Agenda item

(To receive a report by Reena Fehnert, Commercial and Procurement Officer – People Services, which invites the Committee to consider the re-commissioning of the Direct Payment Support Service which is due for decision by the Executive Councillor for Adult Care, Health and Children's Services between 2 and 3 December 2019)

It was reported that the Direct Payment Support Service (DPSS) was the Council's dedicated service contract that helped support service users who had a direct payment with a range of activities.  The current contract had had its full extension, which meant the current provision must come to an end on 31 March 2020.  A new service would have to be procured to start on 1 April 2020.

The Committee was invited to consider a report on the Direct Payment Support Service on which a decision was due to be made by the Executive Councillor for Adult Care, Health and Children's Services between 2 – 3 December 2019.

Members were provided with the opportunity to ask questions to the officers present in relation to the information contained within the report and some of the points raised during discussion included the following:

·         It was queried whether there should be a KPI to encourage a lower percentage of fully managed accounts.

·         There were quite a few people receiving direct payments who also received Personal Health Budgets (PHB).

·         There was a need for a mechanism to allow the number of controls to be more streamlined without having to add another layer of bureaucracy.  It was hoped that this was what the authority was moving towards with the pre-paid cards and virtual wallet.  It would be possible to set trigger points with tolerances for spending by clients which was either too low or too high.  The bank accounts did allow trigger points that would alert the finance team and social workers.

·         Discussions were taking place around whether health partners would also be able to make use of the virtual wallet as they were keen to be involved as some people had social care needs and health needs, which currently needed to be administered separately.  It would be an opportunity for an individual to have one place where they could keep their money but could portion it out.

·         It was noted that an annual survey had also been conducted in May 2019, and the results of this could be provided to members as a follow up.  In terms of the 2018 survey, the response rate indicated 70% approval for the account set up process.  This was tracked against the national picture.  On average, the Lincolnshire service was performing better than the national average.  The 2019 survey showed a similar trend with very similar satisfaction levels.

·         In terms of KPI's which were being developed it was queried whether they should already have been in place for the existing contract.  There were new requirements to focus on where people sit within the support spectrum and how often they should be reviewed.  This would ensure that the money was being spent more effectively.

·         It was queried whether there was still a way of ensuring that things were done correctly if people preferred to withdraw money to pay carers.  Were there checks on this such as who was being paid etc.?    Members were advised that the Direct Payment Policy was clear that where someone was employing a person directly, i.e. not through an agency, the DPSS was there to provide support and advice.  There was also an audit function that would check that people were acting appropriately.

·         Becoming an employer could be quite frightening to most people, and support would be provided by the DPSS.

·         It was noted that the current budget was £485,000 and the actual spend for 2018/19 was £466,000.  It was queried what the spend would be for 2019/20.  It was hoped to manage all costs within £420,000.

·         It was noted that around 100 new direct payments were set up every month, and around a third now chose to take the pre-paid card option. 

·         It was queried what would happen if more people came into the system than expected.  Members were advised that the contract would cover the fixed overheads and some of the tier one activity, the rest would be paid on a by volume basis.

·         In terms of the pre-paid card and the virtual wallet, it was queried what would happen if the service user passed away, and how would the authority retrieve the money.  It was possible to set trigger points, such as if it was no longer needed or if there was misuse there was the ability to claw back the funds to the council's accounts.  However, there was a need to ensure that this happened in the right way.  There was more confidence in this method.

·         It was queried how often payments were made to the pre-paid cards and virtual wallet, and it was noted that it would be the same as direct payments, so every four weeks.

·         One role of the DPSS was to help people in the first few weeks to set up payments and tax etc.

(NOTE: Councillor Mrs M J Overton MBE left the meeting at 10.55am and did not return)

·         The virtual wallet and pre-paid card was welcomed and it was commented that it gave audit accountability.

·         There was a need to bring in the health element to strengthen it and reduce duplication.

·         The new contract would evolve from the last one with better outcomes for service users.

·         It was noted that there had been two cases in the last 18 months of deliberate misuse.

·         A minimum of 10% of sub-contracts were to local businesses.

·         The Executive Councillor commented that she was pleased the service would be receiving more support in terms of IT, and developing this had been one of the first things that the new Commercial Executive Director was tasked with.  For younger people particularly, this was a good development.

RESOLVED

1.    That the Committee support the recommendations to the Executive Councillor for Adult Care, Health and Children's Services as set out in the report.

2.    That the following comments be passed to the Executive Councillor for Adult Care, Health and Children's Services:

·         The proposed joint working with the NHS and the third sector is particularly welcomed. 

·         The development of initiatives such as the virtual wallet and the pre-payment card is strongly supported, as these initiatives should support the overall up?take of direct payments.

·         Paragraph 1.4.2 of the report refers to a 2017-18 annual survey of users of direct payments.  The Committee has suggested that a summary of the findings of this survey, and the 2018-19 survey if available, are presented to the Executive Councillor, at the time she makes the decision.  (The 2017-18 survey of users from Penderels Trust is attached as an appendix to this statement.)

·         The Committee is pleased to see that the proposed contract will include a requirement for local sub-contractors providing a minimum of ten per cent of the service, on the basis that this would be a stimulus for other providers.  

            In addition to the above, it was also confirmed to the Committee that:

·         The performance indicators would reflect an increase in the overall up-take in the number of people using direct payments as a positive; and

·         The level of misuse of direct payments was very low, and monitoring was in place to prevent this.