Live Well

Day Services

We want to support as many people as possible to live independently in their community. Day services provide vital support to people to help them live their lives and access activities which lead to a fulfilling life.

Day services support everyday living activities and can be delivered in a community setting or in a building-based location. These services help people to attend a regular group or centre that provides them with the opportunity to meet other people, develop friendship groups, be offered support with everyday activities, learn new skills, and participate in leisure activities.

Where we are now

75% of day care services are delivered by the Council. Provision includes a skill centre and more traditional building-based day care model. These services help older people and people with learning disabilities, autism or mental health conditions to carry out everyday activities. They provide opportunities to meet other people, develop friendships and learn new skills.

Mapping of day care service provision indicates current opportunities are biased towards building based services offered across urbanised areas of the Borough, with fewer opportunities being offered in community settings such as colleges and other mainstream services. There is little to no provision in rural areas.

There are limited opportunities to support people to achieve any form of employment status.

Where we want to be

We want a new day service model which follows a progression model offering more choice and greater availability to people in their communities.

We want a model which offers choice by being more integrated with existing community assets, services, and organisations as well as building-based services for those who require greater levels of support.

Our new model should have a range of options which suit what people want and where they live.

Who we need

We want to work with innovative providers who understand our vision to help design the day service model of the future.

We want to work with community sector providers and existing businesses and services to develop new ways of supporting people in the community which utilise existing assets and services.

We want to work with universal service providers who are interested in working with care providers to support people to access their service. For example, leisure organisations and private businesses.

Our commissioning intentions

• Throughout 2023, we will review our day services provision for older people, people with a learning disability or autism and people with a mental health condition; and co-design a new vision and future model with people who use day services, their families and providers.

• We will tender for any service opportunities in 2024/25.

Community Mental Health Support

We support people to remain independent through community-based mental health services across the borough. The aim of these services is to prevent adults in the community escalating into health and social care systems and reaching crisis. The provision is led across the borough by a community sector organisation. The contract was let in December 2018 for a 3 year term with option to extend for 2 years. The sub-contracted arrangements to local providers will expire in September 2024.

Jointly they have supported 2484 adults in 21/22 in the community to gain early mental health support preventing escalation. This includes easy to access 1:1 support, therapeutic support, group activities, outdoor groups and a range of low-level wellbeing support. There has been increasing demand for this support so flexibility in being able to continue to deliver what people need is important. This was evidenced during the pandemic period where community in-person led services shifted quickly to a telephone and digital services enabling easier access to support.

Community Led Mental Health support for Carers is sub-contracted under the main Carers contract. The service supports carers with mental health conditions to develop peer networks to support their caring role. The service also provides support and education for carers caring for someone with a mental health condition. In 2021/22 the service supported 300 Carers. The Carers Mental Health contract is due to expire in September 24.

Where we want to be

We want to develop our community mental health offer with more innovative ways of supporting people in the community.

We want to grow the market in areas of the borough which have been harder to serve, such as south of Chester, Neston, Frodsham, and Winsford.

We want to develop a market with services that follow and can evidence a strength-based and outcome focussed approach to mental health support.

This will align with work to update the Mental Health Strategy, which will be ‘Place Based’ and co-produced with a range of interested parties early in 2023 to include health and social care, people with lived experience of mental health support, public health, police and criminal justice, as well as community groups as much as possible.

Who we need

We would like to work with new and existing community sector providers who are keen to think differently and can demonstrate a strength-based approach to delivery which will prevent people’s mental health deteriorating.

We will be developing outcome focussed measures of impact and want to work with partners who are keen to understand what works for people to keep them well in their community.

We will be developing a specification to describe this, and we will be doing this with people who have used services in the past, have experience as a carer or as a provider.

Our commissioning Intentions

• In 2023 we will co-produce a new specification for community mental health services with people who use services, their families and providers.

• In 2024 we intend to tender for community mental health services.

Respite

Informal and family carers do so much to support people in their own homes. We value the role that carers play and are committed to providing appropriate support and rest to enable them to continue to live a great life.

There are many different types of caring roles within the community, whether it’s caring for an older relative, a son or daughter with a learning disability or someone with a mental health condition. The Council wants to ensure that respite is available to all carers who require it.

Where we are now

Respite services are predominately spot purchased and bed based with a small proportion commissioned from council in house services or the general care home market. These services provide traditional accommodation for a range of client needs to facilitate overnight stays whilst supporting residents to attend their usual activities / day services. Respite opportunities are utilised most significantly at the weekends although weekday provision is also provided.

Some learning disability and autism residential respite services have recently closed leaving a shortage of supply of residential respite for people with learning disabilities.

Where we want to be

Over the next five years we want to work with people to redefine what we mean by respite and we want to create a more diverse market and choice for people.

We will continue to have a small bed-based respite offer for overnight respite, people with higher needs and for those requiring emergency respite. Over the next five years it is estimated we will need approximately 5-10 respite beds for people with a learning disability 4 for mental health and 4-9 for older people.

To complement residential respite, we want to create more choice and availability by growing a diverse market of innovative short break opportunities for people and their families which provide much needed respite for carers whilst enhancing people’s lives. These should include a whole range of activities and support which are delivered mid-week, in the daytime and evening and which could work in tandem with an overnight residential placement.

A respite review is underway to consider what a future model could look like.

Who we need

Providers who want to develop our small bed-based respite offer.

A mix of innovative providers who are prepared to redefine respite and work with us on new models which focus on enhancing people’s lives and utilising existing assets in the community.

We want to work with universal service providers who are interested in working with care providers to support people to access their service. For example, leisure organisations and private businesses.

Our commissioning intentions

• In 2023 we intend to commission 5-10 learning disability respite beds, 4 mental health and 4-9 for older people with the highest needs and for emergencies.

• Throughout 2023, we will review our respite model and co-design a new vision and future model with people who use respite services, their families and providers.

• We will tender for any new respite service opportunities in 2024.

Supported Living

We support people to live the life they want in their own home though supported living.

Supported Living is traditionally small groups of people living in shared houses with care and support provided in the home. People living in Supported Living predominantly hold their own tenancy agreements with a registered social housing provider or/ non-for-profit landlord and care is provided by registered care provider.

Where we are now

Supported Living accounts for the majority of learning disability, autism and mental health services and spend across Cheshire West.

Overall, there are more than 42 learning disability and autism providers operating this model across the county in 193 properties. There are 110 people with mental health living within supported living properties.

There is currently limited accommodation for those with complex mental health needs who require 12-24 hours of support/oversight per day, sometimes also with physical health needs.

There are regularly people waiting for discharge from hospital with relatively high levels of need and they can be difficult to house.

Where we want to be

We want to continue to develop our supply of supported living accommodation for people with learning disabilities, autism and mental health needs.

Engagement with people with a learning disability who live in supported living houses has told us that more people want to move away from shared household living and would prefer to live in an independent environment with their own front door, perhaps with shared communal areas.

We want to develop a market of smaller, individual apartment style complexes (of no more than 6 apartments) where people have their own front door, and which are situated in accessible parts of the community.

We want to grow our supply of accommodation which is adapted for people with higher level needs and the supply of properties that have been developed with an ageing population in mind.

We want a model where independence and reablement is promoted by working in strengths-based ways so that individuals can improve their own skills, resilience, and ability to live the life they want to live.

Who we need

We want to work with housing developers, social care providers and Registered Social Landlords or/ non-for-profit landlords to identify new opportunities and to develop our strategy for future development.

Our commissioning intentions

• We will continue to commission new supported living capacity which meets the needs of people, in particular accommodation which will suit older people and accommodation which offers people their own front door.

• We intend to develop the market for specialist one bed units to support with high level mental health need close to Chester or Ellesmere Port in the West and Northwich in the East.

• We intend to develop the market for accommodation with reablement and floating support for 16-18 year olds with mental health support needs.

• We intend to work with housing organisations and providers to develop a supported living vision and development strategy for supporting people with learning disabilities, autism or mental health needs in the right accommodation. We shall establish a Market Shaping Collaborative focussed on supported accommodation and welcome providers to engage with us.

• We intend to provide capital investment to kickstart the development of new supported living accommodation which meets the changing requirements of the people who will live there.