Agenda item

Care Home Model

Report of Barry Norman, Integrated Strategic Lead Commissioning, Integrated Adults and Social Care Services.


The Committee received a report and presentation regarding the capacity and demand planning for Adult Social Care services, and work on the team’s ‘Home First’ approach.

3.Gateshead continues to follow the Discharge to Assess approach but has now been able to plan resources for 2023-24 and 2024-25 and invest in required services to support people at home.

Recruitment and retention have improved across most markets that has also allowed additional capacity to focus on moving people from short-term services to long-term services as and when required. This has improved flow and reduced waiting lists for support. Contracts for Adult Care Homes are being updated with the aim to have a new Contract Framework in place in early 2024-25. The aim is to help shape the market to ensure they can support those in need of long-term care who can’t be supported at home.

Whilst the Home First approach will see an overall net reduction of 250 placements in Care Homes over the next 2 to 3 years, there will continue to be a need for Care Home provision to meet the needs of some of our most vulnerable people. 

Existing providers and their Care Homes have a large part to play in supporting the Gateshead system, but providers will need to look amend their business models and focus on higher end needs in the future such as complex Dementia, Nursing and EMI Nursing.

To ensure we have the capacity to support people at home longer, we need to look at not only the workforce requirements, but also technology and housing offers. The workforce within Care Homes will need to evolve and require additional training and skills to manage an overall more complex cohort of residents within homes.

A different model for Care Home provision is needed in the years ahead as people are supported at home first and for longer.  Whilst there will still be a need for Care Home capacity, we will continue to see people moving in for the later stages of their lives with more complex needs than the current average.

Nursing provision is an area that we will need to grow to meet needs, but recruitment and retention of good quality nurses is a wider system challenge.  We will need to work in partnership with our ICB colleagues and likely look at a regional approach.

Occupancy levels within some Care Homes are likely to reduce as we refer less people into long-term bed base support.  Private funders and out of area placements are semi out of our control, but we are likely to see an oversupply issue in the next 12 to 24 months.

The Committee enquired about interim independent living assessments. These assessments can be done in an equipped centre or in someone’s own home with the right equipment. A social worker would carry out a full assessment. Complications can arise when people want to move out of Borough, but urgent situations get assessments when needed. It was highlighted that the spread of infections and illnesses are higher in care homes and that living at home can help isolate people from this. Additionally, the level of assistive technology available to those living at home is not available in a care home.

Regarding the effects on the workforce, the reduction in care homes is expected to happen over a long period of time and won’t cause immediate job loss. There will be a supported transition period to help staff move into different services and sectors, while encouraging them to remain in health and social care. The Adult Social Care team is also monitoring whether staff will be affected by incoming migration policies from the Central Government.

There were some concerns from the Committee about the surplus of care homes, representing a planning failure. Highlighted reasoning for this was changes in population and attitudes towards the elderly, and changes in government funding which has developed a culture of privatisation.


      i.        The Committee received and discussed the report.

     ii.        To arrange a site visit to newly established care homes for the Committee.

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