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www.islington.gov.uk

Islington Health & Social Care Engagement Strategy

Appendix B: Market Failure Contingency Planning Guidance

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Market Failure Contingency Planning Guidance

INTRODUCTION 4

Scope 4 The Duty for Market Oversight 4 The Temporary Duty to Meet People’s Needs when a provider is unable to continue to carry on the relevant activity in question because of business failure 5

Reasons for Application of this Plan 5

APPROACH TO MARKET OVERSIGHT 7

Overarching Principles 7

CQC Oversight 7 Business Oversight 7 Regulatory Oversight 8

Quality Oversight of Commissioned Services 8

Safeguarding 9

Financial Oversight of Commissioned Services 9

Independent and Service User Funded Providers 10

Local & Specialist Providers 10

Market Choice and Sustainability 11 Market Sustainability 11 Addressing lack of Market Choice (Market Failure) 11

Minimising the risk of failure 12 Commissioning Practices 12 Business continuity planning 13

CONTINGENCY PLANNING GUIDANCE 13

Producing the Contingency Plan 13

Key Details 14

Immediate Action Checklist 14

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Background Information 15 Statutory Duties and Powers 15 Related Plans and Guidance 15

Scope of the plan 16

Risk Analysis 17 Risk Analysis – Identifying Risks of Failure 17 Risk Analysis – Mitigating Risks of Failure 17

Triggering the contingency plan 18

Roles and Responsibilities 18 Plan Sponsor 18 Plan Manager 18 Establishment of a response team 19

Action Plan 21 Continuity of Care 22 Safeguarding 23 Communication & Consultation 23

Ending the Contingency Plan Arrangements 25 Learning 25

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Introduction Scope This plan outlines the council’s approach to tackling provider and market failure in health and social care services in Islington. The plan sets out the council’s definitions of provider and market failure, how the council will seek to work with local stakeholders to reduce the risk of failure and what actions the council will take in the event of failure. The plan addresses both the council’s specific duty to meet the needs of people whose service has been affected by the business failure of a provider as well as the council’s approaches to different types of provider and market failure. Not all types of failure will be the fault of providers (or the council) – failure might occur because of events outside of the control of either party, even instances of business failure. In these instances the plan will set out how the council and providers can work together to mitigate these risks. Some large regulated providers will be encompassed by the CQC’s market oversight regime. This plan will set out how we will work with the CQC to manage the risk of market failure amongst affected services in the borough; recognising that the duties under the Care Act 2014 still fall on the council. Other providers will be subject to local oversight procedures which will be outlined in this plan. The Duty for Market Oversight The council has a general duty to oversee the social care market in Islington; ensuring that services are sustainable and can meet the needs of all our residents. “The Care Act places new duties on local authorities to facilitate and shape their market for adult care and support as a whole, so that it meets the needs of all people in their area who need care and support, whether arranged or funded by the state, by the individual themselves, or in other ways. The ambition is for local authorities to influence and drive the pace of change for their whole market, leading to a sustainable and diverse range of care and support providers, continuously improving quality and choice, and delivering better, innovative and cost-effective outcomes that promote the wellbeing of people who need care and support.” (Care Act 2014 Statutory Guidance) The market failure plan sits within our wider market engagement strategy. We hope that through the wider strategy we will be able to work in partnership with local providers to ensure we have a sustainable health and social care market able to meet the needs of our residents. The Market Engagement Strategy as a whole addresses how the council intends to discharge its duty to provide market oversight. This plan outlines the council’s approach to preventing failure in specific services and the actions we will take to prevent, mitigate and respond to the failure of specific services.

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The duties placed on the council by the Care Act relate to the provision of social care services and the council is not able to intervene in health services as these duties fall on the NHS. However, in Islington given the close joint working between the council and the CCG and cooperation with the NHS in many areas there is a case for the application of this plan to local NHS services which are commissioned under joint arrangements. The Temporary Duty to Meet People’s Needs when a provider is unable to continue to carry on the relevant activity in question because of business failure The Care Act 2014 puts in place a specific duty on the council that where business failure prevents a regulated provider from providing a regulated service the council takes on the responsibility meeting the needs of affected people until new arrangements are put in place regardless of their place of ordinary residence or whether they normally fund their own care. This plan details how the council will meet this duty.

Reasons for Application of this Plan The council has defined the following types of failure covered by this plan:

1. Provider Business Failure: is strictly defined in terms of the Care Act 2014 as a financial failure of the care provider’s business where regulated activity (i.e. care) can no longer continue and services close. When this occurs the specific temporary duties placed on the council in the Care Act 2014 are triggered. However, there will be situations where a provider’s business fails but services do not close so the duty is not triggered; in these circumstances the council may still want to take mitigating action.

The regulations also make clear that the failure of individual parts of a providers business do not fall within the scope of the act. In these instances the guidance makes clear that providers should work within their contractual obligations to the council and/or service users to ensure that no one’s care is disrupted during the process of winding down the failing part of the providers business. Failure to do so would be considered a service failure, as described below. Although the council has no duty to act in circumstances other than business failure which leads to service closure the council does have the power to act to meet urgent needs of service users in a range of circumstances that might be prompted by other types of failure.

2. Service Failure: are circumstances where an individual service or services are interrupted or closed (permanently or temporarily). Service failures may be experienced in regulated or unregulated services. Examples of service failure would be:

A service closing due to a provider withdrawing the service (as per the scenario outlined above).

A service failing to carry out its contractual obligations to the extent default notices or termination proceedings have been initiated. This would include a wide variety of situations including the inability to provide sufficient qualified staff, failure to have adequate care planning systems in place, failure to keep sufficient records.

A service closed, suspended or otherwise subject to formal action as a result of a safeguarding adults or children review/investigation.

A service no longer to legally continue because of lack of a necessary licence/accreditation i.e. CQC deregulation.

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3. Force Majeure: it is unlikely that these events will actually constitute a failure on the part

of the provider. Instead these are circumstances where the service is interrupted or forced to close for reasons outside of its control. Examples of this might include a severe weather event that prevents a provider deploying its staff or damage caused to a building by a vehicle crashing into it. Finally the council also wants to consider a further type of failure in this plan; which relates to the council’s duty to ensure that the health and social care market in Islington meets the needs of all the borough’s service users, carers and residents.

4. Market Failure: describes situation where the market as a whole is unable to provide services that Islington residents require. We have broken down causes of market failure into three sub-categories.

Lack of market interest: this covers situations where no provider is willing to provide a service needed by Islington residents. This may be because overall demand for these services, both in and out of the borough, or where there is not yet a sustainable market developed to supply the required services.

Lack of suitably qualified labour: this covers situations where there is a system wide shortage of suitably qualified labour available at a sustainable cost. In London the cost of housing makes this a particular concern and is already leading to a shortage of qualified nurses. It may also happen when staff with particular qualification, skills and experience are required who are in short supply within the local labour market.

This is not the same as where providers fail to attract staff because they are not offering competitive salaries and terms and conditions.

Lack of suitable estates: in Islington the price of property and lack of available land mean that although there may be willingness in the market to provide a service there is no suitable building or location to base the service.

For further information please refer to the guidance issued by ADASS and the LGIU: http://www.lgiu.org.uk/wp-content/uploads/2015/10/Care-ContinuityFINAL.pdf

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Approach to Market Oversight Overarching Principles The council’s ability to shape and oversee the market relies on the gathering, sharing and interpretation of information about health and care services operating in the borough and used by our residents. A sophisticated understanding of patterns of need and demand will be as important as specific knowledge about the situation of individual services and partners. Our approach to market oversight will therefore be focused on ensuring open and transparent communication between the council and local providers. This approach is described in the Market Engagement Strategy.

CQC Oversight Business Oversight The CQC has duties under the Care Act 2014 to provide oversight over the financial health of providers which, because of their size, geographic concentration or other factors, would be difficult for one or more local authorities to replace, and therefore where national oversight is required. A full list of providers covered by this scheme is available on the CQC website: http://www.cqc.org.uk/content/market-oversight-adult-social-care#providers The CQC monitors the financial health of these organisations and has power to take action where they believe there is risk to the provider’s financial sustainability. However, at this stage there is no requirement to share this information with local authorities. The CQC has a duty to share with the council information only if a provider is likely fail because of business failure. This does not include the closure of individual services. The CQC will instruct local authorities to prepare to implement their temporary duties under the Care Act if they are to be effected by the provider’s failure. The CQC has powers to request information that would help local authorities meet these duties from the failing provider and pass these on to the council. If a provider is expected to fail then the CQC is required to work closely with local authorities to help them implement the temporary duty. The Quality and Performance team will be responsible for acting as a single point of access between operational social care, commissioning and the CQC to ensure that information sharing around market sustainability and the risk of provider failure is shared as well as issues pertaining to regulatory oversight.

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Regulatory Oversight A draft information sharing protocol with the CCG is being developed by the Substance Misuse and Sexual Health Commissioning Team. It is recommended that once approved this is adopted across all commissioning groups.

Quality Oversight of Commissioned Services For all services, whether CQC regulated or not, it is essential that safe, high quality services are delivered. Good and proportionate contract management will underpin the council’s approach to quality oversight of commissioned services. Providers commissioned by the council will be required to submit quarterly and annual performance reports to the commissioning team, to receive a contract monitoring visit on a regular basis (usually once every six months but often more frequently) and to be part of a regular regime of quality audit and review. Good communication Providers should expect to have regular contact with their commissioning manager and are encouraged to make contact as soon as possible if they have identified any quality or safety concerns with their service. Commissioners are keen to engage providers early around quality, safety or performance improvements so that we can work in partnership to support providers address these concerns and identify how the council can support providers get back on track. Commissioners will always seek to work in a supportive, non-interventionist way with providers who have engaged early with us. Providers will also be encouraged to attend relevant partnership meetings and forums where concerns about wider systemic problems can be raised and addressed. Commissioners should include in all contracts clauses that allow the council to take control of key information assets in the event of market failure and ensure that provider consent forms reflect this as appropriate. Involvement of other stakeholders Other stakeholders may include:

Service users and carers

Social workers, occupational therapists and nursing staff

Safeguarding

Social care placements team

Community Safety

Corporate Complaints

Voluntary & Community Sector (VCS) Development Team

Secondary Mental Health Services

Acute Hospitals

Housing

Finance

Corporate communications

Public Health

Leisure, amenities and heritage services.

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Other relevant stakeholders may participate in contract monitoring and service audits and reviews as required. Other stakeholders have a role to share information with commissioners that pertains to the quality or the safety of a service the council commissions and should prioritise doing so after responding to any safeguarding concerns. Team Generic Mailboxes Disabilities Disabilities –

Prevention – preventioncommissioning@islington.gov.uk Older Adults, CHC & Domicilary Care -

Accommodation & Last Years of Life – Intermediate Care & Dementia -

Mental Health Mental Health –

Substance Misuse & Sexual Health Substance Misuse – substancemisuse@islington.gov.uk Sexual & Reproductive Health -

If in doubt stakeholders are invited to contact the Quality and Performance Team:

Safeguarding Where safeguarding concerns have been identified within a service, these need to be prioritised. The individual safeguarding concern needs to be raised with the Access Team. A decision will be made as to whether a safeguarding enquiry is needed in relation to the individual safeguarding concern. Where there is a high level of concern about the practice within the organisation or due to the volume of safeguarding concerns. A decision needs to be made regarding whether the Provider Concerns process should be instigated. Any provider concerns will be discussed at quality group meetings to ensure that concerns are addressed quickly and risks to service users are addressed appropriately. Safeguarding Adult Reviews (SAR) are now on a statutory footing and where the conditions for a SAR are met, providers will be required to participate with any SAR involving a service user.

Financial Oversight of Commissioned Services All commissioned services will be required to submit service budgets and projections twice a year. Where these arrangements are not currently in place the Quality and Performance Manager will work with commissioning managers and providers to develop these systems. Providers should also submit their organisation wide audited accounts annually. The financial health and robustness of organisations will be tested during the procurement process. However, the council recognise that smaller organisations may have difficulty demonstrating financial resilience. Commissioners will work with providers on an individual

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basis to understand their circumstances, what risks exist and the plans providers have in place to manage these risks.

Independent and Service User Funded Providers Many services operating in the borough will not have been commissioned to do so by the council. There is a strong and vibrant voluntary and community sector in Islington, many of them offering support to people with health and social care needs. In the social care sector more generally many small and medium sized enterprises (SMEs) from the voluntary and independent sector operate successfully delivering high quality services to service users; in particular for service users seeking a preventative intervention and for self-funders. Personal budget holders working with us or through a commissioned service to broker their support can expect financial and quality checks to have been carried out on organisations offering to provide services. Self-funders may also want to arrange their services through the council or an organisation we commission to independently broker services. All Islington residents are able to access information and advice around health and social care, from the council or one of our commissioned services. The council may identify to self-funders, where appropriate, providers about which the council has quality or financial concerns. Where the council becomes aware of a serious quality of financial concern with a provider likely to lead to imminent provider or service failure we will contact service users and carers we know about outlining concerns and providing advice and information. Self-funders will be identified when they access other services such as information and advice, and increasingly as they are assessed and registered for care accounts. Links with commissioned services Information gathered about other services delivered by a provider may also be relevant to the commissioning team if we also commission services from that provider as these may be indicative of wider quality concerns that need to be investigated. Stakeholders who have concerns about a provider who operates commissioned services in the borough should ensure that the relevant commissioning team is also informed.

Local & Specialist Providers The council recognises that some providers through their expert knowledge of specific conditions, practice or through the detailed local knowledge they hold will be very difficult to replace if the provider failed. Commissioners, alongside colleagues from other departments such as the VCS Development Team, will work to identify providers and services that fit this description. These contracts may be contract monitored more frequently in order to manage the risk of provider failure. Commissioners will also draw up specific contingency plans about how they will meet the needs of service users of these providers’ services in the event of failure.

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Market Choice and Sustainability Market Sustainability The council’s ability to deliver a sustainable health and social care market for residents will rely on the successful adoption of the actions and attitudes outlined in the wider market engagement strategy, including this document. The council will carry out annual market sustainability audits to identify any areas of vulnerability within the local health and social care market. However, it will be the responsibility of commissioning managers to ensure that the market place in their portfolio is assessed and areas of risk are identified with mitigating actions put in place. This will include working with other stakeholders and colleagues to understand the market for people funding their own care or purchasing services using direct payments. Addressing lack of Market Choice (Market Failure) The council recognises that Market Failure to provide services needed by the borough’s residents will have as big an impact on service users and carers as the actual failure of a provider. We will use the Market Engagement Strategy and our market position statements to mitigate this risk and help providers plan with us a sustainable health and social care market place in Islington. As mentioned previously there are three broad reasons for market failure, actions the council will take to mitigate the risk of each type are listed below: Lack of market interest

Publication of Adult Social Care and Joint Commissioning Market Position Statement

Publication of detailed sector specific market position statements

Regular engagement with providers through contract management, regular and open contact with commissioners and attendance at relevant forums.

Working with colleagues in the VCS Development Team to ensure services in key areas are supported to develop organisationally

Collaborative design of services with providers, service users and carers and other stakeholders.

Encourage collaboration between providers

Focus on quality and outcomes sought rather than highly defined service models.

Explore new ways of procuring services. Lack of suitably qualified labour

Consideration of workforce training and development in contract management and procurement

Opening up council training programmes to staff and volunteers in commissioned services.

Supporting the development of the local workforce, i.e. through use of social value in procurements.

Assessing workforce needs regularly.

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Commitment to fair pay amongst the social care workforce – ensuring all our providers pay at least the London Living Wage and that contracts are designed and offered with sufficient sums to employ and retain quality staff.

Lack of suitable property

Working with colleagues in Housing Property Services to help plan the need for buildings and accommodation on a long term basis; working to increase the number of services delivered from buildings owned by the council or its partners.

To work with colleagues in Housing and the VCS Development Team to map what property is available to deliver services from.

To work with colleagues in planning to ensure that Section 106 contributions are targeted at resources the borough needs.

Working across commissioning areas to ensure that opportunities for sharing sites, buildings and other forms of cross delivery are identified to maximise the potential of buildings and estates we own.

Working with colleagues from other departments to identify opportunities to more efficiently use buildings and identify areas where accommodation could be shared.

To work with local NHS and other statutory providers to explore how property can be shared across sectors to offer residents a more joined up set of services – for instance could advice services share a site with a local GP practice.

Minimising the risk of failure Both commissioners and providers can take steps to minimise and mitigate the risk of failure in a service, provider or the wider market. Commissioning Practices Commissioners can mitigate the risk of failure developing:

Using market position statements to signal our commissioning intentions to providers early and help them plan changes to their businesses in response to the services we need.

Contracting intelligently to ensure that a range of providers can be involved in the delivery of services.

Providing procurement training to providers. Procuring in a way that is accessible to a range of providers.

Fairly pricing contracts to ensure high quality staff and other resources can be sourced and retained within the service.

Avoiding unilateral variations to contract terms, the specification, outcomes or price agreed for a contract. This does not mean variations and reductions during the life of a contract will not be sought. Given the difficult financial position of local authorities and increasing demand for social care it will not be possible to rule this out. However, where this needs to take place Commissioners and Providers should work together to identify savings and understand realistically the impact on outcomes, service users and carers and staff.

Managing contracts using a risk based approach but ensuring that key risk management information around contract performance, the financial status of the service and provider and other key quality information is assessed as part of contract monitoring procedures.

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Where there is significant risk of failure Where the council is aware of the risk of a provider failing or a service failing then the council will need to balance the interests of service users and the risk of undermining attempts by the provider to improve their situation and avert failure. Commissioners need to assess what course of action is least likely to cause disruption and distress to service users before taking any action. However, this should not be at the expense of failure to act where the safety and wellbeing of service users or the wider public is at risk. Business continuity planning Providers should have put in place comprehensive organisational and service business continuity plans. Providers will be asked to supply these as part of contract management at least annually. Commissioners will expect to see that these plans are updated regularly and reflect the content of the council own market failure plan. Business continuity planning on a service level has an important role in preventing service failure or disruption due to Force Majeure events. Providers will be expected to incorporate detailed risk assessments as part of their business continuity planning which address how the service will continue in these circumstances. Ideally providers will involve commissioners and service users and carers in their business continuity planning to ensure that the actions proposed focus on minimising disruption to service users. Organisationally providers should test their business continuity plans and have a system for reviewing their effectiveness following a test or application of the plan.

Contingency Planning Guidance The guidance supplied below outlines a general plan with guidance that can be adapted by commissioning managers where areas of particular risk have been identified.

Producing the Contingency Plan Each contingency plan will be specific to the circumstances and services encompassed by the plan. It is therefore likely that the author of the plan will need to engage expertise from a range of stakeholders. Plan authors should consider involving the following key groups of stakeholders in the development of their contingency plans:

- Commissioners - Operational Social Services - The providers of the services covered - Service users and carers - Other Council departments and the CCG. - NHS providers (i.e. Hospitals, the Mental Health Trust, GPs) - The CQC

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Ideally the plan author should work collaboratively with the relevant stakeholders to produce the contingency plan – in a similar manner to the assessment of risks as outlined in the council’s Risk Management Policy.

Key Details Plan Title Contingency Plan Guidance Version 0.01 Lead Director Determined in “Roles and Responsibilities” Section Contact Number Alternative Contact Determined in “Roles and Responsibilities” Section Plan Manager Determined in “Roles and Responsibilities” Section Date of last review Reviews should be conducted at least annually Date of next review Location Plans should be stored online and physically Staff members in scope Determined in “Roles and Responsibilities” Section Key Stakeholders Determined in “Communications” Section

Immediate Action Checklist This section should outline the immediate actions required by the plan, summarising the content of other sections, to be followed assuming the reader has no familiarity with the plan.

Triggering the Plan

• Trigger circumstance

• Plan manager informed

• Plan Sponsor informed if unavailable.

Initial Actions

• Plan Sponsor approves activation of the plan

• Plan Manager establishes the response team

• Plan Manager takes immediate actions

Implementation

• Plan Manager tasks response team members with delivery of the action plan

• Plan Manager and Plan Sponsor review progress

Ending the plan

• Plan Sponsor agrees the ending of the contignency measures

• Plan Manager produces learning report

• Plan Manager reviews and updates the Contigency Plan

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Background Information Background information should be included to provide relevant context to the contingency plan. Where appropriate other relevant legislation and local plans and policies should be referenced.

Statutory Duties and Powers Section 38 of the Care Act 2014 places a duty on the council that where business failure prevents a regulated provider from providing a regulated service the council takes on the responsibility meeting the needs of affected people until new arrangements are put in place regardless of their place of ordinary residence or whether they normally fund their own care (although the council may charge self-funders and/or other authorities where a person is normally resident for the costs of providing this care). The council also has a wider duty to have oversight of the whole social care market in Islington. The approach the council will take to do this is contained in the Market Engagement Strategy and its Appendixes. The council also has powers under section 19 of the Care Act 2014 to meet urgent needs for people in other circumstances than provider business failure. This gives the council the ability to intervene in instances of Service Failure and Force Majeure events, as defined in Appendix B of the Market Engagement Strategy, where the situations have created urgent needs for service users. Many of these situations will however, be able to be appropriately dealt with by providers and the council should only act where service user needs are urgent and the provider cannot or will not act to meet their responsibilities. Related Plans and Guidance Market Engagement Strategy The Market Engagement Strategy sets out the council approach to market engagement and oversight. It also contains the council’s market position statement for adult social care and joint commissioned services and market failure planning guidance. Adult Safeguarding Policy

The service user needs to remain at the centre of all decision making in relation to safeguarding concerns.

Prevention of safeguarding concerns arising is key

All responses to safeguarding concerns should be proportionate and the least intrusive approach should be taken to the risk posed.

Partnership working is key to get the best outcome for service users within the safeguarding process.

Accountability and transparency during the safeguarding process and sharing information with the service user and/or their representative is a key principle.

All commissioned services will be required to participate in safeguarding enquiries.

Making it Real Islington is committed to personalisation and has implemented a dedicated work programme – Making It Real. For further information see wwww.islington.gov.uk/makingitreal

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At the heart of Making it Real is a commitment to work together as equals to develop policy and services and support each other so each of us can give the best we can offer. We will do this by

Sharing power more equally

Being honest about what is possible

Developing person centred policies and services, rather than systems or process led approaches

Empowering people to make changes to the system

Acknowledging the skills, knowledge, experience and interests people have and using these for mutual advantage in pursuit of a common aim

Taking positive action to include all groups

Valuing equally what everybody brings

Respecting people’s view and wishes-making sure people are heard

Making language, information and meetings accessible to all

Making it reciprocal – giving and getting something back National Procurement Strategy The National Procurement Strategy, which is being adopted in Islington, outlines the following key areas:

Using partnership, collaboration and increasing adoption of category management to help produce savings and contract efficiencies whilst maintaining the quality of services.

Implementing effective contract and performance management underpinned by consistent approaches to risk and demand management.

Supporting the local economy through the use of Social Value criteria in contracts and making procurements accessible to small and medium enterprises and voluntary sector organisations.

Providing leadership, recognising the strategic importance of procurement in the commissioning cycle.

Modernising procurement processes to allow for more e-procurement and to design procurement processes in such a way that encourages provider innovation and capitalising on new procurement processes under the new EU regulations to enable this.

The strategy is available: http://www.local.gov.uk/documents/10180/5878079/L14-304+National+Procurement+Strategy+for+Local+Government+in+England_07.pdf/0c66ccef-9ad8-416c-8e5a-2419b033fbbe Risk Management System Islington’s Approach to Risk and Opportunity management sets out the framework adopted by the council for managing risk and it outlines the risk management process advocated by industry best practice. Policy and templates can be accessed here: http://izzi/council/aboutcouncil/performance-policy/policy/Corporate-Governance/Pages/20100125-Risk-Management.aspx

Scope of the plan This section should clearly describe the following:

Nature of the contingency being managed e.g.:

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o severe weather affecting the ability of homecare providers to deliver services to the borough’s residents;

o business failure of the provider of a residential care home; o deregistration of a CQC regulated service; o significant and persistent failure to meet contractual performance or quality

standards.

Which services are likely to be affected – this should include: commissioned, in-house and independent services.

Number of service users and carers potentially affected and a brief overview of their needs.

Risk Analysis A risk analysis should form part of each plan. The plan should identify the routine steps that should be followed by commissioning managers to identifying whether any risk of failure is increasing or has occurred. Plans should also include steps that can be taken to mitigate the risk i.e. reduce the likelihood of failure from happening, and what measures would help with damage limitation should the risk of failure occur. The council’s Risk and Opportunity Management Guidance should be followed. http://izzi/council/aboutcouncil/performance-policy/policy/Corporate-Governance/Pages/20100125-Risk-Management.aspx The council’s Risk and Opportunity Management Guidance outlines a five stage risk management process. This process is designed to help focus on what could cause the event; what the risk event is and what the consequences would be. It also considers what controls are in place to reduce likelihood of the risk occurring and what controls are in place for reducing impact. The Contingency Plan should summarise the results of the risk analysis process outlined in the guidance referenced above and link these into specific information relevant to the plan using the suggested formats below. Risk Analysis – Identifying Risks of Failure No. Risk Inherent

Risk Score Signs of increasing risk

Sources of information

1. Example – contingency plans are not updated

3 Plans are updated at least annually

Quality Improvement Manager Commissioning Managers

Risk Analysis – Mitigating Risks of Failure No. Risk Actions to mitigate risk Actions to mitigate issue 1. Example –

contingency plans are not completed

Quality improvement manager to record all completed contingency plans

Quality improvement manager to report to directors any plans not reviewed in over twelve

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and dates of review and issue reminders to commissioning managers three months before each review date.

months.

Triggering the contingency plan The contingency plan will be triggered immediately upon the council becoming aware of:

The imminent business failure of the provider of a service in scope of this plan

An imminent service failure

A force majeure service disruption

Any risk which has become an issue where the action to mitigate the issue is to trigger the contingency plan. Plan authors may want to provide more detail.

Any officer who believes that the circumstances for triggering the contingency plan have been met should immediately inform the plan manager or their alternative contact. If they are not contactable the Plan Sponsor or their alternative contact should be informed.

Roles and Responsibilities Plan Sponsor The Plan Sponsor will have overall responsibility for the plan and will be of at least Assistant Director Level, in most case the Director of Adult Social Care will be the most appropriate Plan Sponsor for the plan. The Plan Sponsor will have responsibility for formally activating the plan and will empower the plan manager to carry out the plan. The Plan Sponsor will ensure that all relevant stakeholders and partners who need to participate in the plan do so. The Plan Sponsor will be responsible for ensuring that the right people have been nominated against the roles outlined in this plan. Plan Manager The plan manager will be a senior manager in Adult Social Care who will have responsibility for delivering the plan and reporting to the Plan Sponsor. The manager selected to lead on the plan should be appropriate to the circumstances envisaged in the plans. For instance, in the circumstances surrounding the closure of a domiciliary care provider where there are both council funded and self-funded service users an operational social care manager who can lead the process of assessment and care planning. However, for a plan looking at the closure of a supported housing project the relevant commissioning manager or placements team manager might be a more appropriate plan manager. The plan manager will recommend to the Plan Sponsor whether the plan needs to be activated in response to a report by another officer that the plan needs to be triggered.

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The plan manager will be responsible for ensuring that all the actions outlined in the plan are carried out. The plan manager will immediately establish the response team upon the activation of the plan. The plan manager will be responsible for reporting progress to the Plan Sponsor and escalating issues as appropriate. The plan manager will have an initial responsibility to draft the contingency plan. Establishment of a response team The plan should outline a response team of key named officers who will be responsible for delivering the actions required by the plan. The plan manager should carefully consider who is likely to need to participate in the plan and detail both named contacts and specific responsibilities. The plan should as a minimum consider the involvement of the following stakeholders in the response team: Safeguarding team The plan should consider whether any safeguarding issues are likely to result or have resulted due to the plan’s activation or the circumstances triggering this. Strategy and Commissioning If a commissioned service is involved the responsible senior commissioning manager or joint commissioning manager should automatically be included in the response team. Where the contingency plan may require a response from commissioned services as part of the plan the responsible commissioning manager should also be part of the response team. It may also be appropriate to involve other key managers from within the team such as the placements team manager (especially if it may be necessary to rapidly purchase individual residential and supported housing placements) and quality improvement manager. Operational Social Care Teams Any service(s) providing support to service users likely to be eligible to receive social care support from the council will require input from one or more operational social care teams depending on the circumstances and scope of the plan. Where the scope of the plan covers preventative services offering support to people below the eligibility threshold for social care it may still be appropriate to involve operational social care colleagues in recognition that service user needs may escalate due to the failure in the service or provider.

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It may well be that representatives of multiple operational social care teams are required to be part of the response team. The Assessment Service manager is likely to need to be involved in most contingency plans. For services where service users have or may have mental health needs then Camden and Islington Foundation Trust operational teams should also be involved. Other Commissioned and Independent Providers The plan manager should consider whether it would be appropriate to involve the managers of other commissioned or independent providers. This may be particularly helpful where the plan requires the sourcing of alternative provision for service users and management of this transition. Plan managers should retain some awareness of commercial sensitivities and service user and carer wishes around information sharing and care planning when deciding whether to involve outside providers in the response team. Health The plan manager should consider whether health partners need to be involved in the contingency plan. Health commissioners, not part of the strategy and commissioning team, should be considered for involvement as well as health providers such as Camden and Islington Foundation Trust, Whittington Health, University College Hospital and the Royal Free Hospital. The plan manager should bear in mind the likely impacts of failure on health partners as well as their contribution to the contingency plan when deciding whether health partners should be involved in the response team. Corporate Communications Team Any plan is likely to need input from the communications team. The plan manager should consider how the communications team should be involved in supporting the response team. A communications lead for the plan should be appointed. It is likely they will be recruited from this team; however, it may be appropriate for them to be another response team member. The communications lead has a responsibility to assist the plan manager to draft a communications plan for inclusion within the overall contingency plan. The communications lead will be responsible to then adapt this draft to the specific circumstances and then manage the implementation of the communication plan reporting to the plan manager. Corporate Finance Corporate Finance may need to be involved if the failure and/or the implementation of the contingency plan is likely to have a significant budgetary impact on the council. Corporate Finance will also need to lead on arrangements around re-charging other local authorities or self-funders.

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Other Corporate HR may also need to be involved if the plan has identified the need to recruit, transfer or make redundant staff. Public Health may need to be involved if the plan is to respond to public health issues such as a disease outbreak. Where there might be a significant impact on staff members of services the response team should also consider identifying and including relevant union representatives. Legal services may also need to be involved. If the contingency plan has been triggered as part of a wider event then the council’s corporate emergency planning team may also need to be involved. Other Councils Where the service provision is shared between a number of authorities it may be appropriate to involve representatives in the response team.

The affected provider It may also be desirable and appropriate to involve the affected provider in the response teams. There will be circumstances where this is not appropriate – i.e. quality or safeguarding concerns have triggered the plan – or where it is not possible – i.e. the provider’s business has already failed in such a way that services are being wound down. However, in many circumstances it may be possible to involve staff from the affected provider. The plan should indicate whether it is likely that this involvement would be desirable and possible in the circumstances the plan is intended.

Action Plan The plan manager should produce a detailed action plan based on the previous risk analysis and a detailed breakdown of the actions needed to mitigate issues identified in the analysis. The action plan should also include a number of immediate actions:

Response Team Convened Communications Lead Implements the Communications Plan Commissioning Lead activates any relevant contractual clauses, particularly around

sharing client information Any other local authorities affected should be immediately made aware of the failure and

where possible up-to-date assessment and care plan information about any affected service users should be requested.

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Continuity of Care The priority of the contingency plan is to ensure that service users receive continuity of care. This does not necessarily mean that service users receive the same services as they did previously but they should be provided with services that meet their needs as last assessed. Assessing and Meeting Need It may not be necessary to assess service user needs in all cases. Some services may clearly only offer services to people below eligibility thresholds. For other preventative services the failure may have increased service user needs to a level where they would now be eligible for services until an equivalent preventative service can be put in place; in which case they might mean they need to be assessed. The response team may need to collectively decide whether service users need to be assessed or reassessed. In other situations this might be a clear decision – the contingency plan will need to specify this and recommend actions within the action plan that will ensure that rapid assessment of service users. This may require the provision of additional resources, cover arrangements or temporary redeployment of staff. The plan should also identify if any other stakeholders should contribute to the process of assessing service user needs including medical/clinical partners, housing and carers etc. The council is not obligated to meet service user needs in the same way as they were met before a service or provider failure. The plan should identify whether the council could provide a direct equivalent service or whether services will need to be provided in a different way to meet service users’ needs. The plan should therefore identify the requirement for care planning and any resources needed to carry this out in a timely way. Information Sharing The response team should ensure that all relevant local authorities are contacted immediately upon the activation of the plan and where relevant they should be asked to share assessment and care plan information for their affected service users. Transfer of Provision Where the plan identifies the need for provision of service to be transferred the plan manager needs to consider whether:

Service users will need to change where they are living Whether patterns of care will change (i.e. homecare providers will visit at different times) Whether the types of services people receive will change – the plan manager should be

prepared to communicate why this is required. The wider impacts of a change of provision on service users and carers – i.e. the impact

on friendships and family relationships, access to GPs etc. Whether service users affected will need or benefit from advocacy – either statutory or

non-statutory. The plan should establish a process for determining as quickly as possible:

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What changes to service delivery are required Who will be affected and in what way

o Including how the needs of service users will be assessed, what sources of information will be gathered

When the changes will take place How service users and carers will be involved in any decisions

Charging The plan should also determine whether it is appropriate for the council to pass on the costs of providing care to the service user if they are a self-funder or to the service user’s responsible local authority. Only the direct costs of meeting service user needs can be passed on in this way. Transfer of Staff The rights of staff members affected by provider failure need to be taken into account. Staff members will often have protected employment rights and the right to transfer under TUPE regulations into any new service or service provision. In many instances the service or provider failure will have little to do with the front line staff members and the borough should seek to retain qualified and experienced staff within the borough’s services. Staff members can also help provide continuity to service users. The plan should identify actions that might affect the employment of staff members. Safeguarding Where safeguarding concerns have been identified within a service, these need to be prioritised. The individual safeguarding concern needs to be raised with the Access Team. A decision will be made as to whether a safeguarding enquiry is needed in relation to the individual safeguarding concern. Where there is a high level of concern about the practice within the organisation or due to the volume of safeguarding concerns. A decision needs to be made regarding whether the Provider Concerns process should be instigated. Any provider concerns will be discussed at quality group meetings to ensure that concerns are addressed quickly and risks to service users are addressed appropriately. Safeguarding Adult Reviews (SAR) are now on a statutory footing and where the conditions for a SAR are met, providers will be required to participate with any SAR involving a service user. Communication & Consultation The contingency plan should cover both internal and external communications i.e. who needs to know about the service or provider failure and the activation of the contingency plan but are not expected to play a role implementing the contingency plan.

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It should outline clearly who should be informed and when it is appropriate to do so. It is likely that every communications plan will need to be adapted to meet the specific circumstances of failure. However, the plan manager should work with the communications lead to produce a draft communications plan. Identifying stakeholders The plan manager and communications lead should think about what additional stakeholders should be involved from within the council. The plan should consider staff members and stakeholders at all levels of the organisation – not just those already represented through managers participation in the response team. The communications plan should also identify whether other members of the leadership team or elected members need to be communicated with. Communication with these stakeholders should be conducted through the Plan Sponsor. The communications plan should ensure that a response is prepared to be given out through key advice services including: the social care access and advice team, Contact Islington, CAB and other commissioned advice services. The communications plan should also consider what external partners need to be kept informed including:

Health Other providers Voluntary and Community Sector Services Uniformed services (if appropriate) Trade Unions

The communications plan should also outline how messages will be communicated to stakeholders – in situations both where the affected provider can support this and in situations where this is not possible. The communications plan might include pre-written templates – including:

Press statements Member and Senior Officer briefings Letters to staff Letters to service users Letters to carers and family members Letters to service user representative groups

Engaging Service Users and Carers Where possible the plan manager should consider whether it will be possible to coproduce the plan so that service users affected are able to have choice and control over what happens to them. This may not be possible in all scenarios where it is not the plan manager must be able to articulate to service users and carers why it has not been possible. The plan needs to consider how communication will be managed with service users and carers – some of whom may be very distressed by the situation. It is important therefore that the information given out is timely and accurate.

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The communications plan should consider both how we will inform service users and carers about what is happening but how this supports the plan’s wider work to involve them in the work of the response team and the delivery of the action plan.

Ending the Contingency Plan Arrangements The plan manager will be responsible for recommending that the contingency plan has been completed. It may not be possible in all circumstances for the entire action plan to have been successfully implemented; in these circumstances the plan manager, in consultation with the response team, must decide whether there is no further benefit to continuing the contingency plan. The plan manager will recommend to the Plan Sponsor that the contingency plan should be ended. The Plan Sponsor will make the final decision to end the contingency plan. Learning Upon the termination of the contingency plan the plan manager should prepare a report, with input from the other members of the response team about the lessons learnt from implementing the contingency plan. This report should outline which elements of the plan worked successfully and which worked less well. It should also draw out any implications for other service areas. The plan manager should then review and update the contingency plan.