Market position statement

1. Introduction

The winter 2023/24 market position statement provides an overview of the key issues, challenges and market opportunities for adult social care and health in East Sussex. This statement identifies areas where the need for different types of support is emerging and how we want services and support to develop in the future.

The statement is based on our understanding of demand for care in our county. We work closely with local care providers and the East Sussex voluntary, community and social enterprise (VCSE) sector to understand supply, demand and need.

The last three years have been the most difficult in recent history. Providing social care through the COVID-19 pandemic and the cost-of-living crisis, against a backdrop of significant workforce, recruitment and retention challenges, has tested the resilience of staff and providers to the limit.

During this time, we aimed to pass on available funding to the sector, from personal protective equipment (PPE) provision in the early days of the pandemic, to financial support for recruitment and retention activity. 

The financial pressures continue for the social care sector. We are acutely aware of the impact that increased utility costs continue to have on providers.  Also, whilst we welcome increases in the national living wage, this generates a further pressure on staffing costs.

Over the last two years, we have achieved higher annual fee percentage uplifts than pre-pandemic levels. However, looking forward, we estimate significant budget deficits in the medium-term, with a £40m budget gap in 2025/26 and a £54m gap in 2026/27. We will continue to lobby regarding future funding settlements but may also have to revisit the adult social care offer in future years. 

Over the last two years we have undertaken a range of recommissioning activity. We have recently concluded the recommissioning of community based mental health services on behalf of Adult Social Care and Health. In addition, we have also recently recommissioned home care and the Integrated Community Equipment Service. We have also extended our existing arrangements for carers services and mental health advocacy support.

Given the above, market opportunities in terms of recommissioning activity in the near future are limited. However, this statement gives details of future development to the digital agenda, information and advice, and specialist community-based accommodation and support.

Although market opportunities may be limited, we felt it was important to publish a statement that reflects the current position as our last market position statement was published in 2019.

It is for these reasons that we have used feedback gathered previously from providers and consulted the East Sussex Registered Care Association over the content of this document.

Going forward, we aim to update online market information more often. This will make the position statement more relevant and useful to the local care market.

Mark Stainton
Director of Adult Social Care and Health

2. Our priorities

The 2023 East Sussex adult social care strategy, ‘What Matters To You’, sets out the future direction of adult social care for adults who have, or will have, care and support needs, their carers and families, and those who work within or alongside Adult Social Care and Health.

Our six priorities are:

  • Right support, right place, right time
  • Information and communication about care and support
  • Cost of living and cost of care, now and in the future
  • A suitable home
  • Personal connections with others
  • Group activities, hobbies and volunteering

Messages for the market

  • We are working to improve waiting times for both social care assessments and financial assessments.
  • We have reviewed our approach to supporting care home providers to claim for unpaid client contributions.
  • We have appointed a project manager to take forward changing the current policy on paying for residential and nursing care in the independent care sector from net of the client contribution to gross.

The Council Plan 2023/24 provides further information on the Council’s achievements and its plans for the four priority areas:

  • Driving sustainable economic growth
  • Keeping vulnerable people safe
  • Helping people help themselves
  • Making best use of resources now and for the future

3. Working with providers

Adult Social Care and Health value our relationships with providers across the independent and VCSE sector.

We meet with the local Registered Care Association (RCA) on a regular basis. Our support for RCA engagement activity includes £25,000 funding for 2023/24.

We provide a range of support to providers including:

  • A specific market support function which works very closely with providers and takes a purposefully supportive approach to provider issues to promote and ensure an honest and constructive relationship.
  • Employing three dedicated posts to work in the community to attract new staff into the care sector, through promotion at careers fairs, colleges and universities and work with partners such as:
    • Department for Work and Pensions (DWP),
    • the Armed Forces Network,
    • Rest Less over 50s project,
    • Princes Trust and
    • Refugee Reed in Partnership project.

Candidates are supported with free training, interview preparation and coaching.

  • Grant funding towards the costs of recruitment, settlement and integration of overseas workers. In 2023/24 we offered Lead Providers grants of between £1,850 and £3,750 which is 25% to 50% of their overseas recruitment costs.
  • Weekly newsletters to providers and hosting regular ‘care home huddles’. These are online meetings to discuss and address areas of concern or interest to the market. These involve a range of partners, including NHS infection control experts
  • A free comprehensive programme of training for all East Sussex independent care providers. Delivered by the ASCH training team, the offer includes all mandatory training and covers leadership and management courses, staff wellbeing and specialist training. Bespoke training is also delivered on request.

Our approach to the market is one of partnership and support.  In the event of a business continuity incident (e.g. fire, flood) ASCH have provided advice and support to providers to ensure continuity of care and the safety of residents.  

4. VCSE Commissioning Excellence Programme 2023 - 2025

We are working with partners in the VCSE sector and the Integrated Care System (ICS) as part of a two year programme. We aim to develop East Sussex as a centre of excellence for VCSE commissioning.

The programme includes:

  • Building trusting relationships as peers, sharing different skills and expertise.
  • Exploring and testing different ways of challenging the status quo. We aim to find creative alternatives including funding, contract and delivery models.
  • Supporting VCSE involvement and building capacity.

5. About East Sussex

We are a rural and urban county with a growing and ageing population. There is a higher proportion of people aged 65 and over compared to other places in the UK. Over half the future increase in population is expected to be in this age range.

559,000 people live in East Sussex. The population is expected to increase by 4.1% by 2032. The difference in life expectancy between the most and least deprived areas in East Sussex is eleven years for men and ten years for women.

There are a high percentage (approximately, 92%) of White British and Northern Irish people compared to England and Wales (approximately 80%).

Given the geography of the county we consider rurality a ‘protected characteristic’.

East Sussex is the fifth most deprived county council in England. There are areas of significant deprivation in the county – Hastings is in the top 10% of most deprived areas nationally.

6. The care and health system in East Sussex

Improving Lives Together is the Sussex Health and Care Assembly’s strategy. This sets out the ambition across health and care in Sussex over the next five years to improve the lives of local people. The strategy identifies three pan-Sussex ambitions:

  • A new joined-up community approach to health and care, maximising the power of partnership working. This will allow services and organisations to work together to better meet the needs of each local community.
  • Growing and developing our workforce to attract more people to work in health and care. We will also support and develop the skills and careers of our existing staff.
  • Improving the use of digital technology and information to help join-up our services and enable people to access advice or care more easily.

A joint five-year shared delivery plan contains actions that support the delivery of:

  • The pan-Sussex assembly priorities in Improving Lives Together
  • Our East Sussex Health and Wellbeing Strategy
  • Pan-Sussex delivery of NHS Operational Plans covering access to primary care; recovery of elective and urgent and emergency care; hospital discharge, mental health, learning disabilities, autism and health inequalities, clinical leadership and making the best use of financial resources.

7. Information and advice

The East Sussex adult social care strategy, ‘What Matters To You’, identifies what is most important to local people. It describes six priorities for adult social care based on what local people told us.

One of the priority areas is “having accessible and available information about care and support. Communicating information in a variety of formats that are clear, succinct, and readily available.”

Messages for the market

  • We want to work with providers to make it easier for people to access and share information about the care and support they are receiving in a timely way.
  • We will continue to seek opportunities to work with providers to expand the use of technology and digital solutions. This will include the roll out of the digital social care record (sometimes referred to as an electronic care plan).
  • We want to work with providers to ensure we are all using clear and inclusive language and alternative formats to explain to residents and partners what Adult Social Care and Health offers.
  • We will find new ways to provide updates to people about the services they are getting or have applied for. This includes using digital tools and automatically generated information.

Accessible information and advice is available online covering all aspects of preventative and wellbeing services such as cost-of-living support and welfare benefits. We provide online directories to help people (and practitioners) access local help and support, including:

  • 1Space online directory which brings together groups that offer care, support and wellbeing services and has a dedicated section for Information and Advice.
  • ESCIS (East Sussex Community Information Service) which is a broader directory and includes community information and events.

8. Residential and Nursing Care

We fund approximately 650 older people in long term nursing homes and 1,025 older people living in residential care. We also fund approximately 75 adults of working age in nursing homes and 540 in residential care. Adult Social Care funded clients are estimated to account for 20-27% of residents in older people’s care homes across East Sussex. They also account for 42% in care homes specialising in supporting people with mental health problems and people with learning disabilities. In 2022 to 2023 ASCH supported 3,300 clients to access long-term support in ‘bedded care’.

  • There are 123 providers of older people’s ‘bedded care’ in East Sussex with 168 services.
  • There are 53 providers with 111 establishments for specialist ‘bedded care’. Most care homes are independent operators and small groups, who make up around 87% of beds. This contrasts strongly with national (56%) and regional (60%) averages.
  • The older adult care home market relevant to population in East Sussex (in terms of beds per head of population aged 75+) is 12.2% larger than England as a whole, and 7.6% larger than the average for the southeast region (of which East Sussex is a part).

The occupancy levels of care homes currently average 75%. While there has been a recovery after a significant drop in occupancy during the COVID-19 pandemic, occupancy rates have yet to reach pre-pandemic levels.

Financial viability of residential care is an increasing concern. The impact of the pandemic, cost of living crisis and increasing workforce costs is particularly challenging for small independent providers.

Through the East Sussex Care Homes Group, we support and promote workforce initiatives including the MILE pathway (Managers Investing in Leadership Excellence). This is a management and leadership CPD project for registered managers in Sussex. Adult Social Care and Health continue to offer a comprehensive range of free training and development opportunities and facilitate the local Registered Manager Forum.

Adult Social Care and Health purchase ‘discharge to assess’ beds on behalf of the local health and care system to support timely discharge from hospital. The number of beds purchased is determined by the Integrated Care System, available funding and number of beds available.  The current level of discharge to assess beds in East Sussex have been agreed until 31 March 2024. Overall quality remains high in East Sussex with 78.4% of older people’s care homes rated ‘good’ by the Care Quality Commission (CQC).

Challenges in service provision

Since 2015 there has been a reduction of 1,719 beds in the independent care market in East Sussex due to service closures.

 Messages for the market

  • We have an Approved List of providers who deliver residential and nursing care services for older people. We revised the terms and conditions for this approved list in July 2022 and it remains open to new applications.
  • We will continue to maximise opportunities to support recruitment and retention. We have secured continued funding during 2024 to 2025 for two project officers focussing solely on recruitment, who work with providers rated ‘good’ by the CQC. These officers attend community events, job fairs, colleges and offer interview support to candidates.
  • There is an increase in demand for people living with complex dementia or who need complex nursing care, and for older age adults with alcohol or substance misuse issues. We recognise the need to explore how we can increase capacity to meet individuals support needs, within our Local Authority fee structure.
  • We will continue to seek opportunities to work with providers to expand the use of technology and digital solutions. This will include the roll out of the digital social care record and the use of robotic pets to reduce anxiety in adults with dementia.

9. Home care

  • Over recent years the local authority home care market has been under some pressure – notably around the ability to recruit and retain staff. This year has been unusual because capacity has exceeded demand for the majority of 2023. The reasons behind this are not fully understood, but the impact of the pandemic and cost of living crisis are likely to be among the causes. This trend is reflected in neighbouring and regional areas.
  • There are 2,537 people in receipt of a home care package
  • We commission around £29m for home care packages per annum
  • The average length of a home care package is 37 weeks
  • In East Sussex, our international recruitment scheme (now closed) brought in 250 recruits and approximately 10,000 new home care hours into the market.

Messages for the market

  • In January 2023, a new home care contract was issued on a ten-year (six plus four) basis to give security and assurance to the market and to encourage investment and development. We now operate a model with two lead providers for:
    • Hastings and Rother
    • Eastbourne and Polegate
    • Seaford and Havens
  • Each of the remaining six home care areas have one lead provider. This model supports greater resilience as well as supporting choice.
  • Home care provision includes a specific contract for home care in HMP Lewes.
  • The home care market in East Sussex is vibrant, but the impact of the pandemic and now the cost-of-living crisis may be having an impact on demand as it has fallen during 2023.
  • We are committed to working with providers to improve the quality of care. We are seeing increasing numbers of complaints in relation to home care provision and are keen to work in partnership to address these issues.
  • Due to market conditions of capacity outweighing demand, there is no requirement to appoint additional providers to the Approved List at this time. We have therefore taken the decision to suspend the re-opening of the Approved List to applications for new members during 2024.
  • We continue to offer a comprehensive range of free training and development opportunities for home care providers and their staff.
  • We will explore options around trusted assessor models of home care, ranging from a traditional model to one enabling providers to reduce, but not cancel, call times.

10. Carers

There are an estimated 69,241 unpaid carers in East Sussex. One in 10 people in East Sussex are unpaid carers.

Caring takes many forms, and many carers do not see themselves as carers. They can remain hidden for a variety of reasons, such as not wanting to be labelled a carer, not recognising themselves as a carer, and not knowing there is support available to them. Unpaid carers make a huge contribution to promoting and maintaining the wellbeing of people in East Sussex.

We work with social care providers to identify carers and recognise them as expert partners in care. We are committed to ensuring care and support for carers is continually developed to meet carers’ needs. Anyone who is looking after someone who can’t manage without their help has the right to a carer’s assessment.

When planning or commissioning services, we undertake an equalities impact assessment (EqIA). This involves looking at how services may affect groups who share protected characteristics. We include carers in our equality impact assessments to make sure any changes that may affect carers are considered.

Messages for the market

  • We have a strategic partner arrangement with Care for the Carers who offer information, advice, support, peer support groups, engagement opportunities, counselling, Carers Card (emergency plan, discounts), respite funding for healthcare appointments and training.
  • The value of the main contract is £627,766 per annum and we have recently extended the current contract term by two years, to 31 March 2027.
  • Our strategic partner has taken on extra support for carers of people with severe mental illness. They also undertake carers’ reviews on behalf of Adult Social Care.
  • Small grants funding is now managed through the strategic partner. It delivers a range of carer services provided by other organisations including:
    • dementia training,
    • cookery and arts activities,
    • support for carers from ethnic minorities,
    • carer support in hospices,
    • digital support and
    • lunch and supper clubs.
  • From October 2023, they also took over the commissioning of the volunteer respite service delivered by the Association of Carers, from Adult Social Care.
    NHS funding (currently agreed for one year) has also been added to the contract to provide carer identification and support through primary care in Hastings, the Havens and carer awareness in hospital

11. Technology Enabled Care (TEC)

Nationally there is an increased emphasis on the use of digital technology, including TEC services, to support and improve existing service provision. The adult social care reform white paper ‘People at the Heart of Care’ makes multiple references to the use of technology and using its full potential to support people’s lives and aspirations.

A good quality TEC service is one that provides a reliable, responsive, person-centred service. It should enable its users to live independently and with confidence, while providing peace of mind to their family, friends and carers.

By 2025 all telecoms are switching from analogue to digital. In East Sussex, we started making changes early in 2023 and they will be completed before the deadline.

The East Sussex commissioned service has good uptake with around 8000 people with care and support needs using the service with monitored alarms.

The number of new people using TEC stayed the same during the pandemic, but slightly increased in 2022/23. There are currently the same number of people leaving the service as new people joining.

TEC is currently only available to people who meet the Care Act eligibility criteria.  The maximum client contribution for new clients increased to £3.85 from 1 September 2023, due to increasing costs.

Pilots have been undertaken throughout 2023/24 including:

  • The use of systems that monitor activity to provide information for social care assessments
  • Apps that support people who need help remembering things, making decisions, planning, or managing anxiety
  • The use of virtual assistants such as Amazon Alexa
  • The use of robotic pets to assist adults with dementia to reduce anxiety

 Messages for the market

  • The new contract commenced on 1 September 2023. It will run for a period of five years with an option to extend by up to 60 further months.
  • The annual contract value is £1.705m, with a £900,000 management fee.
  • The intention of the contract is to align the current service with the requirements of health partners to maximise benefits to the whole system.
  • This includes areas such as links with Telehealth, equipment to monitor activities of daily living and implementing a mobile response service.
  • We will implement a new short-term provision service model to provide extra support at the point of hospital discharge. The existing long-term provision service model will continue.
  • Greater importance will be placed on using the information from the equipment used in people’s homes. This will improve service delivery and help to explore the use of artificial intelligence and machine learning.

12. Community equipment

Community equipment provides an essential part of health and social care support. It helps people to remain independent in the community. Community equipment helps by preventing, reducing or delaying conditions from getting worse. For example assisting with mobility and balance, preventing pressure sores and preventing falls. Community equipment also helps to prevent admissions to hospital and supports earlier discharge.

The Integrated Community Equipment Service (ICES) covers the process of purchasing community equipment. Including:

  • logistics
  • delivery
  • collections and warehousing services
  • electronic and stock management systems
  • decontamination
  • recycling and

Equipment is provided to assist with daily living needs and can be categorised as follows:

  • beds and accessories
  • hoists and slings
  • bathing
  • mobility
  • moving and handling
  • pressure care
  • seating
  • toileting

Equipment for children and young people under 18 years of age is commissioned and provided as part of the Children’s Integrated Therapy Service.

The service is available to those who have an ICES eligible need, are over the age of 18 and is:

  • an East Sussex resident, or
  • living outside of East Sussex but registered with an East Sussex GP.

 Messages for the market

  • A new contract started on 1 April 2023. It was sourced via a further competition under a Kent Commercial Services (KCS) framework. The KCS framework is a free to access, national framework for the provision of a full range of daily living health and social care equipment.
  • The contract value is just under £2m per annum excluding equipment. The equipment budget for 2022 to 2023 was around £6m. The service is jointly funded by the NHS and Adult Social Care.
  • The contract is for five years with an option to extend by up to 24 months.
  • The service provider is responsible for the procurement, delivery, collection, repair, maintenance, decontamination and disposal of community equipment including pressure relief.
  • A range of new service developments were included in the new contracts such as developing a trusted assessor model. Trained delivery technicians will complete lower-level assessments for items such as bed and chair raises enabling local prescribers to dedicate more time to complex cases.

13. Housing with care and support

Housing with care and support is purpose built or adapted housing with the availability of up to 24/7 care and support services.  

This includes:

  • Providing the housing and support older people need to maintain their independence.
  • Providing emergency refuge and support for victims of domestic abuse, helping to stabilise their family life and engage with other services.
  • Working with homeless people, some with complex and multiple needs, to secure longer-term accommodation or a permanent home, education, training or employment.
  • Supporting people with mental health needs when necessary to stabilise, recover and live more independently.
  • Supporting people with learning disabilities to maximise their independence and exercise choice and control over their lives.

Extra care

We commission six extra care schemes in Bexhill, Eastbourne, Hailsham, Peacehaven, St Leonards and Uckfield. This comprises 228 rental flats. Most schemes have additional shared equity flats, which are purchased from the landlord, making a total of 285.

Our extra care schemes enable adults to live independently through assured tenancies and some shared equity flats, where 24/7 on-site care and support can meet changing needs. Four out of the six have Care Quality Commission ‘good’ ratings. Most people with increasing needs stay in extra care.

In very exceptional circumstances, the age criteria can be relaxed to accommodate people under 55. Positive behavioural support and other training opportunities have increased in response to the greater number of people with more complex needs.

Messages for the market   

  • The 285 units provide enough capacity and there are no plans to develop any additional sites. We will continue to monitor supply and demand.
  • Services were tendered in 2023 for a six plus four year contract.

Refuge and support for victims of domestic abuse

We have a legal duty to support victims of domestic abuse and their children living in refuges and other safe accommodation.

Within East Sussex refuges, over 45% of people said they had a mental health condition. This is much higher than within the wider population.

We are committed to improving the availability of safe accommodation in East Sussex. We recognise there are areas for development and are working on these:

  • Working with our current provider, we have sourced five new units of self-contained safe accommodation which will be taking referrals in early in 2024. This will increase the options of safe accommodation in East Sussex and be an additional option for those with protected characteristics. The units will be available to male victims, for whom there is currently no refuge provision.
  • There is currently no specialist safe accommodation in Sussex for women from black or ethnic minorities, although there is a specialist service, Hersana, operating in Sussex. 
  • There are two refuge places which are suitable for wheelchair users; one is a self-contained flat. There are also plans to provide specialist equipment for deaf people and those with sensory impairments within refuge and safe accommodation.
  • Provision for larger families is limited. The largest number of refuge rooms have two beds; eight rooms in Sussex refuges have four beds and there are no rooms in Sussex with five or more beds.
  • Our refuge provider can accept women with no recourse to public funds. The authority would meet temporary bridging costs for refuge while Destitute Domestic Violence Concession (DDVC)is claimed, or alternative funding is secured (for example from Children’s Services).

Messages for the market

  • Refuge services were recommissioned in 2021 for a five plus up to five years contract, from 1 November 2021.
  • There will be funding opportunities in 2023-2024 for delivery of the Pan-Sussex Domestic Abuse Accommodation and Support Strategy 2021-2024. This includes safe accommodation and support for those from marginalised groups and those with protected characteristics. There are localised East Sussex action plans for delivery of the strategy.
  • Ring-fenced funding from Government will enable us to increase the number of refuge beds and diversify the refuge services available in East Sussex.

Supported accommodation for homeless people or people at risk of becoming homeless

Supported accommodation supports vulnerable adults and young people who are at risk of homelessness to develop independent living skills. It offers access to keywork support and other services that promote greater independence. Current provision provides support for the following groups:

  • Vulnerable adults
  • Adults with a mental health need
  • Young parents aged 16-25 (pregnant, or with children under five years old)
  • Young people aged 16-25 (including care leavers)

Demand for homelessness services is expected to continue to rise. This is demonstrated by the growing number of people, particularly single, working-aged adults living in emergency accommodation across East Sussex. 

Messages for the Market

  • Services were tendered in 2020 for a six plus four year contract.
  • We commission 18 services which provide 238 units of supported accommodation, each catering for a different type of support need

Supporting people with mental health needs when it is needed, to stabilise, recover and live more independently

During 2022 to 2023 we reviewed provision for people with mental health support needs.  We concluded that mental health services would benefit from expanding the supply of unregistered, approved supported accommodation providers for people with moderate to complex mental health needs in rural areas of Wealden, as well as in Lewes, Eastbourne and Rother. Leading into 2024-25 we still require ongoing expansion, particularly for complex and specialist support and would like to discuss this with providers who are interested in joining our Supported Living Approved Provider Framework.

Supported living has had the highest increase in mental health referrals. We aim to increase the current provision by a minimum of 10% in the next year.

Over the last 12 months we have welcomed new providers into the Supported Living Approved Provider Framework and added 35 new placements with a target of 98 by end of 2024.

 Messages for the Market

  • We would like to talk to providers who are interested in developing a 24/7 provision, as well as floating ‘step-down’ mental health and housing related support as part of their service delivery.
  • For more complex cases, we want to explore new interventions or service models to support people with autism, young people, and people with drug and alcohol issues.
  • Key areas of growth:
  • Supporting people with mental health needs to stay in their own homes
  • Increasing support for complex mental health needs

Reducing the number of out of area placements by increasing Supported Living provision in some areas, such as Wealden, Lewes, Eastbourne and Bexhill.

  • Developing the VCSE market and linking with primary care networks.
  • Developing services that can move with individuals as floating support

Learning Disability and Autism Programme

The Learning Disability and Autism (LDA) Programme (previously known as Transforming Care) supports individuals with a learning disability or autism and complex needs who are in a secure hospital setting, or those at risk of being admitted to a secure hospital setting, to transfer into community-based support and accommodation.

The aim of the programme is to enable more people to receive personalised care in the community, closer to home, and reduce preventable admissions to inpatient services.

Messages for the Market

  • There is a gap in provision in the County for people with particularly complex and challenging conditions.  Increasingly we are seeing requests for single-person, bespoke accommodation and packages of care. We are working with our NHS Sussex colleagues on how we can address this gap.
  • Largely speaking, specialist mental health forensic provision will need to be secured to meet the needs of individuals who fall within the LDA programme.
  • The packages of care required need to meet behavioural and mental health needs. This is likely to include Positive Behaviour Support (PBS), occupational therapy, speech and language therapy, community mental health nursing and medication management.

Supported Living – learning disability

There are 38 providers of Supported Living accommodation in East Sussex, delivering 128 services with 699 beds. In 2022 to 2023 ASCH supported 735 people to access these services. 

Messages for the market

  • There is a lack of provision for younger adults with a variety of needs including physical disabilities, learning disabilities and mental health needs.
  • The Council is committed to increasing supported living provision for adults with a learning disability in East Sussex.

Housing-related floating support service

The service provides short-term housing-related floating support across East Sussex. It provides vulnerable people, aged 16 and over, with support to live independently. This can prevent homelessness by enabling people to stay in their current home or support them to find new accommodation and start a tenancy.

Referrals are made by ASCH, Children’s Services and the local housing authorities. People aged 60 and over can self-refer to the service. Referrals are prioritised to ensure a needs-led approach and to maintain capacity within the service to respond to any changes in need or demand.

Messages for the market

  • We have a Strategic Partner arrangement for the floating support service across the county. The contract was let for 5 years with a possible extension of 60 months.
  • This follows a comprehensive re-design of our housing-related floating support services bringing the previous services for working age adults and older people into a single pathway.

14. Advocacy

Advocates in social care are independent of the local authority and the NHS. They are trained to support individuals to understand their rights, express their views and wishes, and help make sure their voice is heard.

The Care Act states that we must provide independent advocacy to those who would have 'substantial difficulty' in being involved in care and support processes and have no appropriate individual who can support their involvement.

Independent Mental Capacity Advocacy (IMCA) and Relevant Paid Persons Representative (RPPR)

IMCAs support individuals who are facing a decision about a long-term care move, serious medical treatment, a care review or adult protection procedures. They cover the role of the relevant person’s representative when there is a gap between appointments and support the person, or their relevant person’s representative, when a standard authorisation is in place.

 Messages for the market

  • The IMCA service is provided for any person aged 18 years or older who has no one able to support and represent them.
  • Most individuals who access this support are people in residential accommodation with learning disabilities, older people with dementia, people who have an acquired brain injury or people with mental health needs.
  • We discharge our IMCA and RPPR statutory duty through a pan-Sussex contractual arrangement covering East Sussex, West Sussex and Brighton & Hove. Brighton & Hove City Council act as the Lead Commissioner for the contract.
  • The contract has recently been extended until 30 June 2025.

Independent Mental Health Advocacy (IMHA)

The Council has a statutory duty to commission independent mental health advocacy provision under the Mental Health Act 1983 and independent Care Act advocacy under the Care Act 2014.

Messages for the market

  • The contract has been extended to 31 March 2025.
  • Independent Care Act activity is reliant on referrals from the Council of those people identified as having a substantial difficulty so is outside the provider’s direct influence.

15. Direct payments

There are currently 1,520 adults with care and support needs receiving a direct payment. This is around 32% of the people receiving long-term support in the county. The value of these payments is approximately £7.5 million each year.

We commission two direct payment support services, which support around 500 people. This support can include recruiting personal assistants (PAs) and carrying out pre-employment checks, payroll and providing ongoing advice and guidance to employers. We also provide a support service for non-employed direct payments.

Messages for the market

  • Both our direct payment support services contracts have been extended until March 2024
  • We are recommissioning direct payment support services, beginning in April 2024

16. Day services

In 2022 to 2023, 329 older people used day services. Of these, 149 had primary support needs with memory and cognition. Demand for day services for older people with a physical disability is in decline. We directly provide two older peoples day services - Milton Grange in Eastbourne and the Phoenix Centre in Lewes.

 Older people’s day opportunities include:

  • Day time respite for unpaid carers, people with additional needs, and those with dementia
  • Services for older adults
  • Enabling people to stay in the community and prevent or delay them moving to residential care

There are currently 297 active contracts for individuals who use Learning Disability day care or day opportunities. We directly provide four day services – Beeching Park in Bexhill, Linden Court in Eastbourne, St Nicholas Centre in Lewes and Hookstead in Crowborough.

Learning disability services and day opportunities include:

  • Building based services
  • Community based services
  • Social opportunities to maintain independence
  • Day time respite for carers
  • Support to build and maintain independent living skills
  • Work skills and access to employment (supported employment)

 Messages for the market

  • There are a range of independent and voluntary sector providers of day care services and day opportunities across the county. Services are currently spot purchased based on individual need, eligibility, and choice.
  • We are aware that some providers of learning disability day services and opportunities have seen a decline in attendance as a result of the pandemic, whilst others have been able to rebuild occupancy to pre pandemic levels.

17. Working with East Sussex County Council

ASC have a dedicated team who are responsible for managing health and social care procurement activity. Further information about working with the Council is available at our Doing business with us page, including:

  • The Proactis Supplier Network portal where all competitive processes for contracts over £25,000 will be advertised. These include contracts currently under the Public Contracts Regulations 2015, and will be under the Procurement Act 2023. It is also where all competitive processes for contracts under the Provider Selection Regime will be advertised.
  • Information on tender thresholds and procurement regulations
  • Finance and insurance requirements

You can also find the Annual Procurement Forward Plan (which is finalised annually in March) on the Council’s Portfolio plans page. Please note that these only include  contracts over £1m.

Also available are our ASC Providers and professionals pages, including information on:

  • Training and qualifications available to people providing care and support
  • Safeguarding resources
  • Developing support services
  • ASC specific information on contracts and purchasing

You can sign up for our ASC provider email bulletin which has articles about workforce, wellbeing, service news, training and development, events and opportunities to ‘have your say’. 

For any queries or feedback on the Market Position Statement, email: