Market Position Statement Purpose

This Market Position Statement gives our position for the care and support of older people, adults with physical disabilities, mental health needs or learning disabilities and those young people preparing for adulthood in the London Borough of Sutton (Sutton).

The Market Position Statement includes key information for current and future care and support providers to assist them with service development design including:

  • The current and future demographics and service provision
  • Sutton’s commissioning intentions as a facilitator of care and support for those individuals needing adult social care
  • Future proofing wherever possible our local services for younger people preparing for adulthood (also referred to as transitions)
  • Our vision on how the care and support market could respond to the changing needs of care and support for the future
  • The emerging picture of services within an integrated health and care system
  • The importance of quality and digital and technology enabled care within the delivery of care and support within Sutton

It will help identify what the future demand for care and support will be and form a starting point for discussions between ourselves and those who provide or wish to provide care and support services in the future.

The initial focus of this market position statement is our bed based care provision (Care Homes, Supported Living services and Extra Care Housing schemes) but we plan to add to this Market Position Statement to include the following sectors of the market:

  • Home Care
  • Day Services
  • Supported Accommodation
  • Community Equipment
  • Information, Advice and Guidance
  • Respite Care and Short Breaks
  • Shared Lives

This Market Position Statement will be updated annually with Key Data and relevant information.

Our Market

Sutton commissions care and support for those individuals assessed as having an eligible need under the Care Act 2014. These individuals may be older people or adults with physical disabilities or sensory impairments, mental health needs, learning disabilities or autism or be younger adults.

The interactive map provides an overview of bed based care services within Sutton including Residential and Nursing Homes, Supported Living Services, Extra Care Housing Schemes and Independent Living Schemes provided by Sutton Housing Partnership.

 

How We Purchase Services

How We Buy Bed Based Services in Sutton

Social Care provides a unique commissioning challenge as good practice not only focuses on commercial processes and efficiency gains but also on the individuals that Social Care services will support. This personalised approach can sometimes seem at odds with the pressing need to balance the books. However our strategy shows that efficiency gains and a personalised approach are not mutually exclusive. We do this through five themes:

Leadership: championing the value of information sharing and joint commissioning with other agencies and recognition of the need to implement unique processes for social care procurement.

Outcome focused commissioning: putting the needs of individuals at the centre of service design.

Partnering and collaboration: better integration between health and social care and joint commissioning where shared outcomes can be achieved.

A person-centred approach: involving service users throughout the commissioning process and exploring procurement routes that give more choice to service users.

Development of markets: creating an environment in which providers are supported to develop innovative solutions to better meet the needs of service users.

Across bed based care, we commission services in a variety of ways:

Spot Contracts 

Individual contract for services that are provided on a case-by-case basis, typically to an individual / service user. This type of commissioning is used for our residential and nursing care and some supported living services.

Block Contracts  

Guaranteeing a certain volume of business with a service provider over a set period of time, to an agreed written specification, typically at a fixed price. The significant feature of a block contract is that payment is made for the guaranteed contracted volume irrespective of how much of the service has been used. This type of commissioning is used for our extra care housing and some supported living services.

Approved Providers List 

A list of potential providers maintained by commissioners. Providers typically have to pre-qualify for the list either by evidencing compliance with a set of standards, sometimes known as an accreditation scheme, or through a selection process using a Pre-Qualification Questionnaire (PQQ). When services are actually required, the commissioning organisation issues a separate spot contract (also known as a call-off contract) that sets out the remaining terms and specific service requirements. It is anticipated that this type of commissioning will be adopted for some bed based services in the future.

Competitive Dialogue 

A variation of the negotiated process, now available under the new EU Directives, which permits discussion of different options before choosing a particular solution. It can be used in complex contracts where technical solutions are difficult to define, or where development of the best solution is wanted. It is anticipated that commissioners may adopt this process when developing innovative services to meet specific needs of individuals.

Supported Brokerage 

Independent facilitators working alongside individuals, supporting them to understand and explore a whole range of opportunities and to confidently take action to achieve their desired outcomes. This service has recently been adopted and is in its infancy stage working with young adults with a learning disability.

Local and National Landscape

Sutton is ambitious: we want all of our residents to make informed choices about their lives, to stay active, to live well independently and to stay safe.

Our aspiration is that the residents of Sutton are supported to start well, live well and age well through a more personalised and joined-up approach to the delivery of health and care services in Sutton.

The refreshed Sutton Health & Care Plan has been adopted as the new Health & Wellbeing Strategy for Sutton.

Sutton recognises that its residents wish to live independently in their own homes for as long as possible and we are committed to supporting this to happen. By utilising our Strengths Based Approach in Adult Social Care we are continuing to enable people to be more independent at home for longer

The Care Act 2014 provides the framework for how Adult Social Care works, placing more importance on information and advice, prevention and market shaping.

Sutton has a duty to facilitate a diverse, sustainable high quality market for its residents, including those who pay for their own care and to promote efficient and effective operation of the adult care and support market as a whole

The legislation makes it clear that future market shaping and commissioning must focus on:

  • Provision of good information and advice;
  • The needs of a person and ability to achieve outcomes;
  • Promoting a person’s wellbeing;
  • Promoting quality services, including through workforce development and remuneration and ensuring appropriately resourced care and support;
  • Supporting sustainability;
  • Ensuring choice;
  • Co-production with partners; and
  • Effective engagement and joint working with providers.

Following the release of Build Back Better: Our Plan for Health and Social Care, in December 2021, the Government set out it’s vision for reforming adult social care within it’s white paper People at the Heart of Care: adult social care reform white paper

The white paper sets out a 10-year vision for adult social care in England puts people and families at its heart and is based around three key objectives:

  • People have choice, control and support to live independent lives. 
  • People can access outstanding quality and tailored care and support. 
  • People find adult social care fair and accessible

The white paper also sets out how money will be spent on new investments in:

  • Housing and home adaptations
  • Technology and digitisation
  • Workforce training and wellbeing support
  • Support for unpaid carers and improved information and advice
  • Innovation and improvement.

Under the Health and Care Act 2022, from the 1st July 2022, the South West London Clinical Commissioning Group (SWL CCG) was abolished and replaced by the South West London Integrated Care System (SWL ICS). The ICS is a partnership of organisations, including Sutton, that have come together to plan and deliver joined-up health and care services, and improve the lives of people who live and work in their area. In awarding ICS status, NHS England has recognised the strength of the partnership and the shared ambitions for its six boroughs – Croydon, Kingston, Merton, Richmond, Sutton and Wandsworth to meet health and care needs, coordinate services, improve population health and reduce health inequalities.

The purpose of the SWL ICS is to:

  • Improve outcomes in population health and healthcare in SWL
  • Tackle inequalities in outcomes, experience and access
  • Enhance productivity and value for money
  • Help the NHS support broader social and economic development.

For more information please go to SWL ICS Website

Financial Position

Like many Councils, we are still facing increasing pressures on our finances.

The total expenditure for adult social care in 2020/21 was £45.9 million. 

Since 2010, Sutton has been required to continually deliver ongoing savings in response to the Government’s policy of reducing the public sector deficit, mainly through reductions in public expenditure. By the end of 2021/22 the Council had budgeted to make cumulative savings of £102 million. Of this total, Adult Social Care budgeted to contribute £2.1 million during the year 2021/22.

In 2020/21 Sutton supported 2,392 individuals with a long-term support service. This has been broken down in the graph below.

There has been a steady rise in the number of people in long-term support year on year since 2017-2018. Demand has grown by about 5% per year starting at a total of 2095 in long-term support up to 2932 in 2021. 

This increase in demand has been driven mainly by the needs of the elderly population with 22% more elderly people in support in 2021 than in 2017. The numbers of other groups in support, such as those with physical / learning disabilities and mental health disorders, grew by less than 5% total over the last 4 years. The only group to fall in numbers in support were those with other vulnerabilities, decreasing by 33% over the same period.

Despite the fact that there has been further increases in demand, the overall spend on adult social care services has remained relatively stable.

More information can be found in our Local Account

In 2022/23 a proposed adult social care savings target has been identified of £305,000. This will be delivered through a best value review which will support the implementation of an integrated commissioning solution that identifies economies of scale and promotes a variety of placement and support options.

Charging

People may be required to pay towards the cost of their care. The amount that they pay is calculated by completing a means tested financial assessment. This is carried out by applying statutory guidance issued under The Care Act 2014 

Further information is available here:

Paying for Support and Charging

Personal Budgets and Direct Payments

A personal budget is an amount of money allocated to a person who is eligible for social care services following an assessment of needs. While some people choose to take their personal budget as a direct payment and manage the money and support themselves, there are other ways in which they can spend their personal budgets without taking on the full responsibility of a direct payment.

Further information is available here:

Personal Budgets and Direct Payments

Care Headlines

The following headlines will be of importance to the care and support market in Sutton:

Cost of Care Cap

Following the Chancellor’s Autumn Statement published on 24th November 2022, the government has taken the decision to delay the planned Adult Social Care charging reforms from October 2023 to October 2025. This delay covers the implementation of the new lifetime cap on the amount anyone in England will need to spend on their personal care costs.

Self Funders

Self funders account for 57% of the older people care homes market in Sutton.

Self funders often pay significantly more than people who are fully or partially funded by Sutton. However, the government has recently taken the decision to delay the planned Adult Social Care charging reforms. This delay covers the implementation of the extension of Section 18(3) of the Care Act 2014 to enable self funders in residential care to access local authority commissioning. 

Market Sustainability

The Government has initiated a national cost of care exercise for the older people care home and 18+ home care market to inform its overall reforms to Adult Social Care. Information will be gathered about running costs and overheads so that Sutton can be confident it has a sustainable and properly funded adult social care market. We are looking to establish a view across South West London that provides a genuine profile of the actual costs of care in our areas and to understand together the steps needed for a high quality sustainable future care market.

Alongside this, Sutton will develop a Market Sustainability Plan. Both ‌pieces of work will support us in moving towards paying providers a fair cost of care and ensuring a healthy and sustainable future social care market in South West London.

Quality

Sutton’s Quality Improvement Team works across both Children’s and Adults Social Care and is crucial in supporting the strategic commissioning of care and support services.

Our mission is: 

  • To provide high quality services to the residents of Sutton by providing a framework in which all Quality Assurance visits are delivered, monitored, and verified
  • To work in partnership with our stakeholders to drive up quality standards to achieve the best possible outcomes
  • To bring together a range of intelligence and real time reporting that is evidence based and solution focused, highlighting good practice, areas of improvement and analysis that will shape the market
  • To carry out quality visits and promote best practices
  • To contribute to delivering value for money
  • To work to ensure that all providers maintain standards and where there are concerns, report and alert

We use several measures to identify processes, procedures, standards and levels of competency to ensure that the services and environment created for our service users are fit for purpose, person-centred and standards maintained regardless of change of personnel. 

Sutton has agreed an incentive scheme that will reward care homes that receive outstanding ratings from CQC with a cash payment of £1,000 per rating (for safe, effective, caring, responsive and well-led) including an additional £1,000 bonus if a care home receives 5 outstanding ratings overall. Successful care homes will be expected to spend the money on their staff team through the provision of gift tokens and / or a celebratory event. The scheme is effective up to the 31st March 2023. Only outstanding ratings achieved during this period will qualify for the reward. The scheme will also apply to care homes who retain an existing outstanding rating during this period.

Digital and Technology Enabled Care

Sutton’s vision is to support its residents to live well independently and safely at home, taking advantage of the opportunities that digital care technology can offer wherever possible to support self care, anticipate or prevent a crisis from ever happening.

Sutton wants to find the best and most effective ways to support people to live and age well in the place they call home and prevent the need for more intensive and long-term care and support wherever possible.

Technology plays a vital role in supporting people to achieve the best outcomes and complements care and support as well as supporting the delivery of social care. Technology enabled care (which includes telecare, telehealth, consumer technology data tools, software and apps) can be life enhancing and life changing.

By 2025 the telecom industry is required to upgrade their telephony lines from analogue to digital. This will have serious implications for the reliability and safety of our current analogue telecare provision if we do not shift to digital ready technology solutions (as recommended by OFCOM).

Sutton sees a role for digital and care technology:

  • In finding the best and most effective ways to support people at different stages in their lives with a range of needs (including cognitive and communication / sensory needs) and for the technology to have the flexibility to continue to be used by them as their needs change
  • To support people to develop practical independent living skills; connect to their communities and establish networks that reduce isolation and loneliness
  • To support young people to develop in transitioning to adulthood and independence
  • In preventing hospital admissions, facilitating hospital discharges and during reablement and to understand how well someone is coping in the place they call home and with the right level of support

Moving forward, Sutton is embedding technology within it’s strategic commissioning plans and within our contractual arrangements with commissioned care and support providers.

Learning Disabilities and Autism 

Sutton is developing a new ‘Living in a Place Called Home’ Supported Living Commissioning Strategy (2023-2028). Our vision for the future is to provide choice and opportunities for people with learning disabilities to live as independently as possible in ordinary community settings. We aim to significantly increase the range of supported living options and enable people currently living out of area to return to Sutton if they wish to do so. With an aging population and likely growth in numbers of people with dementia and of young people with profound and complex needs, we need to ensure a range of level access accommodation is available to meet future needs.

The SWL ICS will be undertaking a piece of work in collaboration with Sutton and neighbouring authorities to review local strategies and market position statements that support the lives of autistic people and people with a learning disability.

Housing 

Sutton has commissioned a new Strategic Housing Market and Local Housing Needs Assessment with the final report due by December 2022. The report will provide updated projections of population and housing needs for Sutton, including affordable housing, over a 20 year period. The report should also provide information on the housing needs of specific client groups, including the requirement for older person accommodation of different types such as residential care and other supported schemes.

Working Together

We value our relationship with providers as our partners in delivering care and support and recognise the importance of engaging regularly with providers. 

Sutton schedules monthly opportunities to meet with bed based care providers (residential, nursing, supported living and extra care housing) through Question and Answer Sessions and Provider Led Forums.

Scheduled Provider Engagement Dates 2022/2023:

Bed Based Care Q&A Sessions

18th May 2022 11:00am – 12:00pm

15th June 2022 11:00am – 12:00pm

17th August 2022 11:00am – 12:00pm

14th September 2022 11:00am – 12:00pm

16th November 2022 11:00am – 12:00pm

18th January 2023 11:00am – 12:00pm

15th February 2023 11:00am – 12:00pm

15th March 2023 11:00am – 12:00pm

Older People’s Bed Based Care Provider Forums

20th April 2022 2:00pm – 4:00pm

20th July 2022 2:00pm – 4:00pm

19th October 2022 2:00pm – 4:00pm

7th December 2022 2:00pm – 4:00pm

Learning Disabilities and Mental Health Bed Based Care Provider Forums

27th April 2022 2:00pm – 4:00pm

27th July 2022 2:00pm – 4:00pm

26th October 2022 2:00pm – 4:00pm

14th December 2022 2:00pm – 4:00pm

We also schedule additional engagement events throughout the year to support key pieces of commissioning activity and development.

If you would like to be added to the distribution list for events please get in touch with us through the Contact Us section.

Provider Networks

Sutton proactively supports the development of provider networks to encourage the sharing of resources in the delivery of care and support.

An Activities and Wellbeing Network is under development which is a collaboration of bed based care providers with the aim of sharing resources and learning between care providers but also to provide new opportunities for care home residents and service users.

If you would like to find out more and be part of this network please get in touch with us through the Contact Us section.

Sutton Care Hub

The Sutton Care Hub is the single point of access for guidance, resources and information for all staff working across Sutton’s provider services and was developed in partnership with Sutton and SWL ICS.

The Hub provides staff, at all levels, with the assurance that they can access the correct, most up to date information at any time from their computer, phone or tablet. The Hub supports Sutton, its health partners and our providers to work together to build a stable, sensitive and supportive care offer in Sutton. 

The Sutton Care Hub aims to:

  • Hold information, guidance and resources for care and support providers in one location
  • Highlight the latest news and guidance available
  • Signpost staff to the latest local and national resources from other key organisations
  • Provide a single joint calendar for events and activities

Care Matters

Care Matters is a regular newsletter for providers. It is published fortnightly and appears on the front page of the adult’s section of the Care Hub.

The Sutton Care Hub can be accessed with the link below:

Sutton Care Hub

Sutton Information Hub

The Sutton Information Hub is a new website that provides residents with a single place to find information about local groups, clubs, services and support relevant to them. The website will also ensure that professionals in the borough have access to an up to date list of services in the borough, enabling them to better inform residents they are working with. 

The link below provides information about the Hub.

https://suttoninformationhub.org.uk/about

We are encouraging all providers that deliver services in Sutton to register on the Information Hub to market and promote their service to Sutton residents.

Market Opportunities

During 2023/24 proposals will be developed to prepare for the reprocurement of Extra Care Housing and Supported Living services in accordance with relevant strategies and associated commissioning intentions. New market opportunities will also be offered as part of the implementation of the Care Home Joint Commissioning Strategy Delivery Plan. 

A key focus of above will be the need to develop specialist accommodation options for young people in transition with complex needs (principally related to learning disability and autism). Options could include providers redesigning existing services, new services in a purpose built property and Sutton tendering for a service (perhaps involving neighbouring Local Authority / NHS commissioners). 

During 2023/24 commissioners will develop a service model(s) / specification(s) to support the above options, which could involve consideration of a hybrid model of care consisting of short term residential / supporting living focusing on moving people along an accommodation pathway to greater independence. Key service components may include:

  • Improved access to short breaks provision such as respite care and short term placements
  • Residential service for young people leaving residential college (>25 years of age)
  • Placements for people with a learning disability who have forensic backgrounds
  • More residential / supported living provision for people requiring ground floor accommodation due to serious mobility issues
  • Residential / supported living service for young people with ASD (>35 years of age) and exhibiting behaviours that challenge
  • More residential provision for younger adults with severe physical disability

Contact Us

Please contact us if you have any queries or questions in regard to this Market Position Statement.

We can be contacted on the email address below – please add ‘Market Position Statement’ to the email subject.

asc.providercomms@sutton.gov.uk