Market Position Statements (MPS)

Market Context 

The Home-Based Support Service (Homecare) provision consists of a range of services that are put in place to support an adult to remain in their home. The carer who works for an agency provides support and completes tasks that aid an adult to remain independent and safe.  

The type of tasks can vary from personal care, administering medications or supporting the adult with activities. However, their primary role is to maintain the adult’s quality of life and support them to meet their outcomes.  

The length of Homecare provision is dependent on the needs of the service user but is mainly long term. It is commissioned from the new Homecare Framework contract. 

There are existing service users who continue to receive Homecare services from the previous homecare contract known as the Dynamic Purchasing System (DPS). 

From time to time, where care cannot be sourced from the new Homecare contract framework providers, a spot purchase contractual arrangement is used. 

Current Market Status 

The new Homecare framework contract commenced in October 2022 and has a 4-year term, with the 10 providers working across 5 geographical lots for the provision of homecare. 

The framework provides support for adults and children’s personal care for new referrals with an hourly rate range from £17.17 to £18.20. 

Providers on the previous DPS framework do not receive care packages but continue to service the care packages that they currently hold at an hourly rate of £15.38 to £16.14. 

It has been noted that providers are meeting demand for Homecare through various recruitment drive initiatives. This has included the recruitment of carers and staff from overseas which has enabled providers to build capacity. 

Market Data and Insight  

As 1st January 2024, there were circa 829 service users across 10 providers receiving a total of 11196.74 hours of support per week. 

The Table shows the total number of providers across the new homecare framework contract in addition to the existing DPS contract. 

 Distance from Vision 

The Council’s strategic ambition to drive up quality in the market and to work more closely and collaboratively with fewer providers is being achieved. The DPS contract had some 45 providers as compared to the 10 providers on the new homecare framework.  

The intention is to move the majority of the care packages from the DPS providers to the new homecare framework contract and only use spot providers when there is insufficient capacity within the new framework. However, it is not the Council’s policy to  remove care packages from the DPS providers unless there are serious concerns with the service delivery, and it is deemed that there is a high risk to our residents. 

Market Risks 

Key risks that will need to be managed over the next three years include: 

• Hand back of care packages when it is not viable for non-framework providers to work with us.  
• Inflationary and cost of living pressures. 
• Workforce recruitment and retention challenges.  
• Ensuring there is capacity to support the market within framework providers for new referrals and to support service delivery across the E4 postcode.  

Current Areas of Focus 

We will work with providers on the framework to develop their service offer and support them to embed within our integrated Care Closer to Home (a health system that is proactive, provides personalised care closer to where people live and is embedded in communities) and Home First model of care (providing patients with support at home or intermediate care). 

Providing patients with support at home or intermediate care. 

We will work with Care Provider’s Voice to understand how to support and sustain providers and ensure a sustainable market.  

Developing capacity in areas such as E4 and ensuring we have capacity to meet specialist needs as required.  

Commissioning Intentions 

Driving up high-quality Home Care is key to supporting residents to remain well and independent at home for as long as possible. Commissioners are seeking to develop a model of home care that is supported by a proactive approach to support enablement, supporting independence, health and wellbeing and empowering our local community to have control over the support they receive.  

The Commissioning Model also works to enable choice from a variety of quality assured providers who are able to meet challenges in the sector. The Council aims to utilise this model to support providers in valuing its workforce – ensuring good pay, conditions, and development opportunities for staff.  

On a wider scale, the model aims to contribute to the local community and economy, delivering excellent social value. Quality Homecare enables people to stay and live well in their own homes for as long as possible – reducing demand for care home placements.  

To continue to support this, commissioners work collaboratively with providers who share this vision, are person centred, and outcomes focused. Building relationships and supporting provider challenges via regular meeting forums and engagement. 

Commissioners are scoping arrangements to increase providers and develop an outcomes focused Reablement and Homecare pathway and service specifications within the current model. The aim is to create an outcomes-focused Homecare model working jointly with health, social care, and provider partners.  

Further information will be published via provider engagement during 2024. It is hoped this approach will provide a more personalised and shared service for residents, make better use of community resources, create a more trust-based approach with providers and improve local employment opportunities in the sector.