Overview of the care home market in London Aileen Buckton Executive Director for Community Services, Community Services Directorate, London Borough of Lewisham & London ADASS Branch Chair London Clinical Senate Forum, 25 th May 2017
Overview of the London social care workforce as at 2015/16 Source: Skills for Care estimates based on ONS IDBR data, 2016 2
Number of adult social care organisations (enterprises) Estimated number of adult social care organisations in England by region Source: The size and structure of the adult social care sector and workforce in England, 2016 Estimated proportion of adult social care organisations by service type Source: Skills for Care estimates based on ONS IDBR data, 2015 3
Who delivers adult social care? Pre 1945 Post 1945 Post 1980s Post 2014 Local authority as the overseer of the poor law system Local authority as the provider of care and support Local authority as the purchaser of care, predominantly provided by others Local authority as the shaper of a care marker where individuals purchase care and support Source: IPC Market Analysts Centre, the basics of market facilitation 4
Number of residential homes in London Source: NHS London Purchased Healthcare Team based on CQC registration data from 4 April 2017 5
Number of nursing homes in London Source: NHS London Purchased Healthcare Team based on CQC registration data from 4 April 2017 6
Overview of current overall ratings for care homes Source: CQC ratings data published up to 20/02/2017 7
Adult social care market trends in London September 2010 to March 2017 Unlike England as a whole and the majority of other regions London has a greater number of nursing beds than residential beds, but it has similarly seen a decline in nursing beds since 2015 as well as a consistent decline in residential beds. It has also seen a similar combination of decreasing residential homes and beds in conjunction with increasing numbers of domiciliary care agencies to the point where in the last 6 months there is now a greater number of agencies than there are residential homes. It is the only region in the country where this has happened so far. Since September 2010 London has seen the biggest decrease of residential homes (24%) and beds (17%) and the biggest increase in domiciliary care agencies (70%). Source: CQC Registration Data 8
Residential beds market trends in London March 2015 to March 2017 Since March 2015, the number of residential beds across London has decreased by 2%. 20 London boroughs recorded a decreasing number of residential beds, with the largest decrease of -27% recorded in Hackney. Conversely, 10 boroughs recorded an increased number of residential beds. The largest increase, of 25%, was recorded in Redbridge. Between March 2015 and March 2017, Hackney has recorded the greatest decrease in residential beds but the greatest increase in nursing beds across all London boroughs. Redbridge has recorded the greatest decrease in nursing beds yet the largest increase in residential beds. This change is partly attributable to 2 homes, with a combined total of 175 beds, converting from nursing bed provision to residential beds. Source: CQC Registration Data 9
Nursing beds market trends in London March 2015 to March 2017 Since March 2015, the number of nursing beds in London has decreased by 4%. 21 London boroughs recorded a decreasing number of nursing beds, with the largest decrease of -22% recorded in Redbridge. Conversely, 9 boroughs recorded an increased number of nursing beds. The largest increase, of 28%, was recorded in Hackney. Source: CQC Registration Data 10
11 Challenges Variation in primary care provision to residential and nursing homes Variation in the community health care offer to residential and nursing homes Social care sector is performing reasonably well in London but there are wide variations in quality. Why are there such variations? How can these be tackled? How can we drive improvements in quality generally? Regular information sharing meetings between CQC, local authorities and CCGs are critical to lever improvements and tackle poor care. Are these working effectively in all areas? Is there anything else that can be done?