Market Position Statement 2025 - 2040 Community-Based Services - Current supply of CBS

There are many support solutions, groups, and services which support and enable people to live in their own home and community. This includes prevention services, befriending, outreach and day activities. 

Adult social care commissioned homecare services can be defined as CQC registered services that help people stay independent by supporting them to manage aspects of daily living including their personal care. These services are typically provided by an independent care at home provider, or a voluntary organisation. Care at home organisations providing personal care must be registered with the Care Quality Commission (CQC). 

Walsall Council arranges services directly on behalf of people who have social care needs and are eligible for Council funding, although people with eligible care needs and who are eligible for Council funding can choose to receive their personal budget through a direct payment instead and arrange their own care. This may include purchasing care from a personal assistant (PA), from a care provider or a mixture of arrangements to meet their needs. People who fund their own care directly (known as self-funders) will also often engage a care agency or a PA to support them to continue to live at home. This gives people choice in who provides services to them. 

Receiving care at home can help prevent, or delay, the need for other forms of care such as residential or nursing care. The level of help required can range from once-a-week to help several times a day. Care at home services can also be provided on a live-in basis where a care worker lives in the property of the person they are providing care to. The pattern and type of service is designed around individual needs and preferences. 

The homecare market in Walsall is considered to be sufficient in supply. There are an estimated 90 homecare providers in the market many of which are local SMEs. The market is very heterogenous in Walsall and locality based. There is a good diversity of provision to meet the Borough’s diverse needs. Currently, however, there is more supply than demand for homecare. Providers are reporting not enough packages of care being awarded and competition for package allocations.

This is a concern, as homecare is a growth area strategically to achieve the aim of people being able to stay at home and receive the care and support they need in their home and community. Commissioners need to shape supply accordingly to ensure sustainability of this market. There is an opportunity with the strategic re-commissioning of the Community-Based Services contract in Spring 2027 to do this and to test and learn through a ‘Live Well at Home and in your Community’ Pilot to trial different approaches to homecare and community based services that is due to launch in 2025.

Individuals Receiving Homecare In Walsall By Ward

View the map showing individuals receiving Home Care

The table is a snapshot of the current homecare market in Walsall as of late 2024/early 2025.

The table shows that of the 90 homecare provides operating in the Borough, 48 of these homecare providers are on the closed Community-Based Framework. There are 3 homecare providers that are dominant in terms of market share (37.35%). The strategic direction of travel is for more people to stay at home and homecare and other forms of support in their homes and communities.

 The sustainability of the overall homecare sector is currently judged to be mixed in terms of:

• Rates paid to providers by Walsall Council although this has recently gone up with the 25/26 uplift award
• Workforce retention and recruitment to work in homecare • Good plentiful supply of local homecare providers covering the Borough
• Mixed service quality but an improving picture 

The table shows the scale of the homecare market in Walsall and Council spend on homecare. The table also shows the quality ratings of provision and the stability of the market currently with 2 providers exiting the Council’s contract so far in 2024/ 2025.

Market Data And Insight

Walsall Homecare Market Late 2024/ Early 2025

Table with key intelligence on homecare currently commissioned by the Council.
The table below shows Council commissioned homecare packages by ward in 2023/ 2024 (Source: Ward Profiles - Walsall Insight)

The Intermediate Care Service is a reablement, rehabilitation and recovery service jointly operated between Walsall Healthcare NHS Trust and Walsall Adult Social Care. There is also a Council reablement offer run by Adult Social Care. The aim is that this becomes a single approach. 

Currently ICS reablement provides intensive help to patients and their relatives, or carer if they have one, for a short period of time so that they can leave hospital as soon as their health has improved sufficiently or to avoid hospital admission. The team offers support to help the patient regain independence. This could be at home, or in a short-stay care home bed, in the best way to meet their needs. It is often after a period of crisis, ill health, disability, or at a time when they may have lost some confidence.

The ICS Reablement Team is made up of:

• Social workers
• Mental health and general adult nurses
• Reablement support workers
• Key workers
• Discharge coordinators
• Physiotherapists
• Occupational therapists
• Therapy assistants
• Homecare workers

The service operates 7 days a week. Rehabilitation beds are located at Aldridge Court Nursing Home. The service also operates borough-wide working in patients own homes across the Walsall area through a virtual wards model and other provision. CQC inspection states that “community services worked in partnership with the hospital to prevent unnecessary hospital admissions and when required and to promote early discharge from hospital”.

The data below shows hours of ICS reablement delivered between 2021/2022 and 2023/2024.

The ICS reablement market in Walsall is sufficient in supply from a care perspective - there is ample capacity, but in terms of ICS reablement and NHS Trust reablement staff, we are not meeting demand due to workforce pressures.

Council Reablement Services

Reablement Market Data and Insights

Client Outcomes From Reablement

The term ‘Extra Care Housing’ (ECH) describes developments that comprise self-contained homes with design features and support services available to enable self-care and independent living. 

ECH comes in a wide variety of forms, for example:

• Housing with care
• Retirement communities or villages
• Assisted living 

Occupants may be owners, part owners or tenants and all have legal rights to occupy, underpinned by housing law in contrast to residents in care homes (Housing Lin, 2023). 

Typically, ECH services provide care to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant's own home. People's care and housing are provided under separate contractual agreements. 

ECH schemes have separate flats 1 and 2 bedded and have 24/7 hr care. They have communal areas and facilities such as lounges and restaurants, some have hairdressers and gyms, gardens and there are social activities for residents to take part in.

Many Local Authorities see ECH as a growth area as it enables good outcomes for people with a flat and 24 hr care to meet a variety of needs. It is good value for money for Local Authorities and plays a key role in reducing residential placements. It can often be a good bridging provision between home centred care and residential care. 

Housing Lin is a national organisation dedicated to understanding and promotion of ECH.

Walsall Council has a long - term 30-year contract with an ECH Provider. The contract commenced on 9/4/2008 and runs till 8/4/2038 hence there is 13 years to run on the contract. 

The annual value of the contract is £11.155m. This includes 5 ECH schemes and Watermill Residential Home and a 7 Day Dementia Day Service. The contract is a block contract. There are currently 110 Council supported service users in ECHs in the 5 contracted schemes: Alrewych, Deighton, Mattersley, Knaves and Winehala. These schemes are in Aldridge, Delves, Brownhills, Willenhall and Bloxwich so well distributed across the Borough.

Overall capacity/ supply in the 5 ECHs is 286 flats. Walsall Council is using an estimated 38% of all available estimated ECH capacity in the Borough. The nomination rights for these ECH schemes are being examined to better understand what rights Walsall Council has to these schemes and this ECH care and support.

There is some evidence of under-utilisation of commissioned care hours currently in these contracted ECH schemes. These care hours are an underutilised asset when they are people waiting to enter ECH or that could use ECH as an alternative to bed-based care or another form of care. The quality of the five commissioned ECHs is mixed as demonstrated by one outstanding, two good CQC ratings and two requires improvement ratings.

• Alrewych – Aldridge WS9 - Requires Improvement
• Deighton Court – Delves - WS5 - Requires Improvement
• Mattersley - Bloxwich - WS3 – Good
• Knaves - Brownhills – WS8 – Outstanding
• Winehala - WV12 Willenhall - Good

There is a good range of day opportunities in Walsall with an estimated minimum 12 providers operating in the Borough as well as many smaller, community-based organisations that offer engagement and social activities in the day. The Walsall Wellbeing Directory lists known groups and organisations that people in Walsall can access. 

Walsall Council has one in-house provider service Gosgote that offers day provision. 

Day services are used by recipients of direct payments who self-direct their own care and choose which offers are best for them and their needs. Day services cover all age groups and need types primarily learning disabilities, physical disabilities, brain injuries, dementia, frailty. Some of the services are culturally based and others are geographically focussed on serving local communities although people move across the Borough to access day opportunities. These day services include:

• Bloxwich Community Partnership - Stan Bull Centre
• ACE Day Services
• Five Star Day Services
• Rushall Day services
• Sahara Day Centre
• Arboretum Day Centre
• Harmony Day Services
• Watermill (Dementia Care Day Services)
• Walsall Black Sisters Day Services
• Apna Ghar Day Services
• Havenly Close Day Services 

The benefits of day services are social interaction, group work, skills development, respite for carers and a place-based community centre for people to enjoy activities and use facilities. 

Key issues for day service providers include transport to enable people to get to and from day services in the Borough. Some day facilities own their own transport or commission community-based services to transport people to building based services.

Walsall Day Services Market Data And Insights

Equipment services are a critical service to support people at home and to maximise independence. Equipment services are currently provided by Walsall Healthcare Trust under a Section 75 (S75) agreement with Walsall Council. 

In 2023/24 7862 people in Walsall were issued with equipment, of which 3015 were new clients. In terms of all people with equipment, in total 59,647 clients were in receipt of equipment issued through this contract including historical equipment provision. 

In November 2024, 2205 items of equipment were delivered, there was a 95% recycling rate and 96.2% of equipment deliveries were within the agreed 7 day window. Other KPIs were 95+% performance in this month. 

The service is judged by commissioners as mixed currently in terms of availability and range of equipment, timeliness of delivery, quality of service. The provider is considered to do well with the infrastructure is has available. Issues with the current operating model include inability to do electronic ordering, it is a 5 day a week service rather than 7 days a week, lack of stores, lack of certain types of equipment and timeliness of delivery of equipment. 

The Section 75 agreement is currently being updated. Better Care Funding underpins the funding for equipment services: There is an overspend on the equipment services budget currently and the contract and specifications needs updating. Council commissioners judge that this is a service in need of a review and options appraisal for future models.

Walsall Equipment Services Market Data And Insight

Our overall adult social care prevention offer has improved in 2023/24 and into 2024/25 including the implementation of clinic-based Occupational Therapy assessments, the development of a bespoke Occupational Therapy tool to support the capture of therapeutic interventions in a more robust manner and the improvement of our digital offer. Investment in Occupational Therapy Services has continued in 2024/25 in conjunction with the development of the new Pathway to Independence model.

This new initiative supports adults in need of social care services to achieve their personal goals and to live as independently as possible via the principles of person-centred care, choice and control and prevention and early intervention. The majority of staff have now been recruited to the structure with further recruitment ongoing. 

August 2023 also saw the introduction of clinic-based OTA assessments at The Goscote Centre for those requiring low-level equipment or adaptations, the aim being to double the capacity of the OTA team and to reduce waiting times for those in need of support. By the end of 2023/24, 225 people had been seen across 79 clinics. By 2024/25 Q1, the Occupational Therapy (OT) clinics were firmly established as business as usual, with a further 147 people were seen across 48 clinics during the period. Q2 saw 135 people seen across 48 clinics. 6 new Occupational Therapists have been recruited during 2024/25 so far with 2 Occupational Therapist apprentices to follow.

In terms of externally commissioned services, Adult Social Care has an estimated 9 key contracts worth approximately £750,000 pa with providers to deliver prevention and early help services. These contracts support the strategy of maximising people’s independence and supporting people at home and in their communities. There are many other services as listed in the Walsall Directory that also support people in their communities in North, South, East and West localities supported and co-ordinated by VCSE anchor organisation locality leads. These contracts are an important part of this landscape, but adult social care funding has been reduced in recent years for these contracts.

Adult Social Care commissions Forward Carers in partnership with Mencap and Walsall Carers Hub. Forward Carers is a not-for-profit social enterprise. These services offer signposting, wellbeing assessments and guidance. This contract is worth 100k per annum and is Better Care Fund funded. This service was tendered in 2019 and re-tendered in 2024. This service is rated a good service by commissioners and as evidenced in impact statements. Visit Forward Carers for more information.

We want Walsall carers to be able to live a healthy and fulfilling life outside of their caring role. We want to improve the quality of life for Carers. Walsall Borough Council’s Adult Carers Strategy links to the Adult Social Care Commissioning Strategy where there is a strategic commissioning intention focused upon unpaid carers.