South Tyneside Interim Market Position Statement

South Tyneside is committed to delivering high-quality integrated care and support, which improves outcomes, delivers choice and is personalised to meet residents individual needs.

The intention of this Market Position Statement is to set out the direction of travel; clearly articulating the needs of the borough, demand for services and predicted trends. By communicating key information, it is hoped that providers have intelligence to:

• More easily identify opportunities for future development
• Plan proactively
• React to changes
• Identify potential market gaps
• Enter into the market as a new provider

This statement outlines South Tyneside’s ambitions in relation to older people, adults with disabilities, learning disabilities, mental health needs and other needs. As such, it is closely linked to a number of key strategies, including:

• Living Better Lives Strategy
• Mental Health Strategy
• Learning Disabilities Strategy
• Autism Strategy
• Carers Strategy

The statement aligns closely to South Tyneside’s alliancing principles, so is reflective of South Tyneside’s collective goals and values. All partners are committed to collaborative working, adopting approaches which are developed in co-production, and delivered jointly wherever possible.

This statement should serve as a starting point to facilitate dialogue with providers. It is envisioned that intelligence will be further developed through an iterative approach, in order to benefit from a richness of information.

By placing the person at the centre of market shaping, South Tyneside aspires to transform the health and social care offer; delivering a care and support sector which is sustainable, vibrant and agile.

South Tyneside has set out ambitious plans to support residents to be able to:

• Access support which builds on their strengths, friendships, and aspirations
• Live safely and well
• Live independently as much as this is possible
• Have an equal voice in coordinating their care and support
• Tell their story only once
• Have their rights protected
• Be included and treated as equal citizens

Ultimately, the vision for Adult Social Care and Commissioning is:

“We all want people in South Tyneside to live in the place they call home with the people and things that they love, in communities where people look out for one another, doing things that matter to them.”

Further information on overall priorities can be found in the Adult Social Care Living Better Lives Strategy 2022-2026.

In order to achieve these outcomes, the intention is to move away from traditional models of service delivery; favouring approaches which are more flexible, personalised and responsive. By stimulating a more diverse market, capable of delivering more creative solutions, the vision is for increased focus on outcome-centric approaches. This will mean reducing reliance on higher dependency services such as residential care and more focus on community and home-based support; this approach will rely on a greater focus on prevention and early help.

South Tyneside remains committed to working in co-production with residents and experts by experience. Striving for stengths-based flexible approaches, will ensure choice and control for residents; ensuring individual and community assets are utilised fully to maximise independence, and autonomy.

There will be a continued emphasis on integrated approaches and joint working with the North East and North Cumbria Integrated Care Board. Ensuring that health and social care is working in a coordinated way to meet the needs of our underserved communities.

In order to achieve this vision, there is a commitment to the following principles:

• What’s right for the person is right for the system
• Making the best use of the collective South Tyneside Pound
• Working collaboratively and in partnership
• Delivering safe, high quality support at the right time in the right place
• Commitment to co-production
• Supporting people to remain as independent as possible
• Working proactively and preventatively
• Ensuring delivery in the spirit of openness and transparency
• Delivering innovative and outcome-focussed solutions to support choice and control

As at 2021, South Tyneside’s population is estimated to be around 147,800. South Tyneside is the fourth most populated area in the North East with around 16 people living on each football pitch-sized area of land.

Between 2011 and 2021 there has been an increase of 15.1% in people aged 65 and over. There has been a decrease of 5.4% in people aged 15-64 and an increase of 3.9% in children aged under 15 years.

Projections indicate that by 2033 the population will have increased by 6% with the most marked increase in the 65 and over age range.

Detailed projections can be found in the Council’s demographics JSNAA in the population tool.

The most complete overview of population is available from the 2021 census. Population figures indicate a slight decrease at local authority level for South Tyneside. Over the coming months the Office for National Statistics will be releasing further data and rebasing estimates; the intention is for all data to be released within two years.

South Tyneside commissions services to support a range of adults with eligible needs, these include:

• Older Adults
• People with Learning Disabilties, Sensory Disabilities and/or Physical Disabilities
• People with Autism
• People with Mental Health Needs
• People with Substance Misuse Needs
• Carers

Services include areas such as:

• Information, advice and advocacy
• Assistive technology
• Day services
• Self-directed support
• Respite
• Home care
• Extra care
• Independent supported living
• Housing related support
• Shared lives
• 24 hour residential and nursing care

There is a commitment move towards more preventative approaches and achieving outcomes which are personalised to the individual. The market will be required to be flexible and diverse, in order to provide true choice and control to the individual. Aligned to government directives and local aspirations, people will be supported to utilise community-based services and remain in their own home for as long as possible. The market will be required to support people more innovatively within the community to prevent or delay the need for residential care. This may invovle maximising use of community assets and adopting approaches which maximise the benefits of assistive technology.

South Tyneside works with a range of different providers and partner organisations in order to deliver services to meet the needs of the local population. Management of the local market is undertaken through engagement with both providers and residents, as well as activity such as contract management. The section below gives further intelligence in relation the following areas of the market:

• Activity
• Quality
• Capacity
• Service Location

The data below can be filtered to give an understanding of the the current care market in the local area.

South Tyneside is committed to developing services in co-production with residents who use our services, as well as their family and carers. There is an aspiration for residents to be equal partners, with equal power and influence over decisions pertaining to their services. To this end, South Tyneside has committed to involving residents in meaningful co-production; from the development of strategies to the remodelling of services. Rather than consultation or engagement exercises, which can be limited and tokenistic, there has been a commitment to engaging in genuine co-production with residents. Approaches can vary depending on the intended audience and outcomes of each project, but examples of previous co-production approaches include:

• Employment of experts by experience within the Joint Commissioning Unit
• Reimbursing residents for their time to move towards equality with professionals
• Developing a pool of paid EBE leaders as experts within their communities
• Reaching out to a diverse range of residents through community networks and faith groups to secure a richness of perspective
• Fostering a culture of co-production which has been recognised nationally

Further information on our approach to co-production can be found here.

In addition to this, our wider stakeholders are also integral to the development and commissioning of our services. South Tyneside strives to involve all partners wherever appropriate, this includes:

• Operational and health colleagues
• Commissioned providers
• Providers in the broader market including the third sector
• Neighbouring local authorities
• Healthwatch
• Other community organisations

The intention is to adopt approaches which are open and transparent, involving partners in the development of plans from the outset.

Included below is some data from national surveys which give a flavour of what is working well and what could be improved. It is recognised that this information is only a snapshot and its limitations and parameters should be acknowledged.

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 anticiapted 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 opportunties 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 simpy 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

Domicillary Care

Market summary

South Tyneside operates a prime provider model for the delivery of domicillary care across the borough. The Help to Live at Home (H2LAH) domicillary 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 domicillary 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

Accomodation 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 accomodation schemes providing 1018 units. In addition, South Tyneside has 20 Housing Association sheltered accomodation 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 overreliance on residential care. The present ISL model relies on the use of shared accomodation, which doesn’t align to residents aspirations of securing their own accomoation without shared facilities.

Future vision

Signficiant work is being undertaken in relation to accomodation 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 therafter. 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 accomodation, 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 accomodation 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 commission 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 Suppport

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 hollistic; 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 identifed a range of issues with the currrent 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 currrent 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

South Tyneside has developed a comprehensive Medium Term Financial Plan which details priorities, budgets and savings targets. The plan can be found here: South Tyneside Council | Medium Term Financial Plan 2022-2027.

The effects of the pandemic as well as geopoilitical factors and the subsequent cost of living crisis, have placed considerable pressure on local authority finances.

Despite delivering £183m savings over the course of twelve years, financial challenges persist. Existing and anticipated changes to central government funding, as well as increasing demands and duties, ensure that budgets remain tight.

From a social care perspective, services face pressure from an aging population and needs which are becoming increasingly complex. This, alongside the aforementioned factors, means that the council faces challenges to meet demand from resources which are depleting in real terms.

In light of challenges, providers in the market are encouraged to adopt creative and collaborative solutions to meet needs in creative ways which remain safe and effective.

The section below sets out adult social care spend over the last five years. Comparative expenditure data can be broken down by age, service type and primary reason.

Our Approach

South Tyneside aims to work collaboratively with providers to develop a thriving and innovative social care marketplace. There is a commitment to secure outcomes-focused, cost-effective, high-quality services for our residents. To this end, there will be a commitment to:

• Continuing to host providers forums
• Looking for new and innovative ways to engage with providers
• Continuing to commission services jointly wherever possible to ensure an integrated approach
• Working in partnership with providers
• Listening to feedback on how to improve co-operation
• Sharing any market intelligence, including demand, supply and market direction
• Focusing on prevention and early intervention as a responsibility of all
• Supporting providers to develop their workforce

For organisations interested in potential future opportunities with South Tyneside, please respond to advertisements as detailed below, or contact the officer responsible for the service area in question.

Support for businesses

South Tyneside has developed the South Tyneside Pledge which is a collaborative approach with partners who have committed to taking small steps to:

• boost local economic activity
• reduce health inequalities
• reduce carbon emissions
• enhance civic pride

The South Tyneside Partnership champions and monitors this collaborative approach and offers advice and guidance to those providers signing up to the pledge. Providers can sign up here to show their organisations’ intentions to spend and recruit within South Tyneside to support the local area.

South Tyneside advocates for and supports micro, small and medium enterprises to ensure a thriving and diverse market. A range of support is offered such as free start-up support to potential entrepreneurs. To consider what support may be available to your organisation please visit our Invest South Tyneside Site.

Potential opportunities

Tender or quotation opportunities can be bid on via the NEPO portal website. Suppliers wishing to do business with the council should ensure they have access to any new or anticipated opportunities by registering as a provider on the NEPO portal.

Please register by visiting: https://www.nepo.org/