Background
The Learning Disability and Autism Market Development Plan (18-64) is one of three commissioning plans (Older People / Mental Health) that aim to improve supply, quality, and access to appropriate provision in the City according to current and predicted increased future needs.
This plan sits under, and should be read in conjunction with, the Market Position Statement, which provides further context and sets out the shape of the current adult social care market and an indication of projected future demand.
For Learning Disability and Autism services we aim to:
• Promote the greatest level of independence possible, making use of everyone’s personal assets, resources, and abilities.
• Focus on helping people progress through and out of services to whatever extent is right for them.
• Make greater use of community resources.
• Future-proof the market with increased quantity of provision, and greater use of assistive technology, Artificial Intelligence (AI) and innovative models of support.
• Better match supply and demand so there is a choice of good-quality, effective provision to suit different needs, giving us the best possible value for money.
What we plan to achieve
Coventry City Council Adult Social care teams are determined to ensure that all adults with care and support needs, and carers, in Coventry can live as independently, safe, and well as possible and have real choice and control over the care they receive.
This includes:
• Meeting individuals' care needs as defined by and in compliance with the Care Act (2014), ensuring person-centred and legally aligned support.
• Maintaining a spend profile that demonstrates and upholds value for money, ensuring effective use of resources.
• Cultivating a vibrant marketplace that is adaptable, responsive, and capable of accommodating evolving needs and demands.
• Designing flexible care packages that align with individuals' journeys, supporting transitions and offering continuity from early-stages through to elderly life.
• Fostering a marketplace built on strong partnerships with key stakeholders, delivering personalised care pathways that are equitable and mutually beneficial.
• Establishing a review schedule that maximises opportunities to realign care packages with individuals' progress, enabling continuous improvement and enhanced outcomes.
Our current position
There is continuing significant financial pressure facing the City Council with the budget continuing to be over-spent, requiring a strategic approach to achieve financial sustainability and value for money. Demand for services is increasing year-on-year, with the prevalence of learning disabilities and autism in the general population projected to rise by approximately 1% annually over the next decade.
Increasingly complex needs present significant challenges at the point of access. Sourcing bespoke individual commissioning packages of care remains challenging due to affordable accommodation constraints within Housing Benefit limits. There is also a shortage of affordable single unit accommodation.
The Council continues to use Care Cubed as a method to calculate indicative care costs for people. This is a nationally agreed toolkit used extensively across the Country.
Larger core and cluster developments have proven effective where they are financially viable, and they support move on.
Future Commissioning Intentions
The recommissioning of preventative support services, aligned to our adult social care front door offer and complement other commissioned services. The creation of clear service pathways which focus on promoting independence and supporting the person to move on to more independent living.
Value for money optimised by exploring opportunities to reduce reliance on traditional care models and optimise care package sizes whilst ensuring the person remains safe and well and achieves their outcomes. This will be realised through commissioning pathways in accommodation that can support step-down without the need for individuals to move.
The sourcing of bespoke individual commissioned packages of care presents as an opportunity to explore innovative solutions for matching individuals with affordable accommodations that align with Housing Benefit limits. By addressing challenges in commissioning single units, providers can focus on creating scalable and financially sustainable models that deliver high quality care whilst maintaining affordability.
Integration of assistive technology to provide valuable insights capable of informing evidence-based decision making enhancing individual outcomes. Use technology as a creative alternative to traditional night time support where appropriate including consideration from care starting.
Empower individuals by commissioning transitional or short-term support to maximise their potential. By investing in short term support, longer term sourcing decisions made with greater accuracy and alignment to people’s unique needs and aspirations.
At the point of placement, establishing clear expectations regarding an individual’s pathway and future milestones (e.g. 1 year, three years, 5 years) creates a shared vision. Progress consistently reviewed to ensure care packages dynamically aligned with the individual’s achievements and evolving needs.
| Low level | Daytime 1:1 for 6hrs/day for assisting with activities, meal preparation and community access. Night time ratio 1:5 shared support for 8 hours. |
|---|---|
| Moderate | Daytime 1:1 for 8hrs/day for personal care, assisting with activities and community access. Night time ratio 1:2 shared support for 8 hours. |
| High level | Daytime 2:1 for 12hrs/day for assisting with activities, challenging behaviours and ensuring safety. Night time ratio: 1:1 support for 12 hours. |
| Complex | Daytime >2:1 for 12hours/day for assisting with activities, challenging behaviours and ensuring safety. Night time ratio: 1:1 support for 12 hours. |
How will we co-produce:
We will co-produce with stakeholders including providers, social workers, commissioners, individuals in receipt of care and advocates in the following ways:
| Building a shared vision and fostering collaboration |
• Engaging stakeholders in open discussions to align goals and priorities. • Facilitate workshops and forums identifying challenges, exploring opportunities and jointly designing pathways. • Focusing on shared benefits and mutual value – enhancing care outcomes, ensuring financial sustainability and promoting workforce satisfaction. |
| Creating clear service pathways |
• Collaborating to design step-down pathways that are clear and structured, supporting individuals to transition through services and support levels as their needs evolve. • Conducting proof of concept initiatives to test the feasibility and effectiveness of new pathways before scaling them up. • Working with providers to minimise void losses while ensuring service continuity |
| Embedding person-centred care planning |
• Collaborating with providers to ensure tailored care packages to refine how needs are assessed and translated into care packages, ensuring safety, risk management and efficiency are balanced. • Providers must evidence how they work with people to optimise their independence and achieve outcomes, ensuring accountability and transparency. |
| Innovative housing and accommodation approaches |
• Facilitating Affordable Housing Partnerships, promoting an holistic approach that support the development of accommodation achieving value for money. • Promoting development of flexible accommodation models that are co-designed and support move on to more independent living solutions. • This will include shared housing and clustered care models to make single-unit commissioning more financially viable. |
| Promoting and developing the use of assistive technology |
• Providers must utilise assistive technology in developing models of care that meet the person’s needs in the most cost-effective way. • This will include working with the person and their representatives on how to use the technology, ensuring buy-in and confidence from the start of the care package. |
| Setting clear expectations and milestones |
• Coproducing detailed pathway plans for everyone in partnership with the individual, outlining short, medium and longer-term milestones. • Making goals and expectations clear to all stakeholders including the individual and creating a shared vision for progress. |
| Reviewing progress | • The Council expects providers to play an active role in reviewing care packages alongside the individual and their social worker, ensuring support remains cost-effective while keeping people safe and well and meeting agreed outcomes. |
Commissioning Delivery Plan:
Within 2 years
The Council will;
1 Recommission learning disability and autism preventive support services informed by co-production and informed by experts by experience. Building on feedback already received from providers.
2 Explore and test innovative commissioning approaches through personalised 1:1 engagement with providers, fostering collaboration and seeking tailored solutions.
3 Providers to embed Assistive Technology in their care and support models to enhance their promoting independence approach and improve outcomes and efficiencies.
4 Developing a model which supports individuals transitioning through a care pathway designed to meet their evolving needs and aspirations, rather than confining them to static placements without room for growth.
5 Re-assess our approach to commissioning and how we move away from sourcing traditional placements to pathways.
Up to 5 years
We have improved our capacity and capability in supporting the different communities and diversity of needs within the city through:
Optimise our capacity: our preferred model is to support people to move on to create additional capacity for those with higher level needs to receive appropriate and timely support.
Further develop our care and support market to drive forward our ambitions and implement the outlined changes testing innovative commissioning and review approaches that foster a dynamic marketplace, empowering individuals to participate in adaptable care pathways that prioritise aspirational outcomes over static placements.
Where necessary and affordable we will expand our infrastructure to meet increasing demand with a plan to develop the following.
1 Respite Services: Develop flexible respite solutions to provide short-term relief for individuals and caregivers, promoting stability and continuity of care.
2 Enablement/Transition Schemes: Establish two schemes with a maximum of six units each, designed to empower individuals in developing independence and preparing for longer-term care options.
3 Supported Living Scheme: Create one supported living scheme with up to eighteen units, ensuring an environment conducive to semi-independent living and personal growth.
4 High-Needs Scheme: Implement one high-needs scheme with a maximum of six units, tailored to those requiring intensive support for complex needs.
5 Complex Needs Services: Expand services to include two specialised schemes dedicated to supporting individuals with complex needs, fostering stability and pathways for progression.
Contact us
Where providers wish to engage on any of the requirements outlined in this plan, we welcome your ideas for delivery.
Please contact SocialCareCommissioning@coventry.gov.uk [http://SocialCareCommissioning@coventry.gov.uk] in the first instance.
New requirements will be issued via the Council’s procurement system, please register if you are interested in this area at CSW-JETS.