Age Well

Prevention and early intervention

We want to support more older people to live a great life at home and in their community for as long as possible.

Living independently at home for longer means people get to continue to live their lives with the things, people and places they love. When more support is required, it will start with a conversation about what makes a great life for them and there will be just enough of the right kind of support to enable them to keep living the life they want.

By taking this approach, we aim to enable people to be healthier and happier at home and in doing so prevent, reduce and delay the need for them to need longer-term care such as residential or nursing care.

Where we are

Over the last five years, the Council has invested consistently in preventative services such as:

• Technology Enabled Care
• Community equipment
• Falls prevention
• Home improvement
• A range of early intervention and prevention services provided by the Community and Voluntary Sector.

	18-19	19-20	20-21	21-22	22-23
Prevention spend ‘000s	£4,786	£4,786	£4,786	£4,786	£4,786

5 years spend on Preventative services

We have been piloting a new approach to adult social care since 2021. Community Led Support is a strengths-based approach which looks at someone’s need differently and with a different conversation about the things that makes someone’s life good. The idea is that care and support should enhance those aspects of a person’s life and not create a dependency.

As part of Community Led Support, we have established ‘Let’s Talk’ zones in locations throughout the borough. The ‘Let’s Talk’ zones offer people the opportunity for an early conversation with professionals about things that might be impacting on their quality of life and be sign-posted to help and support without the need for a social care assessment. The main topics of conversation have been about housing related matters, people’s mental wellbeing and financial concerns.

Where we want to be

In five years’, we expect there to be more people living a great life at home, in their community with the people and things they love. Over the next five years we will do more to prevent, reduce and delay the need for more formal care and support so people can continue to enjoy their lives at home for as long as possible.

We will grow the number of ‘Let’s Talk’ sites across the borough so that we can help more people earlier with a broad range of support from universal and preventative services.

We want to see a growth in preventative community-based services that people can be sign-posted to, and that are easily accessible for people in their local community. Services which support independent living in people’s own homes and community, which maintain and improve health and wellbeing and complement more formal care and support.

We want to reduce the number of unplanned hospital admissions and see a growth in ‘step-up’ care to reduce the number of people going into crisis. 

We want to create a diverse and colourful market of services, projects and initiatives which promote independence, health and wellbeing.

Who we need

The Council continues to seek alternative, new and effective ways of preventing and delaying the need for long term care and support, whilst enhancing people’s lives.

We would like to work with new and existing community sector providers who are keen to think differently and can demonstrate a strength-based approach to delivery which will reduce and delay the requirement for long term support.

Our intentions

• In 2023, we intend to make our funding for preventative services more accessible to a larger group of organisations though the creation of a Health and Wellbeing Community Grants Fund. This is a joint initiative with the NHS and will allow grants to be awarded to community, voluntary and faith organisations for up to two years. The fund will launch in May 2023 (Providers should start to plan their services and bids now. Support with bid writing is available through Cheshire West Voluntary Action contact)
• In 2024 we will tender for a single community access point for community prevention and carer services.

• We will continue to work with representatives to create an environment which encourages and nurtures the development of a vibrant and diverse community sector market.

Support for Carers

There are approximately 37,121 carers living in Cheshire West and Chester. We know through census data that 35% of carers in Cheshire West and Chester provide over 20 hours of care per week. The majority of carers are aged 50- 64 years.

Cheshire West and Chester Council recognise the very significant role Carers hold within families and communities across the borough. Cheshire West and Chester council want all Carers to feel valued, empowered and have access to good support when they need it. We are committed to working closely with Carers, health and social care colleagues through the Carers Partnership Board to continue to improve outcomes for Carers.

	18-19	19-20	20-21	21-22	22-23
Carers spend ‘000s	845	921	680	699	695

Carers five year spend

Where we are

Cheshire West and Chester commission a carer support service via the voluntary and community sector to deliver carer services and carer breaks via a consortia model of management and subcontracted services. These include:

• Carers Helpline Monday – Friday 9am -5pm
• Information, Advice and Support
• Benefit Advice and advocacy
• Carer Events
• Carer Breaks
• Young Carers activity and one to one support
• Wellbeing sessions
• Carer training programmes
• Personal Budget and Emergency Care fund
• Support for Dementia Carers
• Support for working carers
• Carer Respite
• Support for LD and Mental health Carers

Our contract with our current provider will come to an end in September 2024. For the last two years we have been working with carers and providers to co-produce the service model we need for the future.

Where we want to be

We are committed to ensuring Carers feel valued, empowered and have access to the right support at the right time. Cheshire West and Chester want to champion the diversity of Carers throughout the borough and work closely with Carers as well as health and social care partners to provide appropriate support where needed to improve quality of life and the health and wellbeing of Carers of all ages so they can continue to support people to live a great life.

Our commitment and vision for Carers is set out in the published Cheshire West and Chester Councils All Age Carers Strategy 2021-26.

We want a service model based on what people have told us they want. A model that is:

• Responsive to the needs of carers including young carers
• Has the right level of support
• Integrated with health partners
• Is quick and easy for people to navigate
• Accessible to all

Who we need

We want to work providers who understand our vision and the model we want for people.

Our Commissioning Intentions

• In late 2023 we will tender for a new all age Carers Support service.

Care at home

When more support is required to help people to live at home, care at home provides a range of services.

In Cheshire West and Chester, Care at Home is one of the Council’s largest areas of spend (£13.40m in 2021/22). In the last five years, the Council has seen a 28% increase in the number of hours of care at home required to support people at home and the amount spent has almost doubled.

	18-19	19-20	20-21	21-22	22-23
Care at Home spend ‘000s	8,989	11,332	14,083	13,422	17,198

Care at Home 5 year spend

We expect this trend to continue over the next five years as we seek to support more people at home rather than in residential placements.

	2022/23	2023/24	2024/25	2025/26	2026/27
Projected care at home average hours per week	12,812	14,841	16,573	18,146	19,635

There are challenges with meeting demand as care at home providers have struggled to recruit and retain sufficient numbers of staff to meet demand.

Where we are now

The Council’s current approach is a Prime and Framework model, and the contract is in place until 2025. The borough’s geographical make-up and the shortage of workforce has meant the model has been particularly susceptible to fluctuations in demand.

On average around 13,000 hours of care and support are delivered each week to around 1,000 people. Demand tends to be greatest in our urban areas but the large rural areas are harder to serve.

The quality of care provided according to CQC is good with 75% rated good or outstanding and just 25% Requires Improvement.

Where we want to be

We want a new model of care at home which moves away from ‘time and task’ and supports people to live a great life by being strengths-based, outcome focussed and re-enabling. We want this new model to be more efficient and resilient and to build on work we are doing to trial neighbourhood approaches using efficient ways to build care runs and encouraging walking and cycling routes for carers.

We want any future care at home model to form part of an integrated community health and wellbeing approach. We see care at home providers and workers being part of the wider care communities and working together with local authority, NHS and community sector services to meet people’s needs.

We want there to be a plentiful workforce who are valued for their work, receive at least the Local Living Wage and have career progression opportunities. We will continue our commitment to Unison’s Ethical Care Charter and require our providers to do the same.

We want to nurture smaller independent ‘micro-providers’, rooted in local communities which complement traditional care at home and are able to overcome geographic challenges and changing needs. We are currently piloting an approach with a provider to support people to set up as ‘micro-providers’.

Who we need

The Council would like to work with high-quality care at home providers who are committed to tackling the issues that face the sector to help us develop the future service model for care at home.

Providers of our future care at home service must have a strengths-based and reenabling approach and be ready to move from traditional ‘time and task’ to a model focussed on reablement and outcomes.

We want to hear from people, individuals, or small groups, who want to support their neighbours and local communities by establishing themselves as ‘micro-providers’. More information about this is available on:

Our commissioning intentions

• In 2024 we will tender for a new care at home model. We will co-produce our new model and conduct market testing throughout 23/24; we welcome providers to take part in this.
• We want to work with providers to develop our approach to outcome-based commissioning and welcome providers or other organisations who have experience of this to work with us to develop our approach.
• We will continue to pilot and grow the use of micro-providers particularly in our Rural area.
• We intend to create a Health and Care Workforce Academy to create a sustainable pipeline of future carers along with attractive career pathways.
• In 23/24 we intend to establish a continuous quality improvement reward scheme for care at home providers who we hold a contract with.