The conditions in social care markets are challenging and this is driven by staffing recruitment and retention issues primarily, exacerbated by the Covid pandemic. Individual markets are affected to varying degrees but there have been issues with closure of services in the recent past that could be expected to continue in the future. Conversely the interest in development of new accommodation services appears to be strong and in alignment with ECC strategic direction – it is however impacted by the cost of development and ability to staff new services effectively.
Market Context
The Council provides social care support and services for adults who are aged 18 - 65, with a learning disability or complex behaviours such as autism, or physical and sensory impairments on a long-term basis. In most instances these adults would be known to Social Care from birth. To support families and carers short term respite services can be provided to support unpaid carers due to the long-term nature of the adults needs.
The Council commissions supported living, and shared lives placements to enable adults to be as independent as possible within a community setting. We will also seek to support people into employment opportunities wherever possible.
For more information refer to the following services/contracts:
- Working Adult Adults Residential care
- <Domiciliary care
- <Day opportunities
- <Equipment and TEC enabled care
- <Shared lives
- <Supported living
- Employment opportunities
As with all other market cohorts a financial assessment may be undertaken on adults who are in receipt of certain services. The adult can choose to have a managed service via a Council contract, or directly manage their own support.
- The provider market is varied dependent on the specific category but consists of a large number of small and medium sized enterprises in almost all cases, and a large proportion of VCSEs.
- Some services in individual categories do not align with the strategic direction, notably in AWD and MH residential and work is being undertaken to improve the position.
- Recording of outcomes and progression for adults is not systemised and is difficult to monitor at present.
- There remains a lack of high-quality complex provision to meet the needs of ECC and further development will be required.
- There are still high numbers of adults placed into residential settings and people who have been in residential care for a long period of time.
- Lack of general needs housing and joined up approach to securing a move on from accommodation services for AWD adults.
- Lack of understanding about the domiciliary care market in Essex for adults of a working age.
The current COVID impact highlighted is:
- Providers reported a positive impact on recruitment during Covid but post Covid is seeing a negative impact on staffing, with challenges around retention and recruitment and on staff morale and mental wellbeing.
- Vaccinations becoming mandatory for staff has added to the challenges around staffing with some leaving the sector as a result.
- In some cases, the development of new services had been delayed but are now picking up pace again, but still lags behind demand.
Current market risks:
- Staffing – specifically recruiting and retaining staff of a high enough quality to deliver the services at the rates that are being paid.
- Funding – lack of funding to local authorities prevents any substantial increases to providers which could assist with recruiting/retaining, delivering high quality services, or developing new services.
- Viability – due to a combination of the two previous risks there are some providers that could soon reach a threshold where they are no longer viable and exit the market.
- Social care resource – there is a lack of resource in Adult Social Care to support reviews and the provider market.
Our current area of focus is:
- Development of new and existing services to align with ECC’s strategic direction.
- Market resilience activity to support providers to continue to deliver services or to exit markets in the most planned way possible.
- Outcomes and progression for adults and rethinking contracts and frameworks to capture and reward this behaviour.
- Ensuring sufficient fee levels to enable improvement of staffing conditions in the market to help providers to operate sustainably
- Review of Day Opportunities and the role it plays for adults being supported.
- Piloting of locality based solutions for adults in Essex.