Older People | Provider Hub

Market Context

The Council provides social care support and services for adults whose needs are commonly associated with the ageing process (for example, physical frailty and dementia).

Adults in this cohort may require short or long-term support depending on their circumstances, needs or conditions. The Council’s Adult Social Care function promotes an early intervention and prevention model. When required the Council will provide short term services to maximise any opportunity to keep the adult as well as possible and at home, prior to assessing for longer term services. Adults in this cohort often have multiple conditions, including dementia, and therefore the Council’s aim is for support to be personalised and able to meet holistic needs.

Our provider market for this cohort (commonly referred to as the Older Peoples market) covers a wide range of both accommodation and community-based services. The Council has specific and framework contracts to support the delivery of these services. It is possible for providers to enter the market at set periods throughout the lifetime of the contract, for more information refer to the following services/contracts:

Adults receiving certain services may be financially assessed. The adult will be able to choose whether they would like to manage their services directly by employing a personal assistant via a direct payment or personal health budget. The Council will manage services where provision is sourced through our contracts.

Older people have told us that they want to live as independently as possible and remain in their own home in the community for as long as they can.

The Council has been supporting solutions to help achieve this. Domiciliary care capacity across the County has significantly increased since 2019.When people are accessing residential care, it is increasingly later in life and with more complex needs (therefore the balance between residential and nursing care is shifting toward using nursing).Housing solutions like Extra Care schemes are giving people the opportunity to plan ahead for their later years on sites which support maintaining independence in the community.

The Council is also working with partners in the NHS to develop the intermediate care system, which supports people following a hospital admission or to avoid one taking place. Intermediate care will assist people to regain skills needed for daily living and mitigate some of the deconditioning commonly seen following acute stays. The council has a range of provision in this space and the ambition is that this becomes more joined up and integrated in future, providing residents with a more coordinated response alongside the NHS. Early work is taking place in local systems to trial ways of working that will lead to these joined-up approaches.

Workforce recruitment and retention remains a concern for the older peoples market in Essex and the Council will be supporting further responses to this in the coming year.

Adult Social Care’s role in Older people:

Ensuring quality, options and best value from commissioned arrangements.
Providing information on care and support options and how to access them.
Supporting individuals and families to think ahead about their needs.
Understanding local needs and demand for different types of provision.
Working with partners to deliver/commission according to current and projected demand.
Developing in county provision for people with the most complex needs.
Working with other care groups to understand the potential for cross over solutions (e.g. potential access for adults with disabilities to extra care schemes).
Promoting the benefits of equipment and technology and developing initiatives to enable independent living such as Essex Shared Lives.
Ensuring quality across providers including progressive approaches and enablement for individuals
Ensuring the best use of specialist accommodation and that the right care and support is in place to meet need.

The COVID impact highlighted is:

Providers in domiciliary care and reablement reported a positive impact on recruitment during Covid but post Covid saw a negative impact on staffing, with challenges around retention and recruitment and on staff morale and mental wellbeing. This has seen some recovery in the period since October 2022, partly due to overseas recruitment schemes which are subject to central government policy changes.
Some of our residential care providers report challenges to their financial stability, particularly given reduced usage of care home beds.
In some cases, the development of new extra care schemes had been delayed but are now picking up pace again, but still lags behind demand.

Current market risks:

Stability and financial viability of some residential and nursing care providers.
Development of specialist housing, particularly larger extra care schemes, in the current economic climate can be particularly challenging with a decreasing number of specialist developers and developers being more risk adverse.
Staffing levels and rates of pay given competition for the labour force from adjacent sectors like hospitality.

Our current area of focus is:

Driving collaboration within the intermediate care system to make the most of current capacity and provide more coordinated responses for our residents (including NHS provision).
Delivery of the new Extra Care schemes as per the Council's pipeline plan.
Ensuring the necessary capacity is in place within domiciliary care, given people are spending longer in their own home and less in residential care; this work includes initiatives to support workforce recruitment and retention.
Commitment to ensuring those requiring support in a care home setting are placed in either good or outstanding provision.

Last updated: 31/03/2024

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