FOI Ref: 0195FOI1920
25th February 2020
Freedom of Information Act 2000 – Request for Information
We are pleased to respond to your request for information and our response is set out below:
Request / Response
As a leading provider of complex care we aim to obtain information to assist us in working more closely with CCG’s. Before we move on to the questions below we felt it would be useful if we provided our own definition of complex care and how if differs from standard domiciliary care:
Complex care is a nurse led service delivered by nurse-trained Health Care Assistants in the service users own home, generally service users generally require a minimum of 1:1 care 24 hours a day and have complex medical competencies such as Tracheostomy, ventilation and sometimes have bowel and bladder requirements. Generally only TDDI registered care companies can deliver this level of care as they are delegated tasks.
TDDI Registration: Nursing care means any service provided by a nurse involving either:
https://www.cqc.org.uk/guidance-providers/registration/nursing-care
For clarity: Children: 0-18, Adults: 18+
1. How do you differentiate domiciliary care and complex care?
The CCG domiciliary care contracts deliver a combination of standard and Non-standard care, paid at a blended rate. Individual Patient Agreements operate outside these contracts where care is costed based on each individual’s needs.
Spot providers do not have fixed rates. All children’s packages are complex care.
2. How do you commission complex packages of care? E.g. Spot Purchase, Open Framework, Closed Framework, Lead provider etc.
The CCG domiciliary care contracts deliver a combination of standard and Non-standard care, paid at a blended rate. Individual Patient Agreements operate outside these contracts where care is costed based on each individual’s needs.
Spot providers do not have fixed rates. Lead Provider is commissioned via NHS contract.
3. What is your rate structure for complex adult care? E.g. Specified Rates, ceiling rates, provider bespoke quote etc.
We have completed a public interest test, to decide whether the balance of public interest lies in withholding or releasing the requested information. We are unable to disclose our rate structure for our contract providers due to the exemption applied under Section 43 (2) – commercial interests.
Spot provision is on a bespoke quote from the provider.
4. If you use set rates, please confirm your hourly rate?
No set rates used.
5. If you use a ceiling rate, please confirm what this is?
No ceiling rate used.
6. What is your rate structure for complex children’s care? g. Specified Rates, ceiling rates, provider bespoke quote etc.
Spot purchased. As per NHS tariff for our contracted provider bespoke commissioned provisions have three tier structures. Some have bespoke quote for specialised provision.
7. If you use set rates please confirm your hourly rate?
No set rates used.
8. If you use a ceiling rate please confirm what this is?
No ceiling rates used.
9. How many service users 0-18 do you have requiring complex care?
Complexity is not categorised on our database therefore we are unable to answer this question.
10. How many service users 18+ do you have requiring complex care?
Complexity is not categorised on our database therefore we are unable to answer this question.
11. What are the average hours per week in these packages?
Complexity is not categorised on our database therefore we are unable to answer this question.
12. How many service users do you have requiring 168 hours or more per week?
We have less than 5 in domiciliary care (Adults) and none in Children’s.
13. What is your criteria for awarding a package of care for example;
13a. what percentage weighting is attributed to quality?
No weighting, but expect care manager to look at CQC registration.
13b. what percentage weighting is attributed to price?
No weighting but we must ensure Commissioning of Care Principles are adhered to.
13c. what percentage weighting is attributed to client choice?
No weighting but we must ensure Commissioning of Care Principles are adhered to.
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