Community based services

The older people and physical disabilities market is made up of a mixture of voluntary sector and volunteer-led provision against more formalised services delivering more complex provision to people with:

• Dementia
• Frailty
• Acquired brain injuries
• Physical disabilities

Current shape of the day opportunities market

The older people and people with physical disabilities day opportunities market has been disproportionately impacted by the Covid-19 pandemic. This impacts communities, with challenges for both council and self-funders to access care in some parts of the county.

This market is still in a period of recovery from Covid-19 with a number of sustainability challenges. Work is ongoing to support recovery and will continue through the development of a strategic plan for day opportunity services.

Key data

The 2022-2023 spend and the snapshot at the end of March 2023 of the number of people accessing day services for older people and people with physical disabilities, excluding transport costs:

Day services for older people

• Our spend on day services for older people in 2022-2023: £0.77m
• The number of older people accessing day services funded by us in 2022-2023: 228
• The number of Norfolk County Council (NCC) accredited locations registered by March 2023: 45

Day service for people with physical disabilities

• Our spend on day services for older people with disabilities in 2022-2023: £0.9m
• The number of older people with physical disabilities accessing day services funded by us in 2022-2023: 164
• The number of NCC accredited locations registered by March 2023: 56

Challenges

The challenges we face around day services for older people and people with physical disabilities are:

• The current referral processes pose a risk to the sustainability of the older people's day opportunities market, with a lack of referrals being seen in several areas of Norfolk
• The current mix of provisions and the lack of consistency in the contract terms and conditions across the market present a challenge to the development of a sustainable day opportunity offer

Supply and demand

A snapshot at the end of April 2023 highlights that there were 228 older people and 164 people with physical disabilities accessing day services funded by us and delivered from 101 registered locations.

Covid-19 has had a significant impact on referrals into day services, leading to some centres reporting that they are not financially sustainable.

Commissioning intentions

Our intentions for commissioning day opportunities for older people and people with physical disabilities are:

• A single framework for all-day services is in development, with a plan for the new service model(s) to be implemented in 2024
• To develop a brokerage sourcing process to make it easier to refer people for day opportunities. We started a pilot in April where brokerages are now sourcing placements to support social workers in accessing day services.
• Developing innovative outreach and preventative service models and supporting people to access community and voluntary sector services, as an alternative to formal day opportunity services, where this is appropriate
• Development of improved performance data collection systems to monitor outcomes being achieved and using this information to improve service provision

Key messages to providers

Our key messages to providers are that:

• We want providers to support the strategic re-design of older people's day opportunity services to develop a model that delivers the best value and supports people to access the right services at the right time and in the right place
• We want to enhance collaborative working between providers and the health and social care system
• We want to ensure the delivery of a consistent day-service model across the county

Feedback

We want people to say:

• "I am supported in managing my health and care needs in ways that make sense to me"
• "I am supported by people who listen carefully, so that they know what matters to me and how to support me to live the life I want"
• "I have considerate support delivered by competent, well-trained people"
• "I am confident that the people supporting me have the skills needed to meet my care and support needs in the best way"
• "At all times, I am treated with dignity and respect"
• "I am supported as I want to be"