Shaping Adult Social Care’s care market

Under the Care Act 2014, Surrey County Council has a duty to promote diversity and quality in provision of services and have oversight of the provider market. This means that the council must ensure that people who are living in Surrey and require care and support have a choice of high-quality services to choose from with sufficient information to make informed decisions.

The council works collaboratively with other relevant partners, including experts by experience, to shape the whole market for care and support, and to achieve the best outcomes for people living in Surrey - now and in the future.

Find details on the Adult Social Care vision, priorities and commissioning strategies, which underpin our market shaping work.

Our approach to the market

The council has been working strategically, alongside our care and support providers and with the Surrey Care Association, to improve market stability and relationships with our market providers. In our approach to the market, we aim to:

  • build strong relationships with the whole market to encourage innovation, choice, and availability, enshrined in good information and advice​
  • ​collaborate with providers and system partners, organisations, and suppliers to ensure our services are shaped and mobilised effectively
  • ensure all purchasing decisions are outcome-focused and driven by evidence of what works
  • put in place fair and transparent processes for identifying and purchasing care in line with the Care Act, often working jointly with health commissioners to provide greater consistency for providers

As a result, this has allowed us to:

  • elevate service quality by predominantly purchasing from providers rated as good or outstanding
  • develop better relationships with providers through proactive engagement and collaboration for future procurements or innovation
  • enhance market stability and increase capacity within the Surrey market by encouraging local providers to join our long-term contractual arrangements
  • assess the effectiveness of our current and future workforce, supporting our social care workforce to meet growing demand and greater complexity of need
  • enhance the use of data and insights to inform our market shaping work, identifying market trends, gaps, and opportunities
  • manage costs and ensure value for money by contracting through Dynamic Purchasing Systems where providers select or specify agreed rates, including from joint health and social care pricing matrices
  • use contracts to specify service delivery outcomes and promote fairness and transparency through compliance with Care Act Regulations on Choice of Accommodation and Third-Party Top-Ups

See information on our procurement opportunities.

For detail on market sustainability and the cost of care, please see our Surrey Cost of Care report.

Key challenges and opportunities

There are several challenges that Adult Social Care (ASC) in Surrey continues to face in relation to service delivery:

  • as we celebrate that people are living longer, many individuals are facing prolonged periods of ill health, necessitating increased care and support to meet more complex needs. Meeting demands with limited resources requires innovative approaches to service provision, requiring us to think differently about how we use resources most effectively
  • there is a substantial and buoyant market for private fee-payers in Surrey where more than 65% of care home capacity is either used by older self-funders or is vacant and unavailable to the local authority (see note). This poses challenges in managing the market and procuring good quality care home placements that the council can afford longer term, especially when considering the types of placements required which are often for more complex needs
  • we do not yet have sufficient access to affordable extra care housing, which means many of the people we support move into residential care, instead of living the life they want to in the community
  • since 2021, we have worked to reduce the number of individuals living in residential care homes by 20% from 984 to 790 and will continue to shift the balance of care towards independent living for individuals residing in both in-county and out-of-county residential services where appropriate
  • over the past 4 years, there has been a significant increase in people accessing adult social care services for their mental health needs. Between January 2023 and January 2024, the numbers grew from 2,450 to 3,023, a 23% increase. We need to ensure high quality and affordable services are there to support people to recover and maintain mental wellbeing
  • there are limited services for people with a physical disability or sensory impairment in Surrey. We need to shape the market to develop more options from supported living accommodation to home-based care to support people to remain independent in their own home
  • the number of unpaid carers accessing early intervention carers commissioned services increased from 9,775 to 10,950 between 2022 and 2024. However, there are approximately 91,000 unpaid adult carers in Surrey and recent feedback has suggested that we do not have the early intervention carers replacement break offer quite right; we are in the process of co-producing a different offer
  • supporting young people and their families as they transition to adult social care present significant challenges. There are limited supported living options within travelling distance of further education colleges which can lead to unnecessary out of county placements or the use of residential colleges. We also recognise there is a need to support those transitioning to adulthood to develop everyday living skills, including growing the employment support offer in size scope
  • for adults who are autistic we vitally need to establish more inclusive communities in Surrey and improve access to employment support by working with support providers and employers to support better accessibility in recruitment and retention processes and workplace environments. We are committed to ensuring that adults who are autistic in Surrey do not fall through gaps between services, particularly mental health and learning disability services
  • challenges persist in attracting and retaining a social care workforce equipped with the necessary skills, competencies, and capacity to provide the required level of care and support
  • emphasising prevention of illness and enhancement of overall wellbeing is imperative, yet existing systems have primarily concentrated resources on addressing illness and crises as they arise
  • the single greatest challenge for working-age residents of Surrey with disabilities is accessing appropriate support with everyday living. The council is developing proposals to transform day and evening opportunities, improving the support available to promote independence through skills development

Innovation will be the key to continuing to meet people's needs against this backdrop. We will continue to empower individuals to have more choice and control over their care as a key principle of our commissioning approach. By fostering a diverse and vibrant market, we aim to harness the assets, talents, and aspirations of the population, driving partnership and co-production of outcomes.

We are committed to adopting an asset-based approach to commissioning, collaborating with the residents in Surrey and the care market to identify and build on community assets. Effective coordination and integration between different organisations and services is essential for providing holistic care and support. We will embrace technology to help improve efficiency, quality, and accessibility of adult social care services for better outcomes.

Market sustainability and quality of care

Local authorities have a duty under the Care Act to promote a sustainable care market that meets the needs of residents. There are several ways this happens which are set out below:

  • Surrey County Council oversees the quality of care and support services commissioned by the council as well as services operating within the county that are not commissioned by the council. The council uses the Provider Assessment and Market Management Solution (PAMMS) Market Management system to carry out proactive quality oversight, working collaboratively with providers to drive up quality
  • more serious concerns regarding care quality are addressed through the Provider Support and Intervention Protocol. This is a multi-agency process giving assurance that all risks are being addressed and provides support to the provider to improve. Residents are assessed as part of this process and in cases where risks are assessed as unacceptable, residents are supported to move to appropriate alternative services. A temporary suspension of new commissioning activities by the local authority is normally applied until quality improves
  • both the council and care providers adhere to the regulations outlined in the safeguarding adults legislation. If you are a care provider and you have identified that an adult is at risk of abuse and neglect you must contact Surrey County Council. We investigate all quality alerts and customer complaints. We meet the Care Quality Commission each month and share intelligence
  • the council collaborates closely with care providers in Surrey to address potential disruptions to business continuity. We keep updated contact lists of care providers and promptly share pertinent information in case of urgent risks. Additionally, we actively advocate for the vaccination of care staff to mitigate the impact of flu and COVID-19
  • we encourage all care providers to engage with Skills for Care, to be part of working groups or to access training and other staff support. We also promote training opportunities through the Surrey Skills Academy. We encourage all registered care homes and home care agencies to complete the Capacity Tracker web tool with their data monthly
  • the council engages with providers annually regarding inflation. Service providers are notified of inflationary awards for the next financial year (April to March) after the council's budget for the next financial year has been approved by Full Council which typically takes place in February each year. The council also fully engaged in the Governments (Fair) Cost of Care exercise which provided further assurance to our pricing approach
  • the council has introduced several commissioning frameworks, most latterly the Dynamic Purchasing System for Packages with Community Accommodation (Working Age Adults), which aim to enable stability and growth in the market, quality assurance and greater cost efficiency to support sustainability

Market Position Statements

A Market Position Statement (MPS) is a vital part of what the council must do to ensure that there is a choice of different types of service and support available to residents. Aimed at organisations who provide care and support to people in Surrey, the MPS outlines the local authority's understanding of the market and shares information on:

  • insight about the people who may require services now and in the future
  • future commissioning intentions for care and support and accommodation-based services for adults
  • information on market spend, upcoming market engagement and procurement activity
  • overview of current market pressures, challenges, and future opportunities

The MPS is designed to give the care and support market the opportunity to adapt their delivery model as, and if, required and help to shape their business plans.

This range of documents found at the bottom of this page includes:

  • Market Position Statement: Adults with mental health needs
  • Market Position Statement: Outlining Surrey's support for carers of all ages
  • Older people's residential and nursing care Market Position Statement
  • Market Position Statement: Right homes, right support
  • Market Position Statement: Care within the home
  • Market Position Statement: Direct payments
  • Market Position Statement: People with a disability or sensory impairment

Note: This percentage has been generated through comparison of overall bed capacity and current voids (using Care Quality Commission (CQC) data and the NHS Capacity tracker), and takes into account existing public sector placements and additional availability made to ASC in Surrey which is recorded on our brokerage system, AOSS.

Files available to download

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