We know that one of the best ways to meet your Care Act responsibilities is through collaborating and working with other regions and Integrated Care Systems (ICS) so you can make better use of the resources you have, decrease waiting times, and deliver better continuity of care.
But, we also know that it isn’t always that simple. In order for this to work successfully we know a high level system is needed. At The Access Group we offer an eco-system of solutions that can help ensure you deliver your responsibilities to gain better insights of the provider market both now and in the future.
This article will review the Care Act local authority responsibilities, why they are important, and how technology can help ensure your duties are delivered successfully whilst putting every person using services at the heart of everything you do.
Care Act’s responsibilities for local authorities – What are they?
The Care Act responsibilities for local authorities ensure the provision of services, facilities, and resources to help prevent, delay, or reduce the development of care needs.
It is the local authorities’ responsibility that people in their local area:
- Receive services that prevent their care needs becoming more serious
- Allow easy access to information and advice to make good decisions about the potential care and support needed
- Have a wide range of high quality, appropriate services available to choose from
In order to ensure that people in your local area have a variety of services available to them local authorities should prioritise three keys things:
1. Have effective leadership
Having effective leadership can help local authorities acknowledge where there are weaknesses in your care delivery and be evaluative in how these can improve to get better outcomes in the future.
2. Manage your commissioning efficiently
Through managing your commissioning of services efficiently and your contracting responsibilities you can ensure that the services you work with have the same visions as you and are complaint to help deliver the appropriate care under the legislation from the Care act.
3. Shape your care market to meet everybody’s needs
By shaping your care market to meet everybody’s needs you will allow services to be diverse, enable choice, and encourage independence. This ensures that you have the right services available to meet your demand and only commission the services you need to help stretch limited budgets further.
Under the Care Act there is the need to improve market shaping with more proactive measures to detect emerging risks quicker for better continuity of care.
Not only does The Care Act highlight the duties and responsibilities for market-related issues for local authorities, it also demonstrates these duties for the Department of Health and the CQC too.
Section 5 – sets out duties on local authorities to facilitate a diverse, sustainable high quality market for their whole local population, including those who pay for their own care, promote an efficient and effective operation of adult social care, and to support the care market as a whole.
Section 48 to 56 – highlights local authorities priority to make sure no one goes without care if their provider’s business fails including the CQC market oversight, and local authorities duties for ensuring a continuity of care.
Care Act Commissioning – What are local authorities responsible for?
Care Act commissioning is another key responsibility for local authorities. As discussed above, under Section 5 of The Care Act, the Local Authorities must promote efficient and effective operations of the market service to meet all their community's care and social needs.
Commissioning is the strategic level of care and support services in the marketplace. Here services are designed, delivered, monitored, and evaluated through a contractual agreement with providers to finalise the needs a service must address and what the impact of the service should be on the community. Recommissioning is the process of reviewing and then renewing these contracts with a provider, whereas decommissioning is the process of withdrawing a contract.
Under the Care Act, it is the Local Authorities’ responsibility to facilitate all types of commissioning across the community. This ensures that all the needs of the community are consistently being addressed and the support delivered is always of the highest quality, without going over budget.
Care Act commissioning specifically concentrates and recommends local authorities to follow an outcomes-based commissioning approach. Outcomes-based commissioning is the process of local authorities and providers agreeing on a contract that supports a person, carer, or local population to achieve a set of agreed outcomes instead of specific needs.
Using an outcomes-based commissioning approach makes it easier for all local authorities to deliver their responsibilities under the Care Act. Your local authority can then strategically commission services based on the desired outcomes as well as drive innovation to promote the wellbeing of their residents and go above and beyond the statutory duties of the Care Act
To make this successful, the Care Act’s guidance suggests exploring implementing a payments-by-outcomes arrangement with the providers you work with. This would provide your local authority with more choice and control over the pricing of your contracts as payments for services would then be based on whether the agreed outcomes have been achieved or not. This, in turn, also makes the recommissioning and decommissioning processes more efficient as there will be better data to show if the desired outcomes have been achieved.
Through following the statutory guidance and the additional recommendations from the Care Act on commissioning, your local authority can show that you have better ownership and understanding of your commissioning responsibilities and can make better data-led decisions to show you are consistently concentrating on improving the quality of care your providers deliver to promote the wellbeing of the community.
What is market shaping?
Market shaping in adult social care is the activity of understanding and working with your local market of care providers to deliver a diverse range of care and support services to your local community, making targeted, appropriate interventions when required.
Market shaping includes services arranged and paid for by the state, self-funders, and a combination of the two. Through market shaping local authorities should be able to offer a diverse range of appropriate high quality services as well as types of provider organisations to keep the market vibrant and sustainable.
Through market shaping, local authorities enables people and carers to have a choice on how their care needs are met and the opportunity to concentrate on what’s important to them.
It can also can make sure that the care market as a whole remains vibrant and stable by being prepared for any potential provider failures for a better continuity of care.
Effective market shaping tends to be broken down into a cycle of three activities:
- Market Intelligence
- Market Structuring
- Market Intervention
Here this three step process ensures that councils have the opportunity to gather information and example data about the care market so they can identify what the current care needs are, what additional services are needed that aren’t already available, and what services will be needed in the future. This structure makes certain that the services delivered are needed and can be easily adapted as needs change.
Examples of market shaping
As already discussed effective market shaping can help identify and meet increased demand in service provision. Through gathering, analysing and sharing market intelligence on the increasing demand the types of services needed are easily identified to gain a better market oversight.
When done correctly, this encourages providers to meet this demand so services can be adapted, procurement and commissioning changes can be made, and new market entrants can be introduced to meet the new demands.
Worcestershire County Council found market shaping vital to understand spend and future costs to gain better insights into budgets for more accurate forecasting.
Michael Hudson, Chief Finance Officer at Worcestershire County Council states that:
“ Accessing the management information in Access PAMMS Social Care Landscape is a huge benefit. There is a great level of knowledge and detail and much of it can be bookmarked and stored. This allows inisghts to be shared with staff via weekly, daily, monthly reports which can be built around your geography, organizational structure and team’s needs. As Director of Finance it gives me the ability to pinpoint financial risks.”
Equally, Middlesbrough Council recognised the importance of The Care Act’s recommendation to publish the results of their market intelligence and plans for market influencing in a Market Position Statement. Here Middlesbrough Council realised the value of a self-serve Market Position Statement through public-facing web pages so they could be able to view data and market insights in a clear and comparable form.
Through using our Access PAMMS Social Care Landscape, Middlesbrough Council were able to transform their labour-intensive model to a Market Position Statement which offered their providers a comprehensive up-to-date view of their local care market.
Why is market shaping important?
Market shaping is important as when done correctly it can continuously deliver extensive and diverse improvements in local care systems. It helps councils engage in their market oversight to understand the benefits of having sustainability within local care markets and the providers within them. Through data interventions informed by accurate market intelligence, local authorities can improve the quality, reliability, and sustainability of their care services.
It was highlighted in ‘People at the Heart of Care: adult social care reform white paper’ (2022) that market shaping is an area that the Government want to see significant improvements on, and that they want to maximise the use of technology and the use of data to support commissioning and the delivery of high-quality services.
It is important therefore that councils consider this when updating their commissioning and procurement practices to encourage innovation, investment and continuous improvement within the care market.
What is market oversight?
Market oversight refers to processes in place to monitor, regulate, and support the health and social care market to ensure services provided are safe, effective, and sustainable. Crucial for maintaining the quality of care, market oversight helps protect the wellbeing of some of the most vulnerable and underserved populations.
To have a good market oversight local authorities need to:
- Be able to monitor provider quality and performance
- Monitor financial stability and viability
- Have sufficient data collection for market analytics and intelligence
- Implement demand forecasting and strategic commissioning
- Monitor compliance and prevent risk
The key objectives of market oversight therefore are to ensure quality assurance of health and social care support services across your local authority to improve outcomes and deliver better care.
CQC Market Oversight Providers - Who are they?
CQC Market Oversight Scheme focuses on monitoring the financial stability of some of the largest and most strategically significant adult social care providers in England. The CQC does not list all the providers but some well known ones include large care home operators and home care agencies.
CQC Market Oversight Providers are selected for various things within a specific criteria laid out by the CQC including:
1. Size and Scale
2. The Number of Service Users
3. Geographical Spread
4. Market Impact
Critical in the CQC's efforts to ensure stability and reliability of the adult social care market in England, CQC Market Oversight Providers aim is to safeguard and ensure high quality care for those who need it and rely on essential everyday services.
CQC Market Oversight Function - Why is it important?
The function of CQC Market Oversight is important as it is a regulatory mechanism designed to monitor both the financial stability and operational viability of adult social care within England. Without out, health and social care services commissioned by local authorities would be less coordinated leaving individuals at risk of further health decline.
With its primary goal to ensure the continuity of care both locally, regionally, and then nationally, the CQC Market Function is vital to protect the welfare of some of the most vulnerable individuals relying on care.
Some of the key objectives of the CQC Market Oversight Function include:
- Ensuring continuity of care
- Maintaining market stability
- Safeguarding public funds
- Promoting High Standards
It is clear therefore without CQC Market Oversight local authorities would not be able to foster a successful collaborative approach to health and social care with neighbouring organisations and local authorities to deliver better joined-up quality care. Here understanding the importance of market oversight and having good visibility within your local authority helps to overcome the barriers and challenges facing the health and social care market, as well as encourage the shift from more reactive care to preventative and proactive, delaying future care needs and increasing the independence of your residents.
What are the challenges local authorities face trying to deliver their Care Act local authorities responsibilities?
The Covid-19 pandemic clarified the issues and challenges surrounding adult social care.
The Local Government Association argue that there are four key issues and challenges that local authorities are having to deal with:
- Inadequate funding
- An undervalued workforce
- Provider sectors battling with increasing pressures
- An agenda for integration dominated by the NHS
- Division of market oversight
Thousands of people are receiving less care. The charity Age UK estimates there are 1.5 million people in England who need some help with their day-to-day life but do not receive it. This is predominantly down to restricting budgets. Despite demands constantly increasing, spending is still 3% lower than a decade ago.
Cuts to funding from central government has led to many local authorities trying to protect their spending on adult social care. With the UK having an ageing population too, pressures on the care system will continue to rise.
Here the lack of spaces in care homes and staff shortages in adult social care can cause a knock-on effect for health services. A lack of social care in the community can lead to bed blocking and delayed discharge leaving patients being stuck in hospital beds longer than need to.
There are currently around 14,000 patients occupying beds in England despite being medically fit to be discharged. Here the staffing crisis has meant there are both issues recruiting and retaining staff in adult social care because of staff burnout and issues with pay.
The Local Government Association (LGA) have stated that 71% of councils are struggling to recruit adult social care workers. Here the lack of inadequate funding has meant it has become difficult to generate long-term plans for staffing. Without longer term plans local councils find it difficult to recruit the workforce they need to deliver the best quality of care whilst keeping in budget. Because of this councils tend to only be able to advertise year-on-year contracts and many individuals look for more permanent roles.
Here having a fragmented market oversight can exacerbate these challenges further by making it harder to address them leading to limited coordination and communication with neighbouring local authorities, an increased risk of an overlap of roles, funding constraints, and limited proactive management of the health and social care needs of your community. Having a divided market oversight therefore also makes it harder to contingency plan as resources and budgets can't be compared to local areas increasing the risk of individuals being left without the care and support they need and deserve.
A Market Position Statement is a document to outline a variety of aspects within a local authority’s health and social care market including:
- What services people need and how they will be provided
- The support services available currently, what isn’t available, and what needs to be
- What care services and councils think will be needed in the future
- How will future care be funded and purchased
- How commissioners want to shape the opportunities available
This process of evaluating your data and current services can be difficult and time-consuming for a variety of reasons including:
- Not being able to gather up-to-date information to understand the care market to make better decisions on the most suitable interventions for your local care market
- The process of producing a Market Position Statement can rely on manual processes making it very time consuming so information quickly becomes irrelevant
- Uncertainty that providers will go out of business
- Lack of service availability and choice for care users
- Lack of understanding on public care needs now and in the future
- Increasingly high levels of care needs being left unmet
- A lack of investment in preventative services
- Uncertainties about the future of local government funding
In an attempt to overcome the uncertainties regarding the future of local government funding, in January 2024 an additional £500 million of social care funding was announced. This additional funding demonstrates that the government understand both the challenges and pressures local authorities are experiencing when trying to deliver the best quality social care across both adult and children services. Here this funding can help local authorities better plan both now and in the future to ensure they are delivering their responsibilities of the Care Act to drive innovation and performance to get the best outcomes and continuously improve.
Using the funding to invest in digital technology therefore offers a great opportunity for local authorities to improve outcomes and ensure there are both using better preventative and proactive care approaches to gather information quicker and avoid the need for manual processes to ultimately deliver better person-centred care.
Care Act Local Authorities responsibilities – How can technology help local authorities to deliver their duties and responsibilities?
Local authorities must meet people’s care needs to support them, their carers, and fund care for those people with needs who meet the financial eligibility criteria, as well as those who fund themselves.
Using technology and investing in digital tools is a great way to streamline all data, information, and processes so local councils can know what care provisions and support are available locally and across the care market. Having all data and information in one place makes it easier to manage risks around service interruptions, but also provider failings too so contingency plans can be put in place so everyone receives the care they need.
Through using a variety of technology, local authorities can be better prepared to deliver the duties and responsibilities of the Care Act to deliver a diverse, sustainable, and high-quality care market such as:
- Have an improved understanding of community assets
- Better prevention tools
- More reablement services
- More efficient quality and contract management
- Better market oversight and shaping
1. Have an improved understanding of community assets
Through using different technology local authorities will have a better understanding of the resources, services, and interventions available in their community.
One way this can be done is by investing in social prescribing software. Social prescribing is one good way to deliver a variety of care and support within a community without putting further strain on the NHS.
Social prescribing software helps health and social care professionals, community developers, and more reconnect individuals with a wide range of social, emotional, or practical needs.
Here at Access Elemental Social Prescribing we help to connect individuals to non-clinical programmes and services in their local community through working with local authorities and encouraging collaborative working with other organisations to share resources, solutions, and data.
Our platform offers two-way integrations with leading clinical software to make managing social prescribing referrals easier, as well as encourage self-referrals too.
By working with a variety of organsiations, our social prescribing software offers one centralised place for all information to be placed to help track and measure the outcomes individuals experience in their social prescribing journeys.
Lorn and Oban Healthy Options, an Access Elemental Social Prescribing customer, one of found that since working with us they had a 17% reduction in GP appointments in their first year alone, saving them over £8000.
Therefore through engaging in social prescribing and investing in social prescribing software local authorities can ensure they are delivering Section 5 of the Care Act by having a full understanding of their community assets and knowing what support they have available currently, what they need that they don’t have, and a better understanding of the support services they will need in the future.
2. Better prevention tools
One of the other key responsibilities for local authorities under the Care Act is to make sure no one goes without care, even if a provider fails, even individuals are self-funding their own care.
We are aware of how long-winded producing Market Position Statements can be, so at The Access Group we offer a solution with is automated and interactive so you can make better use of your social care data. This helps you to obtain the market oversight needed to plan your services now and in the future.
Our innovative solution collects information from your data hub to create up-to-date and interactive Market Position Statements to prevent you delivering the services that are not required or risk not delivering services that are needed altogether.
In order to help your local authority gather the data required to prepare for the future, our demand modelling technology closely monitors activity levels to make highly accurate predictions.
Middlesbrough Council, for example, found their future demand predictions are 99% accurate since they started to use our sophisticated demand modelling technology. Here we have helped ensure they deliver an efficient and effective operation of adult social care to support the care market as a whole.
We want to go a step further at The Access Group and ensure we use a range of data intelligently to better prepare you for predicted care trends. We help to eliminate risk and constantly help your local authority deliver a continuity of care that is not impeded by provider failure.
Here our Risk Profiler solution brings together a range of intelligent data to highlight providers at various stages of risk so you can keep a watchful eye over the provider market and have contingency plans in place, so no one is left without the care they need.
We present this information in our Risk Profiler dashboard to make it easier to spot risks and trends as well as offer a variety of sophisticated filtering options so you can monitor risks that are important for your local area.
At the Access Group our Provider Assessment and Market Management Solutions (PAMMs) were developed with Directors of Social Services to help local authorities deliver their duties and responsibilities of the Care Act. Our PAMMs modules work alongside each other effortlessly and can easily integrate so information can automatically be updated between each module to prevent risk, reduce admin, and most importantly deliver better outcomes.
To learn more about how to understand your data compared to the rest of the care market watch our data landscape webinar and find out the best ways to use your data to make more informed data decisions for the best outcomes.
3. More reablement services
In order for local authorities to ensure they are delivering a diverse care market, local authorities need to consider how they commission home care services as well as care in residential homes, and other support services.
Currently there are massive issues with discharge delays and staff shortages. With that there are long waiting times, and medically fit individuals are not be able to as independent as they could be.
Investing in digital telecare is one way you can try and align with the government’s strategy for more joined-up person centred care simultaneously.
Our technology combines both traditional reactive alarm functionality with proactive digital monitoring of daily activities to support preventative and sustainable care in homes.
The Government of Jersey partnering with one of our customers, Airtel Vodafone, found that technology enabled care was a great way to help transform their care services. We provided them a solution which could both trigger assistance when needed whilst provide reassurance to loved ones. They found that the transition to a new digital service was warmly welcomed by users and 95% of users chose to switch to the new service.
Here, investing in technology enabled care demonstrates how your local authority will be able to offer more reablement services to encourage independence and offer a more diverse and sustainable care market to suit all needs.
4. More efficient quality and contract management
Investing in a variety of technologies and working with a range of care providers will lead to multiple ongoing contracts which can be difficult to process. Commissioning these contracts can be long-winded, complex, and sometimes more manually based.
In order to streamline these processes and help keep a sustainable care market, digitalising your contract, and procurement management processes is essential. It helps gain certainty that all the providers you are working with are complaint and can deliver the high quality of care your local area needs.
Our Access Adam Care Commissioning offers comprehensive brokerage and procurement solutions that provide you full visibility of the provider market to help place individuals with complaint providers that meet their needs.
Midlands Lancashire Commissioning Support Unit (MLCSU) has worked with Access Adam Care Commissioning for many years and uses many of our commissioning modules. Through digitising their procurement processes they have better access and control of their provider market and can create more effective patient pathways to improve their outcomes further.
By having more sophisticated and efficient quality and contract management, you can consistently deliver a sustainable care market for everyone in your local area.
5. Better market oversight and shaping
One of the biggest ways your local authority can deliver a diverse care market is by collaborating and sharing data with other neighbouring local authorities so you can create a complete picture of the care services nearby.
By investing in technology that enables data sharing across local authorities to this level your local authority can facilitate the knowledge needed, and share the solutions needed to accommodate certain care provisions. It also helps to utilise your resources to stay within your care budget, and replicate solutions that have worked well in other local authorities too.
Having strategic market oversight therefore improves the quality of care, enhances your markets stability, maintains quality assurance whilst enabling better data-driven decision making to shift care deliveries from reactive to proactive care.
ADASS East have highly benefitted from using our Access PAMMs software to bring together both care quality and financial data across 11 different local authorities, 2,000 contracted providers, and 20,000 service users to reduce risks and gain a clear picture of what is happening in the care market.
This has helped them improve care quality and enable a drive for continuous improvement by creating an environment that shares best practice. Leveraging strategic market shaping and oversight therefore helps local authorities deliver higher quality and more sustainable person-centred health and social care services to benefit the individual and the wider community.
Summarising the Care Act responsibilities for local authorities
This article has summarised the key responsibilities for local authorities under the Care Act and what are the key challenges local authorities are experiencing currently.
We reviewed how technology can help in many different ways and how it can be adapted to best suit your local community’s care needs, as well as help provide support in developing contingency plans in case of provider failure so no one ends up without the care they need.
For more information on how technology can help digitally transform your local authority discover our local government software today.
Contact us now and we can help you deliver your responsibilities to the highest quality and help you get the best CQC rating possible.