Expanded outline of contingency planning guidance

Draft outline to the contingency planning guidance:

LGiU, ADASS and DH project on contingency planning for care provider failure

How you can comment on this outline:  there is a comment section at the end of this page or you can send comments to Ingrid.koehler@lgiu.org.uk

You can alsodownload this document as a PDF

  1. Background to the guidance:
  • Who, why, what?
  • Scope of the guidance: this section will provide an outline of what we will cover and what we don’t cover
  • Specific care act legislation around these duties
  • Regulatory framework
  • How it links with the other two strands.
  • How to use the guidance
  1. What do we mean by failure:

Defining failure: Inability to meet business obligations.

Scope of this project: covers what to do when care providers are no longer able to meet business obligations such that councils have a duty to step in and provide alternative cover for their clients. This could be a temporary problem, such as a catastrophic event like damage to a building or major service interruption, but it could be a permanent inability to serve clients.

It will recognise that the process of failure isn’t overnight and that there may be some reasons to work with providers as they are failing to:

  • Avoid failure altogether
  • Make the process of failure impact less harmfully on users and new providers
  • To delay failure in order to find alternative providers or to reduce logistical problems

This work will not provide guidance for supporting care providers through failure and to the other side. However, as many of the case studies allude to it, it will acknowledge that this sometimes happens for valid reasons. Particularly when dealing with large expensive commissioned contracts in home care or where there is a shortage of good provision elsewhere.

It will also acknowledge that these are providers in a high risk situation and working with them can make the failure process easier.

We will draw a distinction between a social care services to clients failing (unacceptable) and the business that provides those services to clients failing (regrettable, but sometimes acceptable). We will state the important role of the market in reducing surplus places or driving out bad providers, but never equate that with the importance of people receiving the service of social care that meets essential needs.

We will likely make a recommendation that more work needs to be done in this area.

  1. Typology of failure: (NB. This may not appear in this order)

3a – visual typography: We will look at the various causes of business failure:

  • Financial
  • Regulatory – including safeguarding
  • Operational – basically mismanagement
  • Force Majeure and unexpected circumstances (e.g. immigration raids)
  • Strategic exits from the market to reshape business objectives

We will look at the impact of fast and slow failures and how these may differ for home and residential care.

3b: Survey findings: This section will include survey findings about number of failures and anticipated failures.

  • Residential care: planned and emergency and semi-faulures (e.g. re-registration as residential as opposed to nursing care)
  • Home care: planned and emergency and ‘soft’ failures of larger scale providers
  • Special circumstances of specialist failure
  • When to trigger the guidance
  1. Precipitating risk – managing exits – managing risk

4a. Imposing conditions of failure: Although this is guidance designed to help councils deal with failure, it’s worth mentioning the impact councils can have on the market and how they can encourage failure, such as:

  • Commissioning practice (e.g. commissioning frameworks, prices, poor transitional arrangements between contracts)
  • Purchasing practice: spot purchasing, regular payments
  • Vacancy rates
  • Precipitating failure during high risk periods – embargos, lack of clarity around quality standards

4b. Preventing failure – And how can councils can work with their markets to both support providers to work well and to help them prepare for failure.

  • Support networks
  • Understanding ancilliary services, prevention agenda…
  • Helping providers understand changes to care practice and commissioning practice.
  • Helping providers understand the importance of contingency planning
  • Getting providers to develop and make both secure and shareable (in the event of emergency) good data and information about their clients, particulary self-funding clients.
  • Developing good intelligence on providers, the self-funding market and self-funders.
  • Market monitoring
  • Financial systems.

(NB: I do not plan to discuss this in great depth and wherever possible I will refer to existing guidance and the other pieces of guidance in the trio)

A section on hard to replace providers – such as specialist care.

  1. Identifying failure:

Signs of failure: A short section on signs of failure – will make reference to the other guidance, e.g. – this is in the context of placing providers on a ‘concern’ list – or deciding when to put people in readiness for dealing with a provider failure (which may not happen) – or dealing with failure in a hard to replace provider.

  • Poor environment
  • Lack of investment
  • Poor asset quality
  • Whistleblowing issues
  • Safeguarding issues
  • Complaints
  • Declining numbers
  • Changing registered care managers
  • Borderline inspections (change the terminology) –
  • Demand for increased payments (flip this)
  • Rostering problems in home care – e.g. missed, late visits
  1. Dealing with failure:

This section will outline the range of options open to local authorities when providers are identified as at risk.

  • Active monitoring
  • Precipitate failure/ i.e. close or embargo
  • Support

And will probably take the shape of a flow-chart (as decisions and resultant actions can change as the situation changes)

  1. Case studies:

These will be interspersed with the sections above, but only included in this outline separately for clarity. We will aim to include, residential care, home care and specialist care failure stories and how contingency planning helped or lack thereof hindered.

  • Buckinghamshire – home
  • Norfolk – home
  • Nottinghamshire -residential
  • Calderdale – specialist residential
  • Surrey (care provider association)
  • Enfield
  • From the perspective of the insolvency practitioner (with a bit of N Yorks thrown in)

And general comments:

8. The contingency planning template.

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