Cabinet Member decisions

Proposed Decision:

Authorise additional expenditure of £315,000 to enable Commissioners to enact the final 12-month extension of the Direct Payment Support Service from 1 April 2023 to 31 March 2024

Reason for Decision:

As part of the support planning process, Direct Payments (DPs) are offered to individuals to provide a greater choice and control over their care and support arrangements. They are monetary payments that can be made to individuals to meet some or all of their eligible support needs. The legislative context is set out in the Care Act 2014, section 117(2c) of the Mental Health Act 1983, the Care and Support (DP) Regulations 2014 and the Children and Families Act 2014.

Disabled Children and Young People Service commission the Direct Payment Support Service with a not-for-profit provider of Children’s and Young People Services The service is open to:

 Parents and carers of disabled children

 Parents and carers of children with special educational needs

 Young people aged 16-25 with special educational needs

 Young disabled people aged 16-25

The Key Decision to commission the Direct Payment Support Service was taken on the 30 October 2018. The Decision (Decision - 18/00055 - Direct Payment Support Service (kent.gov.uk))provided for a three-year fixed term with two twelve-month extension periods within a maximum budget of £1.7 million over the five-year term. The contract is currently in the first of the two available extensions and demand for the service is increasing beyond current capacity. The cost of the recommended option, to extend the contract for the final year, will exceed the original Key Decision of £1.7 million over the 5-year term and a further Decision is required to authorise the additional expenditure.

Options:

1)        Do nothing. The contract will end on the 31 March 2023 and alternative plans for the current cases and ongoing administration, and support, for Children Young People and Education Direct Payments. Currently there is no resource to undertake this work in-house. This option is discounted

2)        Extend with no additional capacity. Cases are forecast to increase beyond current contractual capacity, this means that a waiting list will be implemented with the anticipated wait length being 8-12 weeks before the case can be allocated to a worker within the commissioned provider. This option is discounted.

The proposed Decision is in line with Kent’s Strategy for Children and Young People with  Special Educational Needs and Disabilities 2021-2024

Priority One: Improve the way we work with children and young people, parents and carers. Qualitative feedback from parents, carers and young people using the service remains extremely high. The survey indicates that as of March 2022 100% of service users rate the support they receive as ‘good’ or ‘excellent’, and a similar number stated that the knowledge of the worker provided tosupport them was ‘good’ or ‘excellent’

Framing Kent’s Future Council Strategy 2022:

Priority 4: New models of care and support: Our commitment is to reshape our commissioning practice to ensure we build strategic partnerships with our providers, through earlier engagement, more consistent and proactive commissioning practice, and a stronger focus on co-designing services.

Our commitment is to support the most vulnerable children and families in our county, ensuring our social work practice supports manageable caseloads, reflective learning, joined up safeguarding and effective corporate parenting arrangements.

As Cabinet Member for Integrated Children’s Services, I agree to:

A)       Authorise additional expenditure of £315,000 to enable Commissioners to enact the final 12-month extension of the Direct Payment Support Service from 1 April 2023 to 31 March 2024

Proposed decision:

To award 6-month extensions to contracts for the provision of Post-Mortem (PM) facilities to Dartford and Gravesham NHS Trust, East Kent Hospitals Trust and Medway NHS Trust and confirm current arrangements.

Background and reason for the decision:

The Coroners and Justice Act 2009 places a duty on Coroners to investigate deaths that are referred to them if they have reason to think that:

§   The death was violent or unnatural;

§   The cause of death is unknown; or

§   The deceased died while in prison, police custody or another form of state detention

In some cases, the Coroner will order a post mortem (PM) to establish the cause of death, and in such cases, the deceased is taken to one of five NHS mortuaries across Kent and Medway located at Margate, Ashford, Tunbridge Wells, Dartford, and Gillingham.

On behalf of the Kent and Medway Senior Coroners, KCC ensures access to body storage and PM facilities across the four Kent coroner areas. KCC does not have its own public mortuary facility and so like many other coroner areas across England and Wales it relies on local NHS hospitals which have the necessary facilities for this purpose; there are no private sector providers of PM facilities anywhere in England and Wales.

The contract extensions were initially entered into in 2021, with the details and intentions set out in planned decisions 21/00079 and 21/00096 (covering Mid Kent & Medway, North East Kent and Central & South East Kent coroner areas).  It is now necessary to review, collate and update the relevant contracting and governance associated with these arrangements and to seek to extend the contracts by a further 6 months until the end of March 2023 via a single co-ordinated decision.  The planned approach will address the outstanding governance and time gap involved with the prior decisions while also supporting ongoing provision – therefore this decision confirms the required arrangements undertaken for the previous year and allows for appropriate service continuation prior to new contracts being put in place (via separate relevant decision-making) for April 2023 onwards.

This six-month period will be used by the Coroner Service to better understand the service and associated costs of running the contract for the Trusts. Contract terms will be updated and developed using these findings and in line with KCC’s future needs, including the implementation of the Digital Autopsy (DA) service. Currently it is unclear how the DA project will be progressing; therefore a 6-month contract extension will allow more time for KCC to determine DA’s direction of travel and develop a contractual arrangement that complements the DA service once it goes live.

Options considered and discarded:

Option 1: Do nothing

This is the current situation as the service is operating outside of a contract. Unless a contract is put in place, the Council is at risk of receiving an inconsistent provision and quality of service, a lack of control over costs, and subsequent reputational ramifications.

Option 2: Go out to tender

Kent NHS Trusts do not have capacity to take on any extra work without significant capital investment, and past use of mortuaries outside Kent have not delivered a suitable service.

Option 3: Use a framework or other viable contract mechanism

There are no known frameworks or other viable mechanisms for the provision of mortuary facilities in England and Wales.

Option 4: Extend the contracts for a longer period until the DA facility opens

Extending the contracts for 12-18 months will not provide KCC with the flexibility to negotiate new contracts for mortuary services that support the DA facility.

How the proposed decision supports Framing Kent’s Future 2022-2026:

The proposed Digital Autopsy facility, to which these contracts are directly linked, supports Priority 2: Infrastructure for Communities via a further digitalisation of KCC’s service offer, and finding better ways to deliver services for Kent.

Data Protection implications:

A Data Protection Impact Assessment screening form has been completed, which concludes that a DPIA is not required.

As Cabinet Member for Community and Regulatory Services, I agree the six-month extension for the provision of mortuary and Post-Mortem (PM) services in the Mid Kent & Medway, North West Kent, and East Kent coroner areas and confirm current arrangements from earlier decisions 21/00079 and 21/00096.

Proposed Decision:

Deployment of £878,000 additional funding to cover the increase in costs including risk contingencies to complete the Kings Hill Solar Park project.

Reason for Decision:

The original agreed funding of £4,167,000 is not sufficient to deliver the project due to delays from the land purchase, ecology finds, additional surveys, UKPN uplifted costs and additional contingencies

Background:

Kent County Council has used some time limited grant funding from Salix towards the delivery of a number of low carbon energy projects including two solar parks (see decision 21/00034). Key Decision 21/00109 approved £4,167,000 capital to deliver a 2.98MW solar park in Kings Hill The project is at RIBA Stage 5 (construction) and actual project costs are currently anticipated to be no more than £5,044,617.

The scheme is seeking to offset over 633 tonnes of carbon a year from KCC’s energy requirement and will contribute significantly to the de-carbonisation of KCC’s energy supplies Construction started in March 2022 and will be completed by or before 30 June 2023.

Revenue income from the project will increase once completed based on current market rates and a longer lifespan of the asset. Based on the original business case the cost offset from the Solar Park was anticipated to be upwards of £90k in year 1 (part year effect) and £140k/annum (on average). The updated position based on the increased capital costs, revenue and projected lifespan now anticipates these figures to be c.£360k in the first full year and an annual equivalent of £330k/annum over the 40-year lifespan of the project.

Options:

Do nothing –stop works and do not complete the project due to the cost increases. There is the risk/likelihood that KCC would have to hand back the full PSDS grant, will incur abortive costs that will exacerbate the in-year 2022/23 revenue monitoring overspend position as well has have to adjust the Medium-Term Financial Plan (MTFP) and remove the planned surplus/rebate of £140,000 per year from future budgets. (REJECTED)

Seek alternative funding – potential to stop works and seek alternative funding solutions, applying for further funding where possible. There is a risk that KCC might have to hand back the full PSDS grant funding used on the project if it is not completed. KCC would also incur significant abortive costs on the project to date and not benefit from the income the project would generate in the future if works were not completed which is already built into the 2022/23 and 2023/24 KCC budgets. (REJECTED)

KCC fund the shortfall complete the project, retain the full PSDS allocated grant, including the element via switch funding, and fund the additional capital cost with Net Zero Reserve funds. (PREFERRED OPTION) 

KCC fund the shortfall (Borrowing) – complete the project, retain the allocated grant, and fund the offset with KCC capital borrowing. Currently KCC is very close to its key performance indicator of borrowing costs at less than 10% of revenue budget, plus KCC’s capital strategy is to prioritise borrowing towards statutory projects/rolling programmes such as basic need, highways, and the corporate estate. (REJECTED)

How the proposed decision meets the priority actions of Framing Kent’s Future: Kent County Council’s Strategic Plan 2022-2026

Decision meets the following priority actions within Framing Kent’s Future

-       Support Kent to become a leading county for carbon zero energy production and use

-       Make use of low-grade land (e.g., landfill, low grade agricultural through use of solar and wind farms)

-       Work towards Kent being Net Zero by 2050

-       Use our commissioning and procurement power to support Net Zero and the green economy, reduce our carbon miles and prioritise buying local goods and services wherever possible, and to further support green economy jobs in Kent

-       Support strategic opportunities for growth through the delivery of sites and premises and support for new investment and business expansion where it will deliver higher value jobs and increased productivity and contributes to our net-zero target.

Financial Implications:

-           Purchase of land has been completed;

-           Project costs have increased and are now anticipated to cost no more than £5,044,617 including client costs, increased contingency, and cost of land;

-           The funding gap of £878,000 is proposed to be funded via the Net Zero Reserve.

-           Given that the council is projecting a significant overspend in the current year, the funding options and approach to complete the project may change to ensure minimal impact on the Council’s financial position.

-           The project assumes that the PSDS switch funding of £1,294,127 is coming back into the project via the Commercial Services Kent Ltd (CSKL) dividend.

-           Further discussions are underway with CSKL around alternative funding options that maybe more beneficial for the Council to pursue.

-           The projected cost offset from the solar park has increased from an average of £140k to £330k per annum, inclusive of these additional capital costs.

-           The increased saving on energy costs set against the increased contingency means that the overall financial benefit from the Kings Hill Solar Park to the council has improved.

Legal Implications:

-           The terms and conditions of the Salix grant funding mean that the energy produced by the solar park must directly benefit KCC through lower carbon outputs and these must be reported back to Salix over the coming years.

-           KCC has entered into contract with Kier for the construction of the development;

-           KCC will enter into contract(s) with private and or Latco companies for the running of the solar park including both operations and management and the sale and purchase of electricity.

-           A decision on access route for utilities.  

As Cabinet Member for Environment, I agree to deploy up to £878,000 of additional funding to cover the increase in costs including risk contingencies to complete the Kings Hill Solar Park project.

Proposed decision:

To give KCC’s approval for the Kent and Medway Interim Integrated Care Strategy as recommended by the Integrated Care Partnership.  In approving the Interim Strategy, KCC is committing to working with partners in the Kent and Medway Integrated Care System to deliver the objectives set out.

Further Information:

This will be the first Integrated Care Strategy to be produced since Integrated Care Systems came into existence in July 2022. Statutory guidance from the Department for Health and Social Care states that Integrated Care Strategies need to be published by the end of December 2022 to inform the first 5-year joint forward plans which Integrated Care Boards (NHS) are required to publish before the next financial year. The guidance recognises that 2022 to 2023 will be a transition period and that Integrated Care Partnerships will want to refresh and develop their Integrated Care Strategy as they grow and mature. Therefore, the Strategy published by the end of December will be an initial or interim version that will be developed later.  This later iteration will expand on the ambitions and commitments of the partners, including the County Council and, therefore, will be subject to a separate key decision through the normal governance process.

In its Council Strategy, Framing Kent’s Future, KCC has committed to seize the opportunity of integrating our planning, commissioning and decision making in adult, children, and public

health services through being a partner in the Kent and Medway Integrated Care System at place and system level. Through its statutory requirements and the commitments it has made, KCC is a key partner in the development and implementation of the Integrated Care Strategy.

The Integrated Care Partnership is required to produce the Kent and Medway Interim Integrated Care Strategy and this has  been managed by the three statutory partners of the Integrated Care Partnership- KCC, Medway Council and the  Integrated Care Board (NHS Kent and Medway).  A multiagency steering group and project group which includes the Director of Public Health and the Director of Strategy, Policy, Relationships and Corporate Assurance working closely in partnership with wider partners have developed the Interim Strategy . providing regular updates to the Integrated Care Partnership which is chaired by the Leader of KCC. Development of the Interim Strategy has followed the requirements set out in statutory guidance, including contents to be included and involvement of stakeholders. The Interim Strategy has been shaped by the Joint Strategic Needs Assessments for Kent and Medway. It has a strong emphasis on the wider determinants of health, recognising that a wide range of factors influence health and wellbeing besides health and care services. The Interim Strategy sets out the commitment to closer working and integration between health and care services and with other services that influence the wider determinants, many of which are provided by KCC as well as other partners in the public and voluntary and community sectors.

Given the limited time available for the development of the Interim Strategy, engagement with stakeholders has been focused on key partner organisations across the Kent and Medway Integrated Care System including at a symposium on 28^th October 2022 and presentations at Joint Kent Chiefs and Leaders meetings.

Cabinet;

-       approves the Kent and Medway Interim Integrated Care Strategy, subject to final recommendation by the Integrated Care Partnership; and

-       Delegates authority to the Director of Strategy, Policy, Relationships & Corporate Assurance to take relevant actions to implement this decision.

Proposed decision:

Agree that the Getting Building Funding (GBF) will be used to support the Kent-based projects that are awarded additional GBF by the South East Local Enterprise Partnership’s Accountability Board.

Delegate to the Section 151 Officer the authority to sign on KCC’s behalf a deed of variation to the original grant agreement or equivalent, where this is required to draw down GBF funds following business case approval.

Further Information:

Getting Building Funding was announced by the Government in June 2020. The funding is part of the Government’s plan to deliver upgrades to local infrastructure, boost skills, and help fuel a green economic recovery by investing in shovel-ready housing and infrastructure projects, creating jobs and supporting economic recovery during the COVID-19 pandemic.

The Government choose that the South East Local Enterprise Partnership (SELEP) would allocate the funding with their endorsement. In total, the Government provided £85m of GBF to SELEP in 2020.

In summer 2022, the SELEP Accountability Board removed one East Sussex GBF project and one Essex projects from the GBF programme. This meant £3.3175m of GBF became available for reallocation to alternative projects by SELEP.

The SELEP Strategic Board has decided to create a GBF reserve project pipeline, so this money can be reallocated. The SELEP Strategic Board has decided that the only projects eligible to be on this reserve project pipeline are existing schemes that have previously been awarded GBF.

Ten Kent-based projects have previously benefitted from a GBF award and are thus eligible to bid for the funding. Four of these Kent-based projects chose to submit a bid to SELEP by their August deadline.

The GBF will be awarded only to existing GBF projects because:

a)    The project has experienced a cost increase due to the impacts of the COVID-19 pandemic, Brexit, or high inflation levels, OR

b)    The project wants to support a further phase of delivery (i.e. project extension).

The SELEP Strategic Board is due to meet in October 22 to decide the pipeline of existing GBF schemes which will receive the extra GBF funding. A formal award of the GBF funding to these projects is then expected to be made by the SELEP Accountability Board in November 22.

This key decision is required to enable KCC to enter into the deeds of variation to the existing grant agreements, so that additional Government funding may be secured for Kent-based projects on SELEP’s reserve GBF pipeline.

For reference, Kent County Council took decisions20/00085, 20/00086 and 21/0005 previously to secure GBF funding for Kent.

Options (other options considered but discarded)

If Kent County Council were to choose to not enter into a deed of variation for the GBF projects selected by the SELEP Strategic Board, the GBF funding could be either (i) retained by central government or (ii) reallocated to other projects by the SELEP Strategic Board.

How the proposed decision supports Framing Kent’s Future 2022-2026: (https://www.kent.gov.uk/about-the-council/strategies-and-policies/corporate-policies/our-council-strategy)

The award of GBF to Kent-based projects supports KCC achieve its Levelling up Kent, Infrastructure for communities, and Environmental step change key priorities.

As Leader of the Council, I agree that the Getting Building Funding (GBF) will be used to support the Kent-based projects that are awarded additional GBF by the South East Local Enterprise Partnership’s Accountability Board and;

Delegate to the Section 151 Officer the authority to sign on KCC’s behalf a deed of variation to the original grant agreement or equivalent, where this is required to draw down funds following business case approval.

Proposed decision:

Procure a Countywide Technology Enabled Care Service and delegate authority to the Corporate Director Adult Social Care and Health to take relevant actions, as required to facilitate procurement activity.

Background:

Technology Enabled Care is a key area of the Making a Difference Every Day; Our Strategy for Adult Social Care 2022 – 2027 and aligns with Framing Kent’s Future Strategy, which lays out four priorities, one of which is the delivery of new models of care and support.

Technology Enabled Care will contribute towards the delivery of the key ambition “we have real opportunities to improve the effectiveness and efficiency of our adult social care services by making full use of new technology and innovations that mean we can better manage demand and focus resources where they are most needed.”

Technology Enabled Care is a term to describe a range of personalised IT and digital solutions which can be used to support outcomes for people who draw on care and support and carers. Innovative technology solutions and data are allowing people to remain independent for longer, identifying risk, preventing incidents and ensuring quick and appropriate responses to avoidable events such as falls.

The data harnessed from these technologies will not only support people more effectively at an individual level, but over the long-term has the potential to support management of health and wellbeing at a population-level and provide insights which support future service planning.

Technology Enabled Care has been evidenced in other local authorities to improve outcomes for people and achieve significant financial and non-financial benefits. The objective of the Technology Enabled Care Service is to fully embrace the range of technology now available in the market and embed a technology-focused and data-led approach in Adult Social Care.

The aim is:

·         To commission and deliver an innovative digital Technology Enabled Care offer that empowers a person and supports them to maintain or improve their independence, safety, and wellbeing.

·         To transform Practice and the way care and support is delivered which will improve lives and make social care sustainable.

·         The future service will bring together the existing KARA and Telecare contracts and the new technology provision in order to develop a transformational service offer that progresses our strategic objectives.

The procurement will start in December 2022 with the aim to award the contract in June 2023. It is proposed the contract will run for five years with a two-year contract extension option.

Options:

As part of the development of the Technology Enabled Care Service, several options have been considered and assessed against the following critical success factors:

·         Develop a robust data evidence base which is used to proactively support independence, improve outcomes and generate insights about future service requirements and population-level need, and support a data-led approach to practice.

·         A clear and innovative offer that empowers people, supports independent living and provides greater choice and control.

·         Proactively considering assistive technology across the social care pathway, including but not limited to, at the first point of contact, care and support assessments and reviews and enablement support.

·         A flexible model that enables Technology Enabled Care to develop over time and explore benefits of partnership working.

·         To develop the private pay market, exploring options for promoting Technology Enabled Care to self-funders and commercial opportunities.

·         Maximise efficiencies in Adult Social Care and embed digital technologies to manage demand. From the start ensuring systems in place to collate and report comprehensive and reliable data, that show the financial and non-financial benefits and impact of Technology Enabled Care.

A short list was then formulated as potential opportunities:

1.    Do Minimum

This option represented the current situation and provided a baseline against which the other short-listed options were measured.  Although this option will be cheaper to deliver, it failed to address the requirement for innovation and culture change which seeks to embed Technology Enabled Care. Therefore, with this option there is a risk that a service will be procured but not utilised.

2.    Less Ambitious than Preferred

This option represented the desired level of service based on the minimum level of change. Although this option would meet the majority of the critical success factors, it failed to include the development of the private pay market. Additionally, there was limited-service development and culture change included in the scope, which means the maximum benefits of implementing Technology Enabled Care are unlikely to be realised and technology will not be fully embedded.

3.    More Ambitious than Preferred

This option represented the desired level of service change based on the maximum level of change. Although this option had the ability to meet and/or exceed all of the Critical Success Factors. The timescales for the procurement of the Technology Enabled Care Service were for the entire service to go live from June 2023, these timescales are extremely tight and not viable to mobilise.

4.    The Preferred Option  

This option represents the desired level of service change:

·         Scope: County-wide Technology Enabled Care Service which is outcome focused and device agnostic with a focus on embedding innovation and culture change through the development of practice and a data-led approach

·         Service Solution: A Technology Enabled Care Partner that delivers core requirements: assessment and referrals, products, installation, monitoring, data dashboards and culture, change management.

·         Delivery: The Technology Enabled Care Partner will work closely with Kent County Council (KCC) to implement the core service and embed the approach in adult social care, as well as exploring commercial opportunities including private pay offer and developing opportunities with partners.

·         Implementation – A phased go-live enables the mobilisation of existing people drawing on Telecare, KARA and Build and Test services and full service go-live from September 2023.

This option is the preferred due to its ability to meet and/or exceed all of the Critical Success Factors. The partnership model outlined in this option will enabled KCC to benefit from the expertise to drive change and embed Technology Enabled Care, achieving benefits and ensure there are effective ways to measure and demonstrate the impact of Technology Enabled Care. The timescales for implementation are achievable.

Proposed Decision:

To procure and delegate authority to the Director of Highways and Transportation to award and enter into appropriate contractual arrangements for the provision of Highway Weed Control including any potential extension periods in accordance with the expectations set out in the report.

Further Information:

The Council has a legal duty to keep roads and pavements clear of vegetation for safe passage of highway users. The main service areas comprise; the control of weeds within hard surfaces; the control of invasive and injurious weeds such as Japanese Knotweed, Giant Hogweed and Ragwort; the management of invasive species such as oak processionary moth and brown tail moth. Due to the specialised nature of the works a standalone specialist contract is required. The current contract expires on March 31st, 2023.

Two weed treatments per year will be provided across twelve districts in Kent.

To enable this delivery across the county the following lots are being sought:

•           Lot 1 - Dartford & Gravesham 

•           Lot 2 – Sevenoaks & Tonbridge & Malling

•           Lot 3 – Maidstone & Tunbridge Wells 

•           Lot 4 – Ashford & Swale

•           Lot 5 – Canterbury & Thanet

•           Lot 6 – Folkestone & Hythe

Other Options Considered:

Option 1 – Do Nothing

Discounted as The Council has a legal duty to keep roads and pavements clear of vegetation for safe passage of highway users.

Option 2 – Deliver in House

Discounted as this is not a core service to the authority. Due to the limited period to apply weed control, the staff would not be utilised all year round and this is of specialist nature.

Option 3 – Procure one provider to deliver the county

Discounted as unlikely to access SME providers and fails to provide resilience throughout the county.

As Cabinet Member for Highways & Transport I agree to procure and delegate authority to the Director of Highways and Transportation to award and enter into appropriate contractual arrangements for the provision of Highway Weed Control including any potential extension periods.