Community Services – Day Opportunities

Last Updated: 19 July 2023

Where are we now

Day opportunities are an essential part of the health and social care landscape, providing support to local people of both working age and beyond.

Services work with people, many of whom may be vulnerable through age, frailty or disability, providing social contact and activities during the day. Such services can improve health and wellbeing, helping people to stay independent for as long as possible.

Service models vary – from ones where the services take place within a building to those where the focus is upon helping people to access community facilities. Services may have a focus upon leisure or be more structured and, for example for younger adults, be based upon gaining skills which might lead to accessing or a return to education and training and also employment.

Sutton applies a ‘lighter touch’ to day opportunities which, rather than entering into a series of contracts, increasingly supports people to make their own choices over where and how their care and support might best be met. To this end, we are encouraging individuals and their families to use our new Sutton Information Hub where they can view local services provided by service providers registered with the hub, to see what the service offers. We are also encouraging service providers (and those who may be thinking of providing day opportunities) to explore the hub and where appropriate, register.

Whilst traditionally people may have attended day services for a full week, people are increasingly selective over days or sessions attended, perhaps complementing other services and or activities.

Sutton supports individuals to access day opportunities in two ways; either through the Council paying a provider directly for the service or via a direct payment paid to an individual to make their own arrangements. Direct payments are payments made to individuals who have been assessed as needing help, and who would like to arrange and pay for their own care and support services.

As at May 2023, there were 27 providers providing services to those individuals Sutton for whom Sutton pays directly. Individuals receiving direct payments can choose to mix the services they buy and can opt to increase or decrease use/frequency of services in line with what they decide best meets their needs. Additionally, the Council recently worked closely with Community Catalyst to pilot a scheme for the development of community micro enterprises within the borough.

The cost of day opportunities are variable, depending upon the services provided, the intensity of support that may be required and the business model applied, including, for example, where other services provided contribute to service overheads. For individuals with a direct payment, comparative costs along with factors such as quality, activities offered etc. will be a factor in decision making to use a particular service. As at May 2023, the approximate total weekly cost of day opportunities to the Council was £58,470 of which approximately £29,930 was paid directly to providers and £28,540 to individuals via direct payments.

Our Day Opportunities Market

Currently the Council supports 290 people using day opportunity services, 138 are using day services paid for directly by Sutton and 152 are in receipt of a direct payment with a day service element.

Diagram 1: Service User Age and Gender

Source: Adult Social Care Sutton (May 2023)

Of the 290 individuals accessing day services either directly or via direct payments, 154 (53.1%) are male and 136 (46.9%) are female. There are 56 individuals aged 18-25, of whom 43 are male and 13 are female; 104 aged 26-49, of whom 66 are male and 38 are female; 31 aged 50-64, of whom 15 are male and 16 are female; 29 aged 65-74, of whom 12 are male and 17 are female; and 70 aged 75+, of whom 18 are make and 52 are female.

As part of the adult social care assessment process, individuals who are identified as having an eligible need for ongoing care and support have their ‘primary support reason’ identified and recorded. Individuals may have a number of identified needs, however a primary reason for support will always be identified.

Diagram 2: Service User Primary Support Reason

Source: Adult Social Care Sutton (May 2023)

Learning Disability Support is the recorded primary support reason for 190 (65.5%) of individuals, followed by Physical Support for 57 (19.7%), Support with Memory & Cognition for 24 (8.3%), and Mental Health Support for 13 (4.5%). Other primary support reasons include Sensory Support and Social Support.

The graphs below show that those individuals whose day support is paid directly to the provider are generally older and more likely to be female than those who are receiving a direct payment only.

Diagram 3: Age and Gender of Individuals Receiving Day Support Paid Directly to Provider

Source: Adult Social Care Sutton (May 2023)

Of the 138 adults, 74 (53.6%) identify as female and 64 (46.4%) identify as male. Only 47 (34%) are below the age of 50 of which nearly two thirds are male. Conversely, of the 91 adults aged 50+ just under two thirds are female.

Diagram 4: Age and Gender of Individuals Receiving a Direct Payment with Day Service Element Recorded

Source: Adult Social Care Sutton (May 2023)

Of the 152 adults receiving direct payments, 62 (40.8%) identify as female, and 90 (59.2%) as male. Nearly three quarters (113) are below the age of 50, of which 70% are male. Conversely, of the 39 individuals aged 50+ 71% are female.

The graphs below show how the breakdown of the recorded primary support reason for each of these cohorts differs.

Diagram 5: Primary Support Reason of Individuals Receiving Day Support Paid Directly to Provider

Source: Adult Social Care Sutton May 2023

Learning Disability Support is the recorded primary support reason for 77 (55.8%) of individuals, followed by Physical Support for 30 (21.7%), Support with Memory & Cognition for 15 (10.9%), and Mental Health Support for 10 (7.2%).

Diagram 6: Primary Support Reason of Individuals Receiving a Direct Payment with Day Service Element Recorded

Source: Adult Social Care Sutton (May 2023)

Learning Disability Support is the recorded primary support reason for 113 (74.3%) of individuals, followed by Physical Support for 27 (17.8%).

Where we want to be

We would like to see accessible, affordable services as close as possible to where people live. The services should offer quality and person centred support that avoids a ‘one size fits all’ approach but is as far as possible tailored to individual needs, helping people achieve greater independence, choice and improved wellbeing.

Services will promote greater inclusion and participation with a greater expectation that people will be actively supported to be part of their communities, having access to community based resources and everyday services such as support to use local leisure centres, cafes etc. and to utilise their own skills to deliver their own service as a part of the day opportunities offer.

We wish to promote services that can show that their approach to planning and delivery is collaborative and reflects national best practice. This will be evidenced through feedback from people who use the service and professionals who make the referral for support.

Challenges and Market Influencers

There are few of us who are not affected by the recent marked increases in costs of living which have in turn affected the costs of services. Against this background it is evident that providers are seeking a range of funding solutions and the efficient use of resources as well as creative staffing recruitment strategies.

The move to a more person centred approach to services does pose some challenges to a more traditional model of services, balancing group activity with individualised opportunities within our community. This requires greater flexibility in the deployment of staffing and increased knowledge and co-ordination and working with community based resources.

With day opportunities being based increasingly upon individual decision making and choice, day services are experiencing demand from a collection of individuals choosing to purchase their services, rather than, for example, the Council commissioning a set number of places for a given period. This means that attendance and income for day opportunities providers can be variable.

Need and Demand

Demand is seen in particular areas and is noticeable in younger adults wishing to access more active services which provide choice with the ability to undertake activities with those with similar interests.

Our Joint Strategic Needs Analysis tells us that the population of the borough is growing. Between 2011 and 2021 we saw an increase of 9.6%. A higher proportion of Sutton’s population are under the age of 18 than the London and England average with growth among school age children being particularly high. The proportion of Sutton’s children with an Education, Health and Care Plan has increased to 4.7%. Overall, 2685 adults in Sutton are receiving long term support from Adult Social Care in 2021/22, an increase of 12% from the previous year.

The borough profile indicates the continued and growing need for day opportunities for young and older adults. We are therefore keen to promote services which are attractive to people who will require day opportunities, many of whom may be making their own decisions about how and where their care and support needs might be met. This provides both a challenge and an opportunity to the market.