Bradford mps autumn 2010

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Market Position StatementAutumn 2010

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Contents

Chapter Title Page

➊ Whothisdocumentisfor 3

➋ FutureDemand 4

➌ CurrentSupply 12

➍ Quality 16

➎ FinanceandFunding 18

➏ ReviewingtheEvidence-DeliveringChange 20

➐ FacilitatingtheMarket 23

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Thisdocumentisaimedatexistingandpotentialprovidersofadultsocialcareandsupport.Itrepresentsthestartofadialogue,betweentheCouncil,peoplewhouseservices,carers,providersandothersaboutthevisionforthefutureoflocalsocialcaremarkets.Wearecommittedtostimulatingadiverse,activemarketwhereinnovationandenergyisencouragedandrewardedandwherepoorpracticeisactivelydiscouraged.ProvidersofadultsocialcarecanlearnabouttheCouncil’sintentionsasapurchaserofservices,anditsvisionforhowservicesmightrespondtothepersonalisationofadultsocialcareandsupport.

Voluntaryandcommunityorganisationscanlearnaboutfutureopportunitiesandwhatwouldenableyoutobuildonyourknowledgeoflocalneedstodevelopnewactivitiesandservices.

Peopleinterestedinlocalbusinessdevelopmentandsocialenterprisecanreadaboutnewopportunitiesinthemarketandtelluswhatwouldhelpyoutocomeintosocialcaremarketsandofferinnovativeservices.

SocialcareprovidersandorganisationsnotcurrentlyactiveintheBradfordDistrictcouldfindopportunitiestouseyourstrengthsandskillstobenefitlocalpeopleanddevelopyourbusiness.

Who this document is for ➊

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Future DemandKey messageslDemandforcareandsupportserviceswill risebutwillnotbematchedbyasimilar commitmentinpublicspendingl Individualaccountswillincreasinglyallow peopletochoosefromawidermenuof activities,optionsanddemandis expectedtodecreasefortraditionalmodels suchasdaycare.Peoplewillbeableto choosetouseamixoftraditionaland mainstreamserviceslThepartnershipbetweenhousing,support andcarewillbestrengthened;withprovisions suchastelecareandequipmentenabling peopletocontinuelivingathomelSpendingonresidentialandnursingcare willcontinuetodecreaseasaproportionof spendingonolderpeople;thereforestaying wellandindependentforlongermustbe integraltomainstreamserviceslTherewillbeopportunitiestoofferaneven widerandmorevariedmenuofoptionsfor peopletomeettheirsocialcareandsupport needslLifeexpectancyisincreasingandentryinto servicesislikelytobelaterinpeople’slives

Opportunities for business changelCommunityactivities-youmaywantto considerofferingrecreational,educational, socialandsupportactivitiesinthelocal community.lDayopportunities–peoplewithcash personalbudgetsaswellasthosefunding theirownsupportmaynolongerwantto usetraditionaldayservices.Youcould considersettingupacluboractivity.

lCommunitymeals–youmaywantto considerofferinghotmealsforpeoplein yourlocalareaortosetupalunchclubl Information,brokerageandadvocacy–you maywishtoofferawiderrangeofsupportto helppeoplefindthehelptheyneed,arrange theirsupportandexpresstheirviewslBackofficeservices–ifpeoplearerecruiting theirownpersonalassistantstheymayneed supportwithadvertising,recruitment,payroll, CriminalRecordsBureauchecksortraininglDomesticservices–youcouldconsider settingupdomestichelp,gardeningor shoppingservices,forexamplehelping peopletoshopratherthandoingitforthemlEquipmentprovision–peoplecanspend theirpersonalbudgetsonequipmentand thereisarangeofitemssuchasrails, stairliftsandriserchairs

Thefutureofadultsocialcareisgoingtoseesignificantdemographicchange.InBradford,thenumberofpeopleovertheageof65isforecasttoincreaseby10%in2015,by20%in2020andby33%in2025.1Thedemandforservicestoolderpeoplewillincreaseastheshapeofthelocalandnationalpopulationchangesasaresultofadvancesinmedicalsciencemeaningmorepeoplearelivinglonger.ThisriseindemandwillnotbematchedbyGovernmentfundingmeaninganewapproachisneededtohowsocialcareandsupportisdelivered.Highereligibilitythresholdsforlocalauthorityfundinghave,inpart,ledtotheincreasednumberofpeoplefundingtheirowncare.Regardlessoffunding,peoplewantmorechoiceandflexibilityoverhowthoseneedsaremet.

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1 Projecting Older People Population Information System www.poppi.org.uk

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Key messageTheNHSWhitePaper‘EquityandExcellence;LiberatingtheNHS’willseecloserintegrationofHealthandSocialCare2

Table 2. Key factors that may influence potential changes in demand for health and social care in people aged 65 and over living in Bradford

2 Department of Health www.dh.gov.uk/en/Publicationsandstatistics/index.htm

2010 current figure

68,800

9,400

2015 figures and % increase

75,90010%

10,80015%


82,40020%

12,50033%


91,20033%

15,00060%

Allpeopleaged65andover

Peopleaged85andover

2010 current figure

4,970

33,417

23,564

28,782

1,161


5,4279%

36,76110%

25,6899%

31,2849%

1,231


6,02221%

39,86419%

28,03519%

34,15919%

1,307


6,87238%

44,42933%

31,42433%

38,33033%

1,542

Peoplelivingwithdementia

Peoplewithalimitinglong-termillness

Peopleunabletomanageatleastonepersonalcaretask

Peopleunabletomanageatleastonedomesticcaretask

Peopleaged75andoverprovidingmorethan50hourscareperweek

Table 1. Potential population growth of older people in Bradford

Thetablesbelowshowtheriseisevensharperaftertheinitialfiveyearsfortheoldestoldpopulationandthosemostlikelytobeinneedofsocialcareservices:

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Table3showsthenumberofpeopleinBradfordaged18-64isalsoforecasttoincreaseby5%by2015,9%by2020and13%by2025,allsignificantlyhigherthantheaverageforEngland3

Table 3. Predicted population in Bradford of people age 18-64 with a disability or a mental health problem 4

ThehighestnumbersofolderpeopleinBradford5liveintheKeighley6andShipley7localities.Theseareasarethoughttohaveahigherlikelyprevalenceofdementia,mobilityissuesandfunctionalimpairment.BingleyandBingleyRuralwards

makeup37.5%oftheelderlypopulation.Thereislikelytobecontinuedgrowthintheolderpopulationofthesewards,asitisapopularlocationforretirement.Figures1and2showthedistributionoftheolderpeople’spopulationinBradfordin2008.

2010 current figure

1,715

23,172

6,635

13,589

50,446


1,8106%

24,1024%

6,8313%

14,1034%

52,7665%


1,90611%

25,2229%

7,2129%

14,8669%

54,7188%


2,01317%

26,11113%

7,53013%

15,43214%

56,64412%

Peoplewithamoderateorseverelearningdisability

Peoplewithmoderatephysicaldisability

Peoplewithaseverephysicaldisability

Peoplewithamoderateorseverepersonalcaredisability

Peoplewithamentalhealthproblem

3. Projecting Adults Needs and Service Information www.pansi.org.uk 4 Projecting Adults Needs and Service Information www.pansi.org.uk5OfficeforNationalStatistics2007www.statistics.gov.uk/hub/index.html

6Craven,Ilkley,KeighleyCentral,KeighleyEast,KeighleyWestandWorthValleywards7Baildon,Bingley,BingleyRural,Shipley,Wharfedale&WindhillandWrosewards

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Figure 1. Proportion of population estimates per ward of people age 65+

Figure 2. Proportion of population estimates per ward of people age 85+

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34

5

67

8

9

10

11

12

13

14

15 16

17

18

19

2021

22

2324

25

26

27

2829

30

12

34

5

67

8

9

10

11

12

13

14

15 16

17

18

19

2021

22

2324

25

26

27

2829

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Key to maps 1Baildon 2Bingley 3BingleyRural 4Bolton&Undercliffe 5Bowling&Barkerend 6 BradfordMoor 7 City 8 Clayton&FairweatherGreen 9 Craven 10Eccleshill 11GreatHorton 12Heaton 13 Idle&Thackley 14 Ilkley 15KeighleyCentral 16KeighleyEast 17KeighleyWest 18 LittleHorton 19Manningham20Queensbury 21Royds 22Shipley 23Thornton&Allerton 24Toller 25Tong 26Wharfedale 27Wibsey 28Windhill&Wrose 29WorthValley 30Wyke

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Attitudesandexpectationsarealsochanging.Theexpectationsofpeoplewhowillreacholderageinthenext10to20yearswillbedifferenttoolderpeoplenow.Peopleareusedtoexpressingfargreaterchoiceandcontrolovertheirneedsandaspirations.Currently,peoplearemuchmoresociallymobilethanbeforeandhavegenerallyexperiencedawiderexposuretodifferentgoodsandservicesthaneverbefore.Peoplenowandinthefuturewillexpectmorefromtheirlocalauthorityandcareprovidersintermsoftherangeandqualityofservicesonoffer.

Tomeetthisrisingdemandandexpectationthesocialcaremarket,includinghowthelocalauthoritybehaves,providerswillneedtorespondinwaysitmighttraditionallynothavethoughtof.Demandandfundingforlongtermresidentialanddaycarewillreduceovertimeandmanyolderpeoplewillwanttostayathomeforaslongaspossible.Providerswillneedtoconsiderhowtomaintainpeopleathome,remaininghealthyandwithasenseofwellbeingforlonger.Thismeansconsideringhowtohelppeoplemaintaingoodphysical,mental,social,emotionalandspiritualwellbeinginordertoremainhealthy,activecitizensnowandinthefuture.

Peoplewillalsofundtheircareinagreaternumberofways,forexample,insurancepolicies,savings,pensionsandinvestments.Significantly,tenurewillplayapartinshapingthemarketasagrowingnumberofolderpeoplewilloptforhomeownership.Thiswillincreasethenumbersofpeoplefundingtheirowncare.Olderpeoplewillenterthemarketplacerequestinginformationandadviceaswellasabroadrangeofserviceswithoutapproachingthelocalauthority.AlthoughtheCouncilseesthisserviceasanimportant,centralisedrole;therewillneverthelessbeagrowingneedtoofferpeopletherightkindofinformationandservicesasthiswillbeacorecustomerbasewantingtopurchaseservicesdirectlyfromprovidersinthefuture.Thereforetherearerealopportunitiesfor

providerstobuildthelinkbetweeninvolvingpeopleinthedesignofservices,offeringpeopletheinformationtheyneedtomakeinformeddecisionsandofferingcustomersnewanddiversifiedproductsandservicestohelpthemremainwellathome.

Arecentsurveyofcouncilstaffandpartnerorganisations8highlightedtheexpectationsofpeoplewithinthedistrictandtheirfuturehousingandfundingoptionsforretirement.23%of50-59yearoldssaidtheywouldprefertoliveinaretirementdevelopment,shelteredhousingoranextracarefacility.Whenaskedabouthowtheyexpectedtofundtheirretirement,73%of50-59yearoldsstatedthatanemployersorprivatepensionwouldbeusedand29%statedthattheywouldusetheirsavings.Althoughthisgivesalocalsnapshotofopinion,itisneverthelessaninterestingindicationastohowsomelocalpeopleapproachingretirementagearethinkingabouthowtofundtheirfuturecareandhousingneeds.Wherethereareapossiblegrowingnumberofpeoplepreparedtoselffundsomeoralloftheircareandsupportneeds,themarketneedstobeabletorespondtothisanddealwithpeopleselfreferringorwantinginformationandsupporttomakechoicesabouttheirneeds.

The importance of prevention and early interventionPreventionandearlyinterventionarewellrecognisedtohelppeoplestaywell,liveindependentlyandremainhealthyforlonger.Itisimportanttoensurethatawiderangeofpreventativeservicesareavailabletosupportpeopleacrossthespectrumofneed,includingthosewhodonotapproachtheCouncilforsupportormeetitseligibilitycriteria.Thiswillensurethatpeopledonotgowithoutthesupportwhichcouldpreventcriticalneedsdevelopinginthefuture.Table4outlinesthedifferenttypesofpreventativeservicesthathelpolderandvulnerablepeople:

Changing attitudes, expectation and paying for care

8 Ridley-Ellis W, Thinking Ahead: Your Housing Options for the Future Bradford. www.bradford.gov.uk

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Table 4. The three types of preventative services

Primary

Involvingolderandvulnerablepeopleintheplanningandoperatingofservices.

Consultation,membershipofcommittees,boardsandworkinggroups.Offeringautonomytorunactivities,groupsorservicesthemselves.

Bybeinginclusiveandinvolvingpeopletheaimistopreventisolationandlonelinessandencourageparticipationandasenseofbelonging.Improvesconfidenceandindependence.

Secondary

Servicesdeliveredtopeopleinthecommunity.

Housingrelatedsupport,telecare,supporttocarers,fallspreventionandreablementservices.Befriendingschemes,sittingservices,providingequipmentoradaptations,wellbeingcafes,lunchclubsandhotmeals.

Tomaximiseindependence,preventfurtherdeteriorationandmaintainagoodlevelofhealthandwellbeing.

Tertiary

Specialistservicesdeliveredtopeopleathomeorinhospitaltoofferaseamlesstransitionofcareortopreventanadmission.

Facilitateddischargefromhospital.Intensivesupportdeliveredathomeorinextracarehousing.Intermediatecarefacilities.

Tospendnolongerthannecessaryinhospitalandtoreturnsafelyhome.

Purpose

Suggestions

Desired outcome

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Table5givessomefiguresonthedistributionofpopulationforthetoptenwardsinBradford.

Table 5. Distribution of older people by top ten wards as compared to those in receipt of council support

Ward by total population 2006/7 ONS

City(16,714)

Bingley(13,838)

BingleyRural(13,625)

Tong(13,570)

Bowling&Barkerend(13,268)

Craven(13,079)

BradfordMoor(12,768)

LittleHorton(12,755)

Toller(12,722)

Royds(12,718)

Ward by population aged over 65

Ilkley(3,589)

Craven(3,308)

BingleyRural(3,073)

Bingley(2,908)

Idle&Thackley(2,536)

Shipley(2,530)

KeighleyEast(2,484)

KeighleyWest(2,439)

Bolton&Undercliffe(2,392)

Royds(2,364)

Ward by number of council funded packages of day care (2009/9 RAP return)

KeighleyWest110

Craven101

KeighleyCentral88

BingleyRural82

KeighleyEast78

Ilkley65

Wharfedale62

WorthValley62

WindhillandWrose56

Bingley55

Ward by number of council funded packages of domiciliary care (2009/9 RAP return)

Craven230

Clayton&FairweatherGreen214

KeighleyWest197

Bingley189

Bowling&Barkerend185

BingleyRural183

Windhill&Wrose182

Ilkley181

KeighleyCentral179

IdleandThackley176

Ranking

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Thenumberofpeoplewithalearningdisabilityinthedistrictisexpectedtorise.Currentlythereare1,660LDserviceusersinreceiptofacare/supportpackagewithinthedistrict.ThehighestconcentrationofLDusersisinBradfordWest.9ThisislinkedtotheconcentrationofpeoplefromBMEbackgroundslivinginBradfordWestandthehigherthanaverageincidenceofpeoplelivingwithalearningdisabilityfromblackandminorityethnic(BME)backgroundsinBradford.Thelocalsituationwillfollowthenationaltrendofpeoplewithalearningdisabilitylivinglongerduetoadvancesinmedicaltreatmentgivinglongerlifeexpectancy.

Peoplewithalearningdisabilityaremorelikelytobelivingwithanelderlyparentastheirmaincareprovider.Societywillalsoseethiscarerolereversingasthepersonwithalearningdisabilitywillstarttotakeonthemaincaringroleforelderlyparents.TheCouncilanticipatesthatthesupportrequiredforthisgroupofserviceuserswillgrowandthatnewtypesofsocialandpracticalsupportwillberequired.Bradford’slowweightbirthrateandpre-termbirthrateishigherthanthenationalaverageandthisincreasestheriskofillhealthanddisabilitythroughoutaperson’slife.10MoredisabledchildrenliveinBradfordWestlocality.HowevereachareainBradfordhasasimilarpercentageofdisabledchildrencomparedtotheirtotalchildpopulation.Theprevalenceofcerebralpalsyis3.87per1000childreninBradfordcomparedto2.08per1,000inEurope.Thereareadisproportionatenumberofchildrenwithneurodegenerativeconditions.Thereisasignificantlyincreasedprevalenceofotherseriousmedicalconditionswhichcanalsobecategorisedasconferringadisability.ThiswillhaveanimpactonAdultServicesasthenumbersofyoungpeoplegrowingintoadulthoodwithaphysicaland/orlearningdisabilitycontinuestogrow.

Anincidenceof17.2%ofcommonmentalhealthproblemscanbeexpectedacrossBradford.Demandonmentalhealthservicesisexpectedtoincreaseinlinewiththepopulationgrowthoverthe

nextfewyears.ThemajorityofsocialcareexpenditureonmentalhealthprovisionisthroughtheBradford&DistrictCareTrust.However,thereissomesmallerinvestmentwithinlocalcommunityandvoluntaryorganisations.AdultMentalHealthDayServiceprovisionhasgonethroughastrategicreviewandisnowenteringtheimplementationstage.AllprovidersworkingwiththeCouncilareexpectedtoofferindividualchoiceandcontrol,anddiversifyfromtraditionalmodelsofcare.Anemphasishasbeenplacedontheimportanceofserviceswhichpromotesocialinclusion,includingaccesstowork,skillsandeducation.

Thenumberofpeoplewithphysicaldisabilitiesandsensoryimpairmentsinthedistrictisexpectedtorise.Thisisbecausechildrenwithcomplexneedsandrecessivegeneticconditionsincludingcerebralpalsy,physicaldefects,deafnessandblindnessareexpectedtolivelongerduetomedicaladvancesandgreatersurvivalrates.Currentlythereareover1700peoplefundedtoaccessservicesinthedistrictwiththenumberofpeopleclaimingdisabilitylivingallowance(oneindicatorofdisabilityprevalence)at14970.Thoseclaimingthisallowanceandthoserecordedaspermanentlyunabletoworkareoftenusedasindicatorsofneed.Bothmeasuresseearisingpatternoverthemediumtolongterm.

Agrowingolderpopulationwillalsoincreasethenumbersofacquiredsensoryimpairmentsinthedistrictaswellasmoreolderpeoplewhoarefrailandwhosemobilityisimpairedbyphysicaldisability.Peoplewithphysicaldisabilitiesandsensoryneedsoftenwishtoaccessuniversalservicesandlocationsbutfindbarriersincludingphysicalaccessandalackofaccessibleinformation,somerequireonetoonesupporttoaccessthisinformationandtheservicesoffered.Morewidelydifficultiesarisewithgainingandsustainingmeaningfulemploymentandasaresultthisclientgrouppopulationprofilecanbelinkedtoindicatorsofdeprivationandareasacrossthecitythatexperiencesmultipledeprivations.

10DisabledChildreninBradfordNeedsAnalysis2010

9Heaton,ThorntonandAllerton,Toller,ClaytonandFairweatherGreenandLittleHortonwards

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Current SupplyKey messages:

l Thecurrentsupplyofresidentialanddaycare servicesisnotsustainabletomeetthelonger termchangingdemandinBradfordlCurrentcostsofserviceswillreduceinresponse tothediminutioninGovernmentspendinglAlternativemodelsofhousingthatoffer integratedcareandsupportserviceswillneed toenterthemarketplacelFocuswillshiftmoreontoshorterterm placementsprovidingrehabilitationanda returnhomelAwiderrangeofhomebasedserviceswillbe neededtomaintainpeoplestayinghealthyand withasenseofwellbeingathomeforlongerlProviderswillneedtooffermoreservicesthat offeraccesstoinformation,advice,advocacy andbrokeragetodemonstrateconfidenceto customersandgenerateinterestandbusinesslServicestomeettheneedsofpeoplewith learningdisabilitieswillneedtodiversifyand offerabroadrangeofstimulatingandrewarding experiencesfortheserviceuserandcarerlEntryintoworkwillbeseenasthenormrather thantheexception

Opportunities for business changelNewtypesofhousingprovision–youmaywish toconsiderdiversifyingintoextracarehousing, assistedlivingenvironmentsandbuilding relationshipswithkeycouncildepartmentsto achievethislHomebasedservices–youmaywantto considersettingupdomesticservices,shopping services,sittingservicesaswellasliveinornight timecarelAccesstoinformation–youmaywishtooffer moreassistancetopeopleseekinginformation andadvice.Morepeoplewillhavepersonal budgetsortheirownmoneytospendthiswill beakeysourceofnewbusinesslSpecialistservices–youmaywishtoconsider reablementorrapidresponseservicesaswell associal,educationalandwellbeingopportunities forpeoplewithalearningdisability

Residential CareTheDistricthas152residentialcareestablishmentsthatprovideatotalof4617beds.11

Older People’s Residential Care Thereare108homesproviding2803bedsregisteredforelderlycareorelderlycarewithnursing.Ofthesethereare61residentialhomesregisteredforelderlycarewith1805bedsand47homesregisteredtoprovidecarewithnursingwith2352beds.Thereare11Counciloperatedhomesproviding354bedsforelderlyresidentialcare.TheCouncil operatedhomesbedspaceiscomprisesof203longstaybeds,116shortstaybedsand46intermediatecarebedspaces.12Inthedistrictthisequatesto26residentialcarebedsper1000peopleaged65andoverand34nursinghomebedsper1000peopleaged65andover.

11Basedonoperationalfiguresfortheweekbeginning20.9.10fromCityofBradfordMDCCommissioningTeam

12Comprisingofrehabilitationbeds,assessmentbedsandinterimbeds

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Younger Disabled Adults (<65 years old)Thereare33homesproviding454bedsregisteredtoprovidecaretothisusergroup.Ofthesethereare21residentialhomesregisteredtoprovidecareforlearningdisabilities,mentalhealthandphysicaldisabilitieswithatotalof249beds.Thereare12homesregisteredtoprovideresidentialandnursingcareproviding205beds.Thisequatesto2.83residentialbedsper1000and2.33nursinghomebedsper1000peopleinthisusergroup.

Thereare34outofdistrictLDplacementsand172withindistrictplacements(residentialandnursing).

Respite Care14

TheCounciloperatesavoucherschemeforrespiteandhasissuedthemto585serviceusersforrespitecarehavingspentonaverage£22,670perweekinredeemedvouchers.

ThePrimaryCareTrusthasissuedrespitevouchersto99serviceusersforrespitecarehavingspentonaverage£16,875perweekinredeemedvouchers.

Intermediate Care and Nurse Led CareIntermediatecareisprovidedwithintheCounciloperatedandprivatesectorcarehomes.TheCounciloperatedhomeshavecapacityfor30rehabilitationbeds,10assessmentbedsand6interimbedsavailable15forusewithinitsowncarehomesforolderpeople.Bedspaceisalsoavailableinsomeprivatecarehomeshowevercapacityvariesaccordingtodemand,proximityofaGPandthetherapeuticinterventionneedsoftheserviceuser.

Therearefourcommunityhospitalsinthedistrictproviding72bedsofferingnurseledcare.Theseofferrehabilitationwithamultidisciplinaryinputwherethereisadefinedsetofnursing/medicalneedsinadditiontothetherapyneeds.Inadditiontothisthereare16bedsofferingasimilartype ofcarewithintwonursinghomes.

ArecentsurveycarriedoutbytheCouncil’sAdultsandCommunityServicesCommissioningTeam foundthatapproximately60-65%ofresidentialandnursinghomebedsareoccupiedbypeople fundingallorpartoftheirowncare.

At17thSeptember2010theCouncilhadatotalof1,993contractedbedsintheBradfordArea(residentialandnursing-allclientgroups).

13Singleroomwithensuitefacilities,figureincludesqualitypremiumspaidtogoodandexcellentestablishments.NursingcarebedincludesFNCpremium.CommunityCareMarketNewsJune2010

14Figuresfrom10.4.10to17.9.10–i.e.financialyeartodate

15Intermediatecarebed:fulltherapyinput6weeksfreeofcharge.Assessmentbed:notherapyinputbutusedforconfidencebuilding,timetoassessandplan,riskmanagementandhomevisits.Interimbed:careplanagreedbutwaitingforelementsofprovisionorrehousing

Cost of Residential care bed

Cost of Nursing care bed

Bradford

£365.26

£534.80

Calderdale

£384.29

£507.80

Kirklees

£376.62

£503.16

Leeds

£385

£535.70

Wakefield

£402

£510.70

The table below shows how Bradford compares to its neighbours in terms of minimum baseline fees for a contracted bed for older people13

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Extra Care Housing / Housing with Care Thereare8purposebuiltextracareschemesthatprovideatotalof474apartmentsforrentorpurchase.

16Basedonfiguresforweekcommencing8thMarch201017ThevastmajorityofLDservicesareprivateprovision

18Basedonsoftmarkettestingfiguresfor201019Basedonfiguresfrom22ndFebruary–22ndMarch2010

Domiciliary Care – Older People and Adults with Physical DisabilitiesThetotalnumberofcarehourspurchasedbytheCouncilacrossthedistrictis30,146hoursperweektoatotalof3130serviceusers,16or1.57millionhoursperyear.ThenumberofhourspurchasedbytheCouncilfromregisteredprivate/voluntaryproviders(OP,PDandLD)istypically20752hoursperweekequatingto69%oftheCouncilpurchasedmarket.17Thenumberofhourssuppliedbythe‘inhouse’serviceistypically8555hoursperweek,equatingto28%ofthismarket.The‘TimeOut’(sittingservice)supplies839hoursperweekequatingto3%ofthismarket.TheaveragecostofdomiciliarycareacrosstheWestYorkshireareaappearstobeintheregion £12.50to£12.80.18TheNationalaveragehourlyrateis£14.34;takenfromapapercommissioned bytheDHin2005witha2.5%increaseeachsubsequentyearto2010.Atpresentthecostofprovidingcareandsupportvariesamongstprovidersandclientgroups.TheCouncilwillwanttomovetowardsafairpricingsystemwherethetruecostsofservicesareshown.

TheCouncilintendstomovetowardsworkingwithinframeworkagreementswhereafairpricewillbesetandpaidforprovidingcareandsupportthatrepresentsgoodqualityandvalueformoney.Thein-househomecareservicealsoprovidesashort-termreablementserviceforpeoplereceivingcareforthefirsttime,withtheaimofmaximisingindependence.Thisformspartoftheassessmentprocess,whichremainsthecouncil’sresponsibility.Thispartoftheworkcurrentlyaccountsforaround11%ofitsbusiness.89%ofitsworkremainsintraditionalhomecare.

Domiciliary Care – Adults with Learning DisabilitiesDuringtheweekbeginning8thMarch2010,theCouncilpurchasedprovided5443hoursofcare andsupporttopeoplewithlearningdisabilities.

Housing Related SupportInatypicalweektheCouncilpurchasescareandsupportfrom60providerssupportingupto13,000serviceusers.Itspendsapproximately£370,000onthisserviceperweek19andthisexpenditureisbrokendownasshownintable6:

Table 6 Proportion of spend per client group on housing related support

Client Group

MentalHealthOlderPeopleLearningDisabilitiesYoungPeopleatRiskGenericsupportDomesticViolenceSingleHomelessOffendersHomelessFamiliesComplexNeedsAllotherclientgroups

Proportion of annual spend

20.1%16.1%15.5%7.1%6.7%6.1%5.7%5.3%4.7%2.4%10.3%

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Grant-funding for older people’s preventive support

TheCouncilallocatesjustover£2mtosupportvoluntaryandcommunitysector(VCS)groupsacrosstheDistrictworkingwitholderpeople.Thisisallocatedinthreefundingprogrammesshownintable7below:

Table 7. Allocation of social care grant funding in Bradford

Evaluating outcomes of grant funding

Theolderpeople’swell-beingteamvisitfundedgroups(twiceayearforthe3-yearprogramme) andrequiresthesegroupstocompletemonitoringdocuments.TheWBAFandWBCprogrammeshaveledthewayinimprovingthewaythatgrant-fundedactivitiesshowtheirsuccessandtheUniversityofBradfordhasevaluatedtheHealthinMindprogramme.

1) Individualstorygathering:Eachfundedgroupis askedtoprovidetheseateachsix-monthly monitoringvisit.

2) Individualquestionnaires:Theteamhas workedtosimplifytheUniversityofBradford questionnaires,astherewereconcernsat the‘monitoringburden’.FromApril2011,the newversionwillbeusedforeveryscheme receivingWell-BeingActivityFund.

3) Outcomes:Reviewsbasedonthesevenadult socialcareoutcomes.Eachgrouphastoshow howtheirschemeisintendedtoachievethese outcomes,andhowtheywillknowthatthisis thecase.Initialevidenceisthatthisis stimulatinggroupstousequestionnaires, photosandothermeanstogivetheevidence.

Programme

Older people’s 3-year VCS commissioning

Well-being activity fund (WBAF)

Well-Being Cafés (WBCs)

Age Concern ‘Helping Hands’

Anchor Housing Staying Put

Age Concern Trades Register

Age Concern ‘Starting Point’

Description

61groupssupportedbygrantswhichareguaranteedfor3yearperiods;currentlyrangefrom£520-£80,000pa.

Short-termgrantsofupto£5,000todeveloppilotandinnovate.Approx.20groupsatanyonetime.

Meetmonthlyforolderpeoplewithdementiaandothermentalhealthneeds,andcarers.Currently16cafés,funded£4,800pa.

HandypersonforOlderPeople(minorrepairs,minoradaptations,smalldomesticmaintenancework).

HomeImprovementAgency–adviceandprofessionalsupportforpeoplewishingtoadapttheirhomes.

Helptofindreliableandtrustworthytradespeople

Informationandsignpostingforolderpeople

£ per annum

£1.35m

£200K

£76.8K

£100K

£170K

£34K

£100K

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QualityKey messages:l Thedemandforarangeofhighqualityservices willrisecreatingnewopportunitiesforbusiness changeanddevelopmentl TheCouncilwillcontinuewithitsstatutorydutyto measureandassurequalityforallitsresidentslQualityassurancewillremainacoreareaof businessfortheCouncil.l Providinghighqualityserviceswillbekeytolong termbusinesssuccessandconfidenceinthe marketl Increasinglypeoplewillmeettheirpersonal needsusingtheirownbudgets

Opportunities for business change:l Focussingonquality–youmayneedtoconsult orreviewwhatyourcustomersthinkofyou; asmorepeoplemanagetheirowncare, recommendationsbywordofmouthanduser feedbackwillbeanimportantmarketingtooll Staffsatisfaction–beingabletoofferahigh qualityservicehelpstorecruitgoodstaffand improvesmotivationandstaffretentionlCompetition–youmayneedtobeawareofwho youarecompetingwithasthemarketwidensout asmorepeoplestarttomaketheirownchoices

lCommunication–youmayneedtoconsiderhow yourorganisationcommunicateswithits customerstocreateapersonalised,customer focussedexperiencelReviewingandmonitoring–youmayneedto thinkabouthowyougoaboutmaintainingquality throughoutyournormaldailybusinessl Involvingpeople–customersvalueinputintothe designanddevelopmentofservices

The Council places great importance on quality assurance and sees its role within this area increasing over time as the uptake of personalisation increases. It aims to deliver this through a number of approaches:l Integratedqualityassuranceframework: TheCouncilisdevelopinganevidencebased approachtoqualityassurancethatwillbe consistentandtailoredtothetypeofservice beingmonitored.l Providerframeworks:Thisisalistofproviders, setbyclientgroup,whohavedemonstrated throughatenderingprocessthattheymeethigh standardsforqualityandvalueformoney.lApprovedListofContractors:Providersof housingrelatedsupportwhorequiredfunding fromtheauthorityarerequiredtobeonthe Council’sapprovedlistofcontractorslStandardspecifications:TheCouncilandlocal NHSaredevelopingastandardspecification fornursingandresidentialhomes,whichwill includequalityrequirementsandperformance managementlinkedtothem.lRegistrationschemes:TheCouncilisalso lookingintoanapprovedregisterforpersonal assistants.lLow-levelsupportaccreditation:TheCouncil commissionsAgeConcerntoruna‘Traders Register’whichfollowinganinitialaccreditation process,addstradespeopletoalist.

TheseprocessescomplementrequirementstoregisterwiththeCareQualityCommissionfora widerangeofhealthandsocialcareservices.TheCouncilseesitsroleinbothprotectingtheinterestsofallresidentswithcareorsupportneeds,regardlessofhowtheyareprovidedorfundedandcontinuingtoworkwithproviderstoimproveandmaintainhighqualityservices.

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17

Quality – facts and figures

20AllstarratingsareBasedonCareQualityCommissionratingsJuly/August2009

Residential Care

TheaverageCareQualityCommission(CQC)starratingofthe152listedprivately/voluntaryoperatedcarehomesinthedistrictwas2.02.20Fourhomeswereratedaspoor(0stars)and33asexcellent(3stars).Ninehomeshadnotyetbeenrated.Theaveragestarratingofthe11Counciloperatedcarehomeswas2.33.TheaveragestarratingforallcarehomesinEnglandwas2.0stars.

TheCouncilalsomeasuresqualityanditsownperformanceviathe’CapturingRegulatoryInformationataLocalLevel’(CRILL)andthe‘LocalAreaMarketAnalyser’(LAMA).For2009/10,initialfindingsshowthattheCouncilisperformingslightlybelowtheEnglandaverageforallplacesingoodandexcellenthomesexceptolderpeoplepersonalcarewhereweareperforminginline.

Forolderpeopleinresidentialcarehomes(nursing),thecouncilpurchased79%ofitsplacementsingoodandexcellentplacements,inlinewiththenationalaverageandhasimprovedonlastyearsfigures.Forolderpeopleinresidentialcarehomes(personalcare),thenumberofplacementspurchasedfrombothwithinandtheauthorityandthoseoutsidetheauthority,ingoodorexcellenthomesisgreaterthannationalpurchasingandourpositionhasimprovedfromlastyear.Therewerenoplacementsmadetohomesratedaspoor.

Foradults(learningdisabilities,mentalhealthandphysicaldisabilities)inresidentialcarehomes(nursing)withintheauthorityarea,theCouncilpurchasesfewernumbersofplacementsingoodorexcellenthomesthannationalaverage,buthasreducedthenumberofplacementspurchasedinpoorhomesfrom9%to0%.Outoftheauthorityarea,thecouncilonlypurchasesplacementsingoodorexcellentratedhomes.Foradultsinresidentialhomes(personalcare),theCouncilpurchases48%ofplacementsintheauthorityinpoororadequateratedhomesagainstanationalaverageof15%.TheCouncil’sperformanceinthisareahasdecreasedfromlastyearandissignificantlybelowthenationalaverage.Outoftheauthorityarea,theCouncilisperformingabovethenationalaverage.

Domiciliary Care

TheaveragestarratingfordomiciliarycareprovidersregisteredinBradfordis2.05starsandforEngland2.1stars.Theaveragestarratingforinhouseserviceswas2.0starsandforthe41listedprivateproviderswasalso2.0stars(8ofthesehadnotbeenrated).

At30.9.09,theCouncilwaspurchasing91%ofitsdomiciliarycarehoursviagoodorexcellentratedcareagencies,3%fromadequateratedagenciesand6%fromagenciesthathadnotyetbeenCQCrated.Thisishigherthanthenational.

Complaints

Duringthesameperiod,atotalof47complaintsreceivedbytheCouncilrelatedto15homecareproviders.Thenatureofthesecomplaintswere8allegationsagainststaff,15complaintsaboutpunctuality,21complaintsaboutthequalityofcareand4complaintsaboutmedication.

18

Finance and Funding

Inthelastfinancialyear(2009/10)theCouncilspent£172.2moncareandsupport.Thisfigurerepresentsgrossexpenditureandcomprisesofspecificgrants(£32.1m)andincomefromchargesandotheragencies(£28.3m).AbreakdownofthisgrossexpenditureisprovidedinTable8andfigure3.In2008-9,theCouncilspent54%ofitsoverallspendforolderpeople’scare

servicesonresidentialandnursingcarerepresentingadecreasefrom56%thepreviousyear;amajoritysharebutadecreasingone.PublicspendingwillstarttobereducedandtheCouncilwillneedtoconsiderhowitallocatesfundingtousersandservices.TheCouncil’scommissioningapproachwillbetoseekoutqualityservicesthatoffervalueformoneyandmaintainhighlevelsofusersatisfaction.

Figure 9.

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ServicesforPeoplewithPhysicalDisabilitiesServicesforPeoplewithMentalHealthNeedsServicesforPeoplewithLearningDifficultiesServicesforOlderPeopleOtherAdultsSupportingPeopleAsylumSeekersVoluntarySectorGrants

ItemServicesforPeoplewithPhysicalDisabilitiesServicesforPeoplewithMentalHealthNeedsServicesforPeoplewithLearningDifficultiesServicesforOlderPeopleOtherAdultsAsylumSeekersVoluntarySectorGrantsTotal£m

£15.612.342.580.411.91.28.3172.2

Table 8. Gross Expenditure by Social Care including grants Year 2009/10

19

How do we compare to other West Yorkshire Councils?

ThetablebelowshowshowwecomparetoothercouncilsinWestYorkshireintermsofpercentagedistributionoftotalgrossexpenditureonadultsocialservicesbyclientgroup.21

Table 9. Comparison of total gross adult social care expenditure across West Yorkshire

Self funders of careAsurveywassentouttoprivatedomiciliarycareprovidersinNovember2009askingaboutselffunders.34providersweresurveyed,9respondedstatingthat170oftheircustomersfundedtheirowncarepurchasing1939hoursinagivenweek.Ofthiscare,69%ispersonalcareand31%isdomesticcare.OverallweestimatethattheselffundingmarketinBradfordwillincreaseovertimeorthatpeoplewilloptto‘topup’theirassessedpackagesofcarewithadditionalservices.

ItisestimatedthattherewillbeasignificantproportionofselffunderswithintheBingley,BingleyRural,CravenandIlkleywards.Thesewardsarethehighestrecordedareasforcouncilfundedhomecaresupport22andareexpectedtohaveahighproportionofolderpeoplelivingtherecoupledwiththerelativeaffluenceoftheseareas.Therefore,the

Councilexpectstoseeanincreasingamountofactivityincareandsupportprovisionforelderlypeopleintheseareaswillneedtomatchthislevelofdemand.

ItisexpectedthatthisshareofthemarketwillshiftovertimeandtheCouncilwillwanttoactivelysupportpeoplewhochoosetofundsomeoralloftheircareandsupportneeds.Itwillofferimprovedaccesstoinformation,support,andadvocacytohelpthemdecideonthebestoptionsforthem.TheCouncilwillwishtodobusinesswithproviderswhocansharethiscommitmenttoofferingpeopletherightadvice,helpandsupportwhereappropriate.OptionsforthefuturefundingofsocialcareandsupportarebeingconsideredbytheGovernmentandtheselffundingmarketisexpectedtohaveasignificantinfluenceoverthewaypeopleaccessandpayfortheircareandsupportneeds.

21NASCIS005ExpenditureReport2008/9http://nascis.ic.nhs.uk 22BradfordObservatorywww.bradfordobservatory.com

There are currently 954 people in receipt of direct payments in the District.

England average

57%

24%

10%

7%

2%

16.45%

17.70%

Calderdale

60%

21%

12%

6%

2%

15.86%

17.86%

Kirklees

59%

24%

9%

7%

1%

14.92%

17.71%

Leeds

59%

22%

10%

8%

1%

14.01%

18.38%

Wakefield

63%

21%

9%

6%

1%

16.64%

18.04%

Bradford

60%

18%

9%

8%

6%

13.41%

17.15%

Older People (65+)

Adults with a learning disability

Adults with a physical disability

Adults with mental health needs

Other adults services

Proportion of older people (65+) of total population

Proportion of Younger Disabled Adults of total population

20

Reviewing the Evidence – Delivering ChangeReviewing the evidence

Demographicgrowthmeansthatthecurrentpatternofservicesandinvestmentisunsustainable;agrowthupwardsof30%inolderpeopleandyoungeradultswithdisabilitiesinthenext15yearswillnotbematchedbypublicfunding.

Funding,demandandcapacityfortraditionalmodelsofcareprovisionwillreducei.e.residentialandnursinghomes.Thiswillmeanmorepeoplewillwanttostayathomereceivingthecareandsupporttheyneed.

Thecurrentcareandsupportmarketoffersarangeofprovidersthatsupplygoodqualityservices.Thereissufficientcapacityinthemarketasitstandsandagoodlabourmarkettosupporttheindustry.However,thecurrentprofileofserviceprovisionisunlikelytomatchtheexpectedriseindemandincareandsupportservicesacrossthedistrict.

Anincreasingnumberofpeople(notwithstandinganygovernmentproposalswithregardtothefuturefundingofsocialcare)willbeexpectedtofundtheirowncare.Currentlyweestimatethatapproximately12%ofserviceuserswhoreceivesupportfundingviatheCouncil,alsoaugmenttheircareorpurchaseotherservicesdirectlyfromthesameprovider.Thefigureforthosefundingtheirowncareoutrightisestimatedataround8%ofthetotalmarket.

TheCouncilcurrentlycommitsover£2mperyearforactivitiesandsupportwhicholderpeoplecanaccessdirectlywithoutaformalassessment.Thisincludeshandypersonhelp,informationand‘signposting’(i.e.helpingpeoplefindoutaboutandaccessactivitiesandservices),daycentres,drop-insandlunchclubs,befriendingschemes,well-beingcafés,

Delivering change

Themarketwillneedtobereadytorespondtobudgetarypressuresthatarebeingfacednationally.Thismaymeanprovidersbeingabletooffersustainablevalueformoneyandqualityservicesatalowercostregardlessofwhetherserviceusersarespendingtheirownorallocatedfunding.

TheCouncilwillbekeentodobusinesswithprovidersthatcandemonstratethattheirservicesareabletodiversifyintoareasofprovisiontomaintainpeopleathomelivinghealthylivesforlonger.Thiswillbethecorecustomerbaseinthefutureandtheareathatrepresentsthemostopportunitiesforsuccessandcontinuedbusiness.

AdditionalcapacitymayberequiredtomeettheexpectedriseindemandforcareandsupportserviceshowevertheCouncildoesnotwishtoseeanincreaseinthesametypeofprovision.Itsviewisthatinvestmentandgrowthinpreventionearlyinterventionandsocialcapitalisabsolutelyvital.Thismeansdeliveringarangeofpreventativeservicesfromlowerlevelcommunityplanningandinvolvementtohigherlevelhousingrelatedsupportneedssuchastelecare,fallspreventionandworkingwithcarers.TheCouncilwillworkcloselywithitsNHSpartnerstodeliverthesetypesofservicesandreduceanyduplicationofservicesoverthecomingyears.

Beingabletodeliverarangeofhomeandcommunitybasedpreventativeandearlyinterventionserviceswillbeasignificantshareofthesocialcareandsupportmarketthatwillneedtodevelop.

Peoplewhodonotrequirethelocalauthoritytofundtheircare,shouldstillbenefitgreatlyfromimprovedhealthandsocialcareinformationandexpertiseregardinge.g.thealternativestocarehomes,inassessingneeds,maximisingindependence,managingrisksandsupportingcarers.

Morepeoplewillwanttochoosethesetypesofservicesfromaproviderthattheytrustandthathaveagoodreputation.

TheCouncilwillactivelyseektodobusinesswithprovidersthatcandemonstratecommitmenttoeithermaintainingordevelopingpreventativeservicesaspartoftheircorebusinessorthatarepreparedtoadvise,supportandguidepeopletotheseservicesaswellasdelivermoreregularformsofsocialcareandsupport.

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21

Reviewing the evidence

activitiessuchasusingtheinternet,walkinggroupsandarts&crafts.Mostofthisactivityisgrantfundedvialocalcommunityandfaithgroups,whocontributetheirownresourcessuchasbuildings,volunteersandfundraising.Althoughwecanhighlighttherecentgrowthinthisinvestment,itremainsaverysmallproportionoftotalolderpeople’sspending.

Thenumberofpeoplerequiringhomesupportasincreasinghoweverweseethatthisrisingdemandwillbemetbypeoplebeingsupportedbyshortterminterventionratherthanrelyingonlongertermsupport.

TheCouncilanticipatesthatthenumbersofpeoplerequiringextracarehousingtomeettheirlongertermneedswillincrease.TheDepartmentofHealthhasrecentlyreiteratedtheimportanceofextra-carehousinginfutureplansforolderpeople’saccommodationandcare.VerypositiveviewswereexpressedaboutthemodelaspartofrecentconsultationonthefutureoftheCouncil’sresidentialhomes.HousingprovidersarestillkeentoworkinpartnershipwiththeCounciltodevelopschemesandarestillabletoraisefundsfordevelopment.

Overonemillionpeopleliveinhousingprovidedspecificallyfortheneedsofolderpeopleandnearlytwothirdsoftheseliveinshelteredhousing.23

Weanticipatethatthenumbersofolderpeoplerequiringspecialisthousingandsomeformofsupporttoliveindependentlywillincrease.

Delivering change

Theevidenceshowsthatthesetypesofactivitiesarevaluedbythepeoplethatusethem.Maintaininghealth,wellbeingandindependencewillbevitalintheleanyearstocome.TheCouncilwillwanttoworkwithprovidersthatcanshowcommitmentandunderstandingtothepreventionandearlyinterventionagendas.

TheCouncilwillwanttodobusinesswithprovidersthatencouragepeopletobecomeindependentagainorrequirelessintensivemethodsofsupportandwhoputpeopleintouchwithlocalorganisationstohelpthemmaintainthatindependence.Supportplanningandbrokeragewilltakeanewshapeasbothinhouseandindependentorganisationswilltakeonthisroleforserviceusers.

Theaimwillbetobrokershorttermpackagesofcareandsupportwiththefocusonreablementratherthansettinguplongertermpackagesofcare.

TheCouncilinitscommissioningapproachwillmovetowardsamodelofoutcomebasedcommissioningandperformancemanagementthatcandelivergreaterflexibilityratherthantheformerblockcontractingofservices.ItwillworkwithGPcommissioningcolleaguestoappropriatelyrewardthistypeofapproach.

TheCouncilwishestocontinueworkingwithproviderstodevelopnewextracareschemeswhichcanpromoteindependenceandwell-beingforpeoplewithhousingandsupportneedsandmeethighlevelsofcareneeded,includingovernightcare.Theextentofsuchdevelopmentwilldependonavailablelandandinvestment,continuedstimulusoftheindependentsectorandtheoutcomeoftheCouncil’scurrentreviewofitsin-housecarehomes.

TheCouncildoesnotexpectthedemandforshelteredhousingwillincrease,nordoesitseethatthisareaofprovisionwillbestmeettheneedsofthelocalpopulation.TheCouncilwillwanttoreducethedistinctionbetweenshelteredhousingandextracarehousingandseesthemodelofprovisionitwillwanttocommissionbeingarangeofhighqualityhealth,socialcareandsupportbasedservicesthatareequippedtobedeliveredintoalltypesofspecialisthousing.TheCouncilwillbekeentoworkwithprovidersthatcanrespondtotheincreaseddemandforthesetypesofvariedsupport.23ElectionManifesto2010TheEssentialRoleof

ShelteredHousing.www.shelteredhousing.org

22

Reviewing the evidence

Peoplehavehigherexpectationsandwantcareprovidedflexiblyinawaythatsupportstheirfamilyandsociallife,ratherthanpeoplehavingtoorganisetheirlifearoundcareservices.

Wealsoknowthatsatisfactionwithgoodquality,skilledandappropriatelytrainedstaffaswellasconsistencyofcare/careworkerwhereverpossibleismoreimportantthanwhichagencyisused.

ThereisstillsignificantexpenditureondirectCouncilprovision(‘in-house’services),despiteofsignificantshiftstowardspurchasingfromtheprivatesectorinthepastdecade.In-houseservicesaremoreexpensiveandsignificantlyforpersonalisation,commitresourcesinadvanceinthesamewaythatblockcontractsdo.Althoughtraditionallytheinhouseservicehasheldasignificantplaceandshareofthelocalcareandsupportmarket,itwillneedtorespondtocurrentfinancialpressuresbyreducingcosts,drivingoutinefficienciesandofferingvalueformoney.

Carersmakeahugecontributiontothesupportofpeoplewithdisabilities.Wewanttooffersupportdirectlyto.A2009evaluationofschemesfundedforcarersacrosstheDistrict,foundsomeofthebestresultswerefromschemesthatgiverelativelysmallsumsofmoneydirecttocarers,e.g.forholidays,computersandITskills,exerciseoryogaclasses.ACouncilschemetoissue£50‘winterwarmth’paymentstohelpcarersinthesevereweatherinwinter2009-10hasreachedover1,400carers.

Delivering change

TheCouncilwillseektodobusinesswithprovidersthatwanttodeveloptheirservicestohelpkeepolderpeopleathomeandabletofunctionsafelyandindependentlyforaslongaspossible.Thismayinvolvefloatingsupport,particularlyintheprivatehousingmarketandofferingawiderchoiceofsupportiveactivitiesthatrelatetomaintainingagoodqualityoflifeinone’sownhome.TheCouncilwillalsowanttodobusinesswithprovidersthatcandemonstrateamorepersonalisedandintegratedapproachtosocialcareandhousingdelivery,recognisingthataonesizeapproachisnolongersuitable.

TheCouncilwillseektodobusinesswithproviderswhocandemonstratetheirabilitytoofferhighqualitycareandsupport,underpinnedbyperson-centredvaluesandapproacheswhilstofferingvalueformoney.

Serviceusersoftensaythatwhatmattersmostisthequalityoftheindividualprovidingthecareandsupportandtheirpunctualityandflexibilitytogotheextramile.TheCouncilwillwanttoworkcollaborativelywithproviderstodiversifythelevelofcompetencyandrangeofdutiesthatcare/supportworkerscanprovidetomeettherisingdemandforhomebasedservices.

TheCouncilwillreviewthefunctionandcorebusinessofthein-houseservices.Forexample,thein-houseresidentialanddayservicesarecurrentlyunderreviewandanextensiveperiodofconsultationtookplacein2009.ElectedmemberswillconsidertheoutcomesandrecommendationsfromthatworkthroughareporttotheExecutiveCommitteelaterintheyear.

TheCouncilintendstodevelopindividualaccountsforcarers,whichwillleadtoopportunitiesforprovidersofawiderangeofgoodsandservicestopromotewell-being,educationandskills,socialandeconomicinvolvement.

Asimple,easytoaccessschemeisplannedtoenablecarerstoreceivearelativelysmallcashsum;withtheoptiontohaveamoredetailedcarers’assessmentandresourceallocationifthecarers’needsrequireit.

23

Facilitating the Market

NewmethodsofdevelopingandfacilitatingthesocialcaremarketarerequiredwhichcanbuildontheCouncil’suniqueposition.TheCouncilcanbringinformationitknowsaboutpopulationanddemandofitsserviceusersandcarersintoadialoguewithprovidersaboutinvestmentandrisk.Theaimistoencourageandsupportproviderstoshapetheirservicestopersonalisation,demonstrategoodoutcomesandimprovedmodelsofpracticeandexplorewaysinwhichtheycancomplementtheseapproachesandberewardedfordoingso.

TheCouncilrecognisesthattodeliverchangeproviderswillrequireinvestment.Thismightincludeprovidingnewtypesofservice,trainingstafftoimprovequalityorspendingtimewithcustomerstoplanandtailorservices.Ifwewishtoseesmallandmedium-sizeprovidersinthemarketwemustconsidertheircapacitytoinvestmoneyandtakerisks.Largerprovidersshouldnotbeoverlookedeither,butgenerallyhavemorecapacitytotakerisksandtoallowdemandforservicestobuildupovertime.Italsorecognisestheneedtofosterasupportiveenvironmentofsharedrisktakingacrosstheboardfromassessmentandsupportplanning,throughtobrokeringservices,frontlineservicedeliveryandreviews.Sharedrisktakingintermsofthepackagesofsupportthatpeoplearegivenwillreducedependencyandpromoteindependence.Wewanttoworkwithserviceprovidersthatcanprovideeffectiveshortterminterventionsandcollaboratewithusduringthereviewprocesstoreducecosts.

Developmentgrantsarebeingtrialledbyotherlocalauthoritiesintheregionandhavebeenusedwithsomesuccesstosupportthedevelopmentofsocialenterprisestoprovidepracticalsupportforolderpeople.24However,itisimportanttobeclearaboutthenatureandpurposeofsuchgrants,allocatingfundsfairlyandinlinewithrestrictionsonpublicsubsidyandtolinktoeventualsustainabilityofanenterprise.

TheCouncilwantstosupportvoluntarysectorprovidersviainfrastructureorganisationstocometogethertobuildmoresocialcapitalinthedistrict.Italsowantstoreducetherequirementsplacedonproviderstoworkwithincomplexcontractualarrangementsandtomakeiteasierforexistingandnewproviderstoenterthemarketandworkwithus.TheCouncilaimstocontinuetoencouragelocalpeopletohelpinfluencelocalcommissioningdecisionsandwillalwaysconsultwithitsresidentstoshapetheservicestheywantandtodowhatisrightforBradford.TheCouncilalsorecognisesthechallengesofunderstandingandmeasuringoutcomesandwelcomestheinitiativeshownbythelocalHealthandWell-Beingforumforthevoluntaryandcommunitysectortodeliveritsowndevelopmentinitiativestohelpthoseprovidersgettogripswiththeissue.

TheCouncilwouldwelcomedialogueabouthowwecanbestworktogetherandoffersupporttofocusonoutcomes,avoidingperformancemanagementsystemsthatinadvertentlyrewardthewrongthings.TheCounciliscommissioningenhancedsupportfordevelopingsmallproviders,supportingvoluntaryandcommunityorganisationsandgroupstoenablethemtodevelopnewfundingandoperatingmodels.

Thismarketpositionstatementisthestartofaprocess.ItisintendedtoserveasanintroductiontothemanydiscussionsthatneedtobehadbetweenthecouncilandprovidersbutalsoasastartingpointforproviderswithintheBradfordDistricttothinkabouttheircurrentbusinessmodelsandhowtheymayneedtochangeforthefuture.Itdoesnotpreventprovidersseekingacompetitiveadvantagethroughtheirownmarketresearchandotheractivities.Therightkindoffreely-sharedandpublishedintelligencecouldlowerbarrierstomarketentryandpreventprovidersfromwastingresourcesonpoorly-targetedinitiatives.Asastartingpointwewelcomeviewsonwhatkindofmarketinformationwouldbeespeciallyusefulinthefutureormightbedifficulttoobtainindependently.

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24www.keepinghouse.org.uk

24

ThewordinginthispublicationcanbemadeavailableinotherformatssuchaslargeprintandBraille.Pleasecall:01274437957.

FormoreinformationabouttheMarketPositionStatementpleasecontactPaulO’Brienon01274437710oremailpaul.o’[email protected]

Bradford mps autumn 2010

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