Market Position Statement - Messages to the market

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Residential and nursing care

What we want for our residents - We want to ensure a sufficient choice of nursing care and residential care in the borough for those with complex needs so that every person who needs a care home placement is able to access a suitable local option of their/their family’s choice.

We want to ensure that care home placements are delivered in care homes that have at least a 'Good' rating from the Care Quality Commission.

Current provision

There are 13 nursing homes with 1,096 beds and 17 residential homes with 300 beds according to CQC data sources as of January 2023. In Wandsworth 87% of these care homes (26/30) are rated ‘Good’ and ‘Outstanding’. Residential and nursing care services are commissioned in and out of borough by spot purchasing.  

Residential and nursing care per client group in 2022 is shown in the table below.

Client group	Residential care beds	Nursing care beds
Older people/physical and sensory disability	186	845
Memory and cognition*	0	0
Learning disability	89	0
Mental health	25	251

*No specialist homes but some specialist beds available in older people's provision

Messages to the market - residential and nursing care

• We want to work with providers to drive up quality and safeguarding practices through agreeing clear standards and monitoring provision through the standards of the PAMMS quality assurance system
• We want to encourage providers to develop links with local communities to increase the choice of activities and social stimulation
• We want to encourage providers to engage in the use of technology enabled care to support independence and improve quality of life
• We want providers to work with us to understand the demand for services from people who fund their own care
• We want to offer inclusive and culturally responsive services and work in a person-centred way, tailored individually to meet the needs of people from all equality groups, for example lesbian, bi-sexual and transgender people

Older people and adults with memory and cognition needs:

• Although there are vacancies in care homes locally, there are too many basic residential care beds and not enough specialist dementia beds. Therefore, we want to work with providers to increase in borough capacity of specialist care home provision for enhanced dementia-related care in both residential and nursing settings, as well as supporting people with behaviour that is seen as challenging, and the provision of bariatric care (which focuses on providing compassionate care and support for those who have obesity to promote better health, through diet, equipment adaptations and purpose built accommodation.
• To provide this more specialist care, providers will need to reconfigure or develop new services, and to review the training and skills of their staff.
• We are working with providers to consider dementia friendly environments when developing their service delivery models.

Adults with mental health needs:

• There is a need for in-borough specialist residential and nursing care that support residents with mental health conditions, as well as those who are neurodiverse, and those who have challenging and risky behaviour.
• This will require providers to employ highly trained and skilled staff. 

Adults with learning disabilities:

• There is a continuing need for some in-borough specialist residential and nursing care for younger and older service users with more complex needs.
• There is also a small but emerging need for bespoke services for people who have been discharged from long-stay hospitals or who are experiencing crisis and require unplanned/emergency accommodation to prevent admission to hospital.
• There is a keenness to expand the range of short break and respite options available to people with a learning disability and their carers. We would like to hear from and work with prospective provider partners with creative ideas that can support carers with a welcome break and promote enjoyable new experiences for people with a learning disability.

Extra care

Extra care housing provides an alternative accommodation based care option which promotes independence and wellbeing. The service provision is flexible and responsive to adapt to needs as they change. These schemes help keep people connected to the local communities for as long as they wish.

What we want for our residents - We want to ensure good quality, safe, accessible and adaptable extra care provision for older adults enabling them to live independently, avoiding or delaying the need for residential care.

Current provision

There are three (150 units) extra care schemes in Wandsworth that are commissioned by us which are rented (no provision for shared ownership) and there are also additional privately run schemes. Our commissioned services are generalist physical health, mobility and sensory needs provision for people aged 55+.  One additional extra care scheme is being developed in partnership with a housing association, due for completion by October 2023. This will provide an additional 41 extra care units.

There are plans to explore part of one mixed community scheme in the borough for potential use for people with learning disabilities.

Messages to the market - extra care

• We want to work with our existing providers to develop flexible, age friendly supported independent living options and explore innovative models such as those that promote mixed communities and intergenerational living. Please refer to the Local Plan
• When developing new service delivery models, we want to work with providers to consider dementia friendly environments
• We are seeking to work with existing providers on new and creative ways to use technology to deliver care and maintain independence
• We want to explore the demand for shared ownership to increase the range of housing options available
• We want to offer inclusive and culturally responsive services and work in a person-centred way, tailored individually to meet the needs of people from all equality groups, for example lesbian, bi-sexual and transgender people

Older people:

• We will continue with service development within our existing extra care schemes which provide a bridge between independent living and residential care homes. This includes working with our care providers and housing providers to develop a community hub model which supports family and community links and connections.

People with learning disabilities and mental health needs:

• Specialist provision within an extra care setting may be beneficial for those who are older. We want to work with providers to explore extra care models for those with more complex or long-term needs.

Adults with physical disabilities:

• We will work with key providers and partners in exploring the possibility of a model that caters for younger adults including those with degenerative conditions which is flexible and accessible.

Supported living

Supported living is a person-centred and strengths-based approach to housing and care and support services. It is based on service users having a tenancy or license agreement which offers them the right to remain in their own home and have choice and control over their care and support. Supported living forms part of a range of community-based care and support available for people with a learning disability and/or autism or mental health support needs. Support provided can vary depending on the needs of the individuals and may range from a couple of hours a week to 24/7 support.

What we want for our residents - We want to ensure a sufficient choice of good quality, flexible supported living services in Wandsworth which are outcomes-focused and person-centred. We want supported living to effectively support step-down from residential care and move-on into more independent living with a focus on recovery and rehabilitation for those with mental health needs.

Current provision

We commission a range of accommodation-based services locally, including supported living and housing support and preventative services (HSPS) to support people to remain as independent as possible in their own home.

Our approach to supported living for adults with a learning disability and/or autism has been developed in partnership with the learning disability partnership board and working groups and is key to the delivery of the Learning Disability Commissioning Strategy 2021-26.  For people with a learning disability and/or autism, we block purchase 75 units of supported living from two providers, and there are a further 169 units across 11 providers. 

In spring 2023, we will be commissioning a framework for accommodation-based care and support services, including supported living. We are also developing a new supported living scheme as part of our wider housebuilding programme.  A new scheme of seven self-contained flats with communal space is due to complete in summer 2023 and a further scheme is in development for 8 units for completion in 2025.

We are also developing new initiatives based on shared housing to support people with learning disabilities with intensive skills learning so that they can move on to greater independence with a focus on move-on. Some of the supported living accommodation available in Wandsworth lacks modern design features, does not have the connectivity required to make the most of new assistive technology, and is difficult to adapt to meet the changing needs of tenants.  There is also a need for more accessible accommodation which can support people with complex needs and behavioural support needs.

For people with mental health needs there are currently 37 schemes, with a total of 238 units. These are categorised as either high, medium or low support. Demand has increased substantially for supported living for those with a mental health need, due to a focus on stepping down residents in residential and nursing care, and from hospitals, into supported living to support more independence where appropriate. Additionally, the move on pathway is held up by the lack of appropriate general needs housing, further restricting residents to progress to lower levels of support.

We are undertaking a review of our mental health provision with a particular focus on accommodation based services and alternatives to accommodation-based provision. As part of our mental health review, we are also examining low level and preventative provision including proposals for floating support, and we will update once our review have been completed.

Sufficiency of suitable affordable housing options across both general needs/social housing and the private sector is  a challenge in Wandsworth and work is ongoing with Housing partners to promote understanding of the accommodation needs of our vulnerable residents.

Messages to the market - supported living

• Our aim is to support people to remain as independent as possible in their own home through alternative independent living options, reducing reliance on residential care. Supported living accommodation is a key destination for service users aged 18-64 (particularly young adults who are aged between 18 and 35)
• We want to work with our housing partners and providers to develop more specialist supported living provision particularly for service users with complex, high-level needs and behaviours that are seen as challenging. The greatest gap is in relation to those with mental health needs
• We want to strengthen our approach to working with providers, developers and partners to encourage the development of more local, flexible and accessible housing which allow aging in place
• We want to work with providers committed to the provision of good quality accommodation with modern configuration which is reflective of the Ministry of Housing, Communities and Local Government national statement of expectations (NSE), October 2020 guidance
• We want providers to explore new approaches such as technology enabled support to help manage risk and health conditions. This will support people to enjoy increased independence and privacy, whilst also offering safety and security in respect of monitoring health conditions, or remote support being available
• We are always keen to hear from and work with prospective developers and provider partners who are interested in developing creative new services particularly for people with more complex needs and young people transitioning into adult social care services from children’s social care services.
• There is an expectation for providers to offer bespoke and targeted services to meet the diverse needs of service users.

Adults with mental health needs:

• We have undertaken a review of our mental health provision with a particular focus on accommodation based services and alternatives to accommodation-based provision.  
• Demand exceeds supply for medium to high support supported living provision for those with complex needs, including for those with a forensic history and/or complex behavioural needs. We want to work with providers to increase capacity and develop specialist provision that is flexible and accessible.
• We are seeking single bedded accommodation with good access to transport, community and health facilities.
• We have been working with our key providers and partners to review our existing supported living provision to ensure it remains fit for purpose, with a particular focus on remodelling provision to increase high support capacity for service users with more complex needs.
• The commissioning model for mental health services is to rehabilitate and promote recovery and enable people to step down from accommodation-based services to live fulfilled and independent lives in the community in a safe manner, ensuring any safeguarding concerns are acted on. We are seeking innovative models of support which deliver the best outcomes for service users to aid move-on to independent living whilst still providing a stable and supportive living situation.
• We also want to work with providers to develop some specialist supported living and housing support and preventative services, that might be beneficial for younger service users with mental health needs and often autistic spectrum disorder in transition from children and young people’s support to adult provision.
• We are interested in exploring the feasibility of housing first models which prioritise access to housing as quickly as possible and would be keen to work with providers to develop proposals for this.
• We are also interested in commissioning provision for people requiring long-term accommodation-based support, primarily in the older age range (55+), possibly using an extra care model.
• We want to strengthen links and work with our housing partners, registered providers and private landlords to increase capacity of step-down provision including general needs and private housing options, deploying floating support more effectively to enable service users to independence.
• We want to explore and take forward opportunities for joint commissioning arrangements with the South London partnership.

Adults with learning disabilities:

• There is a preference for self-contained accommodation with the option of onsite support and communal areas including outdoor space to promote independent living and a sense of community. Some people prefer to live with others in a shared house, and especially for young people moving out of home for the first time, this mirrors the experience of the wider population. Where people are living in a shared house, en-suite bathrooms are preferred. Wheelchair accessible accommodation is also in demand. Accommodation needs to be near public transport networks whenever possible, as this is key for attracting and retaining staff. 
• We also want to work with providers and partners to ensure that our accommodation offers improved service user choice and control, and uses strengths based and trauma informed care approaches to proactively support residents’ recovery, independence and move-on.
• Work is underway to develop a tiered pathway of accommodation, from lower level and short term to high intensity and long term, to respond to a wide range of needs and preferences.
• We are commissioning a framework of accommodation-based care and support services, including supported living in spring 2023.
• We are always keen to hear from and work with prospective developers and provider partners who are interested in developing creative new services particularly for people with more complex needs and young people transitioning into adult social care services from children’s social care services.

Adults with physical and sensory disability needs:

• Key generic requirements are for flexible accommodation to promote independence and meet changing needs and also ensure accessibility to communications (including BSL, Makaton and Braille). Proximity to local community and facilities and transport links as well as accessibility of premises is a key concern in Wandsworth.
• Small sized supported living schemes might be useful for people with a long- term conditions looking to move towards independence.
• Accommodation should be accessible and adaptable for young people.

Home care

What we want for our residents - We want people to receive support to live independently in their own homes as far as possible rather than in residential care.

We want home care services to be person-centred and flexible in supporting individuals to achieve their desired outcomes and aspirations, shifting away from ‘time and task’ based care.

We expect all home care provision to maximise individuals’ independence and to work to an ethos of reablement. Home care should increasingly be supported and supplemented by the use of care technology, and equipment aids and adaptations to support daily living in a way that promotes independence and reduces hours of care and the need for long term care. 

Current provision

Home care services are delivered through our contractual arrangements with 8 providers who are allocated their own geographical zone (“area/patch”). Our intention is to place the majority of business with contracted providers. We also spot purchase from around 27 care agencies. 

Messages to the market - home care

• We want to work with providers to increase the availability and responsiveness of home care, reablement, and short-term ‘rapid response’ provision to support hospital discharge for up to 14 days
• We are experiencing an increase in demand for home care including for more specialist packages, particularly from those discharged from hospital. We want to work with providers who can manage increasingly complex packages which may include service users with multiple needs receiving services from a variety of agencies
• Wandsworth is a diverse borough, and it is important that home care services are inclusive and provide culturally responsive services
• We want providers to be positive about working with digital technology to support users in achieving greater independence
• To support the varying levels of client need, providers will need to review the training and skills of their staff and employ a diverse workforce that reflects the local population, including language skills.

Older people and people with memory and cognition needs:

• We have commissioned a new community equipment provider to ensure there is suitable and accessible equipment to support people at home and in care homes and want to increase focus on working with providers to engage in the use of digital solutions to help to prevent, reduce and delay care needs from increasing.
• We want to work with providers to promote dementia awareness through workforce training.

Prevention and the voluntary sector

What we want for our residents - The vision for preventative services in Wandsworth is that vulnerable and/or older adults in Wandsworth who are most at risk of a decline in their independence and wellbeing can access a range of inclusive and culturally responsive preventative services. The community and voluntary sector will be at the centre of delivering these services.

Prevention is at the core of our approach to improving overall outcomes and health inequalities. The Prevention Framework has been developed which will serve as the umbrella framework for delivering a whole systems approach to preventing ill health and promoting positive health and wellbeing throughout the local health and care system as well as wider services.

Our aim is to develop provision that enables people to get early help and support on things that might impact their physical and mental well- being, focussing also on the wider determinants of a person’s health and wellbeing. We will work with communities and the market to ensure support that promotes early intervention and prevents or delays admission into hospital or long- term residential care. We will do this by developing services which enable timely hospital discharge, including step down beds, reablement and rapid response services, and through promoting community-based services. This includes the use of community equipment and care technology as well as a range of preventative services delivered by the voluntary sector.

Current voluntary sector provision

Wandsworth has an active and well developed voluntary sector with over 900 voluntary sector organisations offering a diverse range of services.  The sector is supported by our Voluntary Sector Partnership team, part of the Community and Partnerships group, which works across both Wandsworth and Richmond

In 2019, Wandsworth council set out its proposals for commissioning a specific preventive offer, entitled the “Wandsworth voluntary sector preventative offer (WVSPO)”. This represents a collection of commissioned services that are designed to improve the health and wellbeing of vulnerable adults, promote their independence and reduce the need for targeted social care services.

These include establishing age well services in Roehampton and Battersea that focus on the needs of deprived communities and support intergenerational activities to improve health and maintain independence. In addition, establishing an enhanced community navigation service working with clients across the life course.  The objective is to reduce the demand on targeted care services by providing clients with up to six months of support to access wider services that support their health and independence.

Messages to the market - prevention and the voluntary sector

• We see the community and voluntary sector as key partners in the planning and delivery of preventative services.
• We welcome providers coming to us with new ideas for improving outcomes through innovative approaches that offer significant social value.
• There is an uneven spread of support for preventative services across the borough with underrepresentation from ethnic minority groups, including Black and Asian ethnic groups. As demographics shift, we will continue to monitor the spread of preventative services across the borough to ensure that they are meeting the needs of our ageing population.

Day care opportunities and outreach

What we want for our residents - Our ambition and vision are to ensure a wide and varied day opportunities offer which promotes independence, social inclusion, and healthier lifestyles.

Current provision

Most day care activity, especially for older persons is building centred day care, with one specialist day centre which supports older people, people with a physical disability, and adults with dementia who have eligible needs.

In addition, there are open access age-well centres as part of the Wandsworth voluntary sector prevention offer.

Following an extensive review of the day opportunities across older persons, physical disability and mental health in 2019 and learnings from the coronavirus pandemic it was identified that broadly speaking, the commissioning model of day service provision has remained fairly static with much activity being centre based, however there is a need to respond more flexibly and creatively to the varying needs of service users and strengthen and build upon the day opportunities offer. A modernisation of council commissioned services has been implemented since 2021 and continues to evolve with the aim of providing a variety of community-based options to meet people’s outcomes.

Our approach to commissioning day support and outreach for people with a learning disability has been developed in partnership with the learning disability partnership board and its working groups. We are commissioning a framework of life skills and wellbeing opportunities which will support people with a learning disability and/or autism at a range of times across the week. Services will include specialist place-based support, community support, home support, virtual support and independent travel training. This will enable people to access support, which is more person-centred, goal-oriented and flexible than traditional day service models.

The local authority commissions a range of support from the voluntary sector and Southwest London and St George’s NHS Mental Health Trust for people with mental health needs, providing daytime activities which support recovery and self-management in the community.

Messages to the market - day care opportunities and outreach

• We have contracts in place with local providers to support residents at all dependency levels, accessing building based day centres and other community support services.
• We want to work with our existing providers to further develop flexible and creative provision across the continuum of need, ranging from people with low level needs to the most complex of care needs accessing a building-based day centre, complemented by services available in the community, in people's homes and on digital platforms for those who do not want or need to be building-based.
• We expect daycare provision to be inclusive and culturally responsive to meet the diverse needs of local communities. A needs assessment of vulnerable and older Black, Asian and Minority Ethnic people and their carers has been undertaken to assess how well their needs are being addressed.

Older people and people with memory and cognition:

• The transformation of Wandsworth day opportunities aims to provide a more cohesive and a varied offer whereby residents can ‘pick and choose’ which services to access to meet their needs and aspirations.
• We want to work with partners and providers to offer older people opportunities that reduce social isolation, build their confidence to use digital tools, learn new skills and engage in new activities that maintain their strength and balance.
• Additionally, we want to work with providers to build links with community facilities to provide different choices and opportunities.
• We will work with providers to consider dementia friendly environments and promote dementia awareness through workforce training.

Adults with mental health needs:

• There is a need for outreach support to enable residents with a mental health need to remain in their own homes. 
• Additionally, there is a need for planned and unplanned respite, short breaks and emergency support for those with or without accommodation.
• Alongside the NHS led community mental health transformation fund, we want provision of daytime activities to support residents to participate as members of the community.

Adults with learning disabilities:

• We are committed to ensuring all adults with a learning disability are active citizens, lead fulfilling lives and are able to feel safe accessing their local communities. We are also establishing a framework in spring 2023 for life skills and wellbeing services which will support adults with a learning disability with eligible care and support needs to access the following services: specialist place-based support, community support, home support, virtual support, travel support.  
• We want to work with partners and providers to offer flexible support which can help people to improve their wellbeing and quality of life, develop skills to live independently, and increase the choice and control people have over their own lives.

Employment

There is clear evidence that being in work can help maintain physical and mental health and wellbeing. ‘Good work’ is defined as having a safe and secure job with good working hours and conditions, supportive management and opportunities for training and development. It is estimated that 65% of people with a learning disability or severe mental health condition want to work. However, there are significant barriers which impact these individuals' abilities to access and maintain meaningful employment in the community.

What we want for our residents - We want residents to enjoy the benefits that employment can bring, including purpose, self-esteem and the opportunity to build relationships and reduce social isolation. Our aim is to work with local providers, other statutory and non-statutory partners, and employers to reduce the barriers to employment that disabled people face in Wandsworth.

Messages to the market - employment

Adults with learning disabilities:

• We want to create more opportunities for people with a learning disability to gain work. Our new supported employment service which launched on 1^st April 2023 will work with people accessing the service, providers, other partners and employers to develop the support available for people both seeking work and in-work.

Adults with mental health needs:

• There is a drive to develop and increase employment and supported employment opportunities (full or part time) and voluntary roles, by working closely with the NHS. Specifically, there will be further focus on those with a mental health condition receiving education and any additional training and or/retraining.

Adults with physical disabilities:

• We want to work with our providers to ensure access to employment/education/training and volunteering opportunities particularly for people with long-term conditions in accommodation-based care and support to enable them to live independent and fulfilled lives in the community.

Direct payments

Direct payments (DPs) are monetary payments made by councils directly to individuals who have been assessed as having eligible needs, to enable them to purchase and arrange their own care and support.

What we want for our residents - We want people to have personalised support and be able to use their direct payments (DPs) to maximise choice and control over their own care, giving them more independence and flexibility.

Current provision

DPs are actively promoted as the preferred means of delivering personal budgets. We are in the process of undertaking a review of our direct payment processes to improve service user experience and outcomes to encourage take up of direct payments.

We currently commission a direct payment support service to provide information, advice and guidance for anyone with a direct payment, including a payroll service, financial management support and employer support. We have recently reviewed the existing direct payment support service to inform a new specification and the new contract will commence 1 July 2023.

Demand

During 2021-22, 802 service users received their personal budget as a direct payment. This represents annually, approximately 29% of people receiving community-based services in Wandsworth receiving their service via a direct payment. This is the fifth highest in London and is above the London rate of 25.1%.  

During the period of March 2021 to April 2022 older persons comprised the largest proportion of those on a DP at 39% of the total, people with learning disabilities comprised 27%, those with mental health needs comprised 12% and people with physical disabilities comprised 21%. Take up has been impacted by a number of factors including availability of personal assistants and impact of the coronavirus pandemic.

Overall direct payments demand from 2017 to 2022 is shown in the table below.

Key client groups	2017-18	2018-19	2019-20	2020-21	2021-22	% change from 2017 to 2022
Older persons	217	307	364	315	-45%	-45%
Learning disabilities	289	274	236	227	215	-26%
Mental health	183	134	120	100	100	-45%
Physical disabilities	183	174	180	187	172	-6%
Total	872	757	843	878	802

Approximately 50% use their direct payment to employ a personal assistant.

Messages to the market - direct payments

• We will continue to actively promote direct payments as a means of maximising choice and control and meeting support needs in new and more effective ways.
• We are undertaking a review of our direct payment processes to improve service user experience and outcomes and increase uptake.
• There is an expectation for providers to offer a wider range of personalised, bespoke and creative services to meet the diverse needs of direct payment service users with differing needs including those with learning disabilities, physical disabilities, mental health needs and older persons, ensuring all protected characteristics are taken account of.
• Building direct relationships with direct payment users and having simple, transparent processes will help increase take up.
• There is a shortage both locally and nationally of personal assistants (PAs) with appropriate skills. We want to work with partners and providers in promoting the role of the personal assistant and the PA register to increase recruitment and develop the local pool of personal assistants.

Carers services

A carer is anyone who provides care to a friend or family member who, because of a limiting long-term condition or addiction, is unable to cope independently. Unpaid carers provide invaluable support to the people they look after; however, their lives can be hugely challenging. Carers may be at risk of social isolation, losing employment and education opportunities, as well as caring having a detrimental impact on their physical and mental well-being.  Our key priorities for carers are identification and recognition of carers and young carers, realising and releasing potential, supporting carers and young carers to stay healthy, and have a life alongside caring.

What we want for our unpaid carers - Our vision is to raise awareness of the vital roles played by carers and young carers; to collectively provide good quality personalised support to carers, and young carers and those they care for; to build solid networks ensuring that carers and young carers know where to go for information and support; to enable carers and young carers to balance their own lives with their caring.

Current provision

We are committed to recognising and supporting unpaid carers in their caring role and to offering a range of services including carer’s assessments, short breaks from caring, carer’s direct payments and voluntary sector support.

Carers partnership Wandsworth is the main provider of local carer support services. It is made up of four partners who work together, and with other agencies, to provide high quality services delivered by the Carers Centre. The four partners are:

• Wandsworth Carers Centre
• Alzheimer’s Society (SW London Branch)
• Bluebird Care Wandsworth
• Carer Representatives

The services provided include information and advice, advocacy, peer support, carers’ respite, back care/therapies and health and social care liaison and training. The Carer Partnership is currently developing several new services including end of life care, mindfulness, support for young carers in schools, a wider range of short break options, greater support for carers from LGBTQ+ communities and the development of a carer’s passport. At the same time, work continues with other open access providers to improve the recognition and support they offer to unpaid carers through day activities.

Young carers (children and young adults) have the same right as other children to enjoy life as fully as possible. Young carers may have different needs to other carers. Specific services for this group in Wandsworth include Carers Trust, Children’s Society and Youth Legal services.

Messages to the market - carers services

• We want to work with local service providers to raise awareness and understanding of the needs of unpaid carers, from all different backgrounds, and create local carer friendly services and communities.
• It is important that providers develop services and systems that are flexible to allow carers to balance their own needs with their caring role. Providers should consider providing increased assistance as carers age or become less able to care.
• The Wandsworth Carers Strategy is currently being replaced by a carers and young carers charter by the carers partnership Wandsworth board. The charter will set our ambitions to improve the carers offer to ensure unpaid carers get the support they need to continue in their caring role.
• We want providers to embrace and use digital technology in creative ways to improve the quality of life for both carers and the cared for.
• We want to work with providers across all of our commissioned services who are constantly considering how their services can better support the needs of unpaid carers.
• We want to providers to actively recognise and identify unpaid carers and provide them with information about options for support.
• We want providers to consider unpaid carers when reviewing services or undertaking new pieces of work to consider the impact on unpaid (family) carers and how to address any emerging issues.

Substance use disorders treatment services

What we want for our residents - Our vision is to enable residents to live their best life, free of the distress caused by the harmful and dependent use of legal and illegal substances and alcohol.  

Current provision

In 2018-19 Richmond and Wandsworth Councils went out to procurement for new services for the provision of treatment and recovery interventions for substance use disorders. The new contract, which was for four years, plus the option of extensions up to 10 years, was awarded to a consortium led by South London and Maudsley NHS Foundation Trust. 

The consortium included the following charities: St Mungo’s, We Are With You (formerly Addaction) and a local charity, CDARS, and represented a continuation of the service delivery when it mobilised on 1 April 2020. The service currently caters for around 1010 people per year for substance use ranging across illegal substances including opiates and crack cocaine through cannabis and prescribed medication to alcohol. Currently our service is predominantly accessed by people who use opiates or alcohol.

Messages to the market - substance use disorders treatment services

• We want to work with providers to consider developments which would co-locate these existing services alongside a range of others which would be commonly accessed by people with substance use disorders. These include mental health, primary care and housing services.
• Providers have access to two government grants which are focused on improving pathways in criminal justice and for rough sleepers and to reduce drug related deaths in the boroughs.
• Whilst our established consortium will continue to be responsible for the core of our service provision, we may look to other providers for some of the new services, although we would expect them to work closely with the consortium.
• We will work closely with providers to address the challenge of recruiting staff with clinical training in substance misuse, and we will welcome providers who are able to deliver effective services for different communities and equality groups in ways that do not depend on recruiting categories of staff that are in very short supply.

Care technology and innovation

What we want for our residents - We want to use technology to empower and support people to do more for themselves and live the best life they can.

Current provision

Care technology is offered to adults to support better outcomes, as well as a preventative intervention or as part of an ongoing care package to reduce and or delay the need for formal or intensive support. The Adult Social Care Digital Strategy 2021-24 sets out how we are embedding technology as a core part of the way we deliver services. There is an increasing range of digital tools to support the way care and support is assessed, monitored and delivered that support better outcomes for people. Gloria care technology service is our new end to end care technology service providing a range of smart home technology and voice enabled devices.

Other care technology initiatives include the brain in hand app which is primarily being offered to people with learning disabilities, to help manage and support independence in daily living activities and travelling. Canary motion sensors to help monitor movements are also being trialled in an extra care scheme in Wandsworth, to support with caring for residents and early detection of changes in normal activity.

Messages to the market - care technology and innovation

• There is an increasing demand for care technology devices to support better outcomes for a wide range of residents from all different backgrounds.
• We want to work with providers who will embrace and use digital technology in creative ways in monitoring and delivering care and support.
• We also want to develop a ‘digital workforce’ where professionals can communicate easily with each other and access client records and care plans.

Adults with physical disabilities:

• There is currently a lack of services targeted specifically at young people with a physical or sensory disability.
• We would like to work with providers to ensure that this group is better provisioned for specifically in terms of use of digital technologies as well as information and advice, and access to adapted housing.

Older people and people with memory and cognition:

• We encourage the use of digital technology to assist in care and support delivery to help to prevent, reduce and delay care needs from increasing.