Overview
48. The Council will remain predominantly a commissioner of services rather than a direct provider. We will have role in shaping the local market to ensure a range of good quality services at sustainable and cost-effective prices that tax-payers can afford. We will use our influence and resources to encourage collaboration and innovation by providers and to promote choice. We aim to increasingly enable individuals and their families to purchase care and support directly from providers via Individual Service Funds and direct payments. We are prepared to provide services, either in-house or through local authority trading companies, where the market cannot the services that people need.
49. We intend to deliver our strategic objectives for disability services working with the provider market. Providers can find out more about our strategic objectives in Living My Best Life – A Joint Strategy for Disabled and Neurodivergent people in Staffordshire 2023 – 2028. We will continue working closely with CQC regarding regulated services and implementation of 'Right support, right care, right culture' guidance. In doing so, we aim to work with providers who can prevent, delay or reduce the development of care and support needs, including unpaid carer support needs, and consolidate our asset-based and outcomes-based commissioning, and ensure we measure our performance as commissioners against the principles, ethos and approach detailed in the Commissioning for Better Outcomes route map. Figure 1 demonstrates how we want the market to shift over the coming years.
Figure 1: Strategic Direction of Travel 
Strength-based approaches
50. We support strength-based approaches to enable people to lead the most independent and fulfilling lives. Strength-based approaches focus on what matters to people, what they can do for themselves, and how their abilities can be complemented by help from family, friends, neighbours and technologies to achieve their goals. We will continue to develop the assets available in our communities and ensure that the public and professionals know how to access them, and to utilise strength-based approaches in our Care Act assessments.
51. Through our Supportive Communities programme we will continue to work with the voluntary sector, NHS, district/borough and parish councils to make communities vibrant, safe and inclusive places for people with disabilities to live. The programme is focused on making better connections between those people that may need additional support and the wider range of voluntary groups and community services that are available locally.
52. We want care providers to have a wider social impact by helping to link people to the communities they live in, and we encourage them to get involved with this work and the community offer through Staffordshire Connects and Community Help Points.
53. We also want care providers to adopt strengths-based approaches within their services, maximising people’s independence, taking positive risks, avoiding restrictive practices and achieving personalised outcomes. As we commission services, we will look at opportunities for promoting strengths-based approaches within service specifications, shifting away from ‘time and task’ and towards outcomes-based contracts that offer care providers more flexibility to meet individual needs and achieve their outcomes.
Co-production
54. Co-production means organisations and their staff, communities and individuals working together as equals to improve services and outcomes. It requires a commitment to working collectively and collaboratively and involving people in the whole process of design and delivery of services, from beginning to end, exchanging information and power for mutual benefit.
55. We are strengthening our arrangements for co-production in Staffordshire. We have a Disability Partnership Board and we have appointed Assist to support it. The Board brings together people with a disability, families and carers, care providers and the statutory organisations responsible for health and social care services, housing, leisure and community safety.
56. The Board will oversee local implementation of the National Disability Strategy in Staffordshire and the Staffordshire Disability and Neurodiversity Strategy 2023 - 2028, champion rights, independence and inclusion and improve the way that public services, the voluntary sector and the wider community work together to help people with a disability to enjoy greater independence and a better quality of life.
Quality
57. For all services we use a range of information to evaluate quality including Care Quality Commission (CQC) ratings, feedback, compliments and complaints from people with a disability, their families and carers, and intelligence from our staff and from other partners in the health social care system. We encourage all care providers to consider and implement national best practice including NICE standards, ‘Making it Real’ from Think Local Act Personal, and CQC quality statements. Where we have concerns about the quality of a service, our Quality Assurance Team will co-ordinate further assessment and support.
58. For regulated services, all regulated services should aim to be assessed by CQC as ‘Outstanding’ or ‘Good’, and every service below this level should be enacting a clear plan to improve. We aim to continue working closely with CQC to improve regulated services in line with 'Right support, right care, right culture'.
59. Quality ratings for the 53 supported living providers the Council was working with in September 2022 are shown in figure 3. All of our residential respite care services are rated ‘Good’.
Figure 2: CQC ratings of 53 supported living services with a Staffordshire placement (including out of county) in September 2022
Source: www.cqc.org.uk
60. Day opportunities are usually a non-regulated service and therefore their care quality is not measured by CQC. We will continue to strengthen our quality assurance arrangements and ensure that quality requirements are specified in contracts and expectations for the services that people purchase using direct payments.
61. Our intention is to strengthen quality assurance arrangements including:
Accessibility and sufficiency
62. The Council needs to ensure that people have access to a sufficient supply of accessible services in the long term. We intend to strengthen our market intelligence about demand and supply. This includes understanding key life stages such as the needs of older children before they transition to adulthood, as well as end-of-life services. This will allow us to assess expected demand against supply of services and shape the market appropriately.
63. We know that there are immediate shortfalls of supply of services for some groups and in some areas:
- We have a gap in capacity for supported living with reablement that can help people develop life skills, for example for younger people as they transition to adulthood, and people of all ages after hospital admission or a prison term. We welcome conversations with care providers who are willing to develop these models.
- We need more capacity in day opportunities for people with highly complex needs.
- We need more capacity in personal assistants who can offer a full range of support to help people with disabilities to live independently.
- There is a relative deficit in capacity of supported living in Lichfield, Newcastle-under-Lyme and Tamworth.
64. We also want to develop our work with district and borough councils and the NHS to ensure that people with a disability can access universal services and general needs accommodation, as well as with housing partners to influence planning opportunities, and ensure that there is a sufficient supply of dedicated housing.
65. We ask that all care providers, under 'Right support, right care, right culture' guidance, consult the Council prior to submitting any planning applications. This is the ideal time to share innovative ideas and local investment opportunities to improve life for people with disabilities in Staffordshire. Please see the ‘How to Contact Us’ section for our contact details.
Person centred care and support
66. We are interested in giving people with a disability greater control over their personal budgets. We are exploring the development of individual service funds (ISF) to allow people with disabilities and their families and carers greater choice and the opportunity to directly shape the services they receive from care providers.
67. To support choice and control we want to make sure that people with a disability have good access to information, advice and guidance so that they can understand the community assets and care services that are available. We are reviewing the Council’s website to improve content and accessibility. We would like to see more care providers offering information, advice and general signposting, including via social media, to help all people with disabilities live as independently as possible.
68. The Council and care providers have a duty to be aware of and responsive to the needs of wider vulnerable groups or demographic characteristics for example in respect of protected characteristics (inducing disability, ethnicity, religion, culture, gender, and sexual orientation etc).
Workforce
69. The Council has a dedicated Valuing Social Care website and has developed a sector wide Workforce Strategy 2023 – 2025 across adult social care and will continue to support the care provider workforce through 8 key actions:
- Improve the use of updated data and intelligence as a shared resource to support the social care workforce
- Promote available resources to providers more effectively, and engage with providers who need the most support to use those resources
- Develop an improved journey into work
- Implement a co-ordinated partnership approach to learning and development
- Improve the positive recognition of social care as a valued career
- Increase the level of capability to use digital and technology innovations
- Support improved practice across the sector in recruitment and business continuity planning
- Seek to reduce travel costs where possible across the partnership
Cost effectiveness and pricing
70. Nationally the financial position of adult social care will continue to be challenging. It is important that the Council and providers work together to ensure that services offer value for money. This will require a commitment to innovation and the continuous development, sharing and testing of new models of care.
71. We have undertaken a local cost of care exercise, in partnership with the market, to help us establish a greater shared understanding of cost pressures facing the Council and care providers.
72. For the Council, cost pressures are driven in part by rising demand from a relatively small number highly complex individuals and we are interested in developing reablement services that can prevent, delay or reduce the development of care and support needs. We also want to understand how we can encourage care providers to take positive risks and avoiding restrictive practices so that people with disabilities can enjoy greater independence and a better quality of life.
73. In line with national policy, we intend to work with the market to standardise prices for services, including in supported living and day opportunities. This will ensure that funding for individuals and for care providers is equitable and based on their care and support needs rather than on market forces. As part of this we will be clear about the service specification that is covered by the price.
74. The Council undertakes an annual fee review for all commissioned services which considers a range of economic factors including the cost pressures facing care providers and the funding available to us. Our contracts do not allow care providers to unilaterally increase fees outside of this process.
75. The Council is in the process of implementing a change to all placements to pay providers gross rather than net of client contributions. This change will be effective for some commissioned disability services from August 2022 and will result in providers having greater certainty of income and reduced bureaucracy associated with invoicing individuals. This will be in place for supported living when it is recommissioned.
Technology enabled care
76. Technology is advancing at pace and presents opportunities for innovative approaches to improve the quality and cost-effectiveness of care, enabling people with a disability to achieve their individual outcomes. The Council is interested in working with care providers to understand, test and implement relevant technologies in their services, and to develop the appropriate skills in staff.
Partnerships
77. The Council will work with a range of partners to help people with a disability enjoy greater independence and a better quality of life – including:
- To support carers supported including with flexible respite care in line with the priorities outlined in the Strategy for Carers
- With the voluntary sector and communities to improve access to local support.
- With district and borough councils and the NHS to ensure that people with a disability can access universal services and general needs accommodation.
- With schools, colleges and employers to improve access to education, training and employment opportunities.
- With housing partners to influence planning opportunities and ensure that there is a sufficient supply of dedicated housing.
- With technology providers to understand, test and implement relevant technologies in care services.
- With the NHS to ensure access to specialist services for people with disabilities and / or autism.