Adult social care

Overview

Barnsley Council is committed to developing, stimulating and supporting a market which can provide safe, effective, high quality and value for money care and support to the people of Barnsley. 

Our Market Position Statement supports this by: 

  • providing a link between local plans and our commissioning intentions
  • providing an overview of our current market and demographic profile
  • describing our strategic priorities
  • facilitating engagement with providers and stakeholders to build and shape provision in Barnsley

Foreword by our Executive Director for Adults and Communities

Our vision

Our 2030 vision is Barnsley - the place of possibilities. By 2030 we want everyone to benefit from and contribute to making our borough a thriving place of possibilities.

Our new council plan identifies five priorities:

Figure 1: The five council priorities.

Council plan priorities

Adult social care priorities

The priority for adult social care and our communities across these plans is that we want people to live independently with good physical and mental health for as long as possible. Our Better Lives Programme will ensure that vulnerable adults and those with support needs are also safe, protected and able to lead full, active and healthy lives.

 Outcomes set out in the council plan include: 

  • People are safe and feel safe.
  • People live independently with good physical and mental health for as long as possible.
  • We have reduced inequalities in health and income across the borough.
  • People have access to early help and support.
  • People are supported to have safe, warm, sustainable homes.
  • People live in great places, are recycling more and wasting less, feel connected and valued in their community.

We've identified five key priorities for improvement and change:

  1. Front door - review of our first points of contact and online channels for self-help and signposting
  2. Prevention and early intervention
  3. Strength-based practice
  4. Integration and partnership working
  5. Market shaping

Aligned to these priorities are a set of service and organisational enablers that play a key role in achieving the outcomes aligned to this programme: 

  • Engagement model
  • Digital
  • Performance framework
  • Workforce (including new structures)
  • Development of a new adult social care narrative

Working with our partners and providers, we'll be working on these areas to put in place new ways of working and achieve better outcomes for the people we support.

Executive summary

  • Offer 1: Help for people to help themselves – early intervention, prevention, healthy population.

  • Offer 2: Help when you need it – help focused on supporting people to regain levels of independence.

  • Offer 3: Personalised support to address health and wellbeing for on-going support needs.

Figure 2: Diagram showing offers 1, 2 and 3.

Support offers

Living well

Please note: the supply and demand for each service shown in the table below is based on commissioning plans and the expected direction of travel in that area.

Service type Supply Demand Summary
Early intervention and prevention Increasing Increasing We will be looking at opportunities to increase our offer around early intervention and prevention, developing support in our communities and ensuring people utilise community assets wherever possible.
Personalisation – direct payment Increasing Increasing We want to see more people take a direct payment to manage their care arrangements.
Recognised Provider List Increasing Increasing We want to increase the number of providers on our RPL to ensure that those people who fund their own care or use a direct payment to manage their care arrangements can select providers who have been given the quality mark from the local authority.
Reablement Increasing Increasing The local authority will increase the capacity within its reablement service to support more people living in the community.
Housing and accommodation - - We want to make sure there is the right type and amount of accommodation with support for younger adults.
Day opportunities - learning disability Stable Stable The local authority has a range of in house day opportunities for people with a learning disability.
Respite - learning disability Increasing Increasing We have lost some residential respite services during the COVID-19 pandemic.
Autistic spectrum conditions Increasing Increasing We will review our strategy for people with autistic spectrum conditions, improving and developing services to meet their needs.
Adult community support and enablement service Increasing Increasing We want to grow the number of providers offering support to people with a mental health problem living in their own home.
Community equipment Increasing Increasing We will review our current offer around equipment to ensure we maximise opportunities to support people at the earliest opportunity.
Assisted living technology/digital solutions Increasing Increasing We will look at how service users and care providers can use technology to help people to meet their care outcomes.
Support for unpaid carers Increasing Increasing We will update our Carers Strategy and develop plans to reach more people and improve the range of support offered to unpaid carers.

Ageing well

Please note: the supply and demand for each service shown in the table below is based on commissioning plans and the expected direction of travel in that area.

Service type Supply Demand Summary
Residential care Decreasing Stable We will reduce the number of residential care beds we have across the borough to increase occupancy and quality in other homes.
Dementia care Stable Stable We want to improve our dementia offer to service users and their families.
Intermediate care Stable Stable We want to support more people requiring intermediate care in their own home
Day care - - We want to see more day services in the communities where people live.
Home care Increasing Increasing We want to increase the capacity we have in home care. This may not mean more providers but could include supporting existing providers to recruit and retain staff.
Extra care - - We want people living in extra care to get the right support to enable them to remain their for life.



Statistics

Barnsley’s population is ageing.

The number of residents aged 65+ is predicted to reach 60,800 by 2030.

This represents an increase of 33% from 2016.

Our data

Barnsley's demographics

  • 0-18 year olds make up 21.7% (52,858) of Barnsley's population.
  • 19-64 year olds make up 59.2% (143,951) of Barnsley's population.
  • 64+ year olds make up 19.1% (46,532) of Barnsley's population
  • The number of residents 65+ is predicted to reach 60,800 by 2030.

Figure 3: Graphic showing Barnsley's demographic figures as detailed above.

Carers

  • The number of family (or unpaid) carers recorded in Barnsley by the 2011 census was 27,167. 
  • In 2020/21 1921 carers received a carers assessment from the local authority.
  • As at March 2021 1053 carers were receiving a service following either an assessment or review.

Figure 4: Graphic showing carer figures as detailed above.

Coronavirus (COVID-19)

Barnsley was in the top five of UK local authorities with the highest death rate from COVID-19 in January 2021.

In Barnsley we have an older population, a higher number of care homes and greater levels of chronic disease and deprivation compared with the rest of the country. This means the population of Barnsley are susceptible to infection, serious illness and death during the pandemic.

Education and Health Care Plans

In 2021 2220 young people had an Education Health Care Plan. This figure is expected to increase to 3520 by 2028.

Figure 5: Graphic showing EHCP and primary need forecasting against 2020 Barnsley population growth for 0 - 25 year old children and young people. 

Graph showing EHCP and primary need forecasting against 2020 Barnsley population growth for 0-25 year old CYP

People accessing care and support 

2019/20

  • In 19/20 Barnsley had 750 social care users per 100,000 population aged 18-64.
  • 5490 service users per 100,000 of the population were aged 65+.

2020/21

  • In 2020/21 Barnsley had 739 social care users per 100,000 population aged 18-64 and 5307 per 100,000 aged 65+.
  • During 2020/21 there were 11,728 contacts made with adult social care.  
  • 8533 were new contacts (people not in receipt of long-term support at the time of contact). 2372 assessments were completed resulting in 1161 packages of care. 
  • In total adult social care funded 3647 packages of care/support during the year and as at 31 March 2021 2634 people remained in receipt of a long-term package of care. 
  • A further 302 packages were funded by Barnsley CCG.
Service type Number of service users
Residential care 969
Nursing care 81
Community support 1823

Figure 6: Graphic showing people accessing care and support figures as detailed above.

Personalisation and direct payments 

In 2020/21 37.1% of adult social care service users received a direct payment to pay for their care and support.

Date Number of service users who received direct payments
June 2020 1497
June 2021 1603

Continuing healthcare funded services

Data as at May 2021.

Type Total number of patients Home care Residential
CHC 130 70 60
JPOC 109 40 69
FNC 63 N/A N/A

Fast tracks

Current patients Home care Residential
79 58 21
Referrals received 2020/21 Home care Residential or no package
847 412 435

Market overview

Residential care

Barnsley currently has 74 care homes operating across the borough. 45 care homes are registered to support those people aged 65 and over with the remaining 29 care homes offering specialist provision to working age adults and/or those people with more complex needs.

Older people's care homes

Of the 45 care homes, seven are registered to deliver nursing care. The average size of a care home is 42 beds, however the smallest is 12 beds and the largest 87 beds.

CQC ratings:

  • Outstanding - 2 (4.5%)
  • Good - 28 (62%)
  • Requires improvement - 14 (31%)
  • Inadequate - 1 (2.5%)

Figure 7: Graphic showing CQC ratings for older people's care homes as detailed above.

Specialist care homes

Specialist care homes have an average bed number of 12 beds; the smallest is two beds and the largest is 46 beds.

CQC ratings:

  • Outstanding - 0
  • Good - 23
  • Requires improvement - 1
  • Inadequate - 2
  • Not inspected - 2

Figure 8: Graphic showing CQC ratings for specialist care homes as detailed above.

No provider has more than three homes operating in the borough, however a number of our specialist homes are part of larger organisations operating both regionally and nationally.

Home care

Barnsley currently has 34 home care providers operating across Barnsley.

The majority of providers are small local independent organisations operating solely in Barnsley, however around 10 providers also deliver home care in other local authority areas.

Four providers are part of the council's framework contract for home care, with the remainder operating on a spot purchase basis.

CQC ratings:

  • Outstanding - 0
  • Good - 18 (52%)
  • Requires improvement - 8 (24%)
  • Inadequate - 0
  • Not inspected – 8 (24%)

Figure 9: Graphic showing CQC ratings for home care as detailed above.

Finance

Barnsley adult social care budget and spend 

Total gross spend in 2020/21 on adult social care services/provision was £72.7m, of which £58.0m (representing 80%) relates to spend on direct care provision, ie residential/nursing care, domiciliary care, etc.

The above was partly funded through contributions from service users, Better Care Fund and government grants. The table below summarises the total net spend on direct care provision within adult social care in 2020/21.

Provision 2020/21 spend (£'000)
Community based support 27,706
Nursing care 3,309
Residential care 23,306
Supported accommodation 1,240
Short term support 2,441
Gross care provision spend 58,002
Client contribution income -11,180
Net care provision spend 32,743

Actual spend on people in Barnsley is lower than national averages across all age groups.

The adult social care budget for 2021/22 has been increased to take account of expected increased cost pressures, on the backdrop of the COVID-19 pandemic, arising from demographic changes and care provider fee increases due to national living wage and other inflationary pressures. The budget increase has been partly funded from the 1.5% council tax social care precept and additional Better Care Fund monies.

However, adult social care is required to save a further £1.4 million in 2021/22, due to funding pressures faced by the council (and which has since been exacerbated by the COVID-19 pandemic).

Average fees paid for care services

Service 2020/21 2021/22
Residential care 519.79 548.90
Residential care (enhanced) 559.09 590.40
Residential EMI 560.87 592.28
Residential EMI (enhanced) 607.61 641.64
Support to live at home - standard care 18.11 18.52
Support to live at home - enhanced care 19.11 19.54
Adult community support and enablement service - standard care 16.90 17.34
Adult community support and enablement service - complex care 18.98 19.40
Residential care for people with a learning disability   1773.83

Nursing rates for residential care and residential EMI (including enhanced service) are as above, plus FNC of £187.60.

Workforce

In Barnsley there are an estimated 6700 jobs in adult social care, split between:

  • local authorities (7%)
  • independent sector providers (76%)
  • jobs working for direct payment recipients (17%)

Skills, recruitment and retention

Skills for Care estimates that the staff turnover rate in Barnsley was 40.6%, which was higher than the region average of 31.0% and higher than England at 31.9%.

We'll be inviting all providers to work with us to develop a Health and Social Care Academy that will offer support to the care sector in improving workforce skills, recruitment and retention.

Through a Better Lives Programme there will be development work for all staff to embed asset based approaches, using strength based conversations and improve the quality of care across the borough.

The local authority has recently made a commitment to ensuring direct care staff working as part of council contracts are paid £1 above the national living wage. There is an acknowledgement that care delivery and the quality of care is significantly affected by issues with recruitment and retention and we have seen a further decline as a result of the COVID-19 pandemic.



Our commissioning intentions

In Barnsley we want to work with care providers to ensure we commission services that are good quality, financially sustainable and create a pathway of care for our service users.

Commissioned services will be based on a strength-based approach in line with our vision for adult social care, and we'll continue to look for opportunities to improve and develop.

Commissioning intentions: living well

Individuals and families are healthy, resilient and have the confidence and skills to thrive and achieve their full potential so that collectively our communities achieve the best possible outcomes for themselves, their families and each other.

Support to individuals and families will be offered within their community and as close to home as possible.

Father and disabled daughter in kitchen at home

Early intervention and prevention

Early intervention and prevention is at the core of Barnsley Council’s approach to reducing the overall need for high cost social care and crisis services, and improving overall outcomes and health inequalities. The authority aims to commission services that promote health, wellbeing and independence, enabling people to have choice and control as well as reducing the risk of people reaching crisis point and/or needing future intensive care and support.

Barnsley wants to ensure that everyone has the ability to live happy and healthy lives. To do this we will work with our communities and organisations involved with communities to develop support that makes sense to them. Our approach will be to work with groups of people and organisations to develop, design and where necessary change the way support is provided. This approach should help people get support early and avoid people escalating into a crisis.

We recognise that most of our resources are used to provide reactive support for people when things have got really challenging for them. We want to target more resources to support earlier on in people’s lives.

Our plans are to commission services which:

  • empower people and communities to build capacity and resilience, so they can do more for themselves
  • address the underlying causes and ensure people have access to early help and support around things that impact on physical and mental wellbeing (housing, mental health, substance misuse, caring)
  • look at solutions to address the risks of social isolation in older people or other vulnerable adults highlighted through the pandemic
  • operate a home-first model, where possible ensuring support is offered in a way that allows people to remain living in their own homes for as long as possible.
  • maximise people’s independence; doing with and not for.
  • support the view of 'lives not services', are asset based, and form part of an individual’s wider circle of support including the community in which they live.
  • are progression focussed, moving away from long term maintenance wherever possible.
  • identify opportunities for early intervention and prevention.
  • reflect Barnsley’s public health agenda focussing on the wider determinants of a person’s health and wellbeing which may impact on their need for support.
  • supports seamless pathways and links to other services.
  • promotes the use of technology to meet individual needs.

To do this, commissioners will: 

  • work with partners and the market to develop support that promotes early intervention and prevention, and support that reduces risks of harm and prevents or delays admission into hospital or long term residential care.
  • commission high quality services that deliver value for money ensuring that the Barnsley pound is maximised.
  • work with providers who can clearly demonstrate a commitment to delivering high quality care and who place service users at the centre of what they do.
  • work with providers to ensure Barnsley has a diverse and sustainable market which can continually grow to meet the needs of the borough in future years.
  • support providers to continually improve services and to ensure that both national and local standards of care continue to be met.
  • co-design services with partners, staff and service users to ensure they are fit for purpose.
  • develop a market that offers service users a choice in how and from whom they receive their support.
  • identify gaps in service provision through the monitoring of data available and ensure these form part of future commissioning intentions.
  • continue to promote community based services and reduce admissions to long term residential care.
  • develop services to ensure people can be discharged from hospital in a timely manner and with the right support avoiding unnecessary admissions into residential care.

Our approach to prevention will be based on a better understanding of our local populations health needs and we will work closely with colleagues from Public Health to understand how we can commission services that support the wider determinants of health.

We will continue to develop stronger partnerships with the third sector and build on existing networks such as Age Friendly, the Dementia Alliance and Good Food Barnsley.

Figure 10: Graphic showing Age Friendly Barnsley and Good Food Barnsley partners.

Age Friendly Barnsley partners: Age UK, BMBC, Berneslai Homes, South Yorkshire Passenger Transport Executive, South Yorkshire Fire and Rescue, Barnsley U3A (University of the Third Age), Barnsley Dementia Action Alliance, Barnsley CCG.

Good Food Barnsley partners: Ad Astra, Barnsley CAB, BMBC, Barnsley CVS, Barnsley Markets, Barnsley Foodbank, Berneslai Homes, Community Shop, Credit Union, DWP, Fareshare Yorkshire, Salvation Army, Station House.

Age Friendly Barnsley and Good Food Barnsley partners

Personalisation - direct payments

Barnsley currently performs well in the number of service users accessing direct payments to manage their support arrangements compared with our neighbouring authorities.

However a number of direct payment holders are using their funding to purchase traditional models of care such as home care. We'd like to see our service users be more creative with their budgets using community assets as part of their care plans.

An area we'll look to develop in 2022 will be Personal Assistants. This is a recognised gap currently with a small number of service users waiting for PA’s to be recruited to progress their care plan.

We'll also look to introduce more flexible arrangements for people using direct payments to allow them greater control over their care arrangements and promote the use of community resources, so communities can become more resilient.

Recognised provider list

The council hosts a recognised provider list (RPL) to support those people who self-fund their care or those wishing to arrange their own care through a direct payment. Providers on the RPL are given a quality kite mark which offers some assurance to purchasers that the provider has been through a quality checking process.

Reablement

Reablement spend in 2019/20 was half the national average, with Barnsley spending £21.49 per 65+ head of population compared to £43.51 nationally.

In Barnsley you're twice as likely to go on to receive on-going low level support: 32.9% in Barnsley compared to 15.3% nationally. This trend continues for older adults with 29.9% getting on-going support compared to 13.6% nationally. For 65+ it's 34.3% compared to 16% nationally.

The current reablement offer in Barnsley is largely based on hospital discharge. It's generally offered to older people following a hospital admission and aims to redevelop daily living skills and reduce the long term need for paid for care.

The authority will shortly pilot a growth in its reablement offer extending this to community support. This means that individuals assessed in their own home will be offered reablement prior to a long term package of care being put in place.

If successful we'll be looking to further increase the role of reablement to ensure that all service users are offered a period of reablement prior to long term care.

Learning disabilities

Operationally Barnsley is part of the Calderdale, Kirklees, Wakefield and Barnsley (CKWB) Transforming Care Partnership (TCP). However we're also aligning ourselves strategically with the South Yorkshire Integrated Care System (ICS).

The overall aims of the TCP are:

  • To ensure individuals are enabled, supported and cared for in an appropriate environment.
  • Increase community capacity for those with complex needs and/or challenging behaviours.
  • Reduce inappropriate hospital admissions.

Day opportunities for people with a learning disability

Pre COVID-19 the council hosted in-house day services for approximately 130 people with a learning disability, based predominantly on a number of buildings-based services operating across the borough. The pandemic has changed demand for this type of service and adult social care is working to review the current demand and service offer for day services. This will inform future commissioning plans 

Respite for people with a learning disability

The measures required for infection control in response to COVID-19 has impacted on access to respite care for a small number of individuals with a learning disability.

A number of smaller residential care homes who previously offered respite have either closed or ceased to offer respite due to the demand and risk, and there have been implications for our shared lives service following a change to the guidance around the numbers of service users forming part of one household.

Commissioners will be looking at the current offer around respite during 2021/22 to inform future commissioning intentions.

Autistic spectrum conditions

In Barnsley we're looking to develop an All Age Autism Strategy. As we await the national All Age Strategy our focus will be on developing actions to improve the lives of adults (as well as children and young people) with autism in line with the Autism Act 2009 and Think Autism. This will include the following:

  • Increasing awareness and understanding of autism and to look at a multi- disciplinary approach to other co-morbidities.
  • Developing clear, consistent pathways for the diagnosis of autism, clear pathway and support between pre and post diagnosis and beyond. Continue work to reduce waiting times (adults).
  • Improving availability and access for adults (and children and young people) with autism to services and support.
  • Helping adults with autism into work.
  • Encouraging local partners to develop relevant services, eg looking at different housing options.
  • Building communities that are more aware of and accessible to the needs of people with autism – greater links with education settings.
  • Promoting innovative local ideas, services or projects that can help people in their communities.
  • Looking at how advice and information on services can be joined up better for people.

Adult community support and enablement service (supported living)

In 2017 the local authority moved away from using supported living to define support offered to working age adults in their own home. The current contract for this type of support is described as ACSES (Adult Community and Enablement Service) and separates support from individual tenancy agreements.

A number of supported living schemes continue to operate with small numbers of service users sharing accommodation and support.

The current ACSES contract ends in 2022 and commissioners will be going out to the market to re-tender this contract.

A gap we'll seek to address as part of this procurement is around support to those people with a mental health diagnosis. Barnsley currently has a limited number of providers who support people with issues associated with mental health and this is an area we'll look to grow.

Mental health

Barnsley is currently refreshing its all-age Mental Health Strategy. This strategy will inform future commissioning intentions and these will be published as part of the market position statement.

Specialist residential care

Commissioners intend to progress this work in the latter end of 2021, which will aim to address a gap in current contracting arrangements for the provision of specialist residential and nursing care for those individuals whose needs cannot be met under the current service specification for residential/nursing care.

This will include, but is not limited to, those with a learning disability whose needs may be complex and/or challenging, individuals affected by their mental health who may need an admission to residential care to support their recovery, those older people with significant cognitive impairments who display challenging behaviour, and those individuals who meet the threshold for continuing healthcare:

  • transforming care
  • continuing healthcare
  • acquired brain injury and neuro rehab
  • dementia
  • transitions (14 to 25)
  • respite

Housing and accommodation

It remains Barnsley’s ambition that vulnerable people are able to access universal housing options and receive the support they need to live healthy and fulfilling lives in their own property. We're working with Berneslai Homes to review the accessibility of the council's allocations and lettings policy.

With our TCP colleagues and NHS England, in 2021 we opened a purpose-built six person supported living service in West Yorkshire. 

During 2020 the SY ICS undertook a specialist housing needs analysis for people with learning disabilities, autism and mental health issues. This has identified the need to develop a small number of specialist accommodation options over the next 10 years. Given the relatively small numbers we're likely to do this in partnership with our ICS and TCP colleagues. 

We're working to further define our local housing and accommodation needs, however they are likely to include: 

  1. Clustered supported living on the same site for people, as well as some dispersed housing. 
  2. Self-contained housing on the same site with some communal space. 
  3. New supported housing developments carried out by registered housing providers.  
  4. Locations where people feel safe and want to live. People want to live in areas with good transport links, near to local amenities and that are safe communities. 
  5. Alternatively, some people need to live in areas with lots of green space and fewer neighbours.
  6. For young people transitioning there needs to be some consideration around adaptations for sensory needs within the accommodation, and in rare cases self-harm and anti-ligature prevention.

The ICS will be publishing a specialist accommodation Market Position Statement in 2021.

Digital innovation

There are now an increasing range of digital tools to support the way care and support is assessed and delivered that would support better outcomes for people.

Digital innovations can improve the way we use information about how people live their lives, so they can have more meaningful support plans.

We will be engaging with providers to trial new approaches and where possible future commissioning will be based on the following principles:

  • Increased support available to back office functions through the automation of tasks.
  • Increasing expectations that a digital option is available eg to keep people in their own homes.
  • The offer of web based information, advice and self-support.
  • Information sharing to support more joined up care and support.
  • Monitoring and reporting of health conditions.
  • Use of video meetings and consultations.
  • Apps to support information sharing and support planning.
  • Robotics to support care workers around manual handling.

Figure 11: Graphic showing the relationship between digital, housing, innovation, and aids and adaptations.

Unpaid carers

Whilst it is acknowledged that not all carers will want or require support, it is imperative that we take steps to identify those that do and provide an offer of both early intervention and more intensive support where appropriate to meet their wide range of needs.

Building on this information, a local needs assessment is currently being complied to gain a better understanding of the needs of those with caring responsibilities across the borough and the impact that this role has on their own health and wellbeing. The needs assessment will look at the following: 

  • Analysis of data from a range of agencies (number of carers, age profile, geography, needs, demographics etc).
  • Literature and best practice review.
  • Analysis of current offer - Adult Social Care Practice.
  • Review of Barnsley Carers Service.
  • Interviews with carers, families and staff.

Findings from the needs assessment and consultation process will then be used to identify the key priorities as part of the development of our new Barnsley Carers Strategy 2021/2024 and will also inform and shape our future service offer. 

Commissioning intentions: ageing well

In Barnsley we'll support our ageing population by offering person-centred, flexible, integrated care and support in their community or at home.

Through early interventions we'll aim to maximise people’s health, wellbeing and independence and reduce the need for long term support wherever possible.

Group of older people talking

Residential care

The proportion of 65+ people with needs met by residential care/nursing is high in Barnsley; 789 compared to 584 nationally per 100,0000 population. This will be a key area to improve.

Barnsley has generally had an oversupply of residential beds within the market, with current occupancy rates averaging at around 71%. A review of out-of-area placements in older people's residential care in January 2021 identified 52 service users placed in residential care out of the borough. Analysis of those placements suggests that around half of the placements were made out-of-borough at the service user's choice, usually to be closer to family. However there are a number of out-of-area placements that have been selected as homes in-borough were unable to meet the needs of those users.

As a result of the pandemic and the current occupancy levels in care homes, both commissioners and providers acknowledge a need to take action to ensure the long term financial viability of the care home market in Barnsley. Over the next 12 months commissioners will start work with care home providers to strategically manage the market and with the aim of increasing occupancy levels in care homes to around 90% through the reduction in overall bed numbers.

Figure 12: Graphic showing the relationship between do nothing/monitor, increase occupancy, market shaping and strategic management.

Commissioners will be renewing the existing framework contract for residential and nursing care (excluding specialist provision) in 2021. The new service specification outlines a number of key outcomes expected of providers whilst also outlining the support available to providers to deliver against these from health and social care partners.

Used capacity and vacancies

Capacity Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21
Total capacity 1743 1868 1869 1869 1965 1862 2001 2055 1955 1896 1999 2063
Closed capacity 243 160 160 160 136 261 121 67 174 239 125 69
Used capacity 1401 1439 1457 1467 1546 1435 1485 1585 1435 1370 1426 1459
Vacancy % 20% 23% 22% 22% 21% 23% 26% 28% 27% 28% 29% 29%

Figure 13: Graph showing total capacity, closed capacity, used capacity and vacancy percentage as detailed in the table above.

Graph showing residential care capacity and vacancies

Vacancies

Vacancies Jun 20 Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21
General residential 200 256 237 222 244 240 278 292 285 300 315 312
General nursing 12 10 16 23 22 23 36 53 32 29 43 46
Dementia residential 91 117 116 115 109 114 144 156 146 143 154 159
Dementia nursing 12 21 17 18 19 17 19 27 19 16 22 23

Figure 14: Graph showing general residential, general nursing, dementia residential and dementia nursing  as detailed in the table above.

Graph showing residential care vacancies

Dementia care

Barnsley has 35 care homes who are registered with CQC to provide dementia care, however only seven of these self describe as EMI.

As of April 2021 the council had 442 service users in residential care with a recorded status of dementia.
30 placements were out-of-area with the average cost of a placement £547 per week.

In 2021/22 commissioners will explore further how the needs of those people who require residential care with dementia can be met.

Our vision will be to commission dementia care that can support residents throughout their diagnosis including any deterioration and increase in needs and to ensure that they continue to enjoy a good quality of life in an environment that allows them to maximise their independence.

Barnsley hosts a multi-agency dementia group which acts as a vehicle for refreshing the dementia action plan for 2018/19 and 2019/20, which is linked to the national strategy, the 2020 Prime Minister's challenge, the Early Help Agenda and the Frailty and Dementia Alliance. The aim of this action plan is to support improvements in dementia services across Barnsley with the view to making dementia everybody’s business and Barnsley a dementia friendly town with a focus on improving:

  • awareness, information and advice
  • earlier diagnosis
  • the waiting time from referral to initial assessment and intervention
  • the quality of care and support both pre and post diagnosis
  • support for carers from an early stage
  • our understanding of needs and demand
  • the equity of access to support and service early across the borough
  • peer group learning, risk managing and development both locally and regionally

Intermediate care

The intermediate care model in Barnsley has recently gone through a significant change with a move to a home-based model of care for large numbers of service users who would previously have been supported in a care home. As such, a number of contracts for the provision of intermediate care within residential homes are coming to an end and have been replaced with one contract for 30 beds purchased on a hotel basis.

The intermediate care unit will be staffed by a team of clinicians from Barnsley Hospital NHS Foundation Trust (BHNFT) who will offer the full range of support required under intermediate care, releasing other services to operate in the community with the home first model increasing from 70 patients to 100. 

Day care

Barnsley currently has three buildings-based day services for older people. The services are centrally located with one supporting those people with a dementia diagnosis.

The overall aim of the health and wellbeing centres (day services) is to promote healthy lifestyles, reduce isolation, stimulate interest and regain skills to promote and increase independence. It provides respite and a break for both the carer and the cared for person.

A review of day services has identified a range of issues including demand for the service and transport arrangements.

Commissioners will review the health and wellbeing model for older people throughout 2021. The current view is that day services should form part of a community model so that people can be supported in an area that is familiar to them and with access to community assets.

Home care

As of April 2021 52% of the council's home care business was with contracted providers, with the remaining 48% purchased under spot contracts to manage increasing demands.

Figure 15: Graphic home care figures as detailed above.

Commissioners will re-tender the current framework for home care during 2021. This framework will aim to grow the home care market as well as bringing the 48% of care packages currently spot contracted under a broader framework arrangement. This will strengthen the arrangements between providers and commissioners, offer service users stronger arrangements around quality assurance, and give providers a stronger role in shaping the future home care market.

Whilst there is no intention to significantly change the current specification for home care services, we will use feedback from operational teams to emphasise the importance of:

  • flexibility
  • 7-day working for referrals
  • response time
  • reablement
  • quality of care
  • agreeing support plans with people
  • timing of visits
  • matching care workers to the needs and interests of the people they are supporting

The table below shows a steady increase in home care hours commissioned from July 2020 to June 2021.

Home care hours commissioned

Type Jul 20 Aug 20 Sep 20 Oct 20 Nov 20 Dec 20 Jan 21 Feb 21 Mar 21 Apr 21 May 21 Jun 21
Support to live at home 4880 4817 5145 4823 5013 4845 4735 4916 5119 5252 5512 5635
Spot purchase 1845 1782 2848 3120 3363 3771 3910 4010 4243 4488 4611 4771
Other home care 362 362 362 362 362 362 352 412 349 414 409 225

The data shows a steady increase in homecare hours commissioned over the last 12 months.

Figure 16: Graphic showing homecare hours commissioned figures as detailed above.

Snapshot of weekly hours provisioned

Hours provisioned Number of service users - June 2020 Percentage of service users - June 2020 Number of service users - June 2021 Percentage of service users - June 2021
0-10 371 58.70% 425 51.58%
10-20 172 27.22% 242 29.37%
20-50 86 13.61% 153 18.57%
50+ 3 0.47% 4 0.49%

The long term plan for home care in Barnsley will be developed with a focus on home care being part of a wider community offer. There will be a move away from purchasing based on time and task, with care packages being outcome focussed and providers given more autonomy to determine how those outcomes will be delivered through multi disciplinary approaches and in agreement with service users and their families.

Extra care

Barnsley currently hosts four schemes designed to offer extra care, however until recently none of the schemes included on-site care arrangements.

A 24-hour model of wellbeing and care was awarded to a single provider operating at two of our extra care schemes in April 2021. This model brings together care and support with a focus on early intervention and prevention, community involvement and with a view to ensuring that extra care residents can remain in their home until the end of their life without the need for residential care.

If successful the council will consider the option of extending the model into the remaining two schemes.

Procurement opportunities

Early intervention

Contract Summary Renewal Value (£)
Able The overarching aim of the Able service, delivered to the over 55s, is to support people to live safely and independently in their own home for as long as possible by providing a spectrum of easy to access assisted living services and monitoring equipment, easy access to other adaptations and devices, as well as accessing grants for larger building alterations where needed. March 2022 150,000
Independent Complaints and Advocacy Service (ICAS) The ICAS service in Barnsley offers a timely, free, independent, professional and confidential complaints and advocacy service for anyone living in Barnsley who has an issue/complaint regarding any health service provided/commissioned by the NHS, or for social care services provided or commissioned by Barnsley Council. March 2022 (option to extend for two years) 43,908
Third sector dementia alliance The alliance pulls together six current third sector organisations operating within Barnsley, coming together to pool their collective local knowledge, expertise and skill sets to maximise support offers to people living with dementia. 2024 43,333
Emotional and mental wellbeing An early intervention and preventative service delivering support to individuals with mild symptoms of common mental health issues such as stress and anxiety. June 2022 (option to extend for two years) 138,764

Carers

Contract Summary Renewal Value (£)
Barnsley Carers Service The Barnsley Carers Service provides information, advice and support to improve the mental, physical, emotional and economic wellbeing of carers. 2022 239,970

Transitions (learning disability/mental health)

Contract Summary Renewal Value (£)
Adult community support and enablement service (supported living) Framework contract for support provision in the service users own home. 2022  

Older people

Contract Summary Renewal Value (£)
Residential and nursing care The council currently holds a framework agreement with 46 care home providers for the delivery of residential and nursing care across the borough. 2023 (option to extend for three years) Approx 25,000,000
Intermediate care 30 beds purchased on a hotel basis with intermediate care provided by NHS staff. 2024 (option to extend for two years)  
Health and wellbeing centres Buildings-based day service to older people. 2022  
Home care (support to live at home) Framework contract for home care support predominantly but not limited to those people over 65. 2024 (option to extend for two years)  
Extra care 24-hour model of wellbeing and care within a purpose built extra care scheme. 2024 (option to extend for two years)  

Other

Contract Summary Renewal Value (£)
Advocacy An independent advocacy service for adults residing in the borough, regarding issues around health and social care. August 2022 (option to extend for one year)  

Tendering

The council aims to advertise all tenders over £2500 via YORtender. As such we encourage all providers to register with YORtender for access to details of tendering activity including soft market testing, consultation and engagement and procurements. 

Details on how to register can be found on our tenders and contracts page. 

In exceptional circumstances and in line with procurement regulations, commissioners reserve the right to directly award contracts in order to meet the needs of service users.



Our commissioning approach

There are a number of national drivers that are shaping the current and future provision of adult social care: 

  • the Care Act and other legislation
  • continued financial pressures on local authorities to meet their statutory duties (finance)
  • the creation of integrated care systems promoting integration and collaboration across health and social care (national agenda)

Quality assurance

We strongly believe that clear quality standards are fundamental to the delivery of safe and reliable services that will help people to achieve their desired outcome.

Our quality standards will be clearly defined in service specifications and all of our contracted providers will be subject to an annual audit against contract compliance.

Through our established partnerships we'll work alongside providers to address quality issues offering support, advice, guidance and training.

The council has recently entered into a three year contract with HAS Technology to implement Provider Assessment and Market Management Solution (PAMMS). PAMMS will be used by commissioners and contract managers to collate data and intelligence on both regulated and non-regulated services across the borough and will be used to support our market shaping.

Social value and carbon footprint

In line with the council's 2030 vision we want to work with providers who can help us to deliver our ambitions around social value and reducing our carbon footprint.

Our contracts will include a requirement for providers to evidence how their services support the principles of social value and deliver the council's ambition to ensure people live in sustainable communities with reduced carbon emissions.

What businesses and organisations can do

  • Champion healthy workplaces and active travel.
  • Bring the zero-carbon ambition to life by using sustainable sources to run their services.
  • Run services efficiently and responsibly to benefit the environment and community.
  • Support volunteering opportunities and community group initiatives.

Read our Social Value Policy.

How to engage with us/co-production

We recognise that we cannot meet the challenges faced by the local authority and our health partners without a continued close working relationship with all of our stakeholders including providers, service users and carers.

In order to develop creative, innovative services which will help deliver our vision, commissioners will continue to use a range of methods to support the on-going development of commissioning intentions and the co-production of services with stakeholders.

Our offer to support providers can be described as follows:

  • Workforce planning and development.
  • Implementing a refreshed quality framework for contracted care homes and home care providers.
  • Continued use of the recognised provider arrangements.
  • Regular provider forums that cover prevention and wellbeing services through to specialist learning disability provision are available to local providers regardless of contract status. Alongside information sharing around gaps and tender opportunities, the forums will provide the opportunity for developing best practice within the provision of care and support.
  • Continued promotion of individual budgets and direct payments.
  • Involving providers in meaningful operational and commercial discussions as part of project work, service shaping and pre procurement.
  • Progression of key commissioning plans.

The recommendations below are for all parts the market and they aim to help organisations to understand what they can do to make sure that their services align with the council’s priorities for care and support in the future:

  • Ensure your organisation and services provided are accurately listed on local information directories and the recognised provider list (RPL).
  • Use tools to gather feedback from people who use your services and develop your organisation and service provision.
  • Support us in developing and shaping the market locally, such as regularly attending provider forums.
  • Access training and proactively use the council’s contracts and quality teams to help improve your service quality.
  • Engage with the work on integrating health and social care services, so the system works for you and your service users.
  • Focus on maximising independence, supporting people to help themselves as much as possible.
  • Think about how your services could support the increase in the number of service users who take up direct payments for their care and support.

Meet the commissioners

Figure 14: Adults Assessment and Care Management joint commissioning structure chart.

Joint Commissioning structure chart

Joint commissioning structure

  • Andrew Osborn - Interim Service Director - Commissioning and Integration

    • Sharon Graham - Head of Service

      • Ruth Newton-Scott - Senior Commissioning Manager - Older People

      • Alison Rumbol - Senior Commissioning Manager - Learning Disabilities

      • Clare Burton - Senior Commissioning Manager - Mental Health
        • Val Cole - Commissioning Manager

      • Adrian Hobson - Senior Contracts and Compliance Manager
        • Diane Swift-Baldock - Contracts and Compliance Manager
          • Joanne Harper - Contracts Projects and Quality Officer
          • Dawn Mullins - Contracts Projects and Quality Officer
          • Louise Clarke - Contracts Projects and Quality Officer
          • Anne Flear - Contracts Projects and Quality Officer
          • Gayle Bennett - Contracts Projects and Quality Officer

      • Emma White - Principal Public Health Officer
        • Alec Tinker - Senior Public Health Officer
        • Odetta Langellier - Public Health Officer



More information

You can find links to our partners, find useful information, and read our plans and strategies below.

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