Age Well

When people need more support to help them live a great life we have a range of accommodation-with-care options that we commission.

We know how important good housing is to people’s lives and how when people age there needs to be a good range of options for people to help them to continue to be as independent as possible.

The majority of homes within Cheshire West and Chester are privately owned, with as little as 15% being social housing or privately rented. By 2035 there is an expected 24.4% increase in adults aged 65-74 and 38.6% of adults aged 75 and over who will be living alone within borough.

We are renewing our Ageing Well Accommodation and Support Strategy. The strategy focuses on how the Council will support residents aged 55 and over to live a great life in appropriate housing with suitable care to meet their needs.

When someone’s own home is no longer possible, having a range of accommodation types to meet changing needs including assisted living and care homes is required. The aim is for a place to call home being affordable, adaptable and accessible to the community that it is situated.

Extra Care

Cheshire West and Chester has a variety of Sheltered Housing and Extra Care schemes ranging in size and location. These types of property are important to support independence as people age.

	18-19	19-20	20-21	21-22	22-23*
ECH spend ‘000s	2,477	3,172	3,093	2,912	3,176

Extra Care 5 year spend ‘000s

Where we are now

There are nine Extra Care schemes commissioned by the Council across Cheshire West. The largest scheme has 131 apartments and the smallest 17. Each scheme is managed by a Registered Social Landlord, with a registered care provider delivering care and support.

Currently we do not believe we are making the most of the opportunities Extra Care presents to support people with care and support needs to live independent lives in their community. There are a mix of people living in our extra care schemes with differing needs - 6% have high needs, 14% medium needs, 16% low needs and 64% have no social care needs.

We believe there is much greater demand for Extra Care for people with care and support needs.

Where we want to be

Over the next five years we need to change the way Extra Care housing is utilised to support people in their community and prevent and delay the need for residential care. Over time we will work towards a more balanced mix where the majority of Extra Care apartments will be available for people who have care and support needs.

Over the next five years we will work with people, existing landlords and care providers on a new model of Extra Care which is focussed on creating communities of people with mixed social care needs.

We will work with developers who wish to explore new Extra Care developments, particularly in areas of the borough currently under-served.

To provide a better experience and quality of life, the Council would like to encourage Extra Care and other assisted accommodation providers to open their facilities up to local communities to help promote greater opportunities for these facilities to be focal points in the community to improve health and wellbeing and quality of life for the people living there.

Who we need

We want to work with existing Extra Care providers and landlords as well as new developers.

Our Commissioning Intentions

• In 2026, we will tender the Extra Care contract. We will conduct co-production and market testing throughout 24/25 and we welcome providers to take part in this.

• We intend to work with housing organisations, developers and providers to develop a supported accommodation vision and development strategy. We shall establish a Market Shaping Collaborative focussed on supported accommodation and welcome providers to engage with us.

Care homes

When people can no longer be supported at home or in Extra Care we commission care homes to provide 24 hr care and support.

Care homes provide people with a good quality of life in the last few years of their lives.

Care homes are an area of significant spend for the Council with the amount spent increasing by almost two thirds in five years.

	18-19	19-20	20-21	21-22	22-23
Care Home spend ‘000s	28,422	30,728	28,399	35,766	45,998

Care Home 5 year spend

Demand for care homes is changing. The Council predicts that there will be a surplus of general residential Care Home beds within borough over the next 5 years. Conversely, we expect an 11% increase in Residential dementia demand over the same period.

Where we are now

We commission 65 care homes which supply a mix of general residential, residential high needs, nursing and nursing high needs beds. Care homes that we commission are currently home to around 865 people.

	17-18	18-19	19-20	20-21	21-22
Residential	505	469	428	354	371
Residential high needs	395	362	397	414	443
Nursing	468	405	418	361	340
Nursing high needs	318	320	325	297	310
Total	1686	1556	1568	1426	1464

Care home mix of bed types

Care homes in Cheshire West overall are good quality with 75% rated good our outstanding by CQC.

The supply of residential and nursing high needs beds is not sufficient to meet current demand.

Where we want to be

The overall vision for Adult Social Care is to support people at home for as long as possible, but when 24-hour care is needed, we require a supply of good quality care homes offering the right kind of care.

Over the next five years we will reduce the number of general residential beds we commission and we will develop a market with more specialist dementia residential and nursing care placements available.

We want a care home market full of high-quality providers who create homes for people in the last years of their lives and work in partnership with the Council, the NHS and each other to continuously improve and drive-up standards.

We want there to be a plentiful and skilled workforce who are valued for their work, receive at least the Local Living Wage and have opportunities to progress in their career.

Who we need

The Council would like to commission high-quality providers who work in a strengths-based way and who want to work with the Council and NHS as equal partners to improve people’s lives.

We want to work with providers who want to be an active part of their care community and work with us and the NHS to identify gaps in care pathways.

We want to work with providers to support higher level needs through specially trained staff in suitable environments including Residential high needs and Nursing high needs homes promoting and sustaining strength-based skills.

We would like to work with existing providers who currently deliver general residential care and are interested in changing their provision to provide more specialist dementia care.

We would like to work with new providers/developers who are interested in creating new specialist residential and nursing high needs homes in the borough.

We would like to work with providers who are interested in creating gender specific homes or parts of homes for dementia.

Our commissioning intentions

• We will commission fewer general residential beds.

• We will nurture the growth in the specialist dementia residential and nursing market.

• We will work with the Cheshire West Integrated Care Board to create a single contract for care homes that are commissioned by both Council and NHS to streamline our monitoring, join up quality assurance and improvement work and make it easier for providers.

• In 2023/24 we will create a capital grant programme to support care homes who wish to change their registration to specialist dementia and/or make their homes more dementia friendly.

• We intend to provide capital investment to support the development of new specialist dementia capacity.

• We intend to create a Health and Care Workforce Academy to create a sustainable pipeline of future carers along with attractive career pathways.

• In 23/24 we intend to establish a continuous quality improvement partnership and reward scheme for care home providers who we hold a contract with.

• We will continue to invest in the skills and knowledge of care home staff through programmes such as My Home Life.