The West Sussex Care and Support At Home Market and Commissioned Provision

West Sussex benefits from a large care and support at home market providing services and solutions to residents. There are regularly new entrants to the market which provides choice to residents in West Sussex, and large volumes of provision for the local authority to commission from. However, the volume of care and support at home organisations can mean that providers can struggle to get a sustainable level of market share, despite the total demand for services, and the care workforce can move between providers creating some challenges and costs for providers in retaining staff. Whilst WSCC does not want to stifle the market and prevent new services from emerging, it is important that care and support at home providers consider the demand for services, the prevalence of other provision, and the availability of the workforce when considering establishing a new service or developing existing services.

Despite the volume of provision in West Sussex as a whole, there are areas where there is less availability and it can be more challenging to source care – particularly in rural areas, where travel time and costs are greater and there are smaller numbers of people requiring services. We want to engage and co-design innovative and sustainable solutions in these areas with providers to ensure that all people across West Sussex including those in rural areas have suitable access to services, and in order to meet both current and future demand.

A number of organisations provide live-in care provision across the county. From time-to-time WSCC commissions live-in provision through our contracted provision to support people to remain in their own homes. This can be a good option for some people although the volumes commissioned through WSCC are small. To utilise live in services people to have a bedroom for the live in carer and be open to sharing their home with a live in carer and it can be a costly option compared to care visits during the day. It may also be a less viable option where people require two carers to deliver complex care needs. However, WSCC will continue to consider live in care as an option to enable people to remain living in their own home, where this suits their need and circumstances and can provide a cost-effective solution. This may also be an option for self-funders who wish to remain living at home.

In recent years WSCC has commissioned specific care and support at home services to support people to be discharged from hospital to their own home, with care and support where this is needed. This is part of a ‘Home First’ offer which is a joint health and social care initiative with an aim to discharge people from acute services as soon as they are assessed as medically able to return home. Sussex Community NHS Foundation Trust (SCFT) are the lead provider for Home First and provide the clinical support for people returning home through their Urgent Community Response Teams. In addition, WSCC has commissioned specific hospital discharge care services to work alongside SCFT in supporting people after discharge from hospital for a short period of time. Whilst these services offer the same personal care and support to people, the delivery is different from traditional care and support at home services due to the urgency to support people home as quickly as possible, the short duration of service, the multi-disciplinary team working required and the delivery across a large area. Contract opportunities are being tendered for new services to commence from April 2025.

In terms of commissioned care and support at home, we have worked closely market to support the development of the Care and Support at Home Framework which commenced in September 2024. As part of this feedback and engagement we have heard, for example, the importance of:

• Working closely with the NHS and other partners.
• Understanding the opportunities that technology can bring, and the potential to innovate the use of technology.
• Ensuring that we support the care workforce through fair and ethical treatment.

The new commissioned framework is in early stages of implementation and WSCC is working closely with providers to establish the framework and particularly prioritising a focus on the quality and sustainability of services in the market. The framework will be reviewed both in initial stages as it establishes, and then regularly throughout the contract term to ensure it remains fit for purpose in the context of changes that will emerge across the health and social care landscape and the care market.

WSCC is keen to explore alternative solutions for people in their own home, beyond more traditional options and learn from other areas. For example, Somerset County Council has developed and established a Somerset Micro-enterprise Project over a number of years which provides choice and different options for self-funders and funded customers seeking care and support at home and supports links between early support and more formal services.

We welcome conversations with partners and providers about the intentions set out in this document and developing the care and support at home market to support future demand. For discussions about the development of care and support at home in West Sussex, please contact adultscommissioning@westsussex.gov.uk.