Caring for someone with Dementia - Care Home Workforce Survey

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Caring for someone with Dementia - Care Home Workforce Survey

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Market Context

ECC believes that only the people with the most complex mental health needs should be placed into residential care. These placements should be within a high-quality market that focuses on enabling and re-enabling people.

People should stay in residential care for the shortest possible time.

ECC recognises that for a small number of people residential care is the most appropriate environment to meet their assessed needs.

Market Rating

 

Market Quality Market Supply ECC Demand
Moderate Good Low
Market Rating = Moderate Market Supply = Good Market Demand = Low
ECC Ambition Market Workforce Market Maturity
Decrease Supply Low/Moderate Mature
ECC Ambition = Decrease Supply Market Workforce = Low/Moderate Market Maturity = Mature

ECC rating of the market, assessed on the 01 October 2022

Mental Health residential is the largest area of spend representing circa 60% of the MH Accommodation Spend.

In line with ECC’s commissioning intentions to only make placements into residential care for the most complex service users and to increase the use of supported living the trend for residential care shows a reduction in the number of placements over several years.

The market is made up of a small number of specialist mental health homes looking after most service users and approx. 30% of placements being made into OP or AWD settings because of their age or specific conditions.

There is sufficient market capacity and providers are holding a level of voids. However, capacity is mainly concentrated in the north of Essex and our data indicates a possible gap in provision in the south and west quadrants who place a large number of service users in other areas.

A third of placements are currently out of county with a high number of these being within the unitary authorities of Southend and Thurrock.

  • In the last 12 months there have been no new residential homes.
  • A couple of providers have exited this market by converting their premises and service offer to supported living models.
  • There are approx. 10 homes offering specialist MH residential services.
  • 30% of placements are made into non specialist homes with other cohorts
  • Services are commissioned on a spot contract basis under the same terms as AWD Residential services.
Essex Market 
No. Homes  17
No. Beds  202
% Homes CQC rated Good or Outstanding 82% 
Total Occupied Beds including funded by ECC  171
Occupancy % 85%
Occupancy % for EC Funded Adults 74%
Market Entrants since 1.April 2022 0
Market Exits since 1.April 2022 0

The market has been segmented based on the main specialism supported by the home.

Essex ASC Market (ECC Funded)
2022-23 Forecasted Spend  £8 Million
No. Adults funded by ECC receiving care in a residential setting 194
% ECC funded placements in a residential setting CQC rated Good or Outstanding 71% 
Average Length of Stay (Years) 5 Years
Essex ASC Market - Sourcing
Average Rate per week £1,849.68
Placements per month 3
% Admissions CQC rated Good or Outstanding 60%
No. Placements ended per month  4

The information shown in the table(s) above is correct as of 31.July 2022

Information in the above table for sourcing is based on activity between 1st April 2022 and 31st July 2022.

Residential placements still make up most spend in Mental Health accommodation services and the vision is to continue to reduce reliance on these services. Where residential placements are needed then the intention is to rely on specialist high quality mental health services where it is appropriate, to avoid such a diversified and disparate provider base.

  • There were a relatively small number of cases and the market generally reacted well with infection control and staff availability.
  • Small pockets required significant support.
  • With compulsory vaccines and competition from other employment markets we are seeing recruitment and retention difficulties.
  • Potential impact of the pandemic on Mental Health demand and on complexity of need which needs to be understood.

Current market isks:

  • Maintaining staffing levels across the market as staff need to be fully vaccinated and there is market competition from other industries.
  • Withdrawal of central funding for Covid response which may mean providers seek increases from us to cover these gaps.
  • Provider sustainability where larger numbers of voids are being held.

Our current area of focus is:

  • A category plan is being prepared and created for MH residential services to define a future commercial and procurement approach.
  • Understanding the cost base in the market and develop approach to rates and uplifts.
  • Understand sustainability of providers and how we ensure that the right quantity and quality of specialist suppliers is maintained.
  • Development of more specialist provision for the most complex cases to rationalize placements and improve quality of provision
  • Procurement and placement approach to be defined as this is currently a spot market
  • Identifying deregistration opportunities and move on potential for some adults placed who could live in more independent settings
Last updated: 14/10/2022
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