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Action summary

We will aim to strengthen our system-based approach with the closer alignment of services across adult social care, health and the voluntary sector. We need to better understand the needs of the whole individual and our population at large, to intervene appropriately and earlier to avoid an over-dependency on health and social care.

Several of the areas we need to address hinge on the development of a system wide approach to prevention of need for adult social care services and early intervention when people begin to require support, this includes:

Public Health led primary prevention:

  • Promoting health and wellbeing to support people entering older age in good health, and then staying in good health for as long as possible

Gloucestershire County Council Adult Social Care-led primary and secondary prevention:

  • Ensuring that all system partners information, advice, and guidance to allow residents to meet their needs appropriately whether from community, VCSE, or ASC/healthcare services
  • Planning to ensure accommodation is appropriate to need in public as well as private provision

Integrated Care System-led primary, secondary and tertiary prevention:

  • Thorough analysis of ASC and healthcare data, to support early identification of need and pro-active care to ensure early intervention and support
  • Intervention to maintain supported independence using equipment and technology enabled care
  • Intervention to help residents to plan for and be supported through crises to minimise their impacts

This work necessarily sits across the entire system, but strategic oversight will be led by our Adult Social Care transformation programme.

We will aim to strengthen our system-based approach with the closer alignment of services across adult social care, health and the voluntary sector. We need to better understand the needs of the whole individual and our population at large, to intervene appropriately and earlier to avoid an over-dependency on health and social care.

Several of the areas we need to address hinge on the development of a system wide approach to prevention of need for adult social care services and early intervention when people begin to require support, this includes:

Public Health led primary prevention:

  • Promoting health and wellbeing to support people entering older age in good health, and then staying in good health for as long as possible

Gloucestershire County Council Adult Social Care-led primary and secondary prevention:

  • Ensuring that all system partners information, advice, and guidance to allow residents to meet their needs appropriately whether from community, VCSE, or ASC/healthcare services
  • Planning to ensure accommodation is appropriate to need in public as well as private provision

Integrated Care System-led primary, secondary and tertiary prevention:

  • Thorough analysis of ASC and healthcare data, to support early identification of need and pro-active care to ensure early intervention and support
  • Intervention to maintain supported independence using equipment and technology enabled care
  • Intervention to help residents to plan for and be supported through crises to minimise their impacts

This work necessarily sits across the entire system, but strategic oversight will be led by our Adult Social Care transformation programme.

We have a proud history of supporting unpaid carers in Gloucestershire and we work with providers to support carers from all communities in the county. The Gloucestershire Carers Hub have increased the number of unpaid carers they support from 2,000 when they took over the contract five years ago to over 12,000 now. We understand that a generic offer might not suit everybody so we also commission smaller voluntary organisations to support specific groups.

To further recognise the importance of unpaid carers and the impact that the Covid-19 pandemic had, we plan to work with them and other representative groups to build on our existing Carer’s Action Plan by developing a new Carer’s Strategy to co-ordinate a system wide approach. It is anticipated that this will include an in-depth study of crisis / emergency response for unpaid carers and the development of a new approach to services in this area.

We will also extend the carer's action plan to include:

  • Timely support for carers 
  • Support during crises (emergency response and out of hours care)
  • Support through transitions
  • Training for unpaid carers
  • Day opportunities, short-breaks and respite

This work will be led by Integrated Commissioning and will involve the Carers Partnership Board, the Gloucestershire Carer’s Hub, as well as other groups to ensure a co-produced strategy is developed which we will aim to publish in spring 2025.

We have a proud history of supporting unpaid carers in Gloucestershire and we work with providers to support carers from all communities in the county. The Gloucestershire Carers Hub have increased the number of unpaid carers they support from 2,000 when they took over the contract five years ago to over 12,000 now. We understand that a generic offer might not suit everybody so we also commission smaller voluntary organisations to support specific groups.

To further recognise the importance of unpaid carers and the impact that the Covid-19 pandemic had, we plan to work with them and other representative groups to build on our existing Carer’s Action Plan by developing a new Carer’s Strategy to co-ordinate a system wide approach. It is anticipated that this will include an in-depth study of crisis / emergency response for unpaid carers and the development of a new approach to services in this area.

We will also extend the carer's action plan to include:

  • Timely support for carers 
  • Support during crises (emergency response and out of hours care)
  • Support through transitions
  • Training for unpaid carers
  • Day opportunities, short-breaks and respite

This work will be led by Integrated Commissioning and will involve the Carers Partnership Board, the Gloucestershire Carer’s Hub, as well as other groups to ensure a co-produced strategy is developed which we will aim to publish in spring 2025.

The delivery of adult social care services across the county is entirely reliant on the care workforce and the pressures in this area are well known. For this reason, we are developing a ‘Working Well’ Integrated Workforce Strategy which will include analysis of:

  • Recruitment and retention across the sector
  • Training and development needs (including healthcare and digital skills)
  • International recruitment and how providers and overseas recruits are supported

Our engagement with providers has identified four key areas for development:

Recruitment

We will need to ensure that providers are offering the best terms and conditions to their staff in terms of pay, career progression and job security. We propose to work with providers and the care workforce to find ways to achieve this.

We recognise that as the older population is growing faster than the working age population, staff are increasingly going to be drawn from a younger age group. This may require a shift in culture to ensure that they are attracted to roles in adult social care. We propose to work with staff and young people to understand what is important to them and what might have the most impact.

Retention

We will work with providers to develop ways that will make a difference to retaining our care workforce. These might include:

  • Efficient recruitment processes to onboard staff quickly
  • Training opportunities
  • Recognition of transferable skills
  • Access to career pathways
  • Job satisfaction
  • Development opportunities (for example, delivery of delegated healthcare activities) 
  • Staff wellbeing support in the preferred style or format

We will work on developing a culture shift to recognise providers and the care workforce as an important part of the integrated care system.

Training and development

We recognise that there are skills gaps in the market as people being supported have increasingly complex health and social care needs. Training and development for staff is key to providers being able to meet these needs.

We will work with providers to further develop the training offer in Gloucestershire and to find ways to make it more accessible for staff. This will include dementia care, delegated healthcare activities, complex behaviours, and digital skills.

We are currently reviewing proposals for the delegation of healthcare activities and seeking sustainable ways to enable this to happen.

We will continue to work with providers to enhance their digital capability and increase their use of digital solutions. Support is currently available to take up the “Digital Security Protection Toolkit” (DSPT) and use of digital social care records (DSCR). More work is proposed to explore how digital developments can further increase the efficiency and productivity of care provision.

International recruitment

We are working with local authorities across the South-west region to support international recruitment practice and there is a focus in Gloucestershire on providing pastoral care to international recruits.

We are also considering what the additional or bespoke training needs are for this group to ensure that they are as effective in their new roles as possible.

We recognise that international recruitment is not and cannot be the single solution for our workforce crisis but are keen to ensure that if used it is used effectively and forms part of a strategic approach to workforce recruitment and deployment.

The work is being led by our Integrated Commissioning and will involve providers and their representative body. We will aim to publish in autumn 2024. 

The delivery of adult social care services across the county is entirely reliant on the care workforce and the pressures in this area are well known. For this reason, we are developing a ‘Working Well’ Integrated Workforce Strategy which will include analysis of:

  • Recruitment and retention across the sector
  • Training and development needs (including healthcare and digital skills)
  • International recruitment and how providers and overseas recruits are supported

Our engagement with providers has identified four key areas for development:

Recruitment

We will need to ensure that providers are offering the best terms and conditions to their staff in terms of pay, career progression and job security. We propose to work with providers and the care workforce to find ways to achieve this.

We recognise that as the older population is growing faster than the working age population, staff are increasingly going to be drawn from a younger age group. This may require a shift in culture to ensure that they are attracted to roles in adult social care. We propose to work with staff and young people to understand what is important to them and what might have the most impact.

Retention

We will work with providers to develop ways that will make a difference to retaining our care workforce. These might include:

  • Efficient recruitment processes to onboard staff quickly
  • Training opportunities
  • Recognition of transferable skills
  • Access to career pathways
  • Job satisfaction
  • Development opportunities (for example, delivery of delegated healthcare activities) 
  • Staff wellbeing support in the preferred style or format

We will work on developing a culture shift to recognise providers and the care workforce as an important part of the integrated care system.

Training and development

We recognise that there are skills gaps in the market as people being supported have increasingly complex health and social care needs. Training and development for staff is key to providers being able to meet these needs.

We will work with providers to further develop the training offer in Gloucestershire and to find ways to make it more accessible for staff. This will include dementia care, delegated healthcare activities, complex behaviours, and digital skills.

We are currently reviewing proposals for the delegation of healthcare activities and seeking sustainable ways to enable this to happen.

We will continue to work with providers to enhance their digital capability and increase their use of digital solutions. Support is currently available to take up the “Digital Security Protection Toolkit” (DSPT) and use of digital social care records (DSCR). More work is proposed to explore how digital developments can further increase the efficiency and productivity of care provision.

International recruitment

We are working with local authorities across the South-west region to support international recruitment practice and there is a focus in Gloucestershire on providing pastoral care to international recruits.

We are also considering what the additional or bespoke training needs are for this group to ensure that they are as effective in their new roles as possible.

We recognise that international recruitment is not and cannot be the single solution for our workforce crisis but are keen to ensure that if used it is used effectively and forms part of a strategic approach to workforce recruitment and deployment.

The work is being led by our Integrated Commissioning and will involve providers and their representative body. We will aim to publish in autumn 2024. 

Our 2020 strategy highlighted that there was an increased need for affordable rental properties in Cheltenham, Cotswolds, Stroud and Tewkesbury and for properties for ownership in all districts except Tewkesbury and Cheltenham. There is a strong partnership in place between Gloucestershire County Council and the six district councils and together we are working to develop more Extra Care Housing (ECH) schemes where they are needed and can be sustained. Opportunities are currently being explored in the Tewkesbury and Stroud districts.

There are barriers to overcome, including a lack of enthusiasm from developers who consider ECH schemes to be high risk and the investment involved often leads to provision which is not affordable for the people whose needs might be met there. We are considering how developments of this type might be further encouraged and made more viable in the future. 

In addition to new developments, there is also the need to make better use of those which are already in place. If ECH schemes are to be fully utilised, there needs to be sufficient capacity and there are some current challenges to this. As a result, we will work with care providers to understand and develop the current model including reviewing the fee structure, referral process, a universal wellbeing offer, falls prevention / response, enhancing the health offer, hospital discharge and a geographical (such as ‘hub and spoke’) model of provision.

There is also scope to make better use of sheltered housing. We have an opportunity to align our ‘hyper-localised’ commissioning model with sheltered housing schemes to ensure that care ii is available to both the residents and other people living nearby. 

We will update our existing Housing with Care Strategy to recognise the importance of the right accommodation in the right place to meet need and this will include:

  • An increase in sustainable ECH schemes
  • Better use of current ECH and sheltered housing schemes
  • Reviewing the referral process
  • Reviewing care capacity
  • Hub and spoke models of provision
  • An enhanced universal wellbeing offer and falls prevention
  • Ways to ensure offer is affordable

This work will be led by Integrated Commissioning working with other stakeholders including the Strategic Housing Partnership and we aim to publish the updated strategy in December 2024.

Our 2020 strategy highlighted that there was an increased need for affordable rental properties in Cheltenham, Cotswolds, Stroud and Tewkesbury and for properties for ownership in all districts except Tewkesbury and Cheltenham. There is a strong partnership in place between Gloucestershire County Council and the six district councils and together we are working to develop more Extra Care Housing (ECH) schemes where they are needed and can be sustained. Opportunities are currently being explored in the Tewkesbury and Stroud districts.

There are barriers to overcome, including a lack of enthusiasm from developers who consider ECH schemes to be high risk and the investment involved often leads to provision which is not affordable for the people whose needs might be met there. We are considering how developments of this type might be further encouraged and made more viable in the future. 

In addition to new developments, there is also the need to make better use of those which are already in place. If ECH schemes are to be fully utilised, there needs to be sufficient capacity and there are some current challenges to this. As a result, we will work with care providers to understand and develop the current model including reviewing the fee structure, referral process, a universal wellbeing offer, falls prevention / response, enhancing the health offer, hospital discharge and a geographical (such as ‘hub and spoke’) model of provision.

There is also scope to make better use of sheltered housing. We have an opportunity to align our ‘hyper-localised’ commissioning model with sheltered housing schemes to ensure that care ii is available to both the residents and other people living nearby. 

We will update our existing Housing with Care Strategy to recognise the importance of the right accommodation in the right place to meet need and this will include:

  • An increase in sustainable ECH schemes
  • Better use of current ECH and sheltered housing schemes
  • Reviewing the referral process
  • Reviewing care capacity
  • Hub and spoke models of provision
  • An enhanced universal wellbeing offer and falls prevention
  • Ways to ensure offer is affordable

This work will be led by Integrated Commissioning working with other stakeholders including the Strategic Housing Partnership and we aim to publish the updated strategy in December 2024.

Many of the areas we need to address depend on how we respond to our increasing older population. For this reason, we will continue to develop an ‘ageing well’ system-wide approach which will include: 

  • Refreshing our ageing well programme (including Enhanced Health in Care Homes (EHCH) and End of Life care)
  • Developing a strategy for older people

We are also proposing that we work together as a system to develop and deliver a way of training care staff to undertake some delegated healthcare tasks. This would enhance and expand the wrap-around approach to health and care services for people in their own homes. This could be done by working with closely with community health services to ensure that all care providers are supported in the way which care homes are through the Network Contract Direct Enhanced Service (DES) for 2023-24 “Enhanced Health in Care Homes” Framework.[1]

This work will be led by Integrated Commissioning and we aim to publish the refreshed ageing well programme in February 2025. 

Many of the areas we need to address depend on how we respond to our increasing older population. For this reason, we will continue to develop an ‘ageing well’ system-wide approach which will include: 

  • Refreshing our ageing well programme (including Enhanced Health in Care Homes (EHCH) and End of Life care)
  • Developing a strategy for older people

We are also proposing that we work together as a system to develop and deliver a way of training care staff to undertake some delegated healthcare tasks. This would enhance and expand the wrap-around approach to health and care services for people in their own homes. This could be done by working with closely with community health services to ensure that all care providers are supported in the way which care homes are through the Network Contract Direct Enhanced Service (DES) for 2023-24 “Enhanced Health in Care Homes” Framework.[1]

This work will be led by Integrated Commissioning and we aim to publish the refreshed ageing well programme in February 2025. 

The provision of support services for adults of working age will benefit from further in-depth analysis, including transitions from children’s services to understand potential future demand from this age group.

In addition, there is work to be done with providers and other local authorities to manage the growth of demand from outside of Gloucestershire in this sector, especially considering our limited workforce capacity. The unpaid care workforce and voluntary sector organisations will also have key roles to play.

We will develop a living well strategy that will provide an in-depth analysis of the provision across all service types and to meet a full range of needs including costs, capacity and usage to help us develop a clear and coherent strategic approach for individuals with:

  • Physical disabilities
  • Learning disabilities
  • Mental health conditions
  • Specific complex conditions such as acquired brain injury or neurological illness
  • Autism

This work will be led by Integrated Commissioning, and we aim to publish a 'living well strategy' in summer 2025. 

The provision of support services for adults of working age will benefit from further in-depth analysis, including transitions from children’s services to understand potential future demand from this age group.

In addition, there is work to be done with providers and other local authorities to manage the growth of demand from outside of Gloucestershire in this sector, especially considering our limited workforce capacity. The unpaid care workforce and voluntary sector organisations will also have key roles to play.

We will develop a living well strategy that will provide an in-depth analysis of the provision across all service types and to meet a full range of needs including costs, capacity and usage to help us develop a clear and coherent strategic approach for individuals with:

  • Physical disabilities
  • Learning disabilities
  • Mental health conditions
  • Specific complex conditions such as acquired brain injury or neurological illness
  • Autism

This work will be led by Integrated Commissioning, and we aim to publish a 'living well strategy' in summer 2025. 

In order to achieve a personalised approach that encourages and enables independence, reduces care need and avoids people receiving community care earlier or for longer than they need, we recognise that we need to encourage the development of services that avoid or delay the need for statutory care.

We aim to increase opportunities for people to use direct payments which will involve increasing the choice of support offers available, including:

  • Personal assistants (PAs)
  • Micro-providers
  • Voluntary sector community support
  • Shared Lives

This work will be led by Integrated Commissioning working with Public Health, the voluntary sector, the social care market and the wider system.

In order to achieve a personalised approach that encourages and enables independence, reduces care need and avoids people receiving community care earlier or for longer than they need, we recognise that we need to encourage the development of services that avoid or delay the need for statutory care.

We aim to increase opportunities for people to use direct payments which will involve increasing the choice of support offers available, including:

  • Personal assistants (PAs)
  • Micro-providers
  • Voluntary sector community support
  • Shared Lives

This work will be led by Integrated Commissioning working with Public Health, the voluntary sector, the social care market and the wider system.

To support more people in their own homes we aim to further develop home care services and the staff working in them. We aim to increase the capacity of providers by commissioning in ways that enable them to use staff time efficiently and supporting them to train and develop their staff to meet the considerable variety of needs. We propose to do this by:

  • Continuing with the development of hyper-localised commissioning wherever possible
  • Developing links to community services to support maintaining and improving independence levels
  • Working as a system to enhance training and development opportunities for staff
  • Working with providers to find ways to incentivise staff

This work will be led by Integrated Commissioning working with home care providers and the wider system.

To support more people in their own homes we aim to further develop home care services and the staff working in them. We aim to increase the capacity of providers by commissioning in ways that enable them to use staff time efficiently and supporting them to train and develop their staff to meet the considerable variety of needs. We propose to do this by:

  • Continuing with the development of hyper-localised commissioning wherever possible
  • Developing links to community services to support maintaining and improving independence levels
  • Working as a system to enhance training and development opportunities for staff
  • Working with providers to find ways to incentivise staff

This work will be led by Integrated Commissioning working with home care providers and the wider system.

Intermediate care

Our intermediate care programme provides a range of short-term services to support people during times of crisis in their lives, including:

  • Same day hospital discharge into home first (including an assessment in the first 48 hours)
  • Timely assessment for individuals stepping up and down into reablement services
  • Support with emergencies, either short term, at night or as support for an unpaid carer who might require treatment themselves
  • Urgent step-up and assessment from the community

Over 100-125 people per week need to flow into home first with 50% likely to then flow into reablement. With specialist reablement supporting step up, we will need this service to manage 60-70 cases per week. 

We want to ensure that everyone receiving care services is supported to live well and to maintain or increase their independence. We want to take an 'outcome-based' commissioning approach and expect to give an increasing focus to reablement in every context. We want to work with innovative providers to understand and develop models of best practice and promote these across the market.

This work will be led by Integrated Commissioning working with providers and the wider system.

Intermediate care

Our intermediate care programme provides a range of short-term services to support people during times of crisis in their lives, including:

  • Same day hospital discharge into home first (including an assessment in the first 48 hours)
  • Timely assessment for individuals stepping up and down into reablement services
  • Support with emergencies, either short term, at night or as support for an unpaid carer who might require treatment themselves
  • Urgent step-up and assessment from the community

Over 100-125 people per week need to flow into home first with 50% likely to then flow into reablement. With specialist reablement supporting step up, we will need this service to manage 60-70 cases per week. 

We want to ensure that everyone receiving care services is supported to live well and to maintain or increase their independence. We want to take an 'outcome-based' commissioning approach and expect to give an increasing focus to reablement in every context. We want to work with innovative providers to understand and develop models of best practice and promote these across the market.

This work will be led by Integrated Commissioning working with providers and the wider system.

We want to work with residential care homes to increase their capacity for dementia care where the buildings and facilities are or can be made, appropriate.

We recognise the need for an increase in staffing to facilitate the enhanced level of care for people with dementia and we will explore how we might facilitate this through strategic partnerships.

There is also a need to ensure staff have access to appropriate training to provide quality dementia care. We want to ensure the training and development offer for all care staff in Gloucestershire is fit for purpose and this will be addressed through the development of the ‘Working Well’ Integrated Workforce Strategy.

In some areas there may be potential for the development of a 'shared care' model where care staff might work both in care homes and in the community. A locality-based outreach service from a care home might have advantages by creating a business opportunity to provide additional capacity in areas where there are limitations.

This work will be led by Integrated Commissioning working with providers and the wider system.

We want to work with residential care homes to increase their capacity for dementia care where the buildings and facilities are or can be made, appropriate.

We recognise the need for an increase in staffing to facilitate the enhanced level of care for people with dementia and we will explore how we might facilitate this through strategic partnerships.

There is also a need to ensure staff have access to appropriate training to provide quality dementia care. We want to ensure the training and development offer for all care staff in Gloucestershire is fit for purpose and this will be addressed through the development of the ‘Working Well’ Integrated Workforce Strategy.

In some areas there may be potential for the development of a 'shared care' model where care staff might work both in care homes and in the community. A locality-based outreach service from a care home might have advantages by creating a business opportunity to provide additional capacity in areas where there are limitations.

This work will be led by Integrated Commissioning working with providers and the wider system.

We will work with nursing care homes to increase their capacity where appropriate and possible. This will sometimes require increasing staffing levels and enhancing staff training. In other cases, it might involve the provision of additional equipment or the adaptation of accommodation.

Ensuring a robust support offer to care homes from Community Health services will be key in facilitating nursing homes to support more people with more complex health needs for longer and more frequently to end of life.

The Enhanced Health in care homes framework is managed in Gloucestershire as part of the ageing well programme.

“The Enhanced health in care homes (EHCH) framework is for primary care networks (PCNs) and providers and commissioners of community health and social care services. It guides the commissioning of and delivery arrangements for health and social care services in collaboration with care homes, so that the entire system works together to provide personalised care, improve outcomes and promote independence for people living in care. It recognises the life course of people who live in a care home and promotes the ethos of living, ageing and dying well.”[1]

We also recognise that community hospitals also have a part to play in supporting older people with their health care needs. The relationship between acute and community hospitals and nursing care homes will need further consideration to ensure that people can have their needs met in the right place at the right time.

The work will be led by Integrated Commissioning working with providers and the wider system.

We will work with nursing care homes to increase their capacity where appropriate and possible. This will sometimes require increasing staffing levels and enhancing staff training. In other cases, it might involve the provision of additional equipment or the adaptation of accommodation.

Ensuring a robust support offer to care homes from Community Health services will be key in facilitating nursing homes to support more people with more complex health needs for longer and more frequently to end of life.

The Enhanced Health in care homes framework is managed in Gloucestershire as part of the ageing well programme.

“The Enhanced health in care homes (EHCH) framework is for primary care networks (PCNs) and providers and commissioners of community health and social care services. It guides the commissioning of and delivery arrangements for health and social care services in collaboration with care homes, so that the entire system works together to provide personalised care, improve outcomes and promote independence for people living in care. It recognises the life course of people who live in a care home and promotes the ethos of living, ageing and dying well.”[1]

We also recognise that community hospitals also have a part to play in supporting older people with their health care needs. The relationship between acute and community hospitals and nursing care homes will need further consideration to ensure that people can have their needs met in the right place at the right time.

The work will be led by Integrated Commissioning working with providers and the wider system.

We will work on a regional basis with other local authorities to understand the demand for out of county placements into Gloucestershire to ensure that they are aware of the impacts on our resource and that any protocols agreed are mutually followed.

We will work with the providers that other local authorities commission with to better understand the drivers for accepting out of county placements and how that impacts on our resource and capacity, as well as compatibility within shared care settings.

This work will be led by Integrated Commissioning, working with Adult Social Care providers and neighbouring local authorities.

We will work on a regional basis with other local authorities to understand the demand for out of county placements into Gloucestershire to ensure that they are aware of the impacts on our resource and that any protocols agreed are mutually followed.

We will work with the providers that other local authorities commission with to better understand the drivers for accepting out of county placements and how that impacts on our resource and capacity, as well as compatibility within shared care settings.

This work will be led by Integrated Commissioning, working with Adult Social Care providers and neighbouring local authorities.

Gloucestershire County Council is currently developing plans for three new care homes in Gloucestershire which we hope will meet some of this additional demand. The model for commissioning the care provision within these new care homes has yet to be determined but the likely options are:

  • The care homes being managed by Gloucestershire County Council employing their own staff teams
  • Commissioning a care home provider to provide the staff teams
  • Developing a partnership with a care home provider (via a selection process) and working with them to design the care homes which they will manage and provide the staff teams 

There are advantages and risks associated with each of these options which will need to be considered and a strategic decision made as to how to proceed.

Given the increasing limitations on our care workforce, we want to ensure that the option selected will maximise the productivity of these resources. This will include the provision being of a size and in a location that enables quality care to be easily delivered and a business model that invests in care staff as the primary asset.

This work will be led by Integrated Commissioning working with stakeholders across the system.

Gloucestershire County Council is currently developing plans for three new care homes in Gloucestershire which we hope will meet some of this additional demand. The model for commissioning the care provision within these new care homes has yet to be determined but the likely options are:

  • The care homes being managed by Gloucestershire County Council employing their own staff teams
  • Commissioning a care home provider to provide the staff teams
  • Developing a partnership with a care home provider (via a selection process) and working with them to design the care homes which they will manage and provide the staff teams 

There are advantages and risks associated with each of these options which will need to be considered and a strategic decision made as to how to proceed.

Given the increasing limitations on our care workforce, we want to ensure that the option selected will maximise the productivity of these resources. This will include the provision being of a size and in a location that enables quality care to be easily delivered and a business model that invests in care staff as the primary asset.

This work will be led by Integrated Commissioning working with stakeholders across the system.

From 2024, we will host dedicated quarterly in-person provider forums for each of the home care, care home and disabilities/mental health sectors to be attended by colleagues from across the local health and social care system. The forums will aim to consider and focus on issues raised by providers as well as those raised by commissioners.

We will engage with providers to ascertain what they need and expect from their representative body going forward with a view to going out to competitive tender for a new contract during 2025-6.

We will improve our support offer to providers by improving accessibility to information and commissioners in relation to both strategic and day-to-day matters.

This work will be led by Integrated Commissioning working with Adult Social Care providers, their representatives, and the wider system.

From 2024, we will host dedicated quarterly in-person provider forums for each of the home care, care home and disabilities/mental health sectors to be attended by colleagues from across the local health and social care system. The forums will aim to consider and focus on issues raised by providers as well as those raised by commissioners.

We will engage with providers to ascertain what they need and expect from their representative body going forward with a view to going out to competitive tender for a new contract during 2025-6.

We will improve our support offer to providers by improving accessibility to information and commissioners in relation to both strategic and day-to-day matters.

This work will be led by Integrated Commissioning working with Adult Social Care providers, their representatives, and the wider system.