Introduction

Welcome to the Commissioning Strategy for Adult Social Care in Coventry, outlining our strategic approach from 2025 to 2030. This strategy outlines our approach to planning, procuring, and delivering adult social care services over the next five years, focusing on collaboration, innovation, and striving for outcomes-based commissioning.

Coventry is a vibrant and diverse city, enriched by its residents' varied backgrounds, experiences, and aspirations. As we navigate the complexities of adult social care, we are committed to upholding the principles of safety dignity, choice and control for all. Our strategy is rooted in collaborative partnerships, informed by the voices of people in receipt of services, carers, professionals, and other stakeholders across the city.

Over the next five years, our commissioning approach will be guided by a set of core principles, which align to our statutory requirements and the Council’s  Adult Social Care Offer [https://www.coventry.gov.uk/downloads/file/38830/adult-social-care-offer-full-version-]

To achieve this, we will be putting the individual at the heart of what we commission, both through increasing our engagement and co-production of services with residents who use them. We also expect of ourselves and our partners that through our principles, we will be getting things right the first time and creating a learning culture to learn from when things go wrong.

To achieve this, we will be putting the individual at the heart of what we commission, both through increasing our engagement and co-production of services with residents who use them. We also expect of ourselves and our partners that through our principles, we will be getting things right the first time and creating a learning culture to learn from when things go wrong.

Our core principles are:

Person-Centred Care: We prioritise placing individuals at the core of our social care provision. Recognising the uniqueness of each person, with their own strengths, preferences, and aspirations, we tailor our services to meet their specific needs and goals. Our aim is to empower individuals to make informed choices and lead fulfilling lives.

Respect and Dignity: We are committed to treating everyone with unwavering dignity, respect, and compassion. Regardless of age, background, or circumstances, we recognise the inherent worth and value of every individual. Upholding the dignity of our residents is paramount in all aspects of service delivery.

Independence and Empowerment: We advocate for independence and empowerment, striving to enable individuals to live with autonomy and self- determination. Our goal is to support people in maintaining their independence for as long as possible, while offering the necessary assistance and resources to help them achieve their wellbeing outcomes.

Collaboration and Partnership: Effective social care necessitates collaboration and partnership across various sectors and stakeholders. By working closely with service users, carers, community organisations, health professionals, and other partners, we can achieve greater outcomes, share resources, and address complex needs more effectively, and ensure people can transition as seamlessly as possible between services.

Equity and Inclusion: We are dedicated to promoting equity and inclusion in all aspects of our social care provision. Ensuring fair and equal access to services for everyone, regardless of background, identity, or circumstances, is our priority. We actively strive to address inequalities and barriers to participation, fostering a community where diversity is celebrated, and all voices are heard.

Transparency and Accountability: We believe in transparency and accountability in our decision-making processes and service delivery. Open communication with our residents, being accountable for our actions, and continually seeking feedback to improve our services and practices are fundamental to our approach.

Continuous Improvement: We are committed to continuous learning and improvement, seeking to enhance the quality and effectiveness of our social care services. Through regular evaluation, reflection, and innovation, we strive to adapt to changing needs, incorporate best practices, and deliver services that meet the evolving expectations of our community.

Sustainability, Efficiency, and Diversity: We recognise the pivotal role of sustainability and efficiency in the delivery of social care services. Our commitment lies in the effective utilisation of resources, ensuring maximum value for money, and fostering environmentally sustainable practices, particularly within our supply chain management. It is imperative to cultivate a diverse, dynamic, and sustainable market that offers our residents a range of high-quality services and choices. In line with this, we strive to support small and medium-sized enterprises (SMEs) and voluntary sector organisations in Coventry to develop and be sustained. We advocate for long-term funding, strategic resource allocation, and comprehensive planning to effectively address both current and future needs within our community.

Outcome and Impact: We recognise the importance of measuring outcomes and showcasing the positive impact of adult social care services on individuals and communities. We share success stories and evidence-based practices for example through our Adult Social Care Annual Report 2023/24 [https://www.coventry.gov.uk/downloads/file/43749/coventry-local-account-for-adult-social-care-2023-24]. By demonstrating tangible results and meaningful changes in people's lives, we will reinforce our commitment to delivering effective and impactful social care services.

Through the implementation of this strategy, we aim to foster a responsive and sustainable adult social care system that enriches the lives of individuals, strengthens communities, and creates a more inclusive and resilient city.

The legislative context

Adult social care in Coventry operates within a robust legislative framework which includes several key pieces of legislation. This strategic approach complies with legislative and policy guidance.

The Care Act (2014) imposes a series of duties and responsibilities on local authorities regarding adult care and support, thereby establishing a consistent pathway for care and support entitlement for all adults with support needs. It also provides support for carers. From a commissioning perspective the Care Act (2014) requires local authorities to ensure that people have a range of provision of high-quality services within the local area and that people can access information to make decisions about care.

The Mental Capacity Act (2005) provides a legal framework for acting or making decisions on behalf of adults who lack mental capacity. This Act empowers individuals to make decisions for themselves where possible and safeguards those who lack capacity. It enables individuals to appoint a trusted person to make decisions on their behalf should they lose capacity in the future. The Act includes provisions for Deprivation of Liberty Safeguards (DoLS) and Liberty Protection Safeguards (LPS), and mandates decisions made in a person’s best interest.

The Health and Social Care Act 2008 (updated in 2022) established the Care Quality Commission (CQC) as the regulator of all health and adult social care services under the Care Quality Commission (Registration) Regulations 2009. The CQC represents the modernisation and integration of health and social care, with powers and duties that have evolved over time to ensure health and social care services provide safe, effective, compassionate, high-quality care and encourage care services to improve. In 2022, the CQC launched a new local authority focussed assessment framework that places an individual’s experiences at the heart of social care. There are also reforms to adult social care legislation proposed by the Government that have been delayed but will impact on the level of demand for services experienced by the Council.

The Mental Health Act (2007) refers to a law used in England and Wales which provides a legal framework for both informal and compulsory care and treatment of people diagnosed with having a mental disorder. The Government has recently introduced a Bill looking to reform aspects of mental health legislation which is in a consultative stage. Key changes are expected to include less reliance on detention in specialist hospitals with more treatment in the community which will have implications for commissioning of services.    

In January 2025, the Government announced an independent commission into adult social care. This is following the Labour Party Manifesto commitment to the establishment of a National Care Service. The Commission is to publish interim findings in 2026 and a full report in 2028 and it remains to be seen what implications might be for commissioning.  

Although not specifically legislative the NHS Ten Year Plan refresh will have impact on adult social care generally and commissioning specifically. Key to the proposed new plan are three core shifts i.e.

Shift 1: Moving more care from hospitals to communities

Shift 2: Analogue to Digital

Shift 3: Treatment to Prevention

Finally, the creation of a National Care System is anticipated over the next few years. Details from Central Government are yet to emerge but it is anticipated that this revised approach will see the Government:

• Address the funding crisis in social care, to ensure that more care is of higher quality and reduce levels of unmet need
•  Provide free personal care to older people, with the ambition to extend this to working-age adults
•  Build local authority capacity to deliver care, so that more care is delivered in-house.
•  Ensure that all providers of care meet our ethical standards for care
•  Invest in the social care workforce, so that care staff are valued and supported
•  Establish the National Care Service, which will provide person-centred, universal care and minimise the financial uncertainty for people who need care.

What is commissioning in adult social care?

Overall, adult social care strategic commissioning aims to ensure that individuals receive person-centred, high-quality support that promotes their independence, well-being, and social inclusion, while also maximising the efficient use of available resources.

The chart illustrates the various components of our commissioning approach:

Key features and components of Coventry’s approach are:

Needs Assessment: Conduct regular needs assessments to identify current and emerging needs among Coventry’s adult population, involving stakeholders, service users, and communities in the process.

Market Engagement: Engage with a diverse range of providers, including public, private, and voluntary sector organisations, to understand their capacity, capabilities, and innovations in service delivery.

Co-Production: Foster co-production and co-design approaches that involve service users, carers, and communities in the planning, development, and evaluation of adult social care services.

Outcomes-Based Commissioning: Commission services based on outcomes, experience, and value for money, focusing on achieving positive outcomes and experiences for service users, such as improved independence, well-being, and social inclusion.

Flexibility and Innovation: Encourage innovation, flexibility, and creativity in service provision, allowing for tailored solutions that meet the diverse needs and preferences of service users.

Partnership Working: Collaborate with health providers, housing associations, voluntary sector organisations, and community groups to deliver integrated, person- centred care and support services.

Continuous Improvement: Monitor performance, gather feedback, and conduct regular evaluations to identify areas for improvement and ensure that commissioned services are responsive, effective, and sustainable.

Coventry's demographic trends

Ageing Population:  Although Coventry has a younger average age (35) than many other cities it is experiencing an aging population. For example, the number of people aged 50-64 has increased by over 18% between 2011 and 2021 population censuses.

Health and Social Care Needs: With age, individuals are more likely to experience chronic health conditions, disabilities, and care needs. This demographic shift will lead to an increased demand for a range of health and social care services, including home care, residential care, and day services. We are also seeing people living longer with disabilities and higher acuity of needs. Our prevention offer is important in this context and our approach is described later in this document (See Prevention and Early Intervention).

Diverse Population: Coventry is renowned for its cultural diversity, with residents from various ethnic, linguistic, and socio-economic backgrounds.  As the city of Peace and Reconciliation this diversity does not stand still as the city continues to welcome people from different parts of the globe to settle and thrive. Different cultural norms, languages, and beliefs influence the types of services needed and preferred by individuals and communities. The proportion of non-white people had risen from 26.2% in 2011 to around 34.5% in 2021.

Rising Complex Needs: There is a growing recognition of the complexity of needs among adults requiring social care services. This includes individuals with physical disabilities, mental health conditions, learning disabilities, dementia, and other complex needs, requiring tailored and multidisciplinary support.

For a deeper understanding of the Council’s demographics and need for adult social care please refer to the Coventry Joint Strategic Needs assessment and Market Position statement.

Increased Ageing Population: The ageing population will drive increased demand for a range of services, including residential care, day services, and home care. This will require investment in capacity, workforce development, and infrastructure to meet growing demand.

Complex Care Needs: The rise in complex care needs, including multiple chronic conditions, disabilities, and cognitive impairments, will require a holistic and integrated approach to service delivery. This may involve closer collaboration between health and social care services and investment in multidisciplinary teams.

Cultural Sensitivity: Coventry’s diverse population require services that are culturally sensitive, linguistically accessible, and respectful of different beliefs and traditions. This may involve training staff, providing interpretation services, and collaborating with community organisations to reach underserved groups. Commissioning activity outlined in our MPS give opportunities to reaffirm expectations on providers to ensure that service cater for the diverse needs of the city’s communities.

Preventative and Early Intervention: Whilst there is a growing recognition of the importance of preventative and early intervention services in reducing the need for more costly and intensive interventions later on the Council is constantly having to consider its financial position and investment in preventative services through the voluntary sector is under close scrutiny.

Community support, and health promotion initiatives will be essential to address emerging needs and reduce demand on acute services.

The financial context

Despite financial challenges, Coventry spends a large amount of money supporting adults with eligible care needs. In 2023/24 this amounted to a gross spend of £106.1m on people

2023/24 spend on people: £1061.m

• Day opportunities: 3.0%
• Direct payments: 11.5%
• Equipment and adaptations: 1.4%
• Homecare: 38.5%
• Housing with care: 7.6%
• Individual service funds: 0.4%
• Nursing: 12.7 %
• Residential 28.4%
• Supported living: 2.6%

The Council focuses effort on maintaining a financially sustainable market and has made above average inflation awards for several years.

Representations regarding fee rate uplifts are considered by the Fee Rates Panel. Providers who query uplifts are required to complete a comprehensive breakdown of cost on an Open Book accounting methodology either using Care Cubed (formerly Care Funding Calculator) for Learning Disabilities /autism or a bespoke tool for Older People/Physical/Sensory Impairment services.

A distinction is always drawn between inflationary pressures and perceived changes in needs with the latter being addressed through a review/reassessment rather than a discussion around inflation. The Council does not “rebase” fee rates as our position is that fee rates charged on admission to a service should hold with the only uplifts contemplated being due to inflation or significant changes in needs.  

Rates are generally lower than average for the West Midlands although not significantly so. The fact that, to date, there have been few hand backs or provider failures suggests that rates are reasonable in the context of the local market.  

Supported living rates are an outlier in that Coventry pays the highest hourly rate in the region. Recent action has been taken to ensure that rates are brought more into line through offering the lower rates indicated by Care Cubed.

Current market position

The adult social care market in Coventry is diverse, stable and is resilient with good quality services in the main. Major events such as the COVID-19 Pandemic and Brexit do not appear to have had a significant detrimental or lasting impact on supply and quality. The Council is generally able to secure sufficient services to meet its current level of demand for these services although noting there are service variations in provision. Efforts are being made to enhance the stability of services that support people with a learning disability, physical or sensory impairment, autism or mental health condition with more complex needs. For example, the market does not appear to have sufficient supply available to meet the needs of individuals with complex needs such as individuals with autism or those with particularly challenging behaviours. This is being addressed through our market development activity.

Coventry produced its Market Sustainability Plan in March 2023 which focused on two care markets: care homes for individuals over 65 years of age and home care (or domiciliary care) for individuals over 18. The council engaged with providers to increase awareness, understanding and participation in the cost of care exercise and the Market Sustainability Plan. The plan focusses on the following key areas:

• Intelligence – Engaging and gaining feedback from care providers
• Accessibility – Encouraging the development of a market that offers choices and meets the varied and sometimes complex needs of residents
• Support – Supporting the market to maintain sustainable services
• Workforce – Providing support in recruitment and retention of the adult social care workforce in the city

The Market Sustainability plan has informed our Market Position Statement which in turn has guided the development/refinement of our Market Development Plans which signal to the market in more detail the type, volume and quality of services the Council wishes to commission over the coming years. 

Coventry’s key service strengths and opportunities for further development

Digital Inclusion and Technology: There is increasing potential for digital technologies to enhance the delivery of social care services, improve access, and empower individuals to manage their own care. We want to see increased and more innovative use of care technology and equipment to keep people well and independent at home for longer so that they thrive in the community, and we achieve better value for money.

Support for Unpaid Carers: This is a key area of strength upon which we intend to build. Coventry is committed to supporting unpaid family carers by offering a wide range of resources designed to meet their needs. Our Digital Platform is instrumental in reaching all unpaid carers, including those who may not be known to Adult Social Care, providing essential support. Collaborating with key charity partners like The Carers Trust, we deliver immediate assistance to unpaid carers within their communities. Our diverse support services feature an optimal array of short break options, ensuring that residential respite is available while prioritising the least restrictive environments. These services are designed to offer meaningful, person-centred activities and breaks that benefit both caregivers and those they care for. Our comprehensive Carers Action Plan includes improvements to access to training, advice, and emotional support, ensuring that carers receive the recognition and support they deserve. Our carers support service is currently in the process of being commissioned with new contractual arrangements planned to be in place for October 2025.

Support for Individuals with Complex Needs and behaviours that challenge: Recognising the growing prevalence of individuals with complex needs and behaviours that challenge in our community, spanning both younger and older adults and various client groups, Coventry is committed to addressing this critical service requirement. This entails equipping staff with specialised training and expertise to effectively support these individuals across all forms of provision, including floating support services. We are keen to discuss further possibilities to meet these needs with Registered providers or supported living providers who have strong links to landlords or their own housing stock who can support the Council in sourcing affordable accommodation for individuals without delay and will be holding regular session with stakeholder to stimulate improved availability of good quality in city provision.

The Council seeks Supported Living services tailored to meet these increasingly higher levels of needs effectively. Another key is the development and integration of Positive Behavioural Support (PBS) and trauma-informed practices throughout the provider market, aligning with our dedication to a strengths-based approach.

More care and support ‘in crisis’ provision: Coventry recognises the need for more services for those at risk of crises, encompassing short-term accommodation-based options and short-term 24-hour 'live-in' support services. These services must be able to accommodate individuals with complex needs and behaviours that challenge; equipped with trained staff who are confident to accept and safely support emergency placements in a short turnaround time.

Dementia-friendly services: Given the increasing prevalence of dementia within our community, Coventry recognises the need for the development of dementia-friendly services that can effectively accommodate residents with dementia across residential, nursing, and care at home settings. This is in addition to dementia specific services that we will continue to support including care home provision, our award-winning Dementia Hub and the specialist housing with care provision at Arden Grove.   

More Move-On Accommodation for Individuals with Mental Health Issues: Individuals with mental health issues often face challenges transitioning from hospital or supported living environments to independent community-based accommodation. We are committed to commissioning and providing high- quality move-on accommodation tailored to the specific needs of individuals with mental health issues, facilitating their transition from institutional settings to community-based living while promoting independence, recovery, and well- being.

Strengthening Transition Services for Young Adults: As young people transition into adulthood they encounter pivotal milestones on their journey towards independence. It is crucial to anticipate and address these transitions effectively. Our focus is on developing robust transition services that cater to the diverse needs of young individuals, preparing them for educational pursuits and entry into the workforce. We are committed to creating an inclusive environment that empowers young adults with the essential skills, knowledge, and resources they need to thrive and achieve their full potential as they navigate this critical phase of life. Supply of suitable housing stock is of critical importance, for example single storey accessible buildings for young adults with complex needs and our Market Development planning reflects this. 

Coventry’s strategic priorities for commissioning

Prevention: We will maintain and develop a robust preventative approach, leveraging universal and community-based services to promote independence and well-being effectively.

Enhancing Choice and Control: Recognising the significance of offering meaningful choices, we prioritise commissioning flexible, person-centred services that empower individuals to shape their care according to their preferences and goals. We are committed to expanding the market for direct payment holders through strategic partnerships and targeted investments. We will ensure we listen to voices that are often overlooked in the commissioning of care services that affect them.

Local and Locality Based Delivery: We are committed to reducing the number of people who are placed out of City for reasons other than choice and are committed to developing in city solutions for people to prevent the need for such placements and, where in the best interests of people, to enable them to move back to the city.   Stemming from our Improving Lives approach, a locality-based offer is in place. This priority underscores our recognition of community connections. We prioritise the development of services within each of Coventry’s three Local Implementation Team areas (LITs). Our commitment is to ensure the foundational aspects are consistently met while tailoring support to the unique needs and preferences of each community. By doing so, we aim to foster a sense of belonging and inclusion, promoting social cohesion and collective well-being.

Driving Innovation: We will strive to support innovative services that leverage new technologies, approaches, and care models. We will ensure that we consider how technology can be used to support individuals and carers.

Promoting Coproduction and Engagement: Central to our approach is coproduction, actively involving service users, carers, and communities in shaping and delivering services. We promote meaningful engagement opportunities to ensure services are responsive, inclusive, and reflective of the diverse needs and aspirations of our community. We will commit to hearing from the voices in our communities that are often not heard through a variety of co-production and participation opportunities. Our approach to  Coproduction [https://coventrycc-my.sharepoint.com/personal/cvjre051_coventry_gov_uk/Documents/Coproduction/UPDATED%20Adult%20Social%20Care%20Services%20-%20it's%20our%20approach%20statement.pdf] is outlined here.

Investing in Workforce: We are committed to supporting training, development, and support of social care staff to deliver person-centred care effectively, attracting and retaining talented individuals dedicated to making a positive difference. Our work in relation to supporting international recruitment has received national recognition and we will continue to support good practice in the market and provide assistance as appropriate to displaced international recruits. 

Recovery and Enablement:  As part of our Improving Lives Programme and collaborative partnerships and evidence- based practices, we prioritise developing services and models that facilitate recovery and enablement, empowering individuals to regain independence, achieved their assessed well-being outcomes and live fulfilling lives.

People with Complex Needs: We prioritise the development of specialised accommodation and support services, facilitating the transition of individuals from hospitals and residential services back to Coventry, exploring innovative and cost-effective service delivery models. Our Market Position Statement outlines our keen desire to speak to providers about any ideas they may have in this regard.   

Reducing Reliance on Residential and Nursing Placements: We prioritise initiatives aimed at reducing reliance on residential and nursing placements, investing in community-based alternatives and wraparound support services to enable individuals to remain in their homes or supportive community settings.

Supporting Carers: Recognising the invaluable role of unpaid carers, we commission services offering flexible access options, providing practical and emotional support to enable carers to achieve their well-being outcomes while fulfilling their caregiving responsibilities.

Monitoring and evaluation

Coventry’s Quality Assurance and Contract Monitoring framework sets out the approach that we will take to ensure local care and support services provide what individual service users need. The document aims to set out the principles and processes that together formulate Coventry’s approach to securing quality care services. Key components include:

Performance Measures: Establish clear performance measures and key performance indicators (KPIs) to monitor the effectiveness, efficiency, and impact of commissioned services.

Quality Assurance: Implement quality assurance mechanisms, such as regular inspections, audits, and user feedback, to ensure that commissioned services meet regulatory and Coventry’s standards and service user expectations.

Outcomes Monitoring: Monitor outcomes and experiences of service users, carers, and families to assess the effectiveness and impact of commissioned services on their well-being, independence, and quality of life.

Provider Performance: Assess provider performance against contractual obligations, quality standards, and performance targets, providing feedback and support for continuous improvement.

Stakeholder Engagement: Engage with service users, carers, providers, and stakeholders in ongoing dialogue and consultation to gather feedback, address concerns, and identify opportunities for service improvement.

Key Performance Indicators (KPIs) 

All contracts and SLAs are monitored at least annually to ensure that services are safe, and meeting needs effectively.  Where provision falls below standards more frequent oversight is maintained.

Some services are performance managed on a more regular basis e.g. quarterly monitoring of Private Finance Initiative contracts and at least, 6 monthly for housing with care and home support contracts.            

Each Commissioning project comes with a set of key performance indicators, performance against which is reported through the Contracts Board. 

There are also a selection of individual strategies each of which have associated delivery plans which are monitored and evaluated through respective boards i.e. Dementia Strategy Board, Learning Disability and Autism Board and Palliative and End of Life Care Board.  All of these are system wide covering both Coventry and Warwickshire. 

Where strategy milestones and targets are not being achieved corrective action is agreed by the respective board and monitored accordingly. 

Health and Care Scrutiny Board occasionally require specific reports to be presented outlining ambitions and oversight of process an example of this being the Coventry and Warwickshire Joint Strategy for Autistic People.  [https://www.coventry.gov.uk/adult-social-care-strategies-policies-plans/coventry-warwickshire-joint-strategy-autistic-people-2021-2026]

These KPIs will provide measurable benchmarks to assess the effectiveness, efficiency, and impact of the commissioning strategy for adult social care in Coventry over the next five years, ensuring accountability, transparency, and continuous improvement in service delivery.

Financial sustainability

Ensuring the financial sustainability of adult social care services is important to Coventry’s commitment to meeting the evolving needs of our community. In this section, we outline our approach to financial sustainability, emphasising efficient resource allocation, value for money, sustainable funding, and robust financial planning. By strategically managing resources and fostering collaborative partnerships, we aim to optimise outcomes, deliver high-quality care, and promote the long-term viability of commissioned services in Coventry.

Resource Allocation: Allocate resources effectively and efficiently to prioritise areas of greatest need and achieve maximum impact in delivering adult social care services.

Value for Money: Ensure value for money in commissioning decisions, balancing cost considerations with quality, outcomes, and service user experience.

Sustainable Funding: Seek sustainable funding sources, including government grants, council budgets, and partnership funding arrangements, to support the long- term viability and stability of commissioned services.

Financial Planning: Conduct robust financial planning and forecasting to anticipate future demand, costs, and funding requirements for adult social care services in Coventry.

Sustainable commissioning

Coventry City Council is committed to ensuring its operations are environmentally sustainable and resilient to future climate change. The Council is aware that their procurement of goods, works and services will have environmental implications, both in their respective local areas and around the planet and, as a result, the Council is actively working to reduce and minimize these negative effects where possible. Environmentally sustainable procurement is the commissioning, sourcing and contract management of goods, works and services in a way that reduces or negates negative environmental impacts within the supply chain. Given the Council’s significant procurement of goods, works and services in the region, we have the opportunity to work with our suppliers to drive significant carbon reductions, improve the natural environment and make meaningful climate action in our commissioning. Our adult social care commissioning incorporates environmental sustainability as a requirement in our contractual arrangements.  

Conclusion

This commissioning strategy outlines Coventry's commitment to providing high- quality, person-centred adult social care services that meet the diverse needs and preferences of our residents over the next five years. By adopting a collaborative, innovative, and outcomes-focused approach to commissioning, we aim to promote independence, well-being, and inclusion for all adults with care and support needs in our community.