Our current position
The Council’s financial position – There is significant financial pressure on the Council, with the budget continuing to be overspent, requiring a strategic approach to achieving financial sustainability and value for money.
Referrals and transitions – We continue to see an increase in numbers and complexity of referrals. The increasing complexity of all packages increases the level of risk of incidents between residents, so this has to be managed carefully between the Council, Health and individual providers to ensure resident mixes remain appropriate and safe. We are especially seeing an increase in referrals where someone has a mental health issue and autism or learning disability, and some transition cases where young people are on extremely high-cost packages with 2:1 or 3:1 support which is not sustainable or desirable in Adults’ services
The type of placements we make – We have made a move away from long-term residential placements where possible. Increasingly we are facing challenges around individuals with incredibly complex presentations and multiple risks. While we are more confident in the market being able to successfully support people with very complex needs than previously , there are a small number of service users the market still struggles to successfully accommodate.
New facilities – since our previous Market Position Statement we have supported the development of 11 new facilities, including 81 supported living beds, 30 medium-term hybrid residential beds delivering specific recovery-focused reablement programmes and 6 longer-term residential beds as part of a specific pathway. We continue to work with developers on further supported living beds to meet demand.
Standards in new accommodation – We have a lot of newly built facilities which have enabled us to design a quality environment for the specific client group. This includes having several accessible flats in each development, green space, locations close to bus routes and amenities to encourage independence. Fittings and design to avoid ligature risk is essential as are communal spaces to encourage residents to build relationships, kitchens to enable development of cooking skills, and flats large enough to offer a comfortable environment in which to recover. We limit the size of developments to mitigate against the risk of too many people with conflicting needs and presentations living close together and ensure everyone has their own personal space (either a flat or well-equipped room). For larger developments over 10 beds we ask that buildings are split into separate units on a site, with a maximum of around 20 flats per site. Smaller facilities have the benefit that staff get to know residents well, and we have a relatively low turnover of staff, and few recruitment problems compared to other parts of the care sector.