well as taking into account the considerations for the wider community. All the current residents that remained had begun to be regularly reviewed and had also been contacted by the local mental health trust so that there had not been any changes with their needs in recent years. The Council had ensured there was a process to update all reviews so that there were no changes to the support and care being provided and it would continue and be sustainable for all concerned. The Commissioner, Mental Health and Prevention stated that he had undertaken a site visit in the summer of 2021 and had spoken to local residents who were both impressed and satisfied with the support and care that was being provided.

7.6  The Chair raised a question regarding paragraph 5.5.5 (fourth bullet point) in the report which stated that; ‘AIHA has developed its own unique model of provision which is a mix of care and support and is different from that which Hackney wishes to commission’. The Chair queried whether this wording was an error in the report as he would expect the provider to be providing what we need and not what suits just their business model. 

7.7  The Commissioner, Mental Health and Prevention replied that this section of the report was a reference to how there was a mix of needs in each service. The service was bespoke to the community with the practicalities of a mixed level of needs in each service; this was not typical. The Council would normally commission high support  needs for individuals who require high support, for example, within a single service. Typically if the Council was commissioning a wider service there would be a wider element. There was more of a need because it was specifically for the Orthodox Jewish community with a need to be pragmatic about the mix of residents. The Council’s approach was almost starting from a blank page and if it was not for a specific community the Council might commission all high or all medium support. The Commissioner, Mental Health and Prevention stated that there was a slightly different characteristic around the resident blend but there was no different way to provide the support.

7.8  The Chair questioned whether there were any particular risks involved  in the Council undertaking this approach.

  7.9  The Commissioner, Mental Health and Prevention replied that there  were no risks to the residents and their care and well-being. Where there were additional care support needs for individuals some individual care packages were funded separately. The Council was confident the residents were getting the care and support they required.

 7.10  The Chair raised a query in relation to paragraph 6.4 of the report regarding savings, The report stated that the savings were an estimate and could not be guaranteed. The Chair asked about the particular risks involved with this.

  7.11    The Commissioner, Mental Health and Prevention replied that that  section of the report was taking into account future admissions as the Council could not predict the exact level of need for each individual Some individuals may require additional staff being brought in. Typically when the Council in the past three years had renewed the previous admissions the Council was confident that the cost was very unlikely a risk to costs because the contract was for payment-by-activity, therefore the Council could not exactly predict every element of need for the future if someone was admitted in for example in six months time what that would be. In terms of the overall cost to Hackney Council there would be additional costs for care packages for those residents with  very high needs. The Commissioner, Mental Health and Prevention stated that there were no financial risks but also there was no 100 percent guarantee on saving.

RESOLVED:

That the Cabinet Procurement and Insourcing Committee:

Agreed  to award Agudas Israel Housing Association (AIHA) a contract to deliver the Orthodox Jewish mental health accommodation based support service for a term of two years. This follows a direct negotiation as approved by the CPC in September 2018.