The shifting landscape of adult social care

The landscape in which local authorities arrange care and support for older and working age adults is shifting.

The last decade has seen authorities do much to increase support for people in their homes which, along with the recent impacts of Covid and cost increases, is having a profound effect on the markets in which they operate. Our recent work with Croydon, West Sussex and Wiltshire Councils has brought these issues into sharp focus.

The impact of these changes has been significant. For older adults, success in securing care for people at home means those entering care homes, both local authority and self-funded, are frailer, with much more complex needs. This includes a large increase of people with dementia, and thus in demand for specialist beds.

The policy agenda

The policy agenda for working age adults is focused on increasing independence, choice and control. Again, this has meant a decline in demand for residential care and an increase in tailored support to people at home and in supported living.

This has led to a change in demand for local authorities’ assets. Those retaining ownership of care homes have seen demand shift, and the impact of Covid – when for a year or two there were very limited admissions – is still being felt. In some cases, there are high levels of vacancies.

Where authorities have entered long-term contracts for their care homes or supported care, the evolving landscape means that the services commissioned may no longer be delivering what is needed. Some years into a long-term contract, when corporate memory of the procurement process has diminished, there may not be sufficient time and resource spent on active and effective contract management. Added to this, contracts are often inflexibly constructed, and providers are feeling stretched, limiting what can be achieved through negotiation.

Local Partnerships can help in a number of ways, such as business case development at project start, including commercial case evaluating, sourcing and procurement options. We can source support at key points in the commissioning and procurement cycle. This includes planning for future service needs, market analysis, assessment of procurement options and targeted assistance with improving outcomes, including by supplier negotiation. Further, we conduct contract management reviews, including assessment of process effectiveness, application, and supplier engagement.