Adult Social Care Market Position Statement

Adult Social Care works in an environment that requires it to set local plans and ambitions by working in partnership with local stakeholders and delivering on national obligations. The Adult Social Care Strategy 2021-25 sets out the collective vision to ensure that people can get the right level and type of support at the right time to help, prevent, reduce or delay the need for ongoing support and maximise their independence.

This vision is underpinned by 4 strategic priorities:

• to provide support to people to prevent, reduce or delay the need for ongoing support and maximise their independence
• to ensure people can get the right level and type of support at the right time
• to develop and support our staff and to support providers of social care services to develop and support their staff
• to work with, and within, communities

The Adult Social Care Strategy is a vital part of the plan for the Borough as we are setting out our vision and plans to provide support and care for the people who need it. Collaborative working across Stockton-on-Tees Borough Council (the Council) and with partner organisations is key; we will be working with others to drive forward the plans identified in these strategies to make sure that together they deliver the greatest possible benefit to the people of the Borough. We want the people in our Borough to feel connected to their communities, for people to feel safe and for people to live the most fulfilled and happy life they can.

Details of the Adult Social Care Strategy 2021-2025 and the strategic planning framework that underpins this strategy can be found at Stockton on Tees Adult Social Care Strategy 2021 to 2025. (PDF) [8MB] .

The Adults Supported Housing Market Position Statement August 2024 brings together information about the local market so that current and prospective partners understand the local context, what is likely to change, and where opportunities could arise.

The Council is committed to working closely with providers, stakeholders, and people who access our services to ensure engagement, particularly in relation to shaping the market together, is meaningful, timely and appropriate. 

Our engagement going forward will include:

• regular meetings with providers that will be specific to key market sectors, for example, residential care, home care, day opportunities
• reciprocal meetings to allow feedback from providers and allow sharing of information and ideas relevant to the market and enabling current and new providers to plan their future business more clearly
• a Lived Experience Coordinator to understand the voice of people accessing our services, to help shape and improve future services, and providing feedback to the market
• a 'Making It Real Board' board to help shape services, which is made up of people with lived experience who have, or will, access Council adults and health services
• separate but specific engagement where there are specific challenges in a geographical area or in a particular sector of the market, to ensure 'place' and its nuances are recognised
• partnership meetings with people with learning disabilities and people with autism to enable us to listen and consider their views to help influence service development
• consultation with other groups and partnership boards where appropriate

For 2023, the Council's future planning and strategic vision in relation to Adult Social Care and support services will focus on several key priority areas.

The Market Position Statement (MPS) bring together information about the local market so that current and prospective providers understand the local context, what is likely to change and where opportunities might arise in the future. Specifically, it will help providers to identify opportunities that they may tender for; and develop their services to meet local need and demand. Providers will need to register their interest via North East Procurement Organisation (NEPO).

The MPS will help providers shape their business plans to support the Council's vision for the future of local public health, social care, and housing markets. It sets out the key pressures for Adult Social Care and our vision for the future. It also sets out the system pressures within the health and social care sector across the Integrated Care System (ICS).

This document has been produced with input from several internal and external stakeholders, including service providers, and sets out the direction of travel for Adult Social Care during 2023 to 2026.

Profile

Stockton-on-Tees is home to over 196,000 people and comprises of 7 townships (Stockton, Billingham, Thornaby, Yarm, Eaglescliffe, Ingleby Barwick and Norton). Each township has their own distinct characteristics influenced by industrial and historical legacies, the built and natural environment, and the diversity of the communities that reside within them.

There is a strong sense of community in Stockton-on-Tees and there are many valuable assets within the Borough, including community leaders and organisations who know their area well and understand its strengths and challenges.

Stockton-on-Tees has areas of great affluence existing alongside some of the most deprived areas in England. The most recent health profile for Stockton-on-Tees highlights that many children do not get the best start in life and many adults experience more ill-health and admissions to hospital compared to the national average.

Life expectancy for people living in Stockton-on-Tees is below the national average with big difference in life expectancy between the poorest and wealthiest areas in the Borough. Residents of Billingham West ward (males = 85 years, females = 88 years) are estimated to live up to 21 years longer than residents of Stockton Town Centre ward (males = 64 years, females = 74 years).

Healthy life expectancy for people living in Stockton-on-Tees is also below the national average and residents of the least deprived areas of Stockton-on-Tees are expected to be healthier for up to 20 years longer than those from the most deprived areas. This means that people living in more deprived areas live shorter lives and are becoming ill at a much younger age than their more affluent neighbours.

Population

The total population in Stockton-on-Tees is 196,600 (source: ONS 2021) a rise of 2.6% since the 2011 census, however, this is lower than the overall increase for England (6.6%). The population in Stockton-on-Tees is estimated to rise to 200,444 by 2030.

Population projections up to 2030 show that there will be a consistent increase in the population of people aged 65 and over in Stockton-on-Tees, in particular with people aged between 65 to 69 and 80 to 84.

In the financial year 2020-21 the Council spend on Adult Social Care services was just under £56 million. The table below shows the comparison of spend by social care services from financial years 2018, 2019, 2020 and 2021.

The Council, partners and stakeholders continue to work within a challenging economic climate which will require all stakeholders to embrace the opportunity that innovation, efficiency and new models of care and support offer. In Stockton-on-Tees there is a continued focus on early intervention and prevention to maintain independence and give choice and control to individuals supported by greater access to good information and advice.

The highest proportion of spend in 2021 was for services for older people and those with a physical disability, followed by home care which includes learning disability and mental health.

The population projections for people 65 and over will continue to rise and we can expect that spend for this proportion of people will also increase, without the right and appropriate intervention.

Figures from Skills for Care estimated that in 2021 Stockton-on-Tees had 5,500 Adult Social Care jobs employed in the local authority and independent sectors. These include 375 managerial roles, 225 regulated professionals, 4,000 direct care (including 3,400 care workers), and 850 other non-care roles. Around one quarter (27%) of the workforce in Stockton-on-Tees were on zero-hour contracts. Around half (52%) of the workforce usually worked full-time hours and 48% were part-time.

Factors affecting turnover 

Across England, variables that influence the likelihood of a worker leaving their role were:

• workers who travelled further were more likely to leave
• those under 25, and over 60 years old, were more likely to leave their posts
• turnover decreased with higher levels of experience working in the sector
• likelihood of leaving decreased as pay levels increased
• likelihood of leaving decreased with higher levels of experience in role
• likelihood of leaving decreased if workers had more training
• turnover decreased if workers had a higher number of contracted hours
• likelihood of leaving decreased if workers had fewer sick days
• workers on zero-hour contracts were more likely to leave their posts
• likelihood of high turnover rates increased if the establishment had high turnover historically

Source: Skills for Care

Skills for Care estimated in 2021 the staff turnover rate in Stockton-on-Tees was 17.6%, which was lower than the regional average of 25.0% and lower than England, at 29.5%.

With the Council's links with the Adult Social Care sector and stakeholders we know that recruitment and retention is one of the largest issues faced by providers. Skills for Care have many resources and tools available to help. For more information, please visit the Skills for Care website. 

In addition to our internal monitoring information gathered from ongoing assessment information, provision of services, quality monitoring and engagement with providers and partners, we also use data and intelligence from the following sources to help us understand the care and support needs of the people in Stockton-on-Tees. These data and intelligence sources are freely available to providers by following the links below.

Joint Strategic Needs Assessment (JSNA)

The JSNA helps the Council and other partners inform the planning and improvement of local services and guides us to make the best use of funding in commissioning services. It identifies and defines the wider health and wellbeing needs of the people of Stockton-on-Tees. It brings together in one place information, statistics, data, and analysis and enables the widest spectrum of partners and organisations (whether public, private or VCSE) to have the intelligence they need to ensure health and social care strategies, commissioning, and service delivery work together for better provision of services for areas of greatest need. The key messages from the JSNA can be found on the Tees JSNA website.

Stockton-on-Tees health profiles

This profile gives a picture of people's health in Stockton-on-Tees. It is designed to act as a 'conversation starter', to help local government and health services understand their community's needs, so that they can work together to improve people's health and reduce health inequalities. These are available on the Local Authority Health Profile website.

Stockton-on-Tees ward profiles

Ward profiles provide information on a range of metrics, covering adult social care, health, housing, communities and regeneration. These are available at on the Ward Profile page on the Council's website.

Shared Lives

Shared Lives is an alternative to traditional types of care and support available to adults with care and support needs. In Shared Lives, a person lives, or stays with a Shared Lives carer within the local community. The Shared Lives carer provides the care and support in their own family home and as part of their own family and community network.

Current market intelligence 

The Stockton Shared Lives Scheme was brought in-house in January 2022, transferring existing provision from the previous provider.

We currently have 11 active shared lives schemes.

Shared Lives is a fantastic alternative to some of the more traditional services. Providing an opportunity for people who require care and support to live independently in the community and can be an alternative to living in a care home, housing with care or housing with support.

The Shared Lives scheme matches people who need care and support with an approved carer. The carer shares their family and community life and gives care and support to the person with care needs. Some people live with their Shared Lives carer, while others are regular day-time visitors. Some people combine day-time visits with overnight stays.

How we propose to shape the market

We propose to grow the provision by a further 10 Shared Lives placements over the next 3 years.

How we will achieve this

A robust recruitment campaign, targeting different audiences as we want to attract potential new carers into the service, including people who are already employed in the care sector, who may be able to provide a short break or respite support, whilst receiving some additional income.

The service will actively promote the benefits of both working as a Shared Lives carer and for service users utilising the scheme via partners and amongst the general public.  

The service will develop robust training and support package for shared lives carers to enable them to develop and retain them within the sector.

We are working alongside Shared Lives Plus (SL Plus) and Social Finance to look at Shared Lives as a model for respite for informal carers looking after those on the dementia pathway. If successful, Shared Lives could be used as a model to meet the needs of those living with dementia and their carers in an alternative environment to residential care, providing support on a 1:1 basis that is personalised and cost effective, producing positive outcomes for all involved.

Housing with Care

Housing with Care combines accommodation with care and support services. It comes in many forms, from small communities of flats and bungalows to retirement villages. The facilities and care provided will vary, but Housing with Care schemes usually include self-contained adapted flats or bungalows.

Current market intelligence 

In Stockton-on-Tees there are four Housing with Care schemes for older people and two for people with complex care and support needs (which will be part of a future Supported Living framework).

As of April 2023, there were 173 occupied extra care units of accommodation.

There is currently a nominations process managed by our Strategic Housing Team. The current nominations process started in 2021.

In 2021 there were 27 referrals to the waiting list.

In 2022 there were 67 referrals to the waiting list.

In 2023, 63 referrals were received. Five of these were from out of area.

Up to the end of May 2024, we have received 34 referrals. All of these are from in-area.

How we propose to shape the market

We have finalised the model for Housing with Care and a new service will start from October 2024.

We produced an agreed specification, specific to Housing with Care services in conjunction with our clients, their families or carers, and stakeholders. Engagement has taken place with residents regarding what is important to them about living in Housing with Care schemes.

We have a consistent waiting list for Housing with Care placements (36 as of March 2024) with priority always given to those that can demonstrate a local connection to Stockton-on-Tees.

We have growth in the aged population and the current criteria we attach to Housing with Care is over 55 years although this does have some flexibility. We do also recognise a slightly younger cohort of customers who otherwise would be eligible and suitable for Housing with Care provision. We are committed to developing more supported accommodation and we would be interested in looking at options for developing additional Housing with Care Services potentially with flexible approaches to meet the needs of a range of people.

Mental health

Mental health residential care home provides accommodation together with personal care providing 24-hour care and support.

Current market intelligence 

Stockton-on-Tees has six homes offering 81 beds. All of these currently come under the Residential Care for Older People framework and the Specialist Mental Health Accommodation Framework. 

There are also 21 Supported Living Schemes where people with a range of support needs, including mental health support needs and learning disabilities, live as independently as possible.

There are a number of people with long term placements within these Mental Health accommodation settings. In addition, there is a recognised need for additional significant and highly complex mental health residential support for individuals within the Borough.

In 2023 to 2024, 261 Mental Health Placements were made (excluding Discharge Support Services and Respite) which included supported living and care at home. 35 of these were out of Borough placements and 37 placements were made to Mental Health Residential settings in Stockton-on-Tees.

All our Mental Health Registered Care Homes in the Borough were rated as 'Good' by CQC in 2019 to 2020. When comparing this to 2021 to 2022 one home has now been rated as 'Inadequate'.

How we propose to shape the market

Following a review of the current provision for those individuals with significant and highly complex mental health support needs a new specification was produced and agreed and went to the market in March 2024.

The framework is aimed at support provision for people who require significant and highly complex mental health residential support services. The aim of this framework is to support commissioning work with interested suitable providers to deliver small scale schemes set around the agreed specification to meet individual support needs. This work will also link to the Housing LIN Report recommendations.

We will continue to work with our existing Mental Health Residential Care Homes and Older People's Care Homes to ensure the standards are improved and maintained where necessary and to ensure that they are providing the right residential environment for those individuals who live within them.

We will continue to work with providers across the market to design services to meet the needs of people within Stockton-on-Tees.

We work closely with our Strategic Housing, Public Health and Voluntary and Community Sector colleagues to help develop and support mental health initiatives and services including a Stockton-on-Tees Wellbeing Hub which will provide wellbeing support in the community following its launch in summer 2024.

We are looking to bring our Supported Living Schemes under a specific framework to ensure consistency where possible while still maintaining person centred care across these services.

Learning disabilities residential care

Learning disabilities residential care homes provide accommodation together with personal care providing 24-hour care and support.

Current market intelligence

Stockton-on-Tees has 16 homes offering 137 beds, with a total of 84 people accessing support in 2023 to 2024 in the Borough and 49 people accessing support out of Borough.

There will be an estimated 2,827 adults with a learning disability aged 18-64 years living in Stockton-on-Tees. This number is not expected to increase significantly over the next 5 years. Autism is the largest associated condition among children with learning disabilities coming into adult services, followed by physical disability.

The Council has engaged with the market twice in 2022: once across Tees Valley with neighbouring local authorities and the other to engage with providers on the local requirements for 2023 and beyond.

How we propose to shape the market

The Council is looking to use the existing Learning Disabilities Residential Framework to work with existing providers and encourage new entrants to the Stockton-on-Tees market to address needs in:

• settings with dedicated and bespoke support that work to support a person to move to greater independence at all points of the individual's life course
• specialist or autism specific setting for individuals with the most complex needs
• all-female unit for sexual disinhibition or personality disorder or autism with complex behaviours
• option for an all-male forensics' unit
• planned local emergency respite provision

Older people's residential care

A care home is a residential setting where a number of people live, providing care and support 24 hours a day.

Current market intelligence

The market for older people's residential care in Stockton-on-Tees remains one of contrast: whilst older people's care home providers are delivering good quality in the main, the market has too many beds for our local population needs which is impacting on overall occupancy, service improvement and viability of some homes.

There are a total of 30 older people's care homes in Stockton-on-Tees offering 1,577 beds. In 2021 to 2022, 911 people were accessing care and support.

As of April 2022, we had 1,629 beds under contract, with 18% vacancies (although there are some significant outliers across the market with 9 homes with greater than 92% occupancy and 3 homes with 30% or more vacancies). Annual gross spend is circa £21.5m (£13.6m net).

Overall quality, when compared to the national averages for 2022, demonstrates a lower percentage of Stockton-on-Tees residential and nursing homes have been awarded Good or Outstanding rating by CQC.

How we propose to shape the market

We will be retendering for a new Older People's Care Home Framework (2024 to 2028) which will be in place by 31 March 2024.

The scope of the retender will be all current Older People's Care Home Providers currently on the 2020 to 2024 Framework who wish to register their interest including other care homes, registered for over 65 care / dementia care that are operating with Good or better CQC rating who have an interest in tendering for the 2024 to 2028 framework.

We will ensure the new framework reflects the work undertaken through the Fair Cost of Care and is sustainable and affordable.

We will ensure the new framework builds on successes on 2020 to 2024 Framework and acknowledges future challenges.         

We will ensure the new framework is effectively co-produced with input from key stakeholders and partners.

Care at home

Care at home provides support to an individual in their own home and is available to those that require additional support with day-to-day household tasks, personal care or any other activity that allows them to maintain their quality of life and independent living.

Current market intelligence 

In 2022 to 2023 we supported approx. 1,096 people to live independently at home, delivering over 70,240 hours annually at an annual gross cost of £14.1m.

We have 26 providers on the Care at Home Framework (including some providers whose offices are outside Stockton-on-Tees), who deliver home care services for older people, people with dementia, learning disabilities and mental health. Of those providers on the framework, 96% who have a current CQC rating were assessed as Good or Outstanding.

Includes care at home for those in prison via Spectrum CiC. Circa £100k.

Recruitment is a significant challenge facing care at home providers and this can have a direct impact on delivering quality care. Nationally, some providers have adopted innovative approaches to recruitment, aiming to maximise retention looking at different approaches to recruiting the right people.

Using technological innovation to improve current service delivery is something which the Council is continuing to use and explore. This could see a person be better connected to a wider support system to improve quality, increase flexibility, and tackle issues such as social isolation.

How we propose to shape the market

We have finalised the model for Care at Home and a new service will start from October 2024.

We will continue to support recruitment and retention in the care sector using a variety of mechanisms, including development of sector-based Work Academy Programme, direct recruitment via the Employment and Training Hub, use of existing projects (for example the Well Led Programme), and the use of communication channels to promote caring as a career.

Alternative technological solutions such as assisting technology will have more of focus as a preventative tool and we will continue to look at different ways, we can deliver care and support in people's home.

Day opportunities

Day opportunities is a package of community-based day time activities which will engage adults with a learning, physical and/or sensory disability, providing person-centred support and maintaining people's independence.

Current market intelligence

In Stockton-on-Tees, day opportunities for adults are currently provided in three ways: 

• Stockton-on-Tees Borough Council's in-house day services
• Stockton-on-Tees Borough Council's commissioned day services from the independent or voluntary sector
• support purchased directly by individuals from the independent and voluntary sector using a direct payment

Day opportunities can be either building or community-based and offer opportunities for social connections, activities which promote wellbeing, skills development and greater independence, and respite or breaks for informal carers.

Day opportunities are accessed by individuals with a range of needs including older people, people with learning disabilities, autism, physical disabilities, and mental health needs.

The two highest primary support reasons for individuals accessing in-house and commissioned day opportunities are for people with a learning disability (48%) and Support with Personal Care (19%).

How we propose to shape the market

Between Autumn 2021 and Spring 2022 the Adult Social Care and Health Select Committee completed a scrutiny review of day opportunities for adults in Stockton-on-Tees.

The report and recommendations produced by the Committee were agreed by Cabinet in May 2022. The full report can be found on the Performance Review and Audit Select Committee document.

We propose to implement the recommendations from the review and to grow the range of options that are available to people with a particular emphasis on growing the range of community-based opportunities.

Transition into adulthood

Current Market Intelligence

Not all young people will require support from the Council when they turn 18. Upon transitioning to adulthood, what an individual receives will depend on their needs. The Council's aim for all young people is to maximise their independence, build on their strengths and networks of support, promote individual wellbeing, and enable them to maximise choice and control over their own lives. 

The number of children and young people looked after has changed by 15% over the last 5 years from 511 in 2018 to 590 in 2023.

The number of children and young people looked after within the 10 to 15 year age group has changed by 9% over the last 5 years from 211 in 2018 to 229 in 2023.

As a percentage of the total cohort, 10 to 15 year olds has reduced by 5% over the last 5 years from 41% in 2018 to 39% in 2023.

The number of young people looked after within the 16-17 year age group has changed by 84% over the last 5 years from 69 in 2018 to 127 in 2023.

As a percentage of the total cohort, 16 to 17 year olds has increased by 57% over the last 5 years from 14% in 2018 to 22% in 2023.

9.2% of children in need have a recorded disability (as of 31 March 2023) which is slightly lower than the mean for all unitary authorities (12.4%).

Percentage of pupils with an SEN is higher than the mean for all unitary authorities, both in terms of mainstream schools for children with a moderate learning disability (19.5% for Stockton-on-Tees and 17% for unitary authorities) and for special schools (20% for Stockton-on-Tees and 10.6% for unitary authorities).

How we propose to shape the market

Work is underway between Children and Families and Adults, Health and Wellbeing commissioners and social care teams to explore opportunities for young people going through the transition process to have a route into appropriate accommodation and support. 

Following an assessment of the market with the Housing LIN in 2022, we have established working groups to focus on identifying Registered Social Landlords or Housing Providers to provide high quality affordable accommodation for young people transitioning into adult services.

Specialist Housing Needs Assessment (2022) identified:

• up to 10 units of accommodation for vulnerable young people at risk or recovering from homelessness (by 2027)
• there is a need for move on accommodation in the form of one-bedroom flats when care leavers are ready to live independently, these properties need to be located in safe areas where young people will not be at risk of exploitation

The current Tees Complex Care and Support framework is designed to support people transitioning from children's services to adulthood. Commissioned in April 2023, we will continue to work with the market to ensure this delivers the right outcomes and timely support people need.

Reduce or eliminate use of short-term emergency provision, for our young people due to their vulnerabilities.

Have a clear pathway of accommodation options to meet the range of needs for young people 16 plus to assist them into early adulthood with stability and support.

Support providers who are skilled as advocates for young people, promoting their independence and self-care while supporting their journey into adulthood. Support providers who are adept at-risk management during transition.

Technology

Current Market Intelligence

Our current telecare service is One Call. The service includes the lifeline unit and pendant or the enhanced service that includes relevant assistive technology to enable the client to live independently. There are currently 5,141 people (as of 31 January 2023) receiving this support and it includes a mobile response service.

The Council is committed to an ambitious programme that will introduce new and innovative technologies and digital approaches, which enhance the experience and the outcomes the people who use the service.

How we propose to shape the market

Our approach to the provision of technology solutions for care and support needs to reflect the changing requirements in our population and the rapidly evolving market of technology.

The current gaps we believe technology could be an enabler and positive influence for change include:

• improving the consistency of technology enabled care as primary consideration as a means of achieving key outcomes or people through Strengths Based assessment planning
• increase the profile of technology solutions as an integral means of achieving care and support outcomes
• regular reporting to partners detailing the impact of timely and appropriate technology solutions as a means of achieving optimised care and support outcomes
• working with stakeholders to ensure that our catalogue of solutions is both currently appropriate to meet the needs of our client group and that it is sufficiently forward thinking that we will be able to maximise service user and self-funder independence
• supporting local partners to develop and pilot innovative care solutions alongside Stockton-on-Tees Borough Council
• work with our partners to educate stakeholders and the general public of available solutions to home automation, smart homes and care and support technology to ensure that products are well understood and adopted

Analysis from the Adult Social Care Annual Survey 2022-2023 tells us what people are saying about the services they receive in Stockton-on-Tees:

• 67% people who use services were satisfied with their care and support
• 72% of people who use services said they find it easy to find information about services
• 84% of people who use services say that those services have made them feel safe and secure

Carers Survey 2021 to 2022

Analysis from the national Carers Survey 2021-2022 provides an overview of the types of issues carers are facing:

• in Stockton-on-Tees the highest proportion of people care for someone who is between the age of 75 and 84 with the second highest of people who are aged 85+.
• 46% of carers in Stockton-on-Tees care for someone with a physical disability; while
• 26% care for someone with a learning disability or difficulty and 27% care for someone with dementia.
• 79% of carers said the person they care for usually lives with them.
• 30% of carers have been looking after or helping the person they care for for more than 20 years and 20% over 5 years but less than 10 years.
• 84% of carers said the person they care for had not used any support or services allowing them to take a break from their caring role.
• 53% of carers felt they have some social interaction with people but not enough.

What carers in Stockton-on-Tees think about the service they receive:

• 46% of carers who had received support services felt satisfied or very satisfied with service they or the person they care for have received.
• 16% of carers were neither satisfied nor satisfied with the services they have received.
• 27% of carers said they had not received any support or services from Social Services in the last 12 months.
• People who care for someone usually have their own health issues, with 34% of carers having a long-standing illness.

Stockton-on-Tees Borough Council encourages carers to carry out a Carers Assessment via the 'Carers Hub' on Stockton Information Directory. The Carers Assessment can be completed online, and the assessment will be directed to the First Contact Team. The Carers Hub is an online service for all carers which brings together a range of information, advice and services for people who provide care and support to a friend or a family member in Stockton-on-Tees. It provides carers with 24-hour online access to relevant information and includes a self-assessment tool, a wellbeing wheel and a register for carers which together help carers to find information, advice and services of relevance to them in their caring role.

In 2016 Stockton-on-Tees Borough Council set up a provision for short breaks initially funded through the Learning Disability Development Fund. The council purchased an adapted mobility caravan at Primrose Valley in North Yorkshire, designed to enhance the current short break offer which the Council has in place. Given this was a relatively new project, the caravan initially provided additional short breaks provision for people within Stockton Borough Council's Learning Disability Social Care Team. Following the success, it was then opened up across all Adult Social Care Teams. 

The short breaks facility can be utilised via a direct payment or be funded by the person. The caravan can be accessed by a carer wishing to take a break from their caring role or by the person who is being cared for. The Council, Voluntary and Community Sector Enterprise (VCSE), and parent carer forum worked in partnership to ensure the project was successful. The Council works closely with a charity organisation who now manage the caravan.

The following suggestions are ways providers can improve the quality of the services they deliver:

Working with stakeholders

Involve relevant Council staff, service users and their carers/family in the design and development of any services; their feedback is key to improving the quality of services. Providers need to consider how feedback can be applied practically to develop new or improve existing services.

Monitor and review performance 

Tracking performance and auditing of key areas of service delivery ensures areas for improvement can be identified. This helps to improve quality; identifying best practice and benchmarking with others ensures learning can be applied, leading to service improvement. Clear standards, consistency and compliance to service delivery expectations ensures quality assurance.

Review marketing tools used

Providers can promote their service in the most effective places, for example. Stockton Information Directory which is Stockton's directory of information and advice. Consider whether information provided to people regarding services is accessible and easy to understand.

Improving outcomes for people

We are looking for providers who can deliver innovative, flexible, person-centred services and, from a broader point of view, we will expect good providers to recognise that the people using their services and their carers are experts in their own lives and are therefore essential partners in the design and development of services.

Focus on workforce development 

Appropriately trained, qualified and competent staff who are well supervised and managed improves the quality of service delivered. The Council has offered the Well Led Training Programme to all adult and older people's care home managers. The leadership programme has been co-produced in partnership with the NHS Leadership Academy and Care Home Providers, to offer key insights, knowledge and skills and learning to better manage, perform, motivate, and ultimately become a successful leader.

Quality assurance 

The Safeguarding Team, Commissioners from both the Council and the CCG, Infection Prevention and Control (IPC) nurses and Care Quality Commission (CQC) work closely together with providers, having regular information sharing meetings to discuss the quality of locally registered services, agree ways to improve this where required and plan how to respond to developing problems.

The Council's Procurement Team will continue to monitor contracted providers to assess the quality-of-service provision using relevant evidence-based measures and to ensure contractual compliance. We will continue to further develop effective processes for ensuring the quality of services, whether or not they are registered with CQC.

Person centred approach

We want all our services to treat each person according to their individual care and support needs and preferences. It is important that providers adapt their service to deliver flexible options and tailored support, particularly as more and more people will be making their own choices in purchasing care utilising their Personal Budgets and Direct Payments, or as self-funders.

A person-centred approach to care and support, will support people to:

• live independent lives in the way they have chosen, based on information about the options available, and as much involvement as they want in decisions about what care and support they need and how it should be delivered
• maintain relationships with family and friends and provide opportunities to take part in community life, including engaging in activities which match their interests, skills and abilities
• live without fear of harm or abuse and support them to manage any risks which might arise and to avoid unnecessary risks
• experience the provision of care positively, through relationships based on mutual respect and consideration, and where care - designed around their needs - is both consistently delivered and well co-ordinated with other agencies

There is no reason in principle why these elements cannot apply to all groups of people needing care and support regardless of the setting in which they live, be it a care home, sheltered housing or their own home. Indeed, it is important that such elements are present for all people in all circumstances. That is the essence of personalisation - tailoring care and support to what individuals choose as a means of helping them to live their normal life. People don't want to be defined by their condition. They are, first and foremost, individuals with very personal hopes, fears, aspirations, and relationships.

Self-funders

The Council has a duty to support those people who choose to fund some or all of their care and support and who need non-residential services. In limited circumstances, the Council may also choose to exercise its discretion under the Care Act to arrange care for self-funders who need residential or nursing care. We will continue to develop information and improve support and advice on the options available to self-funders. The Council also continues to improve and extend its online Stockton Information Directory for both children and adult care information service.

Voluntary and Community Sector Enterprise (VCSE)

The Council will continue to signpost a number of people to services in the community and an assessment will be made about the scope and ability of small and medium VCSE providers to meet this requirement. The role of the VCSE in combating social inclusion is increasingly important and VCSE providers across the county will be encouraged to work responsively in their local communities. VCSE organisations play a key role in the delivery of services, particularly at a time of major change for the public sector, and are well placed to take advantage of opportunities and identify new ways of working. The sector can become a delivery agent that will ensure the sustainability of vital services across the county by taking a proactive approach. The Council will seek to evolve and strengthen our ethos of partnership working with the VSCE sector.

The Council plans to carry out the following procurement activity during 2023-2026. The Council reserves the right to not tender for such services or change the tender start date if required. If you have any queries about the planned procurement please contact the Strategic Procurement Team on sps@stockton.gov.uk.