Update on Market Position Statement

1. Update on Market Position Statement SCA Care Home Providers Network 24 September 2013

2. 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

3. 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

4. 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 homes • 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

5. Residential and nursing care – the financial context for Surrey County Council

6. The residential and nursing care market for older people As at April 2013: 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.

7. 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:

8. 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

9. 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” developments • 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

10. 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

11. 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

12. 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 publicised? • How would you like the Market Position Statement to be made available? • As a document? - Through its own website? • Do you have any further thoughts on content to be covered?