Commissioning intentions
The Warwickshire adult social care market faces considerable challenges, but commissioners remain committed to working with providers to ensure quality of care and sustainable services for the long-term. The commissioning intentions below outline the key activities being undertaken.
The current Care at Home contract has been in place since August 2016, will end in July 2024 and the service will be out to tender in early 2024. The current contract operates on a geographical zonal basis, with fixed pricing arrangements which were calculated according to whether the area is urban or rural; volumes of customers within the zone; travel requirements. Providers who applied to join the contract were invited to bid for specific amounts of business in particular geographical zones with volumes of business guaranteed. There are eight zones across the county, outlined in the graphic below, each with a proportion of urban and rural coverage. This model endeavours to maximise the time that carers spend with customers, as they will only travel within one zone thus contributing to more targeted and effective sourcing of care.
Work is currently underway to review the current service to inform the next contract model and specification. The tender is due to be published in April 2024, with the new contract due to commence in August 2024. Micro-commissioning opportunities such as pilot schemes, smaller business opportunities, along with the retender of the main domiciliary contract will be advertised on our electronic tendering system, CSW JETS and we encourage local providers to register on the portal to ensure they are notified of these tendering opportunities.
CRS provides short-term care (up to six weeks) to a patient who requires care in their own home and also provides them with access to therapy. The service aims to:
- Ensure that care commences for more patients being discharged from hospital within 24 hours of a referral to domiciliary care.
- Support more people home from hospital with a rehabilitation and/or recovery services to increase their functional outcomes so they can remain independent for longer
The service consolidates several previous hospital discharge pathways operating in Warwickshire including Stroke, and Home-based Therapy.
CRS is currently running as a 12-month pilot until April 2024 with a small number of providers. Prior to April the service will be reviewed and evaluated to understand the longer-term service requirement for people coming home from hospital with short term care and rehabilitation needs.
There will be decisions made about the long terms model of CRS as part of the wider care at home domiciliary care offer once the pilot service has been evaluated. Therefore, there may be an opportunity for providers to tender for this service during 2024.
As the number of individuals living with dementia grows, there will be an escalating demand for comprehensive support services, including healthcare, social care, and community-based services. Moreover, we recognise the importance of public awareness and education about dementia, emphasising early diagnosis and intervention to reduce stigma, along with improving access to care and support for affected individuals and their families. Working together with colleagues in health WCC integrated commissioners will be testing out a model of care to support people with delirium or cognitive impairment that require additional shortterm support overnight. It is also essential that all care at home services can embed the key principles of the local dementia strategy within their service delivery including supporting people with dementia to live well at home and within their communities.
We are committed to supporting the care market in working more digitally and adopting technologies to improve the quality and safety of care. When supporting people or giving advice, we will ensure assistive technology is always considered, especially where it can improve hydration; reduce medication errors; reduce falls; support those with learning disabilities; support those with dementia; those with physical disabilities; those with mental health issues; and support carers. We will continue to support care providers to maximise their use of AT to ensure the quality of care and safety for customers.
We are committed to acting decisively to tackle climate change and the biodiversity crisis. Acting now, so that we are a county with a sustainable future, is one of the key strategic priorities in the Council Plan. We have already started work towards our goals of reducing carbon emissions to net zero across the council by 2030 and to support us as a county to do the same by 2050 or earlier. We will be working with domiciliary care providers to assess and reduce the environmental impact of domiciliary care, with a view to agreeing a protocol/ambition which would then form part of our future contracts.
We will continue to work with providers to improve health and wellbeing and prevent ill health for older people, building on the recommendations in the Warwickshire Healthy Ageing JSNA. Conditions that most impact on health in later life for Warwickshire residents include cancer, Ischaemic heart disease and dementia; back pain, hearing loss, diabetes, falls and chronic obstructive pulmonary disease (COPD).
We will continue to work with the domiciliary care market to ensure that we are purchasing the right amount of business to meet the identified care demand. There is an ongoing commitment to get care of good quality targeted into the right geographical areas. This will continue to be achieved, through building strong business relationships with contracted providers and the wider market and ensure that there is ongoing dialogue to understand the ongoing needs of the market. This helps the council to make financial and business decisions to nurture a flexible, stable and evolving market that continues to meet the changing needs of the population.
We have launched several pilot schemes within the county (including Restricted Mobility Pathway, Home Based Therapy Services, the Community Recovery Service) to trial new and innovative ways of meeting the requirements of communities, partners (for example, hospitals, therapy teams, care providers) and internal teams within the council. This is done in partnership with all stakeholders and Warwickshire will continue to push for evolving and improving services, that will improve the lives of its most vulnerable citizens.
We will move domiciliary care services to automated payment and call monitoring processes from 2024. This will allow for the removal of paper-based invoices for individual customers and enable queries to be alerted and responded to in a live system.