What a market position statement is
A market position statement (MPS) is a document produced by local authorities with adult social care responsibilities and aimed at a wide range of care, support and accommodation providers including both existing providers and the care market as a whole.
Leicestershire County Council’s adult social care MPS summarises supply and demand in the county, highlighting business opportunities within the care market county wide. It is intended to be used by providers to plan for the future, informing business choices such as investment in capital or workforce.
The Care Act 2014 guidance para 4.81 states that ‘local authorities should ensure that the market has sufficient signals, intelligence and understanding to react effectively and meet demand’ and that ‘local authorities should publish, be transparent and engage with providers and stakeholders about the needs and supply analysis to assist this signalling. It is suggested that this is best achieved through the production and regular updating of a document like a Market Position Statement that clearly provides evidence and analysis and states the local authority’s intent’.
Keeping the MPS up to date allows adult social care providers to design their services around the Council’s commissioning intentions, enabling them to bid for any work, and identify and establish partnership working. This can enable providers to work creatively and innovatively to meet demand and meet the gaps in provision.
The Council welcomes approaches from prospective providers considering entering the Leicestershire market, or expanding their operations within the county. Please contact the commissioning, contracts and quality service on enquirylinequality&contracts@leics.gov.uk to arrange a no-obligation discussion with commissioners.
To find out about forthcoming adult social care procurement opportunities for Leicestershire County Council, please see doing business with the council.
Legislative and strategic background
‘People at the Heart of Care’ White Paper
The ‘People at the Heart of Care’ White Paper (December 2021) set out the Government’s 10-year vision of how it proposes to transform support and care in England. The proposals contained within the White Paper included:
- An emphasis on the duty of a local authority to shape healthy and diverse social care markets
- Supporting local authorities to deliver reform by giving the Care Quality Commission (CQC) the power to assure the quality of local authority social care
- Initiatives to support the social care workforce, emphasising transferable learning and wellbeing
- Enabling individuals to navigate the system to find the right care and support and setting a cap on what individuals will need to pay towards their care (now deferred)
As part of the reforms, the Council was required to conduct a Fair Cost of Care (FCOC) exercise and publish its findings by 1 February 2023 ahead of publication of its final Market Sustainability Plan for home care and care homes by 27 March 2023. The MSP highlights those areas where the local authority will focus its resources on ensuring its care provider market is both developed and financially stable to meet the County’s residents with care and support needs.
Delivering Wellbeing and Opportunity in Leicestershire, Adults and Communities Department Ambitions and Strategy for 2020 – 2024
Council’s objectives and aspirations for adult social care are detailed in the Delivering Wellbeing and Opportunity in Leicestershire Adults and Communities Department Ambitions and Strategy for 2020 – 2024 document. Read the full strategy and an easy read version.
The Council’s ambition is that through the course of this strategy (2020-2024) it will:
- Enhance wellbeing, prevent, reduce, delay and meet individual and community need
- Ensure people and communities are resilient and safe in times of uncertainty and crisis
- Make it easier for people to access services through information and digital routes
- Work collaboratively across services and partners to commission the right support in the right place at the right time
- Use the inherent strengths of local communities to empower them to do more for themselves
- Employ and develop a highly trained and flexible workforce
- Ensure people feel safe, supported, enabled and satisfied when using Council services
- Save and make accessible the cultural and historic heritage of the County
Strategic commissioning intentions and transformation
The Council’s Commissioning Intentions 2021-2024 support the delivery of the Adults and Communities Strategy 2020-24 and provides the foundation for the MPS.
The Council is keen to innovate in commissioning, to ensure the best outcomes for people whilst forming closer strategic relationships with its providers, and managing its financial pressures. The Transforming Commissioning Programme will bring about change in a number of key areas of adult social care commissioning, procurement and contract management. The areas of focus are nursing development and fees, residential fees, extra care, reablement, home care, supported living, direct payments, and the way in which the council contracts and pays for care and support.
Engagement and co-production
The Council is committed to embedding co-production throughout its service design and delivery; its strategy for 2020-24 sets out an aspiration to increase its co-production, co-design and engagement with people who use services, carers, providers, professionals and other stakeholders. The Council’s Engagement Framework highlights the importance of involving those with lived experience in service design and ensuring that the Council seeks and listens to its feedback.
Leicestershire County Council’s approach to engagement activities reflects the Council’s Consultation and Engagement Principles:
- Inclusive - we involve all those who have a stake on an issue by understanding our communities, actively reaching out to different groups, and tailoring our approach effectively.
- Transparent - we build trust with citizens by being open and clear about our thinking and decision-making.
- Meaningful - our engagement activity is sufficiently well defined and well executed such that local people are able to participate fully and effectively influence our decision-making.
The Council has an Engagement Advisory Panel including representation from all service user groups, with attendance from senior adult social care leaders from the Council.
The Council has committed to the ‘Making it Real’ Framework, which provides a set of statements describing what personalised care and support looks like from the point of view of people themselves to guide and support continuous improvement in the provision of personalised care and support.
Demography of Leicestershire
Leicestershire is a predominantly rural county which covers over 800 square miles, comprised of 7 local authority districts. Within the county, 69% of the population live in urban areas, 18% in rural town and fringe settlements and 12% in rural areas.
Leicestershire is relatively affluent, ranked 137th out of 152 authorities in deprivation (where 1st is the most deprived). However, it has pockets of deprivation, with four neighbourhoods in the most deprived 10% nationally.
Life expectancy is significantly higher in Leicestershire than England. However, healthy life expectancy (how many years people are expected to live in a ‘healthy’ state) is only marginally higher than the national average and there are significant health inequalities in the county.
Whilst Leicestershire has a lower percentage of younger adults than England, it has a higher percentage of residents aged 50+. Leicestershire has consistently had a higher percentage of residents aged 65+ than England.
From 2011 to 2021, the population in Leicestershire rose by 9.5%, the 2nd highest growth rate of all counties in England. The largest increases were amongst older people, with the number of residents aged 65+ having increased in Leicestershire by 28% during this period – significantly higher than the 20% rise in England.
Since 2018/19, the rate of requests for support from adults aged 18-64 has been consistently lower in Leicestershire than the national average. However, the rate of requests for support from adults aged 65+ has been consistently higher in Leicestershire than the average amongst its CIPFA Nearest Neighbours (most comparable local authorities) and England.
| Client group | Overall % change | 18 - 64 % change | 65+ % change | Number 1 Feb 2021 | Number 1 Feb 2023 |
|---|---|---|---|---|---|
| All | 6% | 3% | 8% | 7463 | 7897 |
| Learning disability | 1% | 0% | 2% | 1539 | 1551 |
| Mental health | 1% | 10% | -11% | 972 | 980 |
| Physical support | 9% | 5% | 10% | 4435 | 4835 |
| Sensory support | -5% | 6% | -13% | 41 | 39 |
| Social support | -13% | -1% | -27% | 152 | 132 |
| Memory and recognition | 11% | -13% | 13% | 334 | 370 |
The Joint Strategic Needs Assessment for Leicestershire is updated locally in a rolling cycle of subject-specific chapters and infographics of current and future health and social care needs, aligned to commissioning cycles where possible. Many chapters are relevant and include Mental Health of Adults, Dementia, Special Educational Needs and Disability, Multi-Morbidity and Frailty, and End of Life Care and Support.
Local authority commissioners of social care provision also use the following tool to explore demography and support needs:
• PANSI for people aged 18-64
• POPPI for people aged 65 and over
Self-funders
There is a strong self-funder market in residential care in Leicestershire. Analysis undertaken by the ONS published in May 2022 indicates that self-funded residents account for 42% of care home residents. The same analysis shows higher levels of self-funding in less deprived areas and rural areas. The level reported in Leicestershire is consistent with both those trends. Further information relating to services purchased by people buying their own care can be found in the residential and nursing care section.
There is less information available about other markets, but the indications are that there are relatively few self-funders. Analysis undertaken in relation to the home care market for the FCOC exercise found that most providers that responded (the sample size was small) indicate less than 10% of their provision is delivered to self-funders, although this might reflect a higher proportion of providers responding which do significant business with the Council, rather than with self-funders. Self-funding in Supported Living and Community Life Choices services also appears to be low, but data and analysis in those markets is limited and so it is not possible to give a quantitative estimate.
Workforce
In Leicestershire in 2021/22 there were an estimated 18,000 jobs in adult social care, with 86% employed by independent sector providers or local authorities. In 2021/22, Leicestershire contained 304 CQC-regulated services, of which 175 were residential and 129 non-residential services.
Skills for Care estimates that in the same year the staff turnover rate in Leicestershire was 34.1%, with a vacancy rate of 7.5%. 87% of workers were female, and 26% were aged 55 and over, i.e. 4,000 will be reaching retirement age in the next 10 years.
The total number of adult social care posts in the East Midlands is expected to increase by 27% between 2021 and 2035.
Staff turnover in Leicestershire was 34.1%, higher than the region average (31.4%), and higher again than England (30%)
See the latest workforce summary for Leicestershire (update due in October 2023) and use the Skills for Care interactive dashboard tool allowing comparison across areas.
A national summary of the sector can be viewed in the Skills for Care ‘The State of the Adult Social Care Sector and Workforce in England’ analysis from October 2022.
The Council has a bespoke recruitment and retention support team for adult social care providers, ‘Inspired to Care’, which in March 2023 has 143 organisations and 363 settings enrolled within the county area. In 2022 its achievements included:
• Bespoke recruitment and retention support to providers
• Engaging with the future workforce through schools, colleges and the Ambassador programme
• Topic conferences on key subjects
• Further development of social media campaigns and resources in the members’ area of the website
• Expanding the Inspired to Care membership to roll out benefits to more providers
• Care Professional of the Year awards
Financial position
The Council’s financial position is challenging, with its budget gap set to rise to over £90m by 2026. It has prioritised protecting vulnerable people in its budget planning and financial strategy.
Joint commissioning
In its Market Sustainability Plan, the council identified key risks in relation to nursing, evidenced by a number of nursing homes reporting financial challenges during 2022/23, services deregistering and increased use of nursing capacity for residential placements.
The Council is therefore working closely with Leicester City Council and the ICB to review nursing care. The aim is to better align commissioning activity with sustainable fee structures, contract and quality management arrangements. At the same time, this approach will ensure each agency continues to meet the varying needs in their area, support the providers commissioned to meet those needs and mitigate the current decline in provision.
This joint working will also entail a review of the application of Funded Nursing Care and Continuing Health Care in the area, and the operation of the Integrated Personal Care Framework, under which healthcare tasks are delegated to care home provider staff. It is anticipated that that these new arrangements will be developed during the current 2023/24 fiscal year.
Page last updated in June 2023.