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Easing of Coronavirus restrictions

Market position statement for mental health October 2020

This market position statement is for independent and voluntary sector providers who may wish to provide support in the county of Staffordshire for adults with functional mental health issues who require social care support.

You can download this statement as a printer friendly version and also use it to save for offline viewing:

Printer friendly version (421 KB) 


Who is this for?  Back to top

This background document is to broadly signal intentions to existing and potential social care and support providers for adults with functional mental health issues, residing in the county of Staffordshire. This includes:

  • depression
  • schizophrenia
  • bipolar disorder
  • obsessive compulsive disorder
  • panic disorder
  • post traumatic stress disorder
  • stress
  • anxiety
  • borderline personality disorder

The aim is to help support commissioners and providers in working together to best deliver social care support for adults with functional mental health issues and their families, ultimately enhancing the quality of their lives.


The county of Staffordshire  Back to top

We are a two tier authority with eight district or borough councils:

  • Cannock Chase district
  • East Staffordshire borough
  • Lichfield district
  • Newcastle-under-Lyme borough
  • South Staffordshire district
  • Stafford borough
  • Staffordshire Moorlands district
  • Tamworth borough

Staffordshire is a large rural county covering 2,623 square km. Despite its rural nature, most of its population live in five large towns: (Newcastle-under-Lyme, Cannock, Burton upon Trent, Stafford and Tamworth) and numerous market towns, small villages and hamlets across the county. 

Each district or borough varies in profile with considerable differences between the north and south of the county. It is diverse in terms of population profile and social issues, which is reflected in the type of care and support needed in each district.

Detailed, continually updated information about each of the districts can be found on these sites:

This includes improving mental health and wellbeing outcomes evidence base.

It is anticipated that the overall number of adults with functional mental health issues in Staffordshire will stay fairly static in the coming years.  Whilst nationally there has been research linked to the impact of Covid-19 on mental health and emotional wellbeing, at the time of updating this document it is still too early to fully quantify the current and potentially ongoing impact of the pandemic on mental wellbeing within Staffordshire


Where do we currently spend our money?  Back to top

Detailed below is where we currently spend our money across the county for adults with functional mental health issues.

North

This covers:

  • Staffordshire Moorlands district
  • Newcastle under Lyme borough

South

This covers:

  • Cannock Chase district
  • East Staffordshire borough
  • Lichfield district
  • South Staffordshire district
  • Stafford borough
  • Tamworth borough

 

Mental health gross spend 2019-2020, split by type of support  Back to top

Residential

  • North £860,872
  • South £2,419,009
  • Total £3,279,880
  • % of spend 31.56%

Nursing

  • North £1,001,370
  • South £3,777,890
  • Total £4,779,260
  • % of spend 45.99%

Direct payments

  • North £108,086
  • South £481,825
  • Total £589,911
  • % of spend 5.68%

Adult placement scheme

  • North £0
  • South £71,726
  • Total £71,726
  • % of spend 0.69%

Home care

  • North £10,340
  • South £112,914
  • Total £123,254
  • % of spend 1.19%

Day care

  • North £2,185
  • South £0
  • Total £2,185
  • % of spend 0.02%

Supported living

  • North £866,270
  • South £676,215
  • Total £1,542,485
  • % of spend 14.84%

Other community

  • North £1,945
  • South £1,701
  • Total £3,646
  • % of spend 0.03%

Totals

  • North £2,851,068
  • South £7,541,280
  • Total £10,392,348

In addition to the above, we spend £0.6m across the county in respect of social recovery contracts with three block providers.

There is currently a disproportionate amount of money spent across the county in respect of residential care and nursing care. These make up 78% of the overall placement spend. There are relatively low levels of spend in respect of community support such as home care, supported living and adult placement. 

It is our aim to work with our key partners and the independent and voluntary sector over time to rebalance the current service support far more towards recovery focussed, short term interventions and an increase in support within citizens’ local communities.  The independent and voluntary sectors will be key partners in enabling this shift to more outcome and recovery focussed, cost effective models of support. In the remainder of 2020/21, commissioners will work with the Assessment and Care Management function to better understand the reasons behind this pattern of expenditure and will amend this market position statement early in 2021/22 to reflect where such expenditure is being driven by the lack of an alternative community support market. 

We are really keen to hear from the independent and voluntary sectors about any creative and innovative ideas they have for further developing community support services for adults with functional mental health issues across Staffordshire.

 


How do we need to work moving forward?  Back to top

It’s imperative that Staffordshire County Council ensures that its funding is spent wisely, to meet the needs of the people of Staffordshire, including in respect of adults with functional mental health issues.

Over the next three years, the financial position will continue to be extremely challenging and it's imperative that commissioners and providers work together to ensure that services are high quality, individualised and cost effective.

We will expect independent and voluntary sector providers to be more proactive with commissioners where they feel that support provided can be done so more cost effectively whilst maintaining good quality outcomes for people. 

We will seek to work with providers who can prevent, delay or reduce care and support needs, whilst ensuring we always meet the statutory eligible needs of citizens.

In order to continue the shift towards personalisation and recovery and outcome focussed community-based support, commissioners will work with providers to ensure person centred approaches and coproduction in commissioning and market development, thinking locally and acting personally.

Delivering cost effective, recovery and outcome focussed, personalised and community-based support in the current financial environment requires a willingness and commitment from everyone involved to think and act differently. All parties must be open to new ideas in order to stimulate markets and develop new models of care and support.  Market intelligence and systems of communicating information to individuals and their families need to be improved. Communication, information and interaction between commissioners and providers needs to be further enhanced.

We will act as a conduit between providers, citizens and carers. We will use our influence and resources to ensure innovation and developments take place in a harsher economic climate. People will increasingly buy care and support directly from providers via:

  • Personal budgets
  • Individual service funds
  • Direct payments

The end result will be a diverse, sustainable market. It will meet individual aspirations and provide choice and control for people and carers.  It will meet needs, not wants. There will be less direct commissioning by us. We will take on more of a shaping and influencing role within the local market and encourage collaboration between providers. This will result in fewer block contracts between us and providers.


What are the four key outcomes?  Back to top

In working with providers, we are supporting the delivery of four key overarching outcomes:

  • Promote personalisation and enhance quality of life for people with care and support needs and their families.
     
  • Prevent, reduce and delay the need for care and support. This will reduce dependency on services and increase independence, control and choice for people. We will do this by using recovery and asset based approaches that promote social inclusion and citizens' community assets.
     
  • Ensure a positive experience of care and support for people and their families, treating them as equal partners.
     
  • Protect people from avoidable harm and support them in safe environments. Ensure they feel supported to manage their condition, without stigma and discrimination, within supportive communities.

How do we strengthen the market?  Back to top

In supporting the delivery of the four key outcomes above, the market moving forwards needs to be strengthened in the following key areas:

  • Increased availability of flexible support, especially for people with fluctuating needs, supporting people when they need it and in a timely way, preferably closer to home and family, with people treated as a whole person, not a diagnosis, with better information about the quality of care and support available, with full transparency around costs.
     
  • Increased opportunities for people with mental health issues to access universal services e.g. leisure, employment, housing and health, with increased support for people to live as independently and safely in their own homes and communities as possible and ensuring it is cost effective to do so.
     
  • Providers who work with us to ensure the sustainability of the provider market, recruitment and/or retention and workforce planning.
     
  • Increased availability of support that avoids the placement of younger adults within long term residential care, instead supporting people in community-based support settings.
     
  • Increased availability of support which will allow people to remain in their own home where possible and ensuring it is cost effective to do so. 
  • More providers who ensure there is a clear focus on the recovery model, focussing on working with the individual person to identify their strengths and build resilience.
     
  • More providers who will genuinely explore opportunities of reducing the cost of care and support through cost improvement programmes (CIP) to reflect the pressures of CIP on statutory service delivery.

What are the current plans?  Back to top

Current plans in place to support some of the above are:

  • Establishing a Dynamic Purchasing System for use by social work teams and for access by people who wish to self-direct their support.  Our new Supported Living DPS went live in October 2019 and includes mental health provision. Whilst this is a positive move to strengthen our mental health marketplace, we still want to increase the level of availability to ensure full coverage across all districts/boroughs of the County. We also want to increase the availability of services for some of our more complex individuals (for example, those with a forensic history). The DPS remains open for new providers to join throughout its duration and we will be working to ensure appropriate countywide capacity is available;
  • Establishing a brokerage function for people with mental health issues. 
  • Establishing an individual service fund (ISF) offer. 
  • Ensuring a diversity of community-based support accommodation options are available to individuals as opposed to purely residential care, using the Dynamic Purchasing System that will allow care and support providers to support individuals to source accommodation more expediently. 
  • Working with district councils to map existing services for people with functional mental health issues and identifying any gaps in future iterations of this document. 
  • Continued dialogue with provider forums such as Staffordshire Association of Registered Care Providers (SARCP) and others in respect of the mental health market. 
  • Actively encouraging the independent and voluntary sectors to proactively approach the commissioners with innovative ideas and local investment to improve life for people with mental health issues in Staffordshire, without compromising procurement regulations, financial regulations or standing orders. 
  • Working with local district and borough councils to ensure mental health customers can access universal services and general needs accommodation. 
  • Working with a range of housing partners to increase both general and specialised housing opportunities, based on countywide housing need. 
  • An asset-based approach from frontline staff that fully takes in to account individual assets and community assets, underpinned by an ethos and approach of personal responsibility and just enough support. Frontline staff will be encouraging independence for people as opposed to creating dependence. 
  • Mental health social work teams, the Commercial Unit and the strategic commissioning team working to strengthen market intelligence in terms of knowledge around supply, demand and unmet need. 

In working in true partnership, commissioners and providers will be able to ensure a sustainable cost-effective market is in place for adults with functional mental health issues.


Required approach from providers working in the County of Staffordshire

  • Help people to live independently, with care and support from family, friends and the whole community;
  • Prevent and respond at times of crisis;
  • Provide quality and safe services that meet people’s needs and promote recovery;
  • Support Individuals to access and participate fully in life;
  • Consider an individuals’ strengths, talents and circles of support;
  • Focus on ability not disability;
  • Ensure the right support, in the right place, at the right price;
  • Ensure choice and control and the best possible value for money;
  • Ensure provision that is financially sustainable and statutorily compliant;
  • Look to continuously improve and modernise support;
  • Work with partners to ensure well planned, effective and coordinated support;
  • Help people to help themselves;
  • Work with local services and employers to help people access community facilities and support, training, work and leisure opportunities;
  • Support initiatives which can help people to be active members of their communities and support social inclusion;
  • Promote and implement the use of new/assistive technology to help people with a mental health condition to be safe and well but reduce their need to rely on outside agencies for their care and support;
  • Support individuals to utilise mainstream community services such as gyms and exercise classes, leisure establishments and classes, libraries and community groups;
  • Support individuals and families in managing their mental health earlier by recognising triggers and introducing coping mechanisms and processes to manage;
  • Support carers to identify their own support needs so they can remain mentally, emotionally and physically well and confident to keep caring;
  • Work with partners to implement ways of working that promote independence and recovery and reduce the need for formal support;
  • Ensure that support promotes inclusion, dignity, self-respect, and independence;
  • Individuals are provided with simple, clear information and advice;
  • Work with partners, including families, to ensure that everyone understands what we are trying to achieve, to set goals as part of support planning and check regularly to see if they have been met;
  • Support individuals to increase their independence and recovery and, where appropriate, reduce the level of support required over time to meet their eligible needs;
  • Ensure that quality monitoring systems are in place to support the delivery of safe, value for money support;
  • Ensure that the Provider has signed up to Staffordshire County Council’s Procurement Portal and relevant tender opportunities for the Council to be able to work with them. All provision moving forward will be on a contracted footing in most circumstances.

 

Further information  Back to top

How to work with us

We urge independent and voluntary sectors who wish to work with us to express general interest in mental health opportunities on our contracts database, to so they are automatically notified of all appropriate procurement opportunities.

If you wish to discuss plans you may have as a provider in Staffordshire in relation to services for mental health or any aspect of documentation on this website, then the All Age Disabilities and Mental Health Strategic Commissioning team are more than happy to talk to you. In the first instance, please contact wholelifedisability@staffordshire.gov.uk and we will identify the best person in the team to talk to.

Staffordshire Connects

This is a website where every private, public and voluntary business or organisation offering products, services, activities or things to do to help people live a more independent, healthy, active, safe and fulfilling life can advertise for free.

Please put your details on the website.

Staffordshire Observatory

The site provides research and analytical support to Staffordshire Strategic Partnership.

The overall aim is to provide the partnership with a robust, comprehensive evidence base which informs decision making and service delivery, leading to better outcomes for the residents of Staffordshire. This website is a ‘one-stop-shop’ to access a wide range of data, information and intelligence on Staffordshire and its communities.

You can find Improving Mental Health and Wellbeing Outcomes in Staffordshire: an Evidence Base on the Observatory website.

Mental health strategy

You may find this printable document useful:

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