Cheshire East Council has historically pursued a strategy of internal provision for much of its Adult Social Care provision.  This has primarily been done through a service of the council called Care4CE.  Care4CE provides the following services:

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• Community Reablement

• Dementia Reablement

• Mental Health Reablement

• Mobile Nights

• Day Opportunities

• Supported Living Networks

• Short Breaks

• Shared Lives

• Occupational Opportunities

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The services have a combined turnover of £17.1m and employs 531 FTE staff.  Previous work had been done creating a business case to set Care4CE up as a local authority trading company (LATCo).  This recommendation hadn’t been implemented and we were commissioned to initial review this business case to determine if the assumptions made were correct and if they still held true as a result of market changes from Brexit and the pandemic.  Our review concluded that the business case didn’t stack up and wasn’t the right move for Cheshire East Council.

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We were then commissioned to develop a new model for the delivery of services in Cheshire with the combined objectives of saving (and/or making) money and improving care outcomes.  It quickly became apparent that a one size fits all approach wouldn’t be the most effective.  We engaged with the service, service users, external providers and other internal stakeholders to develop a mixed economy model. 

The development of this overall model was reached by reviewing each of the component services is much the same way that this specification is asking for.

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The essence of the model developed was:

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• Internal provision through Care4CE would be refocused on the hardest cases saving the council a large amount from expensive out of county payments.

• A small LATCo would be created to focus on the self-funder market

• This LATCo would also be a means to transfer staff away from previous Care4CE services

• There would be greater use of external providers to deliver lower level services.  Previously this wasn’t possible as external providers didn’t want to TUPE council staff on their Ts&Cs.  The transfer of Care4CE staff to the new LATCo enabled commissioning with the external market and avoiding many TUPE situations.

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The result of this new model are forecast savings of around £2.5million across the direct Care4CE costs and savings to commissioners.  The greater focus is also expected to raise care outcomes delivered.  As already mentioned, reviews of specific services were part of reaching the overall model. 

This included reviews of day opportunities and an estate and asset review that identified opportunities for the disposal of assets that were no longer appropriate as a way of funding new buildings that enable more efficient and effective service delivery.

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