Market Position Statement - summary
MPS: Summary of market opportunities
- Devon County Council and NHS open framework contract for all care homes for all adults will be put in place 2020/21.
- Regional framework for people with complex and intensive needs associated with a learning disability by April 2020.
- Accredited list of replacement care providers including care homes by October 2019 (see section on replacement care).
- Increased opportunities for care home providers capable of delivering time – limited placements to promote independence particularly for people of working age and even more particularly for people 18 – 35.
- Opportunities, where appropriate, to de-register or diversify into the provision of housing with care services.
We want to work with providers who can:
- facilitate the design and construction of extra care housing (ECH) in areas of need
- secure a significant proportion of the funding to finance the construction and operation of ECH – including the servicing of any debt
- operate ECH and provide or arrange facilities management services
- provide or arrange core care services
- provide or arrange personal care and support services
- engage with communities and partner with other services.
The intention is to commission supported living and carer households through a framework agreement. A review of future commissioning is beginning and the market will be engaged during 2020 on developing future arrangements.
Commissioners will continue administering ‘interim supported living’ shared-hour agreements until any replacement contract arrangement is in place.
- Unmet need amounts to some 2600 hours across Devon and there are significant opportunities for either new start-ups or expansion. Support is potentially available in both capital and revenue funding to support action to address sufficiency
- We will concentrate on solution-focused approaches to unmet need – looking to make system changes with providers to resolve need at an individual level
- We are keen to talk with providers who wish to offer guaranteed hours/shift working to improve the terms and conditions of employment of the workforce, coupled with improved training that upskills and provide career development opportunity
- We are allocating reviewing officers to work with providers to make adjustments to care packages quickly to release capacity and consider how technology might make a contribution to better meeting need.
- A commercial review of the Living Well at Home contract and the price paid for care.
- Continued development of our Proud to Care campaign which celebrates care and encourages people to join this workforce.
- Community action to find local solutions to meeting need and enriching the lives of vulnerable people.
- Learning from our Individual Service Fund pilot (see section on individual purchasing).
- Building our approach to ‘Outcomes Focused Commissioning’.
- Use of technology and other aids to give people maximum opportunity to be independent.
We will take an organisational development approach to addressing current demand and planning for the future, driven by shared values and an action – learning approach to finding solutions that help providers, care managers and NHS staff to use available staffing effectively and in a rewarding way.
We will co-design and develop these actions with the involvement of all parts of the system, but especially listening to care workers and providers about their ideas for what will work best.
In addition, we point providers to the Creative Innovation and Growth Fund, where both revenue and capital are available to social care businesses who have ideas for innovation or change that will address the sufficiency issues set out in this statement.
The Supporting Independence contract runs until the 30 September 2021.
The final entry point will open in March 2020 and close in May 2020 with new contracts being awarded before the commencement date of the 1 October 2020.
The opportunity to pick up unregulated packages of care will be greater for providers on the framework as all new business will be offered to framework providers in the first instance.
We need to see expansion and innovation in replacement care, especially to meet the needs of carers who are supporting a cared-for person with complex needs. For further information, refer to the Replacement Care Commissioning Statement.
For example, a person with complex mental health needs, and on the autistic spectrum, although living in supported accommodation away from home and theoretically independent, had frequent escalations of need and the parent/carers were the only source of support acceptable to that person.
Many carers do not seek assessment and support and many are aware that for formal social care services the person(s) they care for would be regarded as self-funding. So, the assessment of need presented here may be an understatement and may suggest a market opportunity for providers to offer services more widely to carers.
For further information, refer to the Replacement Care Commissioning Statement.
The range and availability of services to support carers is varied across Devon. Providers may wish to think about the services they can offer to carers to extend their portfolio and strengthen commercial sustainability. For example, where staff are employed on shifts, it might be possible to deploy those staff during less bust times to offer affordable carer support. Or personal assistants (PAs) may see and opportunity to develop their offer.
We are looking to innovation in this area beyond traditional service approaches and to making the delivery of replacement care more personalised and sensitive to individual needs. For example:
- carers who have not had a break because the type of care they provide is not easily replaced. For example, parents who provide emotional and some physical care to an adult with complex mental health needs, learning disabilities and or Autistic Spectrum conditions when there are escalations or crises, which occur without warning, frequently and at random intervals.
- host family provision might be further developed for daytime or short stay services, so that families can develop longer term relationships and plan ahead.
Passports: in 2019-2020 we will develop a Carers’ Passport Scheme. The scheme will facilitate carer contacts with health and social are professionals but we will be looking to include discounts and privilege access to community facilities, services and resources – and we will be looking for providers to be partners in delivering this.
Breaks: we wish to see further development of non-social care providers, for example bed and breakfast establishments, small hotels and holiday resorts, working alone or with social care provider where this is necessary, to enable carers to take breaks either by
- accommodating the carers and the cared-for person(s) enabling access to local care provision as needed; and/or
- accommodating the cared-for person(s) who may be provided if necessary with visiting social care; providing low cost accommodation for carers.
- To join the list of services providers will need to be willing to offer replacement care and replacement care bookable in advance.
- To work with commissioners to develop services for people with complex needs.
- Develop host family replacement care and the use of personal assistants.
- Develop volunteer-provided sitting services.
Commissioning arrangements for a mobile responder service (to respond to TECS alerts and meet the gap in the current service) are currently being reviewed with an options appraisal and development of a business case to support an agreed delivery model.
A market engagement event will be held on Tuesday 10 September 2019 to inform our commissioning and budget planning for this service, and we would encourage providers who are interested in potentially delivering a mobile responder service to attend the event.
Following this a business case will be produced, and if agreed, a competitive tender exercise undertaken, with a view to a service commencing from April 2020.
We want to know more about the quality and safety of the social care personal assistant (PA) market, made more difficult as it does not currently fall under CQC regulation.
Encouraging more PAs to join the PA register will give us a better sense of the quality of the PA market, albeit on a self-reported basis. PAs who join the register will have greater access to purchasers and should enhance their business.
(Return to the Market Position Statement)
Last updated: 09/10/2020