Market position statement 2024 – 2027

Contents
Foreword
The Reading Borough
Adult Social Care in Reading

• Our vision
• The needs of our population
• What people tell us
• Our resources
• The adult social care workforce

Where are we now?

• Understanding the council’s adult social care teams
• Working with our partners
• Our current provision
• Early help, enablement and reablement
• Supporting people at home
• Other services
• How does the council work with providers?

What next?

• Opportunites

Further information

A PDF version of this web page is also available: Market position statement 2024 – 2027 PDF

Foreword

Melissa Wise – Executive Director Communities and Adult Social Care

Welcome to Reading Borough Council’s Market Position Statement for 2024 to 2027 which provides an overview of the current social care market in Reading and how we would like to see this develop to meet the needs of local residents. It is our aspiration that information will be updated annually and will support conversations and collaborative working with our Partners, Providers, and the community of Reading.

Reading is a culturally rich and diverse town, blessed with ambition and plentiful opportunities, but at the same time faces deep-rooted social and economic inequality. Within Social Care we are seeing both growing demand for care and support alongside people living with increasingly complex conditions. In order to support our residents well, we must work collaboratively to provide good quality services for people in Reading. Positive and constructive relationships with the Voluntary & Community Sector, Providers and Partners are critical in ensuring we achieve this. We are committed to working together to provide the advice, guidance and early intervention which will support people to reach their potential and live as independently as possible. When people need more assistance, we are striving to ensure that good quality services are available in Reading so that we can support people in the way they want to be supported when it is needed.

Our Market Position Statement will tell you about where we are now; it will tell you about how we work and our strategic direction over the coming years. It is an important aspect of our communication with Providers and the foundation of rich collaboration which will enable us to support our residents well and deliver our purpose of ‘Supporting the life that matters to you’.

Councillor Paul Gittings – Lead Councillor for Adult Social Care

I am pleased to introduce Reading Borough Council’s Market Position Statement for 2024 – 27, the aim of which is to support commissioners, people with lived experience, carers and Provider organisations to work together to explain the current position of the social care market in the Borough, how the Council wants to shape market opportunities and what future care services are needed in the local area and why.

The past few years have seen a significant amount of both national and international turmoil which have affected the landscape in which Councils across the UK are now operating. Reading is not immune to the challenges facing Local Government, however, our sound financial planning over several years means we are in a better position than many to manage in this new environment.

Reading Borough Council remains committed to supporting the people of Reading with good quality, diverse, accessible and personalised health and social care support. We are increasing our focus on preventing emergency needs rather than responding to them and enabling people to get well and regain independence after a period of poor health.

This Market Position Statement is an increasingly vital part of our relationship with our health and social care market. Looking to the future, we will continue to work on further integration with our health partners, focusing on models of enhanced prevention and early intervention. We will also continue to work in partnership with the Voluntary and Community Sector to ensure there are a range of good quality services to better promote independence and wellbeing across the Borough.

Our Market Position Statement maintains a conversation between Reading Borough Council and our health and social care partners that we will continue to lead to facilitate creative and innovative services, which will help people to live their best lives. It gives detailed information about the demographics of our Borough’s population, feedback from people in the Borough that receive services from the Council and care Providers that we work with.

I look forward to working with our health and social care partners on achieving our vision of Reading having a healthy thriving community and “Supporting the life that matters to you.”

The Reading Borough

Reading is home to 174,200 people and 67,700 households (ONS, 2021). The population has increased by 11.9% since 2011. The town is ranked fourth in the Southeast for population density (within the top 20% of authorities in England and Wales) and the number of households is predicted to rise.

When compared with the surrounding County of Berkshire, the town has a generally younger population although around 20,900 (12%) of residents are over the age of 65, including almost 3000 people (1.7%) over the age of 85.

It is a very diverse town and almost half of the population (46.5%) identify as from a minority ethnic background (including white and other communities). The level of diversity in the town has increased since 2011, is significantly higher than the England average (26.5%) and but on a par with other urban areas in the Southeast.

Reading is a major centre of employment with over 130,000 people working in the Borough at the time of the 2021 Census. The town hosts several Information Communication Technology (ICT) companies and is now one of the largest insurance and business centres in the country. It is a major retail centre with a significant evening economy. Overall, there are more jobs in Reading than workers, which means people often travel into Reading for work. The town is a major transport hub and a prime location to live, work and/or run a business with easy access to London by road and rail.

Prosperity has brought challenges, with pressure on infrastructure, communities, and the environment. The high cost of living has had a significant impact on local communities. Although Reading can demonstrate success and wealth, the town also contains some of the most deprived wards in the country. Some people are thriving, others however, face deprivation and disadvantage. There is a significant gap between Reading’s most and least prosperous neighbourhoods – particularly in the South of the town. Affordability of housing is a critical issue, with rising house prices and rents putting housing beyond the reach of many residents. This also forms a barrier to economic growth, with access to housing making recruitment difficult in many sectors.

Detailed information can be found about Reading on the Council’s website, including a profile of the town – Profile of the Reading Borough and further information on individual wards – Ward Profiles for the different areas of the Reading Borough .

Adult social care in Reading

Our vision

The Adult Social Care teams in Reading work alongside Public Health and Housing as part of the Directorate for Communities and Adult Social Care. The Directorate is responsible for meeting the Council’s duties under the Care Act 2014, which include:

• Improving independence and wellbeing by ensuring that people can receive services that prevent their needs from becoming more serious. This means working with the local community to understand the resources available, providing or arranging support that can keep people well and identifying people and carers in the local area who might have care and support needs that are not being met.
• Ensuring that people can get the information and advice they need to understand how local services work and make good decisions about their care and support.
• Engaging with local providers to develop a responsive market that can provide sustainable high-quality care and support for the local community – promoting wellbeing and offering people more choice and control over their care.

In line with the adopted Social Care Futures vision Social Care Future – In Control (in-control.org.uk), our overriding ambition is to support people to realise their potential, be independent and live in their own homes for as long as possible, whilst ensuring that intensive support is available for those that need it most.

This includes:

• Enabling access to good quality information and advice so that people are well placed to make their own decisions and have control over their lives.
• Working with our Voluntary and Community Sector to strengthen the community offer, provide early help and reduce the need for formal intervention and paid support.
• Prioritising enablement and reablement by supporting people to reach their potential, as well as to regain independence after a period of poor health.
• Making innovative and effective use of technology enabled care (TEC) to support independence and reduce reliance on direct support solutions. This includes both specialist equipment but also newly emerging ‘Pattern of Life’ digital solutions and AI which has enormous capacity to put people in control of their lives.
• Improving our offer for unpaid carers; putting them in the best position to support family members at home.
• Encouraging the take up of direct payments so that people have greater choice and control when meeting their care needs, continued development of the personal assistant market and consideration of micro-enterprises to increase the care workforce and provide alternative options for people to purchase care. This will increase choice for people and reduce reliance on home care as a ‘fall back’ option.
• Developing a sustainable, good quality support offer for people who are living in their own homes which supports independence and enables people to have greater choice and control over their own life.
• Investing in intensive support for people with higher levels of need – this includes the continued development and growth of the supported living market to support people with more complex needs and the diversification of extra care housing to reach more people and offer an effective alternative to residential care.
• Supporting the ongoing supply of intensive support services including residential and nursing care homes for people with the most complex needs who are no longer able to safely remain in their own homes. This includes ongoing work with the sector to ensure that local provision is fit for purpose and can meet the needs of people with complex dementia, poor mental health and more bespoke physical needs such as bariatric need. This may include building design, innovative technology, and development of staff knowledge through training.

The needs of our population

The need for services across the Borough has increased both in volume and in the level of complexity that people present with when they first approach social services. Partly, this is a consequence of an increase in the size of the population, but in part may also be the effect of the Covid -19 pandemic. Since the pandemic started in early 2020 the Council has seen a dramatic shift in the number of people needing support and Covid-19 has resulted in a much frailer population needing help, alongside increases in mental ill health. Recent analysis suggests that in some areas, placement trends may be returning to pre-pandemic levels, but this is yet to be confirmed in Reading.

The section below provides a flavour of some of the current trends and pressures. Providers are encouraged to visit the Reading Data Observatory Berkshire Observatory – Reading – Welcome to the Reading Observatory, which provides insight into Reading and improving the health and wellbeing of all who live here.

The overall population in Reading is expected to increase in line with general population changes expected across England. However, Reading’s population will see a decrease in the numbers of working age adults and the increase will be predominantly in the older 65+ age categories where there is a higher risk that people will experience dementia.

Naturally, with an increasing population comes a greater number of people living with disabilities. At present slightly less than 10% of the Reading population are disabled under the Equality Act, where day to day activities are limited a little, and a further 6%are limited a lot. These figures are expected to increase along with the growth in population as the graph below shows.

Predicted change in the Reading population where day-to-day activities are limited by disability

Reading’s figures for people whose day-to-day activities are limited by disability are higher than those in other authority areas in the Southeast and across England for age groups 65 – 84, but lower for those aged 85 and over.

Predicted cases of dementia in the Reading population

Learning disabilities

Data from PANSI and POPPI make the following projections for people with learning disabilities:

Reading’s population with learning disabilities by age

Age	2020	2025	2030	2035	Difference 2020 – 2035	Percentage change 2020 -2035
18-24	540	566	635	645	+105	+19.44%
25-34	652	627	605	635	-17	-2.61%
35-44	584	536	508	490	-94	-16.10%
45-54	481	477	470	446	-35	-7.28%
55-64	364	396	401	394	+30	+8.24%
65+	429	467	522	580	+151	+35.20%
Total 18-64	2,621	2,602	2,619	2,610	-11	-0.42%
Total adult	3,050	3,069	3,141	3,190	+140	+4.5%

The number of people with learning disabilities is predicted to increase in the 18-24 and the 55+ age groups but decrease in all the other adult age groups. This means that we could see greater demand for older adult services and younger adult (including “transition”) services over the next 15 years, whilst seeing slightly less demand for services for working age adults over the age of 24.

The table below presents the number of people in Reading who have moderate or severe learning disabilities who may need more intensive support including accommodation with their support.

Reading’s population with moderate or severe learning disabilities

Age	2020	2025	2030	2035	Difference 2020 – 2035	Percentage change 2020 -2035
18-64	600	597	602	599	-1	-0.17%
65+	58	62	70	77	+19	+32.76%
Total adult	658	659	672	676	+18	+2.74%

Just under 23% of adults aged 18-64 with learning disabilities are predicted to have moderate or severe learning disabilities and this percentage does not change significantly per year or per age group. Around 13.5% of adults over the age of 65 with learning disabilities are predicted to have moderate or severe learning disabilities which, again, does not change significantly between 2020 and 2035.

Adults with autism

Nationally, the overall prevalence of autism is 1.1% of the population. It is challenging to establish the exact number of autistic people in Reading and across most areas as data is not yet consistent and reliable. However, it is estimated that approximately 1,707 people of all ages (1.04%) in Reading are autistic, slightly less than the national average. Of the 1.04% of Reading’s population estimated to have autism, approximately 79% (1,354) are adults and of these, approximately 489 (36%) are known to Adult Social Care.

Predictions for the number of people with Autism who will need support in the future follow the same patterns as those of the population that have a learning disability. Data suggests an increase in both the 18-24 age category and the 55+ age categories, but a decrease in the 25 – 54 age categories. This is likely tied to the predicted decrease in Reading’s general population for those age groups.

Mental health

The population predictions that may be meaningful to Adult Social Care are those for people with common mental health disorders which comprise different types of depression and anxiety, and people with two or more psychiatric disorders (psychiatric comorbidity), which is known to be associated with increased severity of symptoms, longer duration, greater functional disability and increased use of health services. The latter cohort may be more likely to require accommodation with care. This data is only available for adults aged 18-64.

Reading’s population with mental health disorders

Adults aged 18-64	2020	2025	2030	2035	Difference 2020 – 2035	Percentage change 2020 -2035
Common mental health disorder	19,171	19,832	19,744	19,433	+262	+1.37%
2 or more psychiatric disorders	7,639	7,594	7,576	7,576	-63	-0.82%

The projections above indicate that the number of people with common mental disorders is likely to increase slightly, while those with psychiatric comorbidity is likely to reduce marginally by 2035.

There are currently 710 people known to Reading’s Adult Social Care whose primary support need is mental health. 448 (63%) are aged 18-64 and 262 (37%) are aged 65+. 616 (87%) of the total are long-term service users.

What people tell us

Co-production

Co-production is a way of working that acknowledges that everyone involved in adult social care has a valuable contribution to make. It offers an approach to public services that enables the specialists providing, and people with lived experience engaging with services to share power and responsibility, and to work together in an equal, reciprocal relationship.

Reading Borough Council has a strong commitment to working together with people with lived experience, families and carers; as well as the care market, the Voluntary and Community Sector and our statutory partners. In 2023, we employed a Co-Production Officer to lead our work in this area. We have established a ‘Working Together Group’ who are already providing invaluable feedback and advice and have supported in a number of Senior appointments to the Directorate. Over the coming year, we will be developing a Co-Production Charter, and you can expect to see and hear us looking for increasing opportunities to work with the people we support, families and providers in the co-design and co-production of future services. We encourage this approach in our providers.

How people currently feel about the care services provided by the council

The 2022/23 Adult Social Care Outcome Framework (ASCOF) provides an indication of how people feel about the Services provided by the Council. The most recent results were released in December 2023. Positively, the Council has maintained its improvements in the social care-related quality of life score which is in line with the position for the Southeast and exceeds the national average. When compared with peer (comparator) local authorities, the Council ranked the highest out of 16 on the overall satisfaction of people with lived experience for their care and support. Reading is joint first in national ranking for proportion of carers receiving a direct payment, exceeding the national average by 15%. Reading has continued its focus on greater independence and care and support in people’s own homes, and this is reflected in the Council’s ranking for number of long-term support needs for younger adults placed into care homes, where the Council is ranked 3rd best in the country and when compared with peer (comparator) local authorities, the Council ranked the highest out of 16 for fewest adults supported in care homes. Similarly, the Council has significantly reduced the number of people aged 65+ that are supported in a care home environment, improving our ranking when compared to peer authorities from 8th to 3rd out of 16 authorities.

The results of our 2023/24 Adult Social Care Survey were very positive showing for example that more than 70% of people in the Council’s care felt they have enough choice over care and support services (4% higher than the national average). 79.7%responded to say that care and support services help them to have control over their daily life, 87.3% responded to say that care and support services help them to feel safe and more than 70% of people stated that the way they are helped by care services makes them feel better about themselves. All of these responses exceed the national averages. The survey did highlight that care services provided by the Council could be better at helping people to have more social contact and we intend to improve upon this through our community floating support services.

A survey conducted in March 2023 amongst Providers we work with, and other partner organisations told us that providers valued the positive and can-do attitude of staff, our supportive approach and good quality training. They also told us that they would like to see improvements in communication and a single point of access to reduce response times. These are areas we are working on – both in terms of improvements at our ‘Front Door’, our internet offer and communication through Provider Forums.

Our resources

All local authorities in England have 3 main sources of income, Council Tax, Business Rates and Grants. These 3 sources of income form what is known as the General Fund Revenue account for the Council. For the 2024/25 financial year, Reading’s net General Fund is approximately £167.886 million to cover spend across all areas of responsibility, which includes Communities and Adult Social Care (DCASC).

Between the 2020/21 financial year and the 2023/24 financial year the Council has delivered savings totalling £33.501m and has a statutory responsibility to deliver a balanced budget every year whilst managing increasing demand. Savings are the Council’s way of ensuring we remain efficient and provide value for money whilst managing increasing demand services we can during this turbulent economic climate. In order to deliver greater efficiency, the Council has focussed on service redesign, making greater use of technology and streamlining processes.

The Directorate of Communities and Adult Social Care (DCASC) has a strong focus on preventing and reducing the impact of social care needs; earlier intervention and reablement through increased funding to the community services and greater investment in health and social care equipment, including telecare.

While there is still a great need for the Care Home market within Reading to cater for those who cannot manage independently, the Council’s strategy for meeting people’s needs is always to provide interventions that support people to remain as independent as possible and build upon, peoples’ personal strengths to ensure the best outcomes are achieved for everyone. DCASC is also committed to working with Public Health and the VCS on initiatives like ‘Closing the Gap’, the VCS Front Door and the Community Wellness Project.

The impact of the Covid-19 pandemic, difficulties accessing health care in a timely way, inflation, increased staff costs have significantly impacted the cost of providing Social Care in England. The cost of providing services has risen dramatically in the last few years as reflected in the budget increases shown below.

General fund budgets	2020-2021	2021-2022	2022-2023	2023-2024	2024-2025
Adult social care and communities	£38.273m	£37.947m	£43.915m	£48.305m	£56.887m

The 2024-25 Communities and Adult Social Care budget is £56.887m, which breaks down as follows:

• Commissioning, transformation and performance: £2.69m (4.7%)
• Adult services operations: £46.11m (81.1%)
• Safeguarding, quality and practice: £3.567m (6.3%)
• Community and adult social care management: £1.65m (2.9%)
• Housing and communities: £2.87m (5%)

The Council’s Communities and Adult Social Care commitments for 2024/25 can be broken down by service type as shown below (Period 03):

Service type	Annual commitment as per P3 24/25 18-64	Annual commitment as per P3 24/25 65+	Annual commitment as per P3 24/25 ALL	Annual commitment as per P3 24/25 Blocks
Day care	405,451	25,676	431,127	n/a
Direct payments	6,546,613	1,1781,893	7,725,507	n/a
Extra care	164,967	817,894	982,860	716,951
Home care	1,624,627	7,125,233	8,749,880	241,526
Nursing care	1,256,385	7,080,137	8,336,522	2,411,888
Other	91,026	3,945	94,970	281,363
Residential care	10,544,201	7,250,787	17,794,988	586,607
Respite	6,136	13,573	19,709	n/a
Shared lives	169,404	45,949	215,353	n/a
Supported living	11,579,180	999,621	12,578,801	377,529
Sub total	32,388,011	24,541,708	56,929,719	4,615,864

The figures in the table above show commitments rather than actual spend, which is why the totals exceed the annual care budgets outlined above. The Council has in place efficiency plans to ensure that the in-year spend is met within budget.

In addition to the Council’s budget, Reading makes use of several grants to supplement income and support care markets. These grants are applied for and secured each year. During the Pandemic, the Council distributed nearly £5 million pounds of grant funding to care markets to support providers and care workers. The Council collaborates with Health to utilise the Improved Better Care Fund Grant, which supports several services including Discharge to Assess services, the Dementia Care Advisor Service and Falls & Frailty Service. More recently, the Council has been making use of the Market Sustainability & Improvement Fund to manage demand and support provider sustainability.

Sources of Grant income for the Council can be seen below:

Grant funding stream	2020/21 £m	2021/22 £m	2022/23 £m	2023/24 £m	2024/25 £m
Independent Living Fund (ILF)	0.235	0.235	0.235	n/a	n/a
COVID grants	3.031	1.888	n/a	n/a	n/a
Improved Better Care Fund (IBCF)	2.613	2.613	2.693	2.693	2.693
Market sustainability grant	n/a	n/a	n/a	1.344	2.492
Market sustainability – workforce grant	n/a	n/a	n/a	0.866	n/a
Hospital discharge fundings (LA & ICB)	n/a	n/a	0.378	1.211	2.103
Sub total	5.878	4.737	3.306	4.893	7.288

The adult social care workforce

The Council works with Skills for Care to support participation in the Adult Social Care Workforce Dataset. This provides important information about some of the challenges in the Adult Social Care Workforce. My local area – Skills for Care website

This dataset is regularly updated and is based on the contributions of local providers. On a national level, Skills for Care has been able to provide an informative picture of the independent sector’s workforce and to identify some of the factors that impact on recruitment and retention of the skilled workforce which is needed to support people with social care needs. This shows:

• The sector has difficulty retaining younger staff. In turn, people are more likely to leave in their first year of employment. On the positive side, however, people with higher levels of experience tend to stay within the sector and those that have access to training are much more likely to stay in the profession.
• People are more likely to leave if they are on zero hours contracts.
• Workers recruited internationally are less likely to leave than domestically recruited workers.
• Higher CQC ratings are positively correlated with lower turnover, better pay, higher levels of staff undertaking learning and development and a stable registered manager.
• Reading does not face the same level of challenge as is experienced in rural areas. That said, the social care market must compete for staff with other industries such as hospitality and retail.
• Most care workers in the independent sector are female, with an average age of 44. Only 7% of the workforce are under 25 years and 46% are EU or international workers.

Independent sector workforce in Reading – Skills for Care (May 2024)

Nationality

• British: 55%
• EU: 13%
• Non-EU: 33%

Age

• Average age of a worker: 44
• Under 25: 7%
• Between 25 and 54: 68%
• Over 55: 25%

Gender

• 78% of the workforce were female
• 22% of the workforce were male

The Council supports the Ethical Care Charter and payment of the Real Living Wage to care and support staff – in 2024/25, this increased by 10.1% to £12.00 per hour -and is keen to develop and support initiatives to encourage people to work in care -such as learning and development and career progression. The Council has used DHSC Market Sustainability and Improvement Funding to support Providers in maintaining fair pay, has a strong training offer and has also established a Workforce Board to support both the professional (Social Work and Occupational Therapy) and Care workforces. Progress in this work has led to the development of a Workforce Strategy (our Strategy will be published in 2024/25), with engagement from a range of partners. In the meantime, the Council is working with Southeast ADASS group to share learning and develop new approaches collectively.

Independent sector workforce in Reading – Skills for Care (May 2024)

• 2,900 employees defined as workers employe don permanent and temporary contracts
• 31% of workers were employed on a zero-hours contract (or 1,200 filled posts)
• 2,800 full-time equivalent (FTE) filled posts – this is a ratio of 0.76

Employment status

• Permanent: 75%
• Temporary: 2%
• Indirectly employed: 23%

Working time

• Part-time: 29%
• Full-time: 71%

The Council continues to work with Providers to improve recruitment and ensure better training opportunities. Nationally, to ease recruitment pressures in the care workforce the Government enabled care workers to be recruited from abroad via the Skilled Worker Visa scheme. This scheme enabled some care agencies to recruit skilled overseas workers and has increased the number of available workers and improved market sustainability. The Council continues to work with Providers to navigate the complexity of international recruitment, ensure the wellbeing of overseas employees and to support good employment practice. The

(SESCA) has further information on their International Recruitment hub, as well as guidance and resources, and signposting to support services, to help Providers.

Independent sector workforce in Reading – Skills for Care (May 2024)

• The turnover rate was 32.6% (or 950 leavers)
• 7.4% vacancy rate (225 vacant posts)
• Vacancy trend increase of 7.4% from 2021/22 to 2022/23
• Turnover trend increase of 32.6% from 2021/22 to 2022/23

Where are we now?

Understanding the council’s adult social care teams

The council’s customer fulfilment centre

For anyone contacting the Council by phone on any matter, this is the first point of contact. Officers in the Customer Fulfilment Centre provide generalist advice, guidance and signpost people. If people need specialist advice and guidance, then they will be signposted to the Adult Social Care Advice & Wellbeing Hub.

The advice and wellbeing hub

For people in the community, this is the ‘front door’ to Adult Social Care. This team provides specialist advice and support, signposts people to services that can assist, and arranges early help to support independence and wellbeing. This may include short term support or specialist equipment. Adult Social Care have recently developed two pathways through the front door – the occupational therapy pathway and the social work pathway – so that people approaching Adult Social Care can be supported by the right team as quickly as possible.

Improving the experience of residents when they first contact the Council is a priority improvement area for the Council so that people can get the right help as quickly as possible. From Autumn 2024, the Hub will be supported by a Voluntary Sector partner – the Red Cross – who has been commissioned to provide early support and guidance and to liaise with the voluntary and community sector, in turn freeing up Social Workers and Occupational Therapists to focus on people with more complex needs.

During 2024/25, the Council will also be developing additional services so that people have the support they need to make links with the community provision.

Discharge to assess hospital discharge team

For people in hospital, their first contact with Adult Social Care may come through the Hospital Discharge Team. Supporting effective discharge from hospital is an essential part of any Health and Social Care system. The Hospital Discharge Team works closely with Health to support people to be discharged as soon as they are ‘medically optimised’ for discharge. Very often, people are supported to go home with reablement care to enable them to regain their independence. Some people may go to a more intensively supported setting whilst they continue their recovery and any long-term needs can be established.

Operational social care teams

For people who need a more intensive service, the Council has specialist teams with different areas of expertise and specialism. These include:

• Physical Disability & Older People
• Learning Disability & Autism
• Mental Health
• Review Team

Teams are made up of Social Workers, Co-ordinators and Occupational Therapists who carry out Care Act assessments and work with the person and their family to find solutions to meet care needs as well as providing follow up reviews to ensure that care is meeting need.

Safeguarding

Safeguarding is responsible for following up any situation where there is reasonable cause to suspect that an adult who may have care and support needs is at risk of/or experiencing abuse or neglect. The team works closely with other services, providers and other agencies – including the police – to ensure concerns are investigated and resolved. The Council is a member of the West of Berkshire Safeguarding Adults Partnership Board which ensures a co-ordinated and consistent response across Berkshire, ensures that risk of harm is minimised and increases awareness of safeguarding.

Safeguarding concerns can be raised by following the following link – Report abuse – Reading Borough Council

Commissioning

Commissioning is responsible for ensuring that services are available to meet the needs of Reading residents. This includes a wide range of services including home care, supported living, care homes, information and advice, advocacy and equipment. Responsibilities of the team include strategic oversight, procurement, contract management and quality assurance.

The Service has a lead role in market shaping, which includes engaging with Providers and residents to ensure that the services are available to meet current and future demand.

The Provider Quality Team within Commissioning works with Providers to monitor and improve the quality of care and support in the borough. The team carries out both planned and reactive Quality visits working closely with Providers, the Care Quality Commission (CQC), other local authorities and Health; as well as the Safeguarding Team.

Brokerage and direct payments

Once a person has been assessed and a personal budget for care and support has been agreed, the Brokerage and Direct Payments Team work with Providers, Adult Social Care and Commissioning to arrange care and support. As well as care brokerage, the service supports people to consider and access a direct payment, in turn, giving people more choice and control over their care and support. (This team was until recently known as the Personal Budget Support Team – PBST)

Client finance service

The Client Finance Service includes services which support people with lived experience with their finances. This includes the Financial Assessment & Benefits (FAB), Deputies, Direct Payment monitoring and Client Charging Teams. The service was established in April 2024 to improve overall strategic oversight of this area of work.

Emergency duty services

An out of hours Duty Service is provided on behalf of the Council and other Berkshire Authorities by Bracknell Forest Council. The Service, supports people in social crisis situations which require an immediate and/or urgent response. The role of the Service is to carry out an initial screening of the presenting situation and establish a safe and viable solution pending follow up by the appropriate local authority’s day time services. Approximately, 500 referrals from Reading service users are actioned by the EDS per month.

Working with our partners

The Council’s partnership with the NHS and neighbouring Local Authorities is a key enabler to the delivery of support to our community. We work with our partners in the Buckinghamshire, Oxfordshire and Berkshire West (BOB) Integrated Care System (ICS), linking policies, strategies and programmes with those at the Integrated Care System level. Whole systems integrated care is about ensuring every person in Reading receives person centred joined up health & social care services alongside relevant community partners.

Our aim is to increase access to quality and timely care, supporting people to be more independent in managing their conditions and becoming less likely to require emergency care. In turn this is about ensuring that people get the support they need, from the most appropriate service when they need it.

Notably, we work with:

• Primary Care Networks – 17 Primary Care Networks represent 43 GP Practices across Berkshire West.
• Royal Berkshire NHS Foundation Trust which provides acute hospital care at the Royal Berkshire Hospital in Reading and Berkshire; and
• Berkshire Healthcare NHS Foundation Trust who provide a wide range of community health services – including the Community Team for People with Learning Disabilities (CTPLD), the Mental Health Integrated Community Service (MHICS) which focuses on recovery and resilience, and inpatient care at Prospect Park Hospital in Reading for people who need intensive assessment and treatment.

A very important area of focus is supporting people who have needed hospital treatment to get home as quickly as possible. Not only is this the best way of ensuring that people return to independence, but it also means that specialist hospital beds are available to support people who need intensive health treatment.

The Improved Better Care Fund

The Reading Integrated Care Board brings together key partners to ensure effective joint working and strategic planning. The Improved Better Care Fund (IBCF) is a partnership between health and social care with a pooled budget for meeting the challenges of integrating health and social care in England to keep people healthy for longer and reduce unnecessary hospital admissions. Reading’s BCF funding contributes to services such as the Council’s reablement service and our hospital discharge Team, it is also used to fund falls clinics and the care home support Team, who work with care home staff to build their skills, knowledge, and confidence in the vital work they do to improve the wellbeing of care residents.

Our current provision

Services in Reading are delivered both by the Council itself (‘Internal Services’) but also commissioned by the Council from other providers, including local and national businesses, charities and the Voluntary & Community Sector. This diversity of provision maximises choice available to people choosing care services, whilst driving efficiency and reducing the risk of market failure. The intention of our provision is to meet the needs of residents and to support the delivery of our overall strategy and vision – to support people to realise their potential, be independent and live in their own homes for as long as possible whilst ensuring that intensive support is available for those that need it most.

Over the next 3 years, the Council will be moving its Internal Services to more modern and purpose-built buildings. This will improve and extend the current Internal offer. We remain committed to a mixed care economy and have no intention to outsource or close any of our existing internal services. We also remain committed to working in partnership with external providers to deliver a broad range of services to Reading residents.

Reading has adopted the 3-conversation model of assessment and care planning. The model focuses on people’s strengths and supports care professionals to have three distinct and specific conversations about needs and care solutions with a view to increasing self-sufficiency and reducing long-term care packages.

The first conversation is designed to explore people’s needs and connect them to personal, family and community support that may be available.

The second, service user led, conversation seeks to assess levels of risk and any crisis contingencies that may be needed, and how to address these.

The third and final conversation focuses on long-term outcomes and planning, built around what a good life looks like to the user, and how best to mobilise the resources needed and the personal and community assets available. If people need long-term support they will be allocated a Personal Budget. This may be used to purchase services to meet their needs or can be taken as a Direct Payment if people want more control.

This approach to assessment focuses on people’s strengths, capabilities and the potential of their informal support networks alongside their needs and the risks they may face. It ensures that things that are important to people are considered and promotes individual wellbeing. It encourages individual resilience and helps to promote self-reliance and independence, as well as ensuring that the services commissioned reflect what the people who use them want as well as need.

Early help, enablement and reablement

Prevention and early intervention are key to reducing long term poor health and wellbeing. By shifting our approach away from treating ill-health to preventing it from happening in the first place, we can contribute significantly to reducing physical and mental ill-health.

Working with the voluntary and community sector

Closing the gap

The Council’s ambition is to provide information and advice and enable people to receive early help and reduce the risk that they lose independence. A key element of this is recognition of our community assets and partnership work with our VCS. Local organisations support people to be physically active and connected with their communities – including those with long term health conditions, those who may need extra support as they get older, and people who provide unpaid care to friends, family and neighbours.

In 2021, the Council commissioned Closing the Gap – a programme of services jointly funded by Public Health, the Council, Health and others and provided by the VCS to support local residents. This programme piloted a fresh approach to commissioning; allocating funding using an outcomes-based approach and asking organisations to use their grass roots knowledge, skills and creativity to design proposals which would achieve three key outcomes:

Outcome 1: To support people to get out and stay out of poverty.
Outcome 2: To build resilience, independence, and well-being, connecting people to support and focusing on individual and community strengths.
Outcome 3: To invest in VCS infrastructure support.

Following a successful procurement, several VCS organisations were awarded contracts starting 1st November 2022 to 31st October 2025, to work together and meet identified outcomes. This portfolio of provision includes infrastructure support for the wider VCS, provided by Reading Voluntary Action and the Tackling Poverty Partnership which provides advice and guidance for people in financial difficulty; as well as a range of services to support the wider population.

Carers information, advice and guidance and carers grants

Caring can be rewarding but it can also be demanding, both physically and mentally. This can have a huge impact on a carer’s own health and wellbeing. The Council offers carers assessments to focus on how caring affects a carer, and any help, advice or guidance needed to support carers in their caring role and protect their health and wellbeing.

The Council works in a partnership with West Berkshire Council through the Reading & West Berkshire Carers’ Partnership, which is comprised of four commissioned local charities: Reading Mencap, Age UK Reading, Age UK Berkshire and CommuniCare. Between them they offer information, advice, and support to people throughout Reading and West Berkshire who are caring for a child or adult family member, partner or friend who needs help because of their illness, frailty, disability, a mental health condition or an addiction and who cannot cope without their support.

The Carers Partnership carry out carer’s assessments as well as offering advice and guidance. They also help carers to find and utilise grants to help them maintain their caring role. Usually, grants will be for an item of household equipment or a grant to take part in some training, exercise, or for a short break from their caring role.

In June 2024, the Council agreed its new ‘Joint All Age Carers’ Strategy – 2024-2027’ to support unpaid carers and is keen to work with unpaid Carers in Reading to ensure that the range of services meets the needs of residents.

Local connectors and the front door

The Council has commissioned the Red Cross to work alongside the Adult Social Care Advice & Wellbeing Team, providing a first point of contact service for people seeking support from Adult Social Care. The focus of this ‘Local Connector’ service (to start in October 2024) will be to provide early support to people and/or to signpost people to the right place so they can get the advice and support they need. The intention of the service is to give people the best chances of staying independent, as well as to link people to the community drawing on the skills and expertise available in the VCS and beyond. The Local Connectors service will be expanded in 2024/25 to provide Community Navigators who will offer a community-based presence for people who need more support to connect with local groups and services.

In recognition of the significant contribution to wellbeing which is offered by a strong VCS, the Council has a dedicated officer working with the VCS and in 2023 agreed a Compact to support effective working – Voluntary and community sector compact 2023-25 – Reading Borough Council

Reablement and enablement

Reablement and Enablement are essential components of our strategy to support people to be as independent as possible. It is goal-focused, short-term and enables people develop new skills or to regain independence and wellbeing after illness or disability.

We provide reablement through our integrated Community Reablement Team (CRT) which provides support to people who are being discharged from hospital after ill health. This service is provided in partnership with Health to provide an enhanced holistic reablement service to promote independence. Support is provided by reablement support workers, Occupational Therapy, Physiotherapy, Nursing and Community Psychiatric Nursing and offers short term intensive support and therapy to people in their own homes to help them regain all, or most, of their independence following an illness or injury.

In addition, the Council has commissioned reablement support from some providers on our Home Care and Supported Living Frameworks to supplement the CRT offer. A mental health project, working with care providers and Compass Recovery College has been particularly successful in supporting people with poor mental health to gain or regain their independence and reduce their long-term reliance on adult social care services. This support has been provided to people in the community and those being discharged from Prospect Park Hospital following a period of acute mental illness. We are also seeing very positive outcomes from enabling approaches with people with learning disabilities and autism.

As well as community-based support, we provide accommodation based reablement support in one of our extra care housing schemes, as well as a Discharge to Assess service in a local Care Home. These provisions ensure prompt hospital discharge for people when they are ‘medically optimised’, enabling more complex needs to be met in a better suited environment than hospital and supporting people to have somewhere to go for their reablement when their home care packages and any equipment they will need is set up in their home.

Collectively, our Reablement and Discharge to Assess services all contribute to a faster recovery time for people, ensuring the most independent care is given, but also help to ensure that hospital beds are freed up for people who need them as soon as people are optimally ready for discharge. Timely discharge supports recovery and gives people the best chance of getting well and regaining their independence.

We strongly encourage a reablement and enablement ethos from all providers and ask that providers are continuously sighted on how they can support people to be more independent.

Assistive technology and Technology Enabled Care (TEC)

Assistive Technology is another critical component of the Council’s strategy to allow people to maintain independent for as long as possible.

Assistive technology (also known as telecare and Technology Enabled Care or TEC), and equipment can be extremely useful in supporting people to live well, manage conditions, maintain independence, and delay or reduce the need for support. The healthcare market has grown exponentially and there is a vast array of equipment and assistive technology solutions available to meet all sorts of need.

Assistive technology can be used in the community, at home or in other settings such as care homes, where devices can monitor multiple residents’ movements. Adult Social Care and Health services primarily use equipment such as pendant alarms, bed, chair and door movement sensors and automated medication devices. Bed and chair sensors can be used to alert an allocated person if someone stands up or gets out of bed but does not return within a certain amount of time. Movement and door sensors can alert the designated person if someone is moving around and needs attention, or if they leave their home where it may be unsafe for them to do so alone.

In care homes, devices like this can reduce the number of times that staff visit people at night, reducing interruptions and also allowing staff to focus on other tasks. Care homes in Reading can approach NRS Healthcare to directly rent assistive technology and all other equipment to enable them to meet their CQC registration.

We are very ambitious when it comes to using TEC and Artificial Intelligence (AI) to improve our social care offer. We are currently working with the Department of Health and the University of Reading to evaluate the impact of innovative assistive technologies to support our residents, manage increasing demand and complexity of need. Our Independent Living Care Technology Solutions Project is working with people across Reading to test the capability of TEC and fully understand its potential across Adult Social Care.

Supporting people at home

When people need ongoing support, our aim is to enable people to live in their own home for as long as possible. In addition to early help and preventative services, we also provide a range of services which enable people to live in their own home whether this be as an owner occupier, a tenant or in their family home.
Commissioned services include home care, extra care housing, shared lives and supported living. We also commission respite services, supported employment and day-time opportunities which support people to stay well and have an active life.

Whilst some people will receive support provided by the Council, other people opt for a Direct Payment which gives them greater control over their care and support arrangements. Some people who choose a direct payment do use agency services, but others employ personal assistants. The Council is keen to promote Direct Payments as this can give people more control and say over their day-to-day support.

The Care Quality Commission (CQC) register, regulate and rate all Providers who deliver personal care. Within the Borough, 58 services are registered to provide personal care in people’s homes. 30 are rated Good, 9 are rated as Requires Improvement, 1 is rated as inadequate and 18 are yet to be inspected. The Council does not commission services from all providers in the Borough but under the Care Act 2024, we have Safeguarding responsibilities and provide Quality Support to under-performing Services in the Borough.

Home care

Home Care is provided to people in their own homes and may include support with personal care, day-to-day household tasks, or any other activity that allows people to maintain their independence and quality of life.

Most home care purchased by the Council is provided to people over 65 years (81%). Home Care calls are delivered in the comfort of peoples own homes with people receiving up to 4 calls a day depending on their needs. A small proportion of care is double handed, requiring 2 care workers, however, our aim is to reduce the number of these care packages through use of new equipment and training.

Within the home care market, 34 Providers are ‘actively’ working in Reading. The Council also works with a further 7 agencies which are registered outside of the Borough in other Local Authority areas. Some of the 41 Providers deliver exclusively to people who arrange and pay for their own care (often called self-funders). Others operate across self-funder and local authority markets.

The Council operates a framework contract for the supply of home care. 16 Providers work on the framework which has 2 tiers. Tier 2 means the providers have met the minimum quality requirements the Council set for entry to the framework and Tiers 1 providers exceeded the quality thresholds and these providers represent the best quality.

The framework operates a fixed hourly rate of £23.16 per hour (2024-2025). This rate was established through a competitive procurement process. Inflation has been paid each year to ensure that the rate remains competitive, and we have been informed by cost of care exercises completed in 2021.

The Council will be refreshing its Home Care Framework with the new Framework starting in April 2026. The new framework will operate similarly to the current framework but with a greater focus on reablement and enablement and a more standardised approach to quality monitoring with the removal of Annual Quality Assessments in favour of our quality framework approach.

The framework offers a choice of Providers across the Borough with a mixture of both local Providers and national franchises. The framework meets current demand, and spot purchasing is very minimal. Support packages are usually picked up quickly and delays are rare.

Supported living

Supported living is a service where accommodation is provided alongside support to help people live as independently as possible in the community. Supported living is provided in shared accommodation as well as individual flats (often part of a block) but also as floating support. Whilst we recognise that some people will need support throughout their lives, we strongly encourage supported living providers to enable people to build their skills and move towards greater independence.

We are very interested in working with Providers which have a strong enabling ethos, who will work with us to support people to be as independent as possible, with choice and control over their own lives.

As with home care, the Council operates a framework contract for the supply of supported living. All framework providers are CQC registered and have an Annual Quality Assessment which informs a tiering system whereby tier 1 Providers can be offered work before tier 2. The Council has 18 Providers on the Supported Living framework. 6 of those Providers are on tier 1. These providers will be offered work before tier 2.

At present, 75% of care packages are picked up by framework Providers and the remainder are commissioned under spot contracts. The Council has its own internal provision supporting people who are recovering from mental health issues. People are supported to live more independently and to take control of their life. Support is provided across several Council-owned properties with an outreach provision. In total, the Council works with 47 supported living Providers.

The Council commissions packages of care both in and outside of the Borough. If people move outside of the Borough (and beyond Greater Reading), this tends to be for personal reasons – some to be closer to friends and family and some because they can no longer live in Borough. We are aware that some people have moved out area because their needs are more specialist and complex and it was not possible to meet their needs in Reading at the time that they needed support. For the future, we want to ensure our supported living providers are well placed to support people with complex and specialist needs. There is a good supply of shared properties in the borough but would like to develop more self-contained accommodation (e.g. flats as part of a block).

Reading also purchases floating support. This service may be provided to people living in the community. Support may be housing related where assistance is provided to maintain a tenancy or a dwelling (e.g. paying bills or keeping a dwelling tidy) but it may also be to tackle social isolation. As none of the support is of a personal care nature, the Providers that assist maybe charities or private Providers and do not need to be registered with the Care Quality Commission.

The Council will be refreshing its Supported Living Framework with a new Framework commencing in April 2026:

We want to work with Providers with a strong enablement ethos and an outcome focus, who will strive to support people to reach their potential and gain greater independence. We have already seen the fantastic outcomes this can achieve for people.

• We want to work with providers who can offer flexible services, where levels of support can flex to meet changing needs.
• Please note, as mentioned above, there is a good supply of shared supported living accommodation in the Borough, but we are interested in working with housing providers (particularly Registered Housing Associations) to support the development of self-contained accommodation.
• We are also working with our neighbouring authorities and the NHS to look at the option of a jointly commissioned supported living framework to meet the needs of people with complex, intensive and specialist needs. This may include people whose behaviours can put themselves or others at risk, need specialist accommodation or to be supported by a staff team with a higher level of skills.
• We would like to consider the options of increasing the availability of floating support to keep people safe in the community and ensure they maintain their independence.

Shared lives

The Council runs its own Shared Lives Service. This service matches people who need care and support with an approved carer who in turn shares their family and community life and gives support to the person with care needs. Some people move in with their shared lives carer, while others are regular day time visitors. Shared Lives is an alternative both to supported living but also traditional kinds of care, such as care homes.

Extra care

Reading has a long and strong commitment to Extra Care Housing which provides an alternative assisted living option. People can buy or rent a flat within a fully disabled adapted housing scheme that also has a 24-hour care presence available on site. Extra Care can be a positive choice for people who are unable to manage or maintain their own properties, enabling them to maintain their independence, future proofing accommodation choices and ensuring that care is available when they need it.

There are 7 Extra Care schemes in Reading providing 415 1- & 2-bedroom flats for residents who are mostly aged 55+. Schemes are well spread across the Borough with 3 schemes in Tilehurst in the West of Reading, 3 schemes in the South of Reading in Southcote, Whitley and Green Park and 1 Scheme in the North of Reading in Caversham. The range of Extra Care Housing in Reading has supported the Council to reduce the numbers of people going into care homes before they need to and have ensured more older people can get a high level of care in a home of their own.

The Council commissions care and support for 6 of the Extra Care Schemes –Cornerstones, Chimney Court, Beechwood Grove, Oak Tree House, Cedar Court and Huntley Place – and directly provides care and support at the 7th Scheme – Charles Clore Court. As well as a core support offer in each scheme the commissioned provider will usually provide 1:1 care and support for people who need this.

As with all our services, we want to work with providers with a strong reablement and enablement focus, who will support people to regain and maintain independence and enable them to live well into older age.

We are particularly interested in exploring how we can extend the benefits of Extra Care Housing to more Reading residents, recognising the importance to residents of the community the schemes can offer.

Day time opportunities

Reading offers a variety of activities and opportunities for adults of all ages to support quality of life and promote mental wellbeing and good health. This ranges from facilitated social groups and community-based activities to fully supported day activities. The range of provision has grown in accessibility and is instrumental in helping manage and meet current needs. Services support people to live independent and fulfilling lives, help them to maintain a healthy lifestyle, and promote and enhance effective personal support networks. This supports the Council’s commitment to helping people live an independent life at home and be socially included within their local communities.

The Council directly commissions or provides support to around 100 people from several local organisations in and around Reading which offer daytime opportunities. Around 75% of people who attend day services to meet an assessed care need are people with learning disabilities.

The Council runs its own day services:

The Maples: A fully supported day service for older people who require support to take part in social and leisure activities. The service currently offers a building-based service which is delivered from Cedar Court in Whitley as well as an Outreach service which is a community-based service delivered from people’s homes.

Strathy Close: A day service for people with learning disabilities who need a high level of support.

Both services will move to a new building in the next 2-3 years which will offer greater capacity to meet needs.

In addition to commissioned services, some people choose also to use direct payments to benefit from the support on offer. Some of the Extra Care schemes also run day service opportunities aimed primarily at people aged 55+ through activity afternoons or lunch clubs.

The Council provides workshops and social groups for people who may be affected directly or indirectly by mental health or wellbeing challenges through the Compass Recovery College.

The Council will be reviewing its approach to daytime opportunities over the next 18 months (to March 2026) and we are committed to working with our community services and voluntary sector to enable a range of purposeful and meaningful activities. We are working to ensure all our local communities have access to daytime opportunities including people with support needs, mental health conditions and learning disabilities. We will continue to have work with residents to understand how best to offer a wider range of activities and more flexible ways of using services.

Supported Employment

Employment has multiple benefits for people’s health and wellbeing. Supported Employment is a model for supporting people with significant disabilities to secure and retain paid employment. The model uses a partnership strategy to enable people with disabilities to achieve sustainable long-term employment and for businesses to employ valuable workers.

We have recently commissioned a new Provider to support people into employment. This service will commence in Summer 2024. We will be monitoring the benefits of this service closely over as we may wish to extend this provision.

Respite

Respite Services offer a break in caring responsibilities for unpaid carers as well as an opportunity for people to spend time away from home. There are a lot of options for providing respite depending on the need and this is an essential service in enabling unpaid carers to carry on caring and families to stay together.

The Council provides respite through Shared Lives and through its own centre at Whitley Wood Lane. This centre supports up to six people with learning disabilities or autistic spectrum disorder at a time. People stay at the service for short periods, depending on their need. In the next 2-3 years, the centre will be moving to a new building. This will enable the centre to support more people and will extend the range of services on offer.

The Council also commissions from independent providers as and when the need arises. For people who are more independent, needs may be met through the provision of Day Services or a home care visit. For people with more complex needs, a short-term stay in an extra care scheme or a care home can be arranged.

As part of the new Carers Strategy, the Council will be refreshing its commissioning intentions to support culturally appropriate carers breaks over the coming year. The Council is also working with partners across the BOB Integrated Care System to commission a carers break service for Reading, allowing adult carers to have time for themselves.

Residential and nursing care homes

The Council’s ambition is to support people to realise their potential, be independent and live in their own home for as long as possible. This may include living in your own home with home care, or in supported accommodation (such as supported living or in Extra Care Housing) with support. Living in your own home promotes independence, wellbeing, choice and control and we will always work with people and their families to fully explore how people can be supported safely at home before considering care home options. That said, some people will need a higher level of care service that cannot be provided safely in the community and the Council has a responsibility for ensuring that intensive support is available for those that need it most.

Care homes provide accommodation and personal care services to people who need extra support and are no longer able to manage independently. Residential care homes offer a safe environment where people can receive support, personal care and participate in activities. Nursing Homes offer a higher level of care for people with greater needs. With higher staffing ratios and qualified nurses on staff, Nursing Homes are able to meet medical needs as well as personal care requirements.

We know that most people and their families want to remain local when their relative moves into a care home and we aim to support people to use local care homes wherever possible. As a small borough, however, this is not always possible, and some people are living in care homes in Greater Reading and some further afield.

41% of people in Residential Care Homes and 20% of people in Nursing Care Homes are placed outside of the Reading Borough.

There are 33 registered care homes in Reading – all are registered with CQC. 14 are designed to care for older people, 17 for people with a learning disability, 1 specialises in mental health services and 1 for the care of younger people with a physical disability. These homes provide:

• 469 nursing beds within 6 nursing homes, 4 of which provide dementia care
• 105 learning disability beds
• 16 beds for people with a mental health disorder
• 323 beds for older peoples’ residential care – including support for people with dementia

Of the 33 registered care homes. 2 are rated as Outstanding, 20 are rated Good, 8 are rated as Requires Improvement and 3 homes are yet to be inspected.

The care home market in Reading is stable with only 1 care home closing in the last 5 years and 2 new care homes opening. At present, overall occupancy across care homes is 93%. Around 30% of beds are purchased by the Council; 39% are purchased by self-funders and 20% beds by other commissioning authorities. 7% of the maximum capacity is vacant although 4% of beds are not presently available due to building work.

As stated above in the Reablement section, care homes play an important part in making sure hospital discharge is carried out quickly and effectively, helping people to receive the best quality of care they can whilst ensuring effective management of overall System pressures.

The Council commissions care for 254 people in Residential Care Homes. This includes 133 people over the age of 65; and 121 adults of working age. Many older adults in Residential Care are living with dementia and it is this which has made it very difficult to continue living in their own home. Of the adults of working age who are living in Residential Care, 92 people have complex and significant learning disabilities. Whilst we recognise that Residential Care is an appropriate option for some people, we are keen to work with supported living service providers to support people with more complex and specialist needs to live in their own home.

The Council commissions care for 183 people in Nursing Care Homes. This includes 153 people over the age of 65; and 30 adults of working age. Older adults in Nursing Care may be receiving this level of support because of significant health and social care needs or because their lives are very significantly impacted by dementia. Of the adults of working age, 20 people need significant support with their health or a physical disability. As stated above, we are keen to work with providers to support working age adults to live in their own homes as an alternative to Nursing Care.

At present, we predominantly spot purchase care home placement and we have agreed fees with most of our local care homes. We do have 4 block contracting arrangements in place in Reading which include arrangements for:

• 38 Nursing Care Home beds (End date
• 12 Nursing Dementia Care Home beds
• 15 Residential Dementia Care Home beds
• 4-6 ‘Discharge to Assess’ Nursing Care Home beds

Our needs analysis indicates that we have a growing requirement for Nursing Dementia Care Home support to meet the needs of an aging population. We anticipate commissioning up to 20 additional Nursing Dementia Care Home beds during 2024/25.

Alongside the need for Nursing Dementia, we are also keen to work with services that can provide bespoke and specialist care solutions when needed. At present bariatric care is provided by care homes whose structure and design makes them large enough to cater for equipment that is larger than normal. However, no service within the Borough currently has an area within its home designed specifically with bariatric care in mind. Equally, there is a need for care home services that can support people with a combination of dementia and mental health needs that means they are both physically active but can with behaviours that can place themselves or other at risk. As only as small number of people need this type of support, we are working with neighbouring authorities and the NHS to explore joint commissioning opportunities.

86% of dementia placements are made within the Borough. 80% of nursing placements are made within the Borough.

Other services

Advocacy

Advocacy in social care is provided by organisations that are independent from both the local authority and the NHS. Advocates are trained to help people understand their rights and to help them express views and wishes and to help make sure their voice is heard and their choices are known and respected. The Council commissions the Advocacy People to provide statutory advocacy support. This includes Care Act Advocacy, Independent Mental Health Advocacy (IMHA) and Independent Mental Capacity Advocacy (IMCA).

Healthwatch

Local Healthwatch organisations are a statutory service commissioned by local councils as part of the Health and Social Care Act 2012. They are funded by and accountable to local authorities. The aim of local Healthwatch is to give people and communities a stronger voice to influence and challenge how health and social care services are provided within their locality. Their main statutory functions are to obtain the views of people about their needs and experience of local health and social care services, and make these views known to those involved in the commissioning and scrutiny of care services.

Healthwatch Reading is run by The Advocacy People. The service was commissioned by the Council in June 2022 for a period of up to 5 years. As a consumer champion, Healthwatch Reading has an important role in encouraging people to have their say and challenge local services.

How does the council work with providers

The Commissioning Team

The Commissioning Team was restructured in April 2024 to support a transition from transaction-based commissioning to a stronger focus on strategic commissioning. The team is split into 5 areas:

Living Well

Manages contracts and commissioning for services for 18–64-year-olds. This team is responsible for developing supported living and day services and strategic oversight of services for people of working age. Team members are developing specialisms to enhance strategic work in these areas this includes a named workers for Transitions, Learning Disabilities and Autism and Mental Health.

Ageing Well

Manages services for those who are aged 65 and over. This team works closely with residential and nursing care homes in the area. They are responsible for market oversight and strategic development of Discharge to Assess services, Extra Care and Home Care to work with Operations Teams and Providers to support people to stay at home where they can.

Staying well

Is responsible for preventative services and works closely with partners to develop and maintain our prevention agenda and voluntary sector offer. This Team works closely with Public Health and Front Door to ensure seamless working and that we are all working together to achieve outcomes that enable people to be independent for longer.

Quality & contracts

Oversees care quality and contracts across commissioned services. The team lead on quality monitoring. They work in partnership with (but not limited to) Safeguarding and Providers to gather and share intelligence where applicable, undertake due diligence checks, risk assess providers, oversee improvement plans, and maintain good governance over the local adult social care market.

Access to resources

Covers Brokerage and Direct Payments Set-up. Brokerage source care placements and care providers, amend care packages, ensures sign offs, produce purchase orders and deal with provider payment issues. They are the central pin between operations and Providers to ensure contract compliance, value for money and procurement processes are followed. The team also supports people who want a direct payment and are responsible for supporting people and Operations Teams in the promotion, set up and amending of direct payments.

Our Approach

Our approach to Commissioning broadly follows the principles of the Institute of Public Care Commissioning Cycle (IPC, 2008).

Strategic oversight

When planning Services, we analyse information about needs, available budget, and our strategic intentions to inform our commissioning. We use information about what has worked previously – both in Reading and in other areas. We also seek to engage with Providers and people with lived experience of care, families, and unpaid carers and explore opportunities for Joint Commissioning with Local Authority partners and the NHS.

Working in partnership with Providers is important to the Council and there are several ways we achieve this. We host regular Provider Forums to share best practice, discuss local or national changes that may impact service delivery, and to facilitate better working across health and social care. We also host focus groups to gather feedback on specific issues. We want to see our approaches to engagement and co-production grow and develop and you should expect to see us looking for more opportunities to work with the people we support, families and providers in the co-design and co-production of future services. We also encourage this approach from our Providers as we believe that working in partnerships creates more effective services. We encourage good communication from our Providers and strive to offer the same.

Procurement

When purchasing services, as a Public Sector organisation, we must follow the rules for purchasing laid out in the Public Contracts Regulations 2015, the soon to be published Public Contract Regulations 2024 and our own contract procedure rules (CPR) laid out in the Council’s constitution. These rules stipulate that certain practices must be followed depending on the value of the services being purchased. As well as demonstrating your ability to deliver Services efficiently and effectively, we will also drive social value in our procurement and contracting to support a more inclusive local economy. More information is available here – Social Value Policy -Reading Borough Council.

We use an e-tendering system called In-Tend. Providers wanting to contract with the Council are encouraged to register on In-Tend so they are aware of current and future business opportunities.

Contract management

The Council seeks to develop a fair and effective contract management approach with all Providers who provide Services to the Council. The aim of contract management is to ensure that outcomes are being met, service quality is good, and that Providers are stable and can manage unexpected challenges to their business continuity. We also seek assurance that public sector funding is being used effectively to meet the needs of residents. Whilst our expectations of Providers are high, we also aim to be supportive and will fairly work alongside Providers to address issues of concern. We expect our Providers to do the same. We are presently refreshing our Contract Management Framework.

The Council supports The Ethical Care Charter and when we contract with providers, we will, wherever possible, encourage the use of permanent employment contracts and the use of zero-hour contracts only when permanent contracts are not appropriate or where an employee has specifically requested a zero-hour contract. The Council also became an accredited Living Wage Employer The Living Wage Foundation and is committed to promoting and requiring, to the extent permitted by law, that staff working for the Council’s contractors are paid an hourly rate no less than the Real Living Wage. Through commitment to these ideals the Council is supporting the care workforce and improving staff retention for Providers in the market.

Quality assurance

Our Quality Team makes regular visits to local services and will work with others including Safeguarding, the Care Home Support Team, CQC, health colleagues and our neighbouring Local Authorities to encourage good quality. If we have cause to be concerned about the quality of provision, we will address this with the Provider. We have a Provider Concerns Process and will ‘flag’ providers if there is a significant level of concern. A red flag indicates a ‘Serious Concerns’ and that new placements should not be made until issues have been resolved; an amber flag indicates issues with the ‘Standard of Care’ and that placements can be made, but with caution. We will actively work with Providers to improve Services as quickly as possible. Our expectations of Providers are high, but our aim is to be supportive and work alongside Providers to promote good quality across Reading.

The Council offers a range of learning options to support the local social care workforce, delivered as a mix of classroom training and online/virtual delivery. Our priority is to support Reading based organisations or those who have a social care contract with the Council. Further information on available training opportunities can be found here Adult Social Care Training.

Our approach to fees and funding

When Commissioning services, it is essential we make effective use of Public Sector funding. Our aim is to pay a fair price for services, and we expect providers to keep costs as low as possible, to be efficient and to look for ways to support people well, whilst making good use of resources. This links also to our preventative, reablement and strengths-based ethos and we encourage Providers to work with us and be innovative in how we support residents; for example, by looking at how we can increase independence and reduce reliance on paid support through skilled and effective support and the use of equipment and assistive technology. Alongside this, we aim to ensure that the price we pay for care is fair and sufficient so that Providers for example can pay the Real Living Wage and recruit and retain staff. Over the past 3 years, we have used DHSC Market Sufficiency and Improvement Funding to support Providers. For further information on our 2022 Cost of Care and Market Sustainability Plan see here – Social Care Reforms: Fair Cost of Care Reports and final Market Sustainability Plan

Without doubt, there will continue to be a strong focus on Public Sector funding over the coming years and it is essential that Commissioners and Providers work together to make effective use of funding.

What next?

Opportunities

The following information outlines future opportunities that the Council is likely to need fulfilled to address gaps in provision or renew existing service agreements whilst testing the market for best value and quality.

All opportunities are provided as a guide only and may be subject to change.

Service requirement	Opportunity	Guide price (indicative only)	Guide dates (indicative only)
Supported living framework	An opportunity for all care providers that are registered with CQC for personal care and supported living to apply to be part of the Council’s supported living framework. Being part of the framework gives providers the opportunity to do business with the Council for supported living services and the ability to bid for packages of care and support that the Council is tendering out to the market.	£30,000,000 (over 3 years) – The Council usually requests 2 new packages of support each week.	New framework by march 2026.
Specialist supported living framework	An opportunity for all care providers that are registered with CQC for personal care and supported living to apply to be part of the Council’s specialist supported living framework. Being part of the framework gives providers the opportunity to do business with the Council for supported living services and the ability to bid for packages of care and support that the Council is tendering out to the market. The specialist framework will be for those packages of care that are for individuals with especially complex care needs that may require providers to supply additional staffing above and beyond what is normally required or have specialist training to enable care provision.	To be confirmed	To be confirmed
Home care support framework	An opportunity for providers of home care services to be considered for the Council’s Procurement Framework for all home care packages of care.	£21,000,000 (over 3 years) The Council usually requests 15 new packages of support each week.	New framework by March 2026.
Nursing dementia care home beds	The Council is looking to secure nursing dementia care home provision within the local area to ensure that there is sufficient bed capacity available to meet current and future nursing dementia care home needs. An opportunity for Providers registered with CQC to provide nursing dementia care home services to bid on a block contract for up to 20 nursing dementia beds that will be tendered out in 4 block contracts.	To be confirmed –in the region of £2.9m + Funded Nursing Care (over 3 years).	To be confirmed –likely new provision by April 2025.
Extra care housing schemes	An opportunity for care providers registered with CQC for personal care to become the care provider within the 6 Extra Care schemes across the borough. Care Providers will be able to provide commissioned care throughout the day to residents living within the schemes as well as Waking night care and an element of floating support.	£3,300,000 (over 3 years)	May 2025 (may be extended)
Carers breaks	Ease the strain of unpaid caring by enabling carers to take breaks and to participate in activities which may ordinarily be difficult because of their caring role. Jointly commissioned service using Accelerated Reform Funding.	£180,000 (over 3 years)	September 2024
Direct payments pre-paid cards	An opportunity for providers to supply the Council with Pre-Paid Card services. This product is designed to support people to directly manage their personal health budgets. cards operate in a similar way to normal credit and debit cards except that funds are preloaded onto the cards by the Council and then spent by the cardholder until the balance is exhausted. As they do not incorporate a credit facility, the cards cannot become overdrawn. The service will also provide effective monitoring of how money is spent as all transactions are recorded electronically and details are available for to the Council for analysis.	£50,000 (over 3 years)	September 2024
Voluntary and community support sector – infrastructure support	An opportunity for a provider or group of providers who work in the Voluntary and Community Sector to bid on and if successful offer infrastructure support to the wider sector, in order to increase resilience and extend reach so that the sector is able to provide flexible, effective and accessible support for our most vulnerable residents.	To be confirmed	New arrangements from 1st November 2025
Services to support people to get out and stay out of poverty	An opportunity for a provider or group of providers working with the Voluntary and Community sector to bid on and if successful, support people to get out and stay out of poverty through debt management services, support in managing and maximising residents’ income, and addressing barriers to learning, wellbeing, employment and generational poverty.	To be confirmed	New arrangements from 1st November 2025
Preventative community services to support disadvantaged group	An opportunity for a provider or group of providers working within the Voluntary and Community sector to bid on and if successful deliver a range of preventative services which build resilience, independence, and well-being; connecting people to support, and focusing on individual and community strengths.	To be confirmed	New arrangements from 1st November 2025
Front door – community navigators	A Service to provide support to people to connect to community provision.	£400,000 (over 3 years)	To be confirmed –April 2025
Day opportunities framework	An opportunity for providers of day opportunities to be considered for the Council’s Procurement Framework for all day opportunity packages of care.	To be confirmed	To be confirmed – September 2025

Further information

People at the heart of care

The white paper setting out proposed government reforms for social care in England.

Berkshire West Health and Wellbeing Strategy (HWBS) 2021 – 2030

Our joint strategy designed to drive real change on the underlying causes of poor health and wellbeing across the West of Berkshire.

Reading Borough Council Corporate Plan 2022 – 2025

Our Corporate Plan tells the Council’s story – both what we have achieved and what we hope to achieve in the year ahead.