Commissioning Intentions

Our commissioning intentions have been focused on changing behaviours to promote independence, developing evidence-based early interventions to prevent peoples’ care needs increasing, and devising new delivery models through joint work with our partners.

We gather data and feedback from a wide range of sources and analyse this in conjunction with predicted demand models to determine the requirements for future service provision.

We have a particular focus on using available resources more effectively and seek to work with a more diverse range of partners including voluntary and community sector organisations, small and medium sized enterprises (SMEs), and entrepreneurs to deliver high quality support for our residents.

The current Coronavirus pandemic has had and will continue to have for some time, a significant effect upon both the provider market and the demand for support. As such we are continuing to monitor the situation closely to understand what this means for our current commissioning plans and to engage with our providers and stakeholders to ensure that we maintain a stable market in these unprecedented times.

Where necessary we will revise our commissioning plans and re model services to ensure that we continue to meet needs of Darlington residents in the “new normal”

Coming Soon

Strategies – Gateshead Council

The purpose of a collaborative commissioning process is to design how we best respond to the needs of people and communities by putting them at the heart of everything we do; the aim of improving outcomes, ensuring the right care, in the right place at the right time, harnessing the
power of people and communities by taking an inclusive asset-based approach, and making informed investment to ensure we maximise the value of the Gateshead pound.

Effective commissioning will be driven by a data led, evidence-based approach which also promotes collaboration, integration and innovation across the Gateshead System to meet identified current and future needs, as well as any gaps in provision. Our ambition is to provide a high quality, high
performing market through support and collaborative service design with people, providers and communities.

The aims of effectively commissioning in Gateshead will support:
• Early identification, assessment and diagnosis – effective working across health and social care to streamline processes, reduce waiting times for assessment and diagnosis, and avoid people having to tell their story multiple times.
• Continuity of care – there are arrangements in place to ensure continuity as young people move into adulthood.
• Information, advice and support – ease of access to a good range of services and user-friendly information.
• Early intervention – support the move towards ‘Prevention’ as well as improving access to and the availability of universal services.
• The availability and range of services – services are personalised, flexible and outcome focussed with a range of solutions on offer to meet people’s needs, often moving away from traditional models of support.
• Opportunities for connecting – enabling providers and the health and social care workforce to come together to identify opportunities for improved processes and service delivery. Also connecting communities and incorporating peer support into all health and social care pathways.
• Family and carergiver support – there is a range of mechanisms and support in place for caregivers to support them with and/or give caregivers a break from their caring role.
• A competent workforce – appropriately skilled and trained workforce.
• Value for money – that any services commissioned are done so on the basis of providing the most efficient and effective way of meeting people’s needs.

Last updated 2nd May 2024

We acknowledge that developing long term commissioning intentions in this time of a Covid pandemic is challenging. However, our focus over the next 3 years will be to further implement Community Led Support This will offer opportunities to commission in a different way to meet the needs of the local population, both in terms of prevention and ongoing support. Our aims are that:

– Co-production brings people and organisations together around a shared vision;

– There is a focus on communities and each will be different;

– People can get support and advice when they need it so that crises are prevented;

– The culture becomes based on trust and empowerment;

– People are treated as equals, their strengths and gifts built on;

– Bureaucracy is the absolute minimum it has to be; and

– The system is responsive, proportionate and delivers good outcomes.

Home Care aged 18+

The Council currently has a number of Business Partners and Spot Providers that are supported by an Approved List of Spot Providers. Should demand needs change, then any opportunities will be advertised via the North East procurement Organisation (NEPO). The current contract ends in November 2025.

Residential & Nursing Care

Middlesbrough Council are keen to engage with providers who are looking to develop or expand their Residential and Nursing Care Homes for Mental Health and Learning Disability provision.

We would like to hear from providers who are looking to develop general residential services for those aged 18-64.

Extra Care Housing for persons aged 55+ with eligible care and housing needs

There are currently voids in both of the extra care schemes within Middlesbrough and this remains reasonably stable. Middlesbrough Council are not looking to increase our Extra Care capacity at this time.

Enablement and Support for persons with Learning Disabilities, Mental Health, Physical Disabilities and/ or Autism

The Focussed Care & Support Framework provides care, enablement and support in the community and also in Independent Supported Living (ISL). Should demand needs change, then any opportunities will be advertised via the North East procurement Organisation (NEPO). This contract runs until the end of May 2026 with the option to extend for a further 2 years.

ISLs / Supported Housing

At the current time the Council is not looking at increasing ‘shared’ supported accommodation.

Tees Valley Complex Care and Support Framework

The current contract is Teeswide and is in partnership between Middlesbrough, Redcar & Cleveland, Stockton, Darlington and Hartlepool Council. The contract ends in March 2029, should demand needs change, then any opportunities will be advertised via the North East Procurement Organisation (NEPO).

Tees Advocacy Service

The current contract is in partnership between Middlesbrough, Redcar & Cleveland and Stockton Council to provide access to IMHA, IMCA, paid RPR, Care Act and general advocacy advice. The current contract ends April 2026, with the option to extend until 2030.

Day Services / Day Opportunities

Organisations that are looking to develop innovative services / opportunities in Middlesbrough can contact the Council via contractandcommissioningunit@middlesbrough.gov.uk Of particular interest would be any services / opportunities that would be available in the evenings or weekends. We will be mapping current services to identify any gaps in provision throughout 2024.

Supported Housing

Middlesbrough Council’s Commissioning Team are always keen to hear from housing providers to discuss new and innovative models of service provision which can meet our current demands. Housing providers should be registered with the Regulator of Social Housing and should be able to evidence their inclusion on the list, found on GOV.UK

Support for Carers

Middlesbrough Council jointly commissions the South Tees All Ages Carer Support Service with Redcar & Cleveland Council. The contract ends in March 20025 and there is the option to extend for a further 2 years.

Support for People with Dementia and their Carers

The Dementia and Wellbeing Community Hub is a community base for people living with dementia, and their carers. Middlesbrough Council contract for a Dementia Advisor Service at the Hub. The contract ends in September 2024 and there is the option to extend for a further 2 years; further information can be found on middlesbrough.gov.uk

To inform future Commission intentions, data from a variety of sources is regularly reviewed and analysed, to determine local need.

Redcar and Cleveland’s commissioning intentions are increasingly being affected by the ongoing Covid-19 pandemic. Previously agreed intentions may now be subject to review as we cannot accurately predict the future market based on the significant effect on services, directly related to the Corona virus. These changes will no doubt re model the way future services are aligned, and consultations will be required to ensure the Council develop the right services to meet the needs and demands within the Borough.

South Tyneside has ambitious commissioning intentions over the coming year. A number of factors, including the Covid-19 pandemic have meant unavoidable delays to the delivery of some long term strategic aims. Moving forward, the commissioning team will be focused on developing a thriving market which delivers outstanding quality and performance.

There is a commitment to continuing to develop models in co-production with residents, ensuring an outcomes-focused, person-centred, assets-based approach to all commissioning activity. With a focus on data and evidence, South Tyneside will continue to work in an integrated way to meet current and future needs as well as address any gaps in the market.

Self-directed Support

Market Summary: The council provides an in-house direct payments support service. The service currently supports 458 individuals with a direct payment, of this number:

29% are aged 65 or over,
43% have a learning disability as their primary support reason
9% have mental health as their primary support reason

Individuals are supported to purchase a range of care and community services. The service facilitates the payment of a personal budget to an external provider should a third party managed account be preferable.

Future Vision: The council aims to further increase the uptake of Direct Payments and Personal Budgets as a means of giving people greater independence, choice and control over the care and support they receive. To meet the anticipated demand in the market, there will be a requirement for support in relation to the recruitment and support of personal assistants. The council intends to build on the review of the PA market to ensure that the market can meet increasing demand.

Intentions: Our intentions in relation to direct payments are to:

Further develop personalised commissioning approaches such as Individual Service Funds
Develop a Personal Assistant database
Increase the number of support options available for people to purchase

Residential and Nursing Homes

Market Summary: The council currently commissions 23 care homes for older people. This includes homes which are residential, EMI residential and nursing. These homes provide a total of 1,087 beds. The need for South Tyneside’s older person’s care homes can fluctuate, but occupancy currently sits at 89%. There are also 9 specialist care homes in the borough, 6 of which predominantly support people with learning disabilities and 3 predominantly supporting mental health. These homes provide 134 beds and current occupancy currently sits at 93%. At present there is an over-reliance on the use of residential care setting for older people and on out of borough placements for people with challenging and/or forensic behaviours.

Future Vision: It is envisaged that, where appropriate, people currently residing in out of borough residential settings will be supported to return back into borough. The intention is for more people to be supported at home for as long as possible; as a consequence, people entering into residential care are likely to be admitted later in life with increased complexity of need.

Intentions: Our intentions in relation to residential care are to:

Undertake a comprehensive review of the Care Home Market
Reduce the number of people residing in out of borough care homes
Support residents to return to South Tyneside where appropriate
Support people to remain within the community and their own homes for longer

Day Services

Market Summary: At present, day services are predominantly funded through direct payments or personal budgets. The current model of delivery is predominantly building-based with very little opportunity for innovation with regards to delivery. At present, South Tyneside has 1 commissioned provider delivering day opportunities for people with learning disabilities. There are 4 additional day services providers, delivering the majority of support for people with learning disabilities in the borough, these are accessed through direct payments and/or self-funding.
There is a current commissioned day service which supports people with more advanced dementia. This is delivered through a combination of building and community-based offer. The provider is utilising an ISF-based approach to serve as a broker for individuals to pursue interests via mainstream services.

Future Vision: The council intends to review the current day service offer for people with Learning Disabilities. This will ensure that there is a broad range of opportunities for people to make social connections, engage in meaningful activities and take part in community life in local inclusive settings wherever possible. Rather than simply providing traditional day services, the council aspires to commission a modern, person-centred, outcomes-focused offer.
There is also a longer-term aspiration to develop day services for people with broader needs including older people without a dementia diagnosis. The council will continue to explore innovative delivery solutions to achieve this.

Intentions: Our intentions in relation to day services are to:

Develop a framework of day services providers for people with learning disabilities
Move from a building-based to a community-based model
Reduce reliance on Learning Disability specific services and increase the proportion of people accessing mainstream services (with support if required)
Continue to support market diversity and choice for individuals
Develop day services for people with a broader range of needs

Domiciliary Care

Market Summary: South Tyneside operates a prime provider model for the delivery of domiciliary care across the borough. The Help to Live at Home (H2LAH) domiciliary care contract comprises of a long term element (Home Independence Support Service- HISS) and a short term element which includes hospital discharge (Home Independence Crisis Support Service- HICSS). There are currently 4 providers with each provider supporting a defined geographical location within the borough. The contract supports 907 individuals through the HISS element and 108 individuals through HICSS. The current contractual arrangement is a long-term solution and expires in 2030.

Future Vision: There are plans to implement a reablement at home element within the HICSS function being delivered by each of the providers. This will be achieved through close partnership work with existing providers and collaboration with health colleagues to expand our reablement offer.

Intentions: Our intentions in relation to domiciliary care is to:

Work in collaboration with providers to further develop the H2LAH model
Develop the HICSS reablement offer in the community in close partnership with health colleagues

Accommodation and Extra Care

Market Summary: There are currently five Extra Care schemes in South Tyneside providing 177 units, only two of these schemes can support people with dementia, providing only 17 apartments. At present, much of the council stock is outdated; work is required to ensure the existing stock is suitable for a wide range of needs including physical disabilities and dementia.
South Tyneside has 28 council owned sheltered accommodation schemes providing 1018 units. In addition, South Tyneside has 20 Housing Association sheltered accommodation schemes providing 695 units.
It is recognised that the current market provides a lack of choice for residents with Mental Health needs, Learning Disabilities and/or Autism; resulting in an over-reliance on residential care. The present ISL model relies on the use of shared accommodation, which doesn’t align to residents aspirations of securing their own accommodation without shared facilities.

Future Vision: Signficiant work is being undertaken in relation to accommodation for people with care and support needs. The Council is working in partnership to build three new extra-care schemes to support people over 18. Planning permission for the first scheme of 95 units has been secured, with building work commencing in Hebburn in 2024. It is intended for a further two sites to be developed thereafter. An existing housing scheme has also recently been repurposed to improve
In order to address some of the challenges in relation to lack of suitable accommodation, the council has also progressed with developing two small-scale specialist supported housing developments. This will provide an additional 21 homes for people with Autism and/or Learning Disabilities. Work is also being undertaken to identify opportunities to developing accommodation options for people with mental health needs; the long term aspiration is to develop step-up/step-down provision and where appropriate ensure people residing in out of borough placements can return.

Intentions: Our intentions in relation to accommodation and extra care is to:

Develop an all-age Accommodation Strategy for people with care and support needs by 2024
Develop a landlord framework to work with housing providers to maximise housing benefit
Complete the development of specialist supported housing
Commence with building three extra care schemes

Independent Supported Living

Market Summary: South Tyneside currently commissions Independent Support Living services for people with learning disabilities, autism and mental health needs. Providers deliver support with properties which are owned or rented by the individual or on behalf of the individual. South Tyneside currently has 15 providers in total. There are 120 properties with the space to support 145 individuals. Capacity varies, however, at the time of writing, capacity sat at 94% occupancy. Major barriers at present include the lack of suitable properties locally and the recruitment and retention of staff.

Future Vision: There are upcoming opportunities for delivering independent supported living to support people to live as independently as possible; supporting adults to access education, employment and social opportunities and exerting choice and control over their lives. The Council is currently reviewing its ISL provision to ensure the most appropriate model is in place. This may result in increased demand for such services. We are seeking to ensure that the range of providers we commission comprehensively supports all of the needs in the borough including those of people with complex behaviours related to autism, mental ill health or offending.

Intentions: Our intentions in relation to ISL’s are to:

Review the existing model
Undertake a competitive tender exercise
Secure a more outcome-focused range of services

Housing Related Support

Market Summary: We currently commission non-CQC regulated supported accommodation for adults aged 18+. These services support individuals with a range of needs, including, homelessness, drug and alcohol issues, mental health needs, and those at risk of social exclusion. This support is commissioned from five providers across a range of shared and dispersed accommodation. We currently commission a total of 137 units.

Future vision: The council aspires to move towards a more outcome-focused model of supported accommodation for adults. This will need to have an increased focus on progression and independence. The aspiration is for services to be more outcomes-focused and holistic; supporting people to access community assets and Primary Care-based health support. There is also the intention to foster greater choice and control by securing more geographically dispersed accommodation across the borough.

Intentions: Our intention in relation to Housing Related Support is to:

Undertake a co-production exercise with residents, services, professionals, current providers and the wider market
Develop a new model of supported accommodation for adults
Undertake a full procurement exercise in 2024

Specialist respite

Market Summary: South Tyneside currently commissions one specialist respite provision for learning disabilities. This provision provides six general respite beds and one emergency bed. At time of writing the service was supporting 36 individuals with respite care. A number of South Tyneside’s in-borough specialist residential homes also offer respite care, however, a number of residents are attending out of borough respite provisions due to complexity of need and the demands in the market.

Future Vision: A light-touch co-production exercise was undertaken following the pandemic to understand the views of residents and carers accessing specialist respite. Initial work with individuals and families identified the value of respite, as well as how the future could look for respite in South Tyneside. Based on the feedback from individuals, it is clear that there is an appetite for an improved model with a greater focus on outcomes and independence. Further work needs to be undertaken in co-production with individuals and their parents/carers to develop the future model. The intention is to undertake this exercise in the coming months in order to progress swiftly.

Intentions: Our intentions in relation to specialist respite are to:

Review the existing model
Undertake a competitive tender exercise

Shared Lives

Market Summary: Shared Lives is a family-based approach to support adults to live independent lives. In South Tyneside, Shared Lives carers predominantly support individuals with Learning Disabilities, providing both long term and respite arrangements. There are currently 72 individuals supported through a Shared Lives arrangement. South Tyneside employs a total of 68 long term Shared Lives Carers and 32 short break/enabling carers.

Future Vision: There are many flexible solutions for Shared Lives schemes; the approach is utilised variably across the country with many innovative approaches. A review of the Shared Lives offer is currently being undertaken with the intention to increase the number of individuals being supported by the service. There are aspirations to also diversify the offer to support more residents with varying needs, including people with Autism and Mental Health needs. The review intends to implement more creative approaches to improve outcomes and increase independence, choice and control.

Intentions: Our intentions in relation to Shared Lives are to continue to undertake a comprehensive review in order to:

Expand the Shared Lives offer with a focus on enabling
Adopt creative approaches to improve outcomes and independence (e.g. assistive technology)
Improve capacity for those going through life course transitions

Carers

Market Summary: The council has recently developed a Carers Strategy shaped by the voice and experience of carers. The themes identified throughout conversations have directly produced a number of strategic priorities for the next five years, these are to:

Recognise and support carers
Support young carers to achieve their full potential
Increase access to stable and supportive employment
Keep carers connected
Improve health and wellbeing of carers

Future Vision: The council aims to continually enhance the advice and support available to unpaid carers. The aspiration is to reduce the potential for carer breakdown; ensuring they are supported to look after their own health and wellbeing, and are able to remain in (or return) to employment as much as possible.

Intentions:

The council is currently undertaking a competitive procurement exercise to commission remodeled support services for Young Carers and Adult Carers
This new model has been fully co-produced and it is anticipated that the new contracts will be awarded in 2024

Advocacy

Market Summary: The council has a range of statutory duties under which advocacy services should be commissioned. These are:

Care Act 2014 (Care Act Advocacy)
Mental Capacity Act 2005 (Independent Mental Capacity Advocacy and Relevant Person’s Representatives)
Mental Health Act 2007 (Independent Mental Health Advocacy)
Health and Social Care Act 2012 (NHS Complaints Advocacy)

These services are currently commissioned via a range of block and spot contracts. A co-production activity has identified a range of issues with the current approach, including confusion amongst professionals around which provider to access, a lack of outcome-focus, and instability for providers.

Future vision: The council intends advocacy services in the future to be more outcome-focused, better coordinated, and aligned to current best practice (e.g., NICE guidelines etc).

Intentions: A remodelling proposal is currently being progressed through governance processes internally. Our intentions are to:

Undertake a procurement exercise in 2024 for a new service offer
Provide the market with more certainty and stability by commissioning a longer-term contractual arrangement

UPDATED APRIL 2024