Adult social care and housing commissioning strategy - Strategic commissioning priorities

To meet the needs of our Customers the Council’s commissioning intentions are set out below, applying the principle that people want to remain at home for as long as possible.

Supporting people to live independent lives in their communities and in a place they call home

1. Supporting the health and care system through the proactive commissioning and delivery of both universal and targeted prevention services.

Collaborating within the broader health and care system, we will enhance the effectiveness of prevention services to eliminate, reduce, or delay care needs. By developing a coordinated offer across all council-wide commissioned services, we aim to empower individuals to gain and maintain independence without relying on formal care services. We will maximise independence through strength-based approaches and the utilisation of community assets.

Our Carers contract includes a digital component designed to reach unpaid carers who are not yet connected to services, offering them the opportunity to complete an online self-assessment without needing to contact the Council or a Carers organisation. Additionally, we will focus on building community networks of peer carer support in our Key Service Centres, with a pilot program underway in one of Cumberland’s most rural areas.

Our aim is to prevent all forms of homelessness by providing:

• clear and accessible information and advice
• working closely with partners
• supporting existing accommodation arrangements where safe and suitable

This includes following national recommendations to protect homeless individuals, increase targeted rehousing pathways, and adopt a 'housing first' multi-agency approach to address repeat homelessness and rough sleeping.

2. Reducing the rate of older people moving into long term residential and nursing care.

Whilst recognising that the majority of people wish to remain in their own home for as long as possible, there are some occasions where residential and nursing care is the best option. We are clear that there is a need for good quality residential and nursing care and expect that the reduction of placements will be gradual as alternative services become available.

We will explore options around additional services needed for keeping people at home including improving and expanding assistive technology offer (see below) and the provision of Night homecare services.

For working age adult residential and nursing provision we will work with existing customer and providers to explore options around decommissioning residential care services replacing with alternatives such as Supported Living.

We will work with providers and health colleagues to ensure the new generation of supported living services are suitably designed to work with complexity, behaviours that challenge and dual diagnosis. We will have agreed processes which enable additional support where required.

We will review our approach to respite care and short breaks so that people are better supported at home.

Right care, right place, right person

3. Expanding access and choices for individuals by enhancing the supply of extra care and other forms of supported accommodation.

We will increase options for working age adults who are eligible for long term care and support. This includes developing a new strategic approach to extra care housing with the aim to facilitate more new schemes over the next 4 years combining services for older people and those aged 18 years and above. This will be set out in our Extra Care Housing Strategy (in draft). This will include exploration of core and cluster models for working age adults.

Following the publication of the Cumberland Supported Housing Needs Study (2024 – 2039), the Council will create a delivery plan to increase supply in identified areas and establish pathways and protocols for working with the market. The Cumberland Supported Living Framework will also be reviewed and subsequently recommissioned to meet this need.

We will collaborate with providers across the Cumberland footprint to develop comprehensive solutions for supported accommodations needs, aiming to prevent homelessness and ensure stable housing options for residents across Cumberland.

4. Expanding access and choices for individuals by enhancing the market for complex care including dementia care.

We will continue with our price banding structures, incentivising more complex care and look for opportunities to support the market to deliver in this area.

We will work with the market and Cumberland Care, to move customers with complex care needs back to Cumberland to be closer to their families.

5. Ensuring a sustainable market, particularly for domiciliary services.

The newly commissioned Homecare Framework is working well and has supported the Council to increase the quality assurance and diligence around providers. Rates paid support the payment of Real Living Wage. The Council has the option to close the Framework to new suppliers should there be sufficient supply to ensure provider and market sustainability. This is subject to regular review.

Excellence in practice and innovation

6. Transforming and streamlining our equipment services and supporting the development of the Cumberland Home Improvement Agency.

The Cumberland Home Improvement Agency is a council run service which has been designed to help residents adapt, repair or improve their homes so they can live safely, independently and comfortably. As part of this service, we will conduct a comprehensive review of equipment services with the aim of transforming how they are delivered. We will also examine existing contracts to ensure that pricing tariffs accurately reflect the true cost of provision.

7. Improving and expanding digital and assistive technology solutions.

Over the next 2 years we will be working with our existing assistive technology provider and developing a number of pilot schemes to better understand how technology services can best support the market alongside, transforming and recommissioning our Assistive Technology contract. In addition to this, the Council will explore ways in which we can integrate Assistive Technology better into existing contracts for example Supported Living, Day Opportunities, Homecare and emergency accommodation for homelessness services.

8. Transformation of Day Opportunities through a 24/7 offer that increases skills, independence and choices.

Our new Day Opportunities Framework introduces a range of employability and skills programmes along with community outreach activities available during evenings, weekends and holiday periods. For the first time, the Framework gives providers the option to offer their own transportation which is vital enhancement in a rural area such as Cumberland

9. Working with the market to further promote and deliver outcomes-based services.

The Council will commission outcome-focused services driven by choice by ensuring that service specifications and tender submissions clearly detail strength-based approaches. Commissioned services will be flexible where possible, and work when and where people need and want them. Social workers and operational staff will understand the range of services on offer and will respond to needs and outcomes identified in assessments and reviews.

The Council will use its Frameworks to run mini competitions where we can pilot the delivery of outcome-based commissioning. Our aim is to evidence local best practices and integrate national best practice models to achieve excellence and foster innovation in our services.

10. Working collaboratively with the Integrated Care Board around joint commissioning and reducing duplication.

Over the next 2 years partners will look to collaborate at all stages of the joint commissioning process, from the assessment of needs to the planning and procurement of services and monitoring of service delivery in Cumberland.

In practice, this means that the Council and the NENC/LSC ICB will:

• share our market intelligence and service user feedback
• take strategic decisions relating to joint commissioning arrangements via our Joint Commissioning Board (JCB)
• consider how market engagement and consultation is conducted
• review the services that are commissioned separately and consider whether and how these could be brought together
• commit to considering combining resources where appropriate in order to secure the best effective services for Cumberland
• agree which organisation should take the lead on a particular procurement
• ensure evaluation panels contain representatives from both the Council and NENC/LSC ICB where appropriate
• share contract performance and management information
• take a joint role in quality monitoring of jointly commissioned arrangements
• share responsibility and accountability for the impact of the services put in place
• identify how providers can be suitably upskilled to continue to work with individuals that present with complexity

It is recognised that the delivery of the above intentions will be impacted by increased demand, the need for the Council to deliver within its budget, workforce challenges and the delay in Health and Social Care Reform (now expected in 2028). Despite this the Council is confident that by setting out the ways we will work with the market in this strategy and treating our commissioned providers and customers as partners we will deliver excellent services.