Current Supply of Care and Support At Home in West Sussex

West Sussex has an estimated 160 care and support at home providers, although many more organisations recently bid for the Care and Support at Home Framework and hence the local market continues to grow. It is unknown exactly how many people purchase care and support at home services directly (self-funders). However, estimates suggests that WSCC are funding between 50% and 60% of all customers supported in West Sussex. WSCC fund and purchase on behalf of around 2400 customers and hence it is anticipated there are around 4,000 customers in total. The new Care and Support at Home Framework 2024 replaces all previous domiciliary care and care and support at home council commissioned contracts. Over 120 providers are currently part of the new framework, with around 95 currently actively supporting customers through the framework.

According to the Office of National Statistics, self-funders commission an estimated 40% of the home care capacity in the market. This is above the South East projected average. West Sussex has the 9th highest estimated percentage of self-funder numbers in England.

The average size of a package of care and support at home commissioned by WSCC is estimated to be 12.6 hours a week, representing approximately 24,000 hours of homecare a week commissioned by WSCC.

It is important to note that the number of providers does not always equate to more service. West Sussex has a high proportion of small and medium enterprises providing care and support at home, and therefore some providers have small workforce numbers and volumes of provision they are providing. The below table shows the estimated number of customers with each provider WSCC commissioned prior to the commencement of the new framework.

Therefore there is diversity in the size of providers commissioned by WSCC with 35 providers (43%) delivering a service to 10 or less WSCC funded customers whereas there are 5 providers who deliver a service to more than 100 customers.

The provider base in West Sussex is predominantly made up of small and medium sized providers although there are some medium and large providers with potential infrastructure to grow capacity.

The image above shows that Arun has the highest number and percentage of WSCC commissioned providers delivering care and support at home followed by Chichester, Worthing, Mid-Sussex, and Horsham.

In WSCC’s experience, there is currently sufficient supply of care and support at home to meet the demand for services. Whilst on some occasions it can be more challenging to source packages of care, there are often multiple providers who respond to referrals to provide packages of care. This has not always been the case and means fewer people waiting for care and support at home than in previous years which is a very positive development. However, it does mean that providers are not currently receiving all packages of care that they apply for which can be challenging for providers to maintain a sustainable service, particularly when they have committed hours to employees. Less is known about the level of demand and supply for self-funders, although indications are that West Sussex currently has a vibrant care and support at home market with adequate choice for its residents. This market is however subject to changes from time to time which can be caused by a range of legislative, economic and social changes as well as commissioning approaches and purchasing trends. WSCC will continue to work with the care market to support sustainability in the context of the changing environment in which health and social care operates.

As mentioned, there can be challenges in securing care and support at home in some locations, although these locations are known to vary and generally it is more rural locations which can be more challenging to source services within. The limitations to provision in rural areas are likely to be due to factors such as the challenges of additional travel time and the high cost of housing reducing the ability to attract local staff. WSCC has in the past found it difficult to find providers willing and able to accept and retain care packages in more rural areas – this can be particularly difficult when people require two carers to deliver their care.

Providers report several challenges, including the impact of a very competitive market for care workers (with staff movement to competing providers and recruitment, competing with other industries for staff, the difficulties of finding appropriately trained staff and the higher, prohibitive costs of agency staff). The high turnover of staff means higher costs of recruitment, which can have an impact on the resources available for ongoing staff development.