We have developed good working relationships with the independent providers who deliver care in both residential and community settings in the East Riding. We strive to improve those relationships and build on the work that is being delivered to ensure services are safe, good quality and affordable. We do not know all of the support needs but are committed to working together to address issues through various approaches and encourage feedback from partners at every stage of the process.

We work collaboratively to try and ensure that services, and the businesses that deliver them, are sustainable and can meet the challenges that emerge from the changing landscape across health and social care. We support providers to utilise technology and we provide training and support for staff across the independent sector.

Market Pressures

The key market pressures currently experienced across the East Riding are listed below. These not only inform our actions now but also our commissioning priorities moving forward.

• • • Lack of appropriate care and support facilities for younger adults with complex care needs
    • Lack of capacity to meet the needs of people with a learning disability or mental health condition in an appropriate setting, and across the spectrum of needs
    • Difficulty in recruiting good quality nursing staff and a general lack of nursing and nursing dementia placements
    • Current and future supply of extra care accommodation
    • Shortage of Personal Assistants
    • Lack of home care capacity, particularly in rural and coastal areas having a knock-on effect
    • Lack of complex dementia placements
    • Shortage of dedicated reablement beds

 

CQC Ratings and Information

 

 

 

 

 

 

 

 

 

*CQC Inspection Information correct as of October 2023

Current Profile of Commissioning Activity and Future Plans

There are 144 Care Homes currently registered in the East Riding. These are located in the  following areas:

As of February 2023, 70% (96) of our homes are rated outstanding or good with only 3% (4) being rated inadequate.

We are currently commissioning 4,424 registered beds 279 of these are nursing beds with the remaining 4,145 being residential for all categories including Learning Disability and Mental Health with an average occupancy level of 82.9%. There are 91 homes that have a majority of clients aged 65 years or above, with 3,790 registered beds of which around 1,370 (36%) are placements made by the Council.

East Riding of Yorkshire has a larger percentage of the population aged over 65 than the regional and national average, making up 26% of the total.  The proportion of people aged over 65 is projected to increase to 34% by 2041.

The largest commissioned geographical area is Haltemprice with 25% of beds followed by Bridlington with 20%, Holderness with 16%, West Wolds and Goole and Howden with 15% and Beverley with 9%.

Occupancy levels remain high with all areas being over 75% of capacity. Holderness has the highest occupancy with 86% followed by Bridlington and Goole and Howden with 84%, Haltemprice with 83%, West Wolds with 81% and Beverley with 79%.

In April 2020 the average occupancy across all care homes in East Riding was 93%.  This reduced to 83% by April 2021 and showed a limited recovery by April 2022 to 86%.  Within these averages, which at February 2023 was 89%, occupancy for homes registered for learning disabilities, mental health and nursing care were all higher than the average.

Average occupancy in homes providing residential care to elderly people was at 87% in February 2023, indicating that at the current time there is an oversupply of beds.  Geographical variations in occupancy levels across the area will be one of the considerations in the Council’s market shaping work.  For residential care for elderly people occupancy ranges from 76% to 94% across the six care assessment areas.

The care home market has been relatively stable with only two homes closures among those providing care to older people in the last two years. A further two homes providing services to younger adults have exited the market over this time. In the same period there have been three entries of homes providing care to older people (four in total).

We expect there to be some care home exits in the next few years and some homes may need to change their service provision.  This reflects both the recent reduction in demand for ‘traditional’ residential care and the financial uncertainties faced by a number of homes. Providers who can offer more person centred, enabling approaches are likely to be best placed, together with those able to support people with more complex needs, particularly those with dementia.

Residential & Nursing Care Costs

Below are breakdowns for Residential and Nursing care costs for 2022/23 and 2023/24. Click on each image to view in more detail.

*Social Care Date Effective: 10/04/2023 **FNC Date Effective: 01/04/2023 FNC is set by the CCG

Placement Cost Breakdown

As of February 2023, the Council was able to place 25% of it’s placements at standard costs. There were then another 25% which had agreed enhanced costs and the remaining 50% were above the usual cost placement. There are geographical variations to these cost and each package is assessed on it’s own need, with 1 to 1 care negotiated on an individual basis.

It is estimated that the council has arranged around 48% of current care home placements, with the remainder being placements from other local authorities or self-funding placements. Again there are differences in this proportion across the council’s area. The majority of homes operate with higher fees for self-funders who arrange their own care. This has been identified as a future risk by providers but the delay in the introduction of the charging reforms allows more time for the impacts on sustainability to be assessed.

The Council continues to support the sector with outbreak prevention and control, and has in place a dedicated outbreak response team. A range of other support, including financial support, was also in place during the pandemic. The Council undertook a one-off project to provide grants to registered care providers for I.T. equipment and software which introduced sector wide electronic case recording and improved the management of care, quality and safety outcomes, maximised staffing resources and provided cost efficiencies.

Future Intentions

The Council continues to work with the marketplace to understand and agree a structure which ensures that the future the commissioning of residential and nursing care is undertaken at rates that are realistic and sustainable for the Council, the provider, and those in receipt of the care provided. Where possible, clients should be empowered to understand their care requirements and have an active part in deciding their care outcomes.

We are continuing to review all contracted care home provision to ensure we can meet demand and explore flexible utilisation of both short and long term bed provision. We will work with providers to strengthen the process for admissions to care homes 7 days a week, with a focus on discharge from hospital;  engage further in the use of TEC where this will support the outcomes of residents; and increase links with local communities.

From 2025 we will have a new and improved framework in place to help support the care market and allow the Council to commission care in a more effective way.

The vision for Adult Social Care is to promote independence, wellbeing and choice that will support individuals in achieving their full potential in healthier communities. It is our aim to ensure our approach is person centred, accessible, flexible and responsive for those in greatest need and to enable people to maintain their independence for as long as possible in their own homes and local communities. The Council is dedicated to providing quality responses that are sustainable and flexible in order to meet current and future needs and demands.