John Woodroffe Market Position Statement

Update on
Market Position Statement
SCA Care Home Providers
24 September 2013
A recap
• A Market Position Statement is a document to help the
market plan its future role and function
• Produced by the local authority, with partners, to inform the
whole market, regardless of funding source
• Outlines future supply and demand, market opportunities and
future care models
• An initial discussion was held on this subject with:
– Domiciliary Care Providers Network – 7 May 2013
– Care Home Providers Network – 18 June 2013
What’s in the Market Position Statement?
Although the Market Position Statement will be focused on older
people, the scope is broad!
• Overarching strategies – Ageing Well in Surrey and
Dementia Friendly Surrey
• “Generic” services used by older people
– Direct payments
– Guidance and advice services
– Carer support
• “Traditional” services
– Home based care
– Residential and nursing care
• Innovation & the future of care
– Localism & development of social capital
– Impact of new government funding proposals
What you told us...
• Serious challenges in recruiting qualified nursing staff
• Occupancy is an issue for some residential and nursing care
home operators
• Concerns clearly expressed about the potential arrival of new
residential and nursing care developments near existing
• Home based care (HBC) – outline of challenges as shared in
previous presentations
• Reasons given by HBC providers for not bidding to be on the
SCC framework:
– Timeliness of payments
– Travel costs
– Concerns over lengths of funded visits
– Size of business
• All: more face to face contact with SCC Commissioning staff 4
Residential and nursing care – the financial
context for Surrey County Council
The residential and nursing care market
for older people
As at April 2013:
Care home type
With nursing
No. of care homes
No. of beds
Surrey County Council’s “market share” was approximately:
• 25% of the whole market
• 38% of all residential care places
• 17% of all nursing care places.
The remainder can be accounted for by:
• Self-funders
• Recipients of Continuing Care Funding from the NHS
• Other local authorities; and
• Vacancies.
The residential and nursing care market
for older people
Relatively strong focus on self-funders than elsewhere in England
– countrywide estimates for self-funders range from 40% - 50%+
Under the current funding system it can be expected that the
relative level of self-funders will rise, given Surrey County
Council’s focus on supporting people at home for longer:
The future?
• Given demographic change, Surrey County Council is likely
to see a future increase in demand for funded residential and
nursing care
• Care funding reforms will require Surrey County Council to
have a proactive role in supporting people, regardless of
financial situation, to make care choices:
– Assessments
– “Independent Personal Budgets”
– Support for self-funders who do not wish to arrange their
own care
• Government drive towards more integration with health
means that SCC is exploring the commissioning of services
in partnership with CCGs
The limits of our knowledge
Currently, we do not have a clear understanding of:
• Occupancy in the wider market. This has planning
implications for residential, nursing and “retirement village”
• The capacity of the market to absorb future care demands
• The current levels of third party top ups, and deferred
payments, amongst SCC funded placements
• The challenges faced in recruiting qualified staff, particularly
for nursing care, beyond anecdotal evidence
• How the Government funding proposals will affect the future
demand for care, regardless of funding situation
Broad messages
Surrey County Council needs to:
• Continue working with Borough and District planners to help
evaluate local planning applications
• Develop a mechanism for providers to advertise spare
capacity to SCC staff and care brokers (bearing in mind
business sensitivity)
• With providers, establish care models which support a
continuum of care through to end of life care, and which
promote excellence in dementia
• Support CCGs in the establishment of local care home
forums, which will examine local quality of care issues and
work to reduce “avoidable” hospital admissions
• Develop a better understanding of future demand for
residential/nursing care, including levels of third party top-ups,
number of people funded by the NHS etc
Broad messages (cont.)
Surrey County Council needs to:
• Calculate a “fair cost” of residential and nursing care under the
Government’s future funding proposals. This will be done
together with providers through a Market Development Group
• Develop a better understanding of barriers to training and the
challenges faced in recruiting appropriate staff. This will form
part of the work on Surrey’s Workforce Development Strategy
• Explore the development of small- to medium-sized block
contracts to create an additional supply of Council- funded
residential and nursing care beds
What do you think?
• What should our approach be to the wider market, i.e.
providers supporting people not funded by the local authority?
• How would you like the Market Position Statement to be
• How would you like the Market Position Statement to be made
– As a document?
- Through its own website?
• Do you have any further thoughts on content to be covered?