Prepare for ASC Reform

Bristol City Council (BCC) were early adopters of the place-based
licence of iESE’s social care benchmarking tool CareCubed. The aim
was to bring consistency and governance around day-to-day
commissioning processes, improve engagement with providers by using
a single solution to collaborate and have the tools in place to prepare
and implement the reform agenda.

The council can now allow providers to submit information relating to
specific person-centred placements (new/reviews/uplift requests) or
whole services directly to them via the CareCubed platform. The council
can then review this information, add comments, work through with the
provider all within a single system. This removes the need for duplication
of data entry, but also cuts down on the subsequent checking of what
different amounts relate to or include because the provider enters the
information themselves in an already structured format. It also means
that the council can compare services because the data is in a
consistent format, and they can agree cost templates for services once
instead of having the same conversation about a provider’s specific
costs each time a placement is made.

“With the place-based licence we ping them a link and when dealing
with organisations with large volumes of placements that is a godsend
because they are entering the data and we are reviewing it for
consistency,” explains Jonathan Wright, Strategic Commissioning
Manager at Bristol City Council, “It makes the negotiations a lot less
fraught and complex because they enter the data and we review it –
there is no quibbling because they enter it themselves. It takes me
about 20 minutes to review a case in CareCubed which is significantly
less time in comparison to our previous approach. And the data is saved
in a digital system that can be used as part of our day-to-day
commissioning processes.”

BCC started using CareCubed in 2020 when they realised the tool could
replace the manual and labour-intensive way it had been gathering
provider data in Excel spreadsheets to form guide prices for the
Learning Disability (LD) market. BCC first bought the council licence,
but quickly switched to the place-based licence as an early adopter and
their efforts have been instrumental in helping iESE to develop and shape
the place-based offering.

“When our new Director of Adult Services came in, he took one look and
asked why we weren’t using CareCubed,” said Wright, “That’s when iESE
came in and I realised that CareCubed could do what we had been doing
on an Excel spreadsheet manually. It ticked so many boxes in terms of the
issues we have on a daily basis, but also for the important strategic, market
shaping projects that we are working on now and in the future.” Wright
immediately felt confident that CareCubed gave accurate information. “The
benchmarking was very close to what we had arrived at, which gave me a
great deal of faith. We were within a percentage of CareCubed on most key
items, but CareCubed benchmarked a lot more of the operating costs, and
by using an independent, nationally recognised tool it has opened up new
and better dialog with our market,” he explained.

Whilst CareCubed has been brought in to deliver a wide range of strategic
benefits, it has also made an immediate impact, with lots of examples of
cost avoidance on new and existing placements. One provider, for
example, with three placements in the same service had approached the
council saying that they were underfunded. However, using CareCubed,
they found there was less resource required which resulted in saving the
council around £40,000 per year and reduced some of the recruitment
pressures this particular provider was facing. Another provider wrote to
the Chief Executive stating they were underfunded and should be being
paid £3,700 a week for their service user. “We CareCubed it and it came
out at about £2,600 at the top end. We asked to talk through the
differences and they said ‘capital costs’ without any detail or explanation,
so we said no to the request. It is about having a conversation and giving
providers the opportunity to help us understand the unique services they
offer, whilst paying for what is being delivered,” said Wright.

Another benefit of CareCubed has been the connection to other councils
through the online CareCubed user community. “The CareCubed Forum
has been a saviour because you can go in and say I am having issues with
X – has anyone else got similar,” said Wright. In one dispute which went on
for nine months, Bristol City Council linked with other local authorities and
found that the provider was giving each commissioner different operating
costs. “We worked out that between the three local authorities we had a
third of the provider’s business. So, when we banded together it was
easier for us to defend,” he explained.

The council now has a tool to support with day-to-day conversations and
have much better governance and control on costs. Working in an open
and transparent way with providers is improving relationships and opening
up new opportunities to work in partnership to develop new services.
BCC is also well placed to prepare and implement changes as part of the
Adult Social Care Reform Agenda knowing that CareCubed can be used to
model changes to the future delivery of health & social care services.