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July 2014

The Act introduces number of reforms concerned with the adult social care market.
Dual focus on promoting and facilitating the growth of a market of quality services, and providing protections for people should their provider fail financially – including a new function for CQC.
Market shaping
Section 5
Market shaping and commissioning
Provider failure
Sections 48-52
Managing provider failure
Definitions of business failure
Market oversight
Sections 53-57
Entry criteria
Group company info.
2 The Care Act: reforming care and support

Duty on local authorities to promote a
sustainable, diverse and vibrant market for care and support that delivers high
quality services for all local people.
– Focusing on outcomes and promoting wellbeing
– Promoting choice to drive quality
– Supporting sustainability
– Working with partners and people who use care/carers
– Approaches to market intelligence and facilitation
– Importance of workforce development and pay
– Securing quality and outcomes through contracting
Local authority
Strategic commissioning
Market Position
Statements
Market interventio n
M a r k e t
Vibrant Diverse
Sustainable
A L L L O C A L P E O P L E
3 The Care Act: market shaping

DH has funded the Developing Care
Markets for Quality and Choice
(DCMQC) programme, delivered through the Institute for Public Care.
More information available at: http://ipc.brookes.ac.uk/dcmqc.html
Support available to local authorities to develop capacity to shape local markets through:
Market intelligence
Market structuring
Market interventions
4 The Care Act: reforming care and support

• 126 local authorities have either published or are about to publish a Market Position Statement (MPS)
• Facilitated provider engagement events
• A better understanding of self-funder market through development of a toolkit for estimating self-funder use of home care services
• Identification of potential future implementation support programmes
5 The Care Act: reforming care and support

• DH funded; ADASS/LGA led through Think Local Act Personal group
• Delivery by Birmingham University Health Services
Management Centre
• Co-production with local government & sector
• Set of standards to be used as part of sector-led improvement process led by LGA
• Aim of understanding and spreading best practice for local government commissioning of social care
• Standards will be tested with local authorities later in the year; final delivery by end of 2014.
6 The Care Act: reforming care and support

Local authorities manage small scale provider failure effectively, and that most exits from the market are handled responsibly by providers.
Duty to step in to ensure that no vulnerable person is left without the care they need if their service closes because of business failure.
• Emphasis on contingency planning.
• Relationship with new CQC regime for certain providers.
• Determining the most appropriate support for the person.
Business failure
• Registered provider enters administration, receivership, liquidation etc.
Service closes
• The provider can no longer carry on providing services.
Local authority duty triggered
• Local authority informed and steps in to meet care and support needs for ‘as long as it deems necessary’.
• Flexibility to determine how needs are met.
• Duty applies in respect of all local people.
7 The Care Act: provider failure

Southern Cross demonstrated potential effect of a large provider failing financially.
CQC to begin monitoring the financial sustainability of those 50-60 providers local authorities would find difficult to replace were they to fail from April 2015.
Aim is ensuring continuity of care and early warning, not propping up failing providers.
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CQC will engage with stakeholders to develop its operating procedures for the new regime. Consultation on CQC’s proposed approach in autumn 2014.
– Regulations specify which “difficult to replace” providers are included – the entry criteria
– Requirement for CQC to assess financial sustainability – regulations allow CQC to look at finances of organisations in providers group to assess sustainability
– Powers for CQC to require contingency plans, or an independent business review
– Requirement to inform local authorities when failure is imminent for a provider in CQC regime, and to support local planning.
The Care Act: Market Oversight

We invite views on the entry criteria to the market oversight regime ,and whether and how it should be made simpler for residential and non-residential care providers
We invite views on the approach to defining business failure by reference to insolvency situations
We invite views on the insolvency situations listed e.g. are they appropriate and clear?
Should other situations be covered?
Are they appropriate and relevant to the various legal forms registered providers can take?
Does the statutory guidance provide a framework to support local authorities and their partners to take new approaches to commissioning and shaping their local market?
Are there any further suggestions of case studies or tools that can assist local authorities in carrying out their market shaping and commissioning activities.
9 The Care Act: Market Oversight