Residential and nursing care home market

Our vision

There are few alternatives in Norfolk to residential care for people with complex physical disabilities and long-term conditions. The independent living programme will provide supported living to enable more choice and control for some people.

Challenges

The challenges we face in providing care for adults with physical disabilities include:

• Small sector, not much diversification
• No strategy was developed for this sector, so there is no clear vision or commissioning intention for this sector
• There are few options for people with more complex needs, resulting in the use of provisions at rates above what is affordable

Key data

The 2022-2023 spending by service type includes the number of people accessing services for people with a physical disability, the number of accredited locations, the number of accredited places, and the percentage of services with a 'good' or 'outstanding' rating. This includes people accessing both long- and short-term services:

Residential care home services for adults with physical disabilities

• Our spend on residential care home services for adults with physical disabilities in 2022-2023: £7.1m
• The number of people accessing residential care home services for adults with physical disabilities funded by us in 2022-2023: 109
• The number of Norfolk County Council (NCC) accredited locations (buildings) registered for adults with psychical disabilities by March 2023: 69
• The number of NCC-accredited places (beds) registered for adults with physical disabilities by March 2023: 1,568
• The percentage of locations for adults with physical disabilities registered and inspected by the care quality commission (CQC) with a 'good' or 'outstanding' rating from the CQC or provider assessment and market management solution (PAMMS) as of 1 March 2023: 58.5% (excluding services that have not yet been inspected)

Nursing home services for adults with physical disabilities

• Our spend on nursing home services for adults with physical disabilities in 2022-2023: £4.1m
• The number of people accessing nursing home services for adults with physical disabilities funded by us in 2022-2023: 67
• The number of NCC-accredited locations (buildings) registered for adults with psychical disabilities by March 2023: 41
• The number of NCC-accredited places (beds) registered for adults with physical disabilities by March 2023: 1,731
• The percentage of locations for adults with physical disabilities registered and inspected by the CQC with a 'good' or 'outstanding' rating from the CQC or PAMMS as of 1 March 2023: 58.5% (excluding services that have not yet been inspected)

Physical disability services can register to deliver services to people aged 65 years and older. Older people's services may also register for working age adult groups.

This can therefore cause some overcounting of locations and places and slightly distort the quality ratings. Services registering with CQC for multiples of learning disability, mental health and physical disability care provision can have a similar effect on the figures.

Supply and demand

Although there is an adequate supply of residential provision for people with physical disabilities, we are lacking provision for people with more complex needs at affordable fee rates.

The ambition is to increase the availability of independent living options for people with physical disabilities as an alternative to residential care.

The current supply and demand for nursing home care are seen as stable, and therefore the ambition is to continue as is.

Key messages to providers

Our key messages to providers are that:

• We want to work with providers who are keen to develop capacity to meet the needs of people with more complex needs at more affordable fee rates
• We will work with providers in 2023 to review our approach to commissioning these services and the way that we pay for care
• As part of our supported housing programme, we want to develop specialist housing for people with complex physical disabilities to live in a home of their own with support to stay independent for longer