Adult social care and support

Living Well in Later Life Older People’s Commissioning Strategy 2021 to 2030

We work closely with our partners in Surrey to provide information, support and services for people over 65 and those who care for them (unpaid carers).

We collaborated with local older people and their support networks to produce the Living Well in Later Life Strategy. It outlines how we plan to make Surrey a place where people can make the most of their old age.

Page contents

Help shape plans for older people

Please help us shape our plans further. To get involved and register your interest, fill in the:

Living Well in Later Life survey

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What are the plans?

The following Living Well in Later Life video explains our plans.

You can also watch Living Well in Later Life with a British Sign Language translator.

Download a summary version of the strategy

Older People's Commissioning Strategy: Summary version (PDF)

Download the approved strategy

The below strategy was approved by the Cabinet meeting on 30 November 2021. It was last updated in January 2023.

Living Well in Later Life: Older People's Commissioning Strategy 2021 to 2030 (PDF)

Market Positioning Statement

Our Market Position Statement (MPS) focuses on the Residential and Nursing Care Market for Older People (over 65). A MPS is a vital part of what Surrey County Council must do to ensure that there is a choice of different types of service and support available to residents. The MPS outlines:

  • The type of residential care (with or without nursing) that older residents need.
  • The residential care (with or without nursing) available at present, and what is not available but needs to be.
  • The residential care (with or without nursing) the council thinks will be needed in the future.
  • An overview of how Surrey County Council needs to shape the market and work with providers to develop a viable and sustainable market for older residents.

The MPS highlights data on future supply and estimates that, by 2025, Adult Social Care (ASC) residential general placements will decrease by 40%, ASC residential dementia placements will increase by 22% and ASC residential placements with nursing care will decrease by 4%. Overall, there will be a significant increase for ASC placements into residential dementia settings (non-nursing needs), supporting people with more complex needs. Low level residential placements with no additional complex needs will continue to be supported at home.

Older People's Residential and Nursing Market Position Statement (PDF)

Action plan

Our objectives for 2024

Prevention: Supporting people to stay healthy, happy, and independent for as long as possible

  • Work with local district and borough councils to ensure that residents have opportunities to lead healthy and active lives focusing on health promotion and preventative services to avoid long term care requirements.
  • Review current SCC funding arrangements made through grants to ensure that services provided by local organisations are protected to enable people to remain independent and living in their own homes and to recover from a hospital stay.
  • The Stroke Support Service will be reaching the end of it's first term and plans will be made to extend or recommission the service for September 2024 to ensure specific support is available to all adult residents effected by Stroke.
  • Review new advocacy contracts (that started in July 2022) and initiated a range marketing and consultation events with Surrey charities and networks so that Surrey residents know about the range of advocacy services in Surrey available to support them, and how to approach them.
  • Initiate additional ASC staff training to ensure that staff understand advocacy services available and how to support residents to use them.

Living Independently: Facilitating people to continue living at home for as long as possible through timely care and support that works around their priorities and outcomes

  • Continue to ensure there is a wide choice of cost effective Care Quality Commission (CQC) registered homecare and live in care from providers with available capacity to meet care and support requirements for people who can receive care and support at home. Existing providers on the 'Care within the Home contract' will be monitored and reviewed on a regular basis, new applicants will be assessed according to their ability to provide services as set out in the 'Care within the Home service' specification.
  • Ensure care providers that have sponsored staff from overseas to deliver care in Surrey are following all relevant guidance and procedures regarding the safe recruitment of care staff.
  • Continue to focus on care delivery, ensuring that homecare staff stay for the full length of the commissioned care call, for example 30 minutes, 45 minutes.
  • Continue to encourage providers where possible to allocate care staff to calls that provide continuity of care provision.
  • Extend the recommissioned 'Collaborative Reablement' service launched in October 2021 by a further year to allow us to continue to support residents whilst we build a longer-term countywide service in 2024.

Residential and Nursing Care Homes: Maintaining a strong emphasis on strength-based, personalised care for older people who require intensive support in a specialist care environment

  • Ensure that residents that are offered opportunities to receive support in their own homes, for example live in care, to avoid unnecessary care home stays and to ensure that capacity in care homes is maintained for residents that really need that level of support.
  • Provide support to staff working in residential and nursing care homes with older residents with dementia who may present distressed behaviours and to enhance the skills and competencies of care home staff in supporting people with complex dementia needs.
  • Explore ways to support the care home market in working with older residents with a learning disability and/or autism through enhancing skills and confidence in working with this client group.
  • Continue to grow the residential and nursing care contract to offer greater choice to older residents who require a care home placement both within and outside of Surrey.
  • Develop a Generic Design Brief for future care home capacity to be fit for the future to meet increase in demand and complexity.
  • Working with local communities to develop strong relationships with care homes, this will enable residents to continue to feel part of their local community and improve their own wellbeing with inclusive activities and engagement.
  • Engage with local care home residents, their families and carers to ensure commissioners and local stakeholders understand what is important when commissioning services now and in the future.
  • Continue to work through till 2030 in line with the strategy to develop new capacity and shape the Surrey care home market to meet local needs of residents by offering affordable care home capacity that meets complex needs.

Our objectives for 2023

Prevention: Supporting people to stay healthy, happy, and independent for as long as possible

  • The New Stroke Support Service contract that went live on 1 September 2022, will have developed standardised referral system in to the service to ensure all effected by Stroke have the opportunity to receive individualised support.
  • Complete the tender process for five new extra care sites in Surrey, with a successful partner appointed to design, build, finance and operate the settings.
  • Carry out an annual review of the New Instructed & Non-Instructed Adult Advocacy Service contracts were initiated July 2022. Implementation of marketing and communication plan ongoing.

Living Independently: Facilitating people to continue living at home for as long as possible through timely care and support that works around their priorities and outcomes

  • Develop a strategy for care delivery to new extra care housing settings in Surrey (currently Pond Meadow in Guildford and five other sites, with more to come), which will ensure people receive flexible, high quality and responsive services to support people to live independently and well.
  • Appoint a CQC (Care Quality Commission) -regulated provider to deliver care and support to the Pond Meadow extra care housing scheme, which is expected to open in mid-2024. The provider will work in partnership with Pinnacle Housing as the future housing operator to ensure people are supported to live in a community focused on health, wellbeing and maintaining independence.
  • The new county-wide Collaborative Reablement Service evaluation findings from the first year of contract will be incorporated into County Wide Reablement operations in New Year 2023. This will support decision making for possible extension of contracts beyond October 2023.
  • Ensure there is a wide choice of cost effective CQC registered homecare and live in care from providers with available capacity to meet care and support requirements for people who can receive care and support at home. Existing providers on the 'Care within the Home contract' will be monitored and reviewed on a regular basis, new applicants will be assessed according to their ability to provide services as set out in the 'Care within the Home service' specification.
  • Commissioners will meet with prospective new providers of homecare on a monthly basis to provide them with market information on the demand for CQC regulated homecare and live in care in Surrey and to advise on the current level of provision of homecare in Surrey.
  • Continue to provide the opportunity for providers of homecare and live in care and anyone interested in the provision of homecare and live in care in Surrey to meet commissioners in person at a SCC office to discuss the current level of services and new opportunities.
  • Continue to support providers of CQC regulated homecare and live in care that experience problems with the provision of services or receive a poor-quality rating from CQC through structured Provider Support and Intervention meetings chaired by a SCC commissioner to support the provider to improve services.
  • Commissioners to continue to work to support all providers on the SCC Care within the Home DPS to submit required key performance indicators and update the NHS Capacity Tracker on a monthly basis.

Residential and Nursing Care Homes: Maintaining a strong emphasis on strength-based, personalised care for older people who require intensive support in a specialist care environment

  • Develop a Market Position Statement for older people Residential and Nursing Care that details the gaps and challenges that are current faced within the sector and what is required to meet future demand.
  • Hold a Market Shaping event to engage the care home market in developing new capacity in Surrey, communicate about the changing needs of older people in Surrey, and how to respond to them.
  • Define our future capacity needs and integrated care pathways to meet the increasing demand for complex and challenging placements for older people's care homes
  • Develop detailed plans /options for future care home capacity within each locality considering the existing care home portfolio sites and/or other Surrey locations if required.

Our objectives for 2022

Prevention: Supporting people to stay healthy, happy, and independent for as long as possible

  • Contribute to the review of the Better Care Fund in Surrey by March. This is a joint budget between health and social care. Support the use of this funding to maintain the independence and improved health and wellbeing of Surrey's older population.
  • Publish how much we spend on prevention by April. We will use this to plan better ways of investing in prevention and develop opportunities to support residents where needed. This will include existing projects, services and grants we fund.
  • Review and implement changes to our webpages by April. This aims to ensure residents, providers and stakeholders can make best use of the information provided.
  • Support providers with changes in COVID-19 funding and guidance to help ensure safe and supported workforce in Surrey and care settings by April.
  • Launch the Living Well in Later Life Strategy online and in easy read formats and supporting video in May.
  • Produce Market Position Statements for priority work areas. These will help guide and support providers and commissioners with making key decisions for the population of Surrey by August.
  • Develop and share a provider communication and engagement plan by November. It will offer better support for residents, including newsletters, events, and online services.
  • Review the Collaborative Reablement Service's (CRS) new arrangements by April 2023. We rolled these out in October 2021 and applied them to existing contracts.
  • New advocacy contracts to start in July. These include building operational relationships with new and existing providers.
  • New Stroke Support Service to go live in September. It will build on the success of the current service, with clear outcomes and close working with the wider Integrated Stroke Delivery Network to help stroke survivors and their carers receive the support they need.
  • Engage regularly with residents, unpaid carers and stakeholders to review progress against the Living Well in Later Life strategy objectives and set Action Plan for 2023.

Living Independently: Facilitating people to continue living at home for as long as possible through timely care and support that works around their priorities and outcomes

  • Review Care within the Home services and Collaborative Reablement in January, including completing contract management meetings.
  • Commissioning Development Officers will be in place in February to support provider management and our operational teams.
  • Update suppliers with financial uplifts for provider services and support by February.
  • Award Surrey's first commissioned Extra Care housing setting in Guildford in March.
  • Tender for four more sites for Extra Care Housing in May or June.
  • Identify support required for Discharge to Assess across Surrey in June, following changes to funding a local approach.
  • Launch a new brokerage system to support the way we buy care from the Care within the Home market in September.
  • Complete a 'Fair Cost of Care' exercise for residential and nursing care and home-based care as part of the proposed social care reforms by September.
  • Recommission care contracts that are due to expire by end September and work to design care specifications for new Extra Care settings.
  • Engage with people that use services to shape the Care Commissioning Strategy for Extra Care Housing.
  • Reflect on the recruitment challenges for home-based carers in Surrey and ensure that we have enough reliable capacity available.

Residential and Nursing Care Homes: Maintaining a strong emphasis on strength-based, personalised care for older people who require intensive support in a specialist care environment

  • Work with NHS colleagues to plan a regular calendar of events and communication strategy to work more closely with the social care sector in January.
  • Commissioning Development Officers will be in place in February to support provider management and our operational teams.
  • Re-open the tender for care homes to join the new purchasing approach for delivering care home placements in Surrey by March.
  • Complete the Choice workshops to ensure consistency on how we purchase residential and nursing care by April.
  • Develop plans to support the closure of the eight In House homes in Surrey by April. We managed those homes.
  • Launch our new brokerage offer and contracts, with NHS colleagues, for purchasing care home placements in Surrey by May.
  • Define our future capacity needs to meet the increasing demand for complex and challenging placements for older people's care homes by September. This includes scoping the support needed for residential dementia care provision after the block contract provision ends.
  • Scope options for future capacity within each locality by September. We will evaluate the existing portfolio, whether current sites will support future need or if we need to consider extra sites in Surrey.
  • Manage the capacity requirements within Surrey and map out the required Dynamic Purchasing System (DPS) capacity we need for 2023 to 2024 by December.

Our objectives for 2021

Prevention: Supporting people to stay healthy, happy, and independent for as long as possible

  • Undertake a day opportunities survey to understand what people value and use by June. Use the information to shape a community and voluntary sector Market Position statement in 2022.
  • Complete the co-production of the Living Well in Later Life strategy by November.
  • Review services offered for older people based on the findings from the Information and Advice strategy surveys and workshops. Plan an improved information and advice offer for Older People and their families and unpaid carers by December. This work will include reviewing our website content.

Living Independently: Facilitating people to continue living at home for as long as possible through timely care and support that works around their priorities and outcomes

  • Launch recommissioned Care within the Home services by October. In partnership with NHS colleagues, we commissioned Home-Based Care and Live in Care arrangements to deliver better care for residents within their own home.
  • Launch a recommissioned 'Collaborative Reablement' service by October. This is a vital service supporting people to return home and reduce their dependency on social care by promoting independence and strengths.
  • Begin piloting and developing our 'Discharge to Recover and Assess' services by October. This uses government money to support people leaving hospital to return home or find the right longer term social care support.

Residential and Nursing Care Homes: Maintaining a strong emphasis on strength-based, personalised care for older people who require intensive support in a specialist care environment

  • Ensure regular relationship and provider management meetings are in place by March. These aim to support the contract providers we do most business with and to manage these contracts and services before they end in 2027 and 2028.
  • Establish regular meetings and workshops with providers to support them during the pandemic and to understand how we can improve relationships and change our approach to purchasing care by April.
  • Review our spending and purchasing of care home capacity across the market to identify where our challenges and opportunities are to work better by June.
  • Review of our systems to improve the way we record and share information by July. Identify areas that need investment and development. This is our Market Management systems project.
  • Complete an independent review of costs for care in the residential and nursing care market in Surrey to better understand the costs of care within diverse types of homes by September. We will share this with providers to support our future approach to buying care.
  • Support the development of brokerage by September. This team will provide consistency when making placements and help manage the money we spend. The brokerage team will ensure contracts are in place and will support providers in making decisions about who they can and cannot support. This is essential as we support people when leaving hospital and to build better relationships with providers in Surrey.
  • Support the public consultation process for the eight In House homes we manage and plan to implement the decisions made by Cabinet by December.
  • Launch our new tender for purchasing care home capacity from Surrey providers by December.

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