Market position statement for adult social care services - Homecare

Homecare is delivered within people’s own homes, either as short or long-term personal care/low-level healthcare.

Cumberland Care provides a Cumberland-wide reablement service (for up to six weeks) whereas the independent sector is commissioned via an open framework agreement.

The council commissions low-level healthcare on behalf of NHS North East and North Cumbria Integrated Care Board via the framework. Cumberland Care also provides a long-term nighttime homecare service.

Demand for homecare services has grown year on year, aligning with our ambition to support more people in their own home, with international recruitment being a major factor in meeting recent demand.

Currently, the independent provider market is strong, particularly in Carlisle (where demand is greatest) and other urban areas. Most homecare providers in Cumberland are small organisations, many of which are local and well established. However, in recent years, we’ve seen an increase in new providers who also deliver in other areas. National providers make up a relatively small part of the market.

Much of Cumberland is rural, so this is reflected in our fixed framework hourly rates (urban, rural and extra rural). There are access and distribution challenges in rural and extra rural areas, where securing provision can take longer due to increased travel time and associated costs. As a result, people living in these areas may experience longer waiting times for care to commence.

Most packages of care advertised to framework providers receive at least three offers, with recent activity typically generating closer to four offers, indicating a generally responsive and competitive market.

On average, it takes 12 days for homecare to start from the time we approach the market (October 2024).

Around 24% of commissioned calls are ‘double ups’, meaning that two carers are needed at each visit.

Approximately 17% of people that our framework providers support self fund their care.

Market strengths:
Buoyant provider market, particularly in urban areas and responsive to demand.
Mixed market of large, medium and small providers.
Workforce strengthened through overseas recruitment.

Market pressures and opportunities:
Local recruitment and retention challenges.
Sustainability of smaller providers and those most reliant on overseas recruitment.
Access and distribution challenges in rural and extra-rural areas.
Reliance on cars for transport due to geography and limited public transport provision.
We are particularly interested in innovative rural delivery models, use of technology and care coordination and models that reduce travel inefficiencies.