I am excited to introduce Cumberland Council’s first market position statement, which provides an overview of our local adult social care market, highlighting its strengths, challenges and opportunities.

We are a new council so I hope this document will help set the foundations for a new and exciting period of market shaping in our area. Our aim is to help current and prospective care providers understand the local context, including demographic trends, service gaps and future demand.

We wanted to ensure that this statement accurately reflects the true needs and aspirations of our care market. To achieve this, we have actively engaged with a wide range of stakeholders, including care providers, customers, and their families to understand their perspective of the Cumberland market. This engagement has been managed through a series of consultations, surveys, and feedback sessions, gaining us invaluable insights that have directly influenced the development of this document.

This statement helps to outline our commitment to working in partnership with providers across Cumberland to develop, stimulate and support a vibrant and diverse care market that focusses on people’s strengths, enables people to live their best lives and provides good value for money.

This statement supports this by providing:

• an overview of our place, people and adult social care workforce
• a breakdown of our market strengths and market challenges, both across Cumberland as a whole and by key service centre area
• clarity around what our care market looks like, including what services are currently delivered and whether there are any gaps or opportunities

This statement will serve as a tool in the process for developing our commissioning strategy (which will be published later in 2025), allowing us to use the insights and data gathered to make informed decisions that align with current and future demand.

I would like to invite you to explore this document and gain a deeper understanding of Cumberland’s care market. Together we will build on our strengths, seize new opportunities and achieve positive outcomes for the people we support.

Chris Jones-King
Director of Adult Social Care
and Housing

As a council, we are responsible for ensuring that our local adult social care market is efficient, effective and responsive to the needs of our population.

We can do this by providing ourselves or commissioning services for our eligible residents and working with our wider market, for the benefit of everyone in Cumberland regardless of who arranges or funds services.

These activities can best be described as ‘market shaping’. This market position statement is the first step towards shaping our local market. In this statement, we will set out our understanding of key services, highlight current and potential future demand issues, and identify supply challenges. We will also provide information on Cumberland, our people, our adult social care workforce as well as what working with the council is like. We have provided key service centre level information in appendix 1.

This statement should assist providers in understanding our local market so that well-informed business and investment decisions can be taken. We hope it will ultimately be used as a tool to strengthen our care market and bolster the Cumberland economy.

Further information around commissioning intentions will be explored in our commissioning strategy. The strategy will enable providers to understand the council’s vision for our market and commissioned services in order to plan business development.

This is our first market position statement and we hope that it will be the beginning of shaping and facilitating a strong, sustainable and person- centred market for our people in collaboration with our providers, customers and anyone with an interest in care and support services.

This statement will be of particular interest to:

• providers of regulated (Care Quality Commission-registered) services, such as homecare and residential and nursing care providers
• providers of non-regulated services, such as day opportunities
• people who use adult social care services (whether these services are self-funded or arranged by the council or NHS)
• NHS Integrated Care Boards (ICBs)
• providers of services that support the wellbeing of local populations, such as voluntary, community, faith and social enterprise organisations

Our council plan 2023 to 2027 outlines what we want to focus on in our first four years. It also describes how we want our new council to work and what residents can expect from us.

Read the council plan 2023 to 2027

Our central aim is to improve the health and wellbeing of our residents. It is at the heart of everything we do. As part of this, we are determined to deliver excellent public services, with adult social care being a vital component.

Cumberland Council takes a fresh approach to the delivery of inclusive services that are shaped by our residents and communities. By enabling positive outcomes for health and wellbeing, prosperity and the environment we will fulfil the potential of our people and our area.

This market position statement will inform our commissioning strategy. Our key strategic actions set out in the strategy will include:

• reducing pressure on the health and care system by commissioning and developing universal and targeted prevention services
• reduction the overall number of placements of older people in residential and nursing care
• increasing the market for more complex care including dementia care
• ensuring a sustainable market, particularly for domiciliary services
• increasing the supply of extra care and other supported housing
• improving and expanding our assistive technology offer
• transforming and streamlining our equipment services
• working with the market to further promote and deliver outcomes-based services

Cumberland is a large, mostly rural area located in the ceremonial county of Cumbria in North West England. Cumberland is known for its rich history, diverse economy, and stunning natural landscapes. Cumberland boasts a varied economy with strong sectors in agriculture, tourism and manufacturing.

Cumberland has a high level of rurality with significant variations in population density across the region. We have many rural communities with large areas of open countryside and small villages/towns. This rural nature is a defining feature of our area, contributing to its scenic beauty and agricultural economy.

Whilst predominantly rural, Cumberland does have some more built up urban areas such as Carlisle, Workington and Whitehaven which service as economic and administrative hubs.

In April 2023, the six previous district councils and Cumbria County Council were replaced by two new unitary authorities and a fire and rescue service, with Cumberland Council taking over responsibility for providing services to people who live in the former Allerdale, Carlisle and Copeland district areas.

Cumberland has 14 key service centre (KSC) areas. These are towns and larger villages which provide a range of essential services and facilities to the surrounding rural areas.

The 14 KSCs in Cumberland are:

• Aspatria
• Brampton
• Carlisle
• Cockermouth
• Cleator Moor
• Egremont
• Keswick
• Longtown
• Maryport
• Millom
• Silloth
• Whitehaven
• Wigton
• Workington

Key service centre areas that are more densely populated are smaller, whilst larger KSCs are less densely populated.

The rest of Cumberland is referred to as ‘not in KSC’ and most of these places are quite rural.

As Cumberland is a diverse region with a number of key characteristics at a local level, further information broken down by KSC areas has been provided in appendix 1.

Cumberland Council acknowledges the financial challenges facing adult social care nationally. Despite these constraints, we are committed to making sure residents’ eligible care and support needs are met. This may not always be within their key service centre, however, the council works collaboratively across Cumberland to ensure a reasonable offer (Care Act 2014) is available to all eligible residents in the community.

Cumberland has a mixed adult social care market within a blend of local and national independent sector providers and in-house services, which work together to meet the diverse needs of our community. This mixed economy approach makes sure we have a range of care options available, helping to promote choice and flexibility for customers whilst also generating local spend and social value.

Independent sector

The independent sector plays a crucial role in our local care market, offering a variety of services including residential care, homecare, and specialist support. In fact, the majority of our services are delivered by the independent sector either through commissioned arrangements or self funded.

In-house provision

The council operates a number of in-house care services via Cumberland Care, which is part of our Adult Social Care and Housing directorate. The vision for Cumberland Care is to focus in-house delivery around services which support people to maximise their independence, and we will increasingly look to reshape services in order to provide more specialist and complex care.

Approach to delivering care services

In addition to the statutory services described on the following pages, the council also provides a number of intermediate care services, operating a reablement approach to support people to live better, healthier and more independent lives, ideally within their own homes.

Our budget

Cumberland Council faces significant budget pressures in relation to adult social care, these pressures are driven by several key factors
including:

• a ‘super-ageing’ population in Cumberland which has led to an increased demand for adult social care services
• the cost of providing care continues to rise, influenced by factors such as inflation, higher wages for care staff, national insurance changes and the need for specialised services

To help mitigate against these financial pressures, the council is undertaking a number of transformation projects to streamline processes and reduce inefficiencies. It is hoped these projects will support us to deliver services more cost effectively, whilst making sure we continue to provide high quality adult social care services, through both in-house provision and commissioned services, across the Cumberland footprint.

Quality

We are proud to support a high-quality adult social care market, with over 80% of our providers being rated Good or Outstanding by the Care Quality Commission (CQC). We continue to work closely with a wide range of care providers to make sure that all services are delivered to the highest standards. Our Quality and Contract Officers (QCOs) undertake regular monitoring and quality assurances processes with providers of regulated services, both to support our providers in delivering the service and to make sure our residents receive the best possible care.

A breakdown of our adult social care budget for 2024 to 2025

Homecare: £18.6 million
Internal provider: £33.9 million
Nursing care: £8.7 million
Other contracts: £13.4 million
Residential care: £43.8 million
Respite care: £4.9 million
Supported living: £16.1 million
Care management: £13.2 million
Day opportunities including transport: £5.3 million
Direct payments: £8.3 million
Equipment: £1.3 million
Extra care housing: £1.6 million

The population of Cumberland is around 273,555 people. Cumberland is sparsely populated with an average of 235 people per square mile, significantly lower than the national average of 1,124.

Cumberland has a ‘super-ageing’ population with a significantly higher proportion of people aged 65+ than the national average. This trend is expected to continue with an increase of around 35 to 40% in the number of older people (65 and over) unable to manage at least one activity on their own or admitted into hospital due to a fall, by 2040.

Cumberland has some of the least deprived areas in England, often within rural areas and parts of the Lake District. However, there are pockets of high deprivation in parts of Carlisle and within ex-industrial towns along the west coast. Life expectancy varies across our area, but generally it is lower than that of England as a whole.

The proportion of people in Cumberland in good or very good health is lower than in the North West and England. We have more people proportionally who identify as disabled than in the North West and England. We have the same proportion of people who provide unpaid care as the North West and slightly higher than in England.

Nationally, expenditure on support for working age adults (for example, younger adults with learning disabilities) will increase by 50% per year by 2030. This is in part fuelled by an increase in complex care requirements and Cumberland will likely see a similar trend.

The adult social care workforce in Cumberland is a vital component of our local health and social care system, which is dedicated to supporting the wellbeing of its ageing and vulnerable population.

Our adult social care workforce faces a number of challenges:

• local recruitment is a major challenge with providers facing competition from other sectors
• Cumberland has a ‘super-ageing’ population with a reducing working age population
• a number of services or residents requiring support at home are in rural and
• remote locations, making it difficult for workers to travel to deliver care

In response to these challenges, the council is undertaking the following workforce
measures:

• promotion of ethical overseas recruitment to bring new care staff into the Cumberland region
• use of technology to streamline administrative tasks and improve care delivery
• promotion of the Real Living Wage to support providers to recruit and retain staff within the sector
• supporting the development of an adult social care workforce strategy and partnership working with Skills for Care to provide training and support

Key employment statistics across Cumberland

Over 2,150 care staff, 170 nurses and 790 non-care staff employed in care homes

Over 2,130 staff providing care services within community settings

26 providers holding licenses to support international recruitment

Key workforce statistics (Skills for Care data for Cumberland)

12% of independent sector care staff are employed on zero-hour contracts (England is 28%).

Vacancy rate for independent care staff is 9.9% (England is 9.3%).

56% of independent care staff have a qualification relevant to social care and 46% have completed the Care Certificate (England is 47% and 46%, respectively).

Turnover rate is 31.1% for independent care staff (England is 28.3%).

We commission residential and nursing services for older adults through a framework agreement. This framework has been developed to deliver person-centred care. Currently, over 70 providers are registered to deliver services on behalf of the council, including 44 providers (54 care homes) within the Cumberland region. In addition to the framework, the council’s in-house provider, Cumberland Care, also operates a further eight care homes within Cumberland.

We use a usual price banding. These bandings are: residential, residential and nursing - physically frail, residential dementia and nursing dementia.

The maximum capacity of care homes in Cumberland is 2,374 beds with a reported occupancy rate of 87%. A number of the reported vacancies are currently unavailable, so the number of vacant admittable beds is closer to 8%, with less vacant admittable beds in residential dementia (6%) and nursing dementia (6%) services.

Proportion of older adults beds by provider type

This uses CQC data:

• National: 50%
• Regional (North East): 8%
• Regional (North West): 1%
• Cumberland Care: 12%
• Local: 29%

We have a mixed residential and nursing provider market. We have a larger locally-based care market than many other areas, which generates and keeps wealth in Cumberland.

12% of older adults beds are within Cumberland Care residential homes. Cumberland Care does not operate any nursing homes.

72% of older adults beds in Cumberland are residential.

There is a gap in nursing provision (particularly dementia nursing) in many areas.

The west Cumberland area generally has higher provision of both residential and nursing care relative to population size.

Market strengths

Mixed provision (care home size and ownership type).

Widespread residential provision.

Quality of market (over 80% of care homes rated Good or Outstanding by CQC).

Market challenges

Recruitment and retention of skilled staff.

Increasing number of people with complex and specialised care needs.

Gap in provision in some areas, particularly for nursing.

We commission enhanced residential services for adults with a learning disability, mental health needs, autism or a physical and/or sensory disability. These services are generally for younger adults aged 18 to 64, although some adults continue to live in these homes after the age of 64. We commission 22 providers to deliver enhanced residential services, both within Cumberland and out of area.

The maximum capacity of care homes providing enhanced services is 195 beds with a reported occupancy of 81%. Due to the complexity of enhanced residential services, it is difficult to determine how many of the vacant beds are admittable to meet the needs of Cumberland residents.

Enhanced residential services tend to require more specialised care, such as specific equipment, staff training and resources.

The provision of these services has been more focused within the large key service centres of Carlisle and Workington.

Market strengths

We commission a range of residential providers and are able to tailor services to meet the unique needs of each individual.

We have a positive relationships with local providers.

Market challenges

Gap in specialist provision in many areas, which has led to some people moving out of area.

Wide ranging needs and a variety of home sizes mean standardisation of pricing is challenging.

Utilising the available space within limited residential buildings, making sure to balance accessibility, safety and privacy.

Homecare is delivered within people’s own homes, either as short or long-term personal care / low-level healthcare. Cumberland Care provides a Cumberland-wide reablement service (for up to six weeks) whereas the independent sector is commissioned via an open framework agreement. The council commissions low-level healthcare on behalf of NHS North East and North Cumbria Integrated Care Board via the framework. Cumberland Care also provides a long-term nighttime homecare service.

Demand for homecare services has grown year on year, aligning with our ambition to support more people in their own home, with international recruitment being a major factor in meeting recent demand.

Currently, the independent provider market is strong, particularly in Carlisle (where demand is greatest) and other urban areas. Most homecare providers in Cumberland are small organisations, many of which are local and well established. However, in recent years, we’ve seen an increase in new providers who also deliver in other areas. National providers make up a relatively small part of the market.

Much of Cumberland is rural, so this is reflected in our fixed framework hourly rates (urban, rural and extra rural). However, there are gaps in rural provision and people living in these areas often have to wait slightly longer for their care to start. Increased travel time and costs contribute towards this.

Most packages of care that we advertise to framework providers receive at least two offers. In recent months, this has been closer to four offers.

On average, it takes 12 days for homecare to start from the time we approach the market (October 2024).

Around 24% of commissioned calls are ‘double ups’, meaning that two carers are needed at each visit.

Approximately 17% of people that our framework providers support self fund their care.

Percentage of weekly commissioned hours by rurality

(Independent framework providers) (uses SProc.net data)

85% Urban
15% Rural and extra rural

Market strengths

Buoyant provider market, particularly in urban areas and responsive to demand.

Mixed market of large, medium and small providers.

Workforce strengthened through overseas recruitment.

Market challenges

Local recruitment and retention.

Sustainability of smaller providers and those most reliant on overseas recruitment.

Gap in provision in rural and extra rural areas.

Reliance on cars for transport due to geography and gaps in public transport provision.

Extra care housing is a form of accessible accommodation mainly for older adults that is designed to promote independence and includes 24/7 on-site care and support.

Accommodation is in the form of self-contained ‘units’ - either flats or bungalows. Most schemes have communal spaces and facilities for all residents.

The accommodation is usually owned by a housing association whilst the care and support element is provided either in-house (Cumberland Care) or via the independent market, commissioned through a framework agreement.

Commissioned care providers are deemed to be the ‘provider of choice’ for all residents in a particular scheme, including people who self fund, though customers can choose to organise support from alternative providers if they wish.

There are currently nine extra schemes in Cumberland (including the soon to open Harbour Place in Workington). Five of these have care and
support delivered by the independent market. Four are delivered by Cumberland Care.

Find extra care housing schemes in Cumberland

Extra care housing units

Extra care housing units per 1,000 people (aged 65+) by key service centre:

• Brampton: 28
• Carlisle: 8
• Keswick: 48
• Millom: 8
• Whitehaven: 9
• Wigton: 28
• Workington: 12

Current provision is centred in a few areas of Cumberland only. It is very much a developing service area and demand is likely to substantially increase over the next few years.

There are gaps in provision in areas of west and north Cumberland. Current provision is focused on older adults with physical health needs, so this will likely need to increase for working age adults (such as people with learning disabilities, autism or mental health needs).

Market strengths

Growing market.

Increasing provision in west Cumberland.

Customers can stay in their own homes as their care needs increase, with assurance that support is available in an emergency.

Market challenges

Ensuring schemes have an appropriate mix of needs as current provision tends to focus on supporting a large number of residents with lower-level needs, making it more difficult to find suitable vacancies for people with medium or high level needs.

Sustainability of independent market.

Half of key service centre areas do not have extra care provision.

Gap in dementia-focused and working age adult.

Day opportunities are activities designed to promote independence and social inclusion, reduce loneliness and provide respite for carers. Activities
can take place in a building or be focused on outreach and getting out into the community.

We commission these services through a framework agreement, of which there are 15 providers (including Cumberland Care). We also commission some specialist transport to and from day opportunities for people unable to travel safely on their own. The new day opportunities framework 2025 will enable day opportunity providers to provide transport.

Find out more about day services and opportunities in Cumberland

Market strengths

Small group of well established, mainly local providers with knowledgeable and passionate staff

Willingness in market to innovate and think creatively about service offer.

Market challenges

Gaps in provision in some areas (rural market towns, Millom and parts of west Cumberland).

Gap in current market offer to support people with learning disabilities (for example, with vocational and training- based models).

Capacity of specialist transport providers to meet demand at required times.

Gap in provision in evenings, weekends and holiday periods.

Supported living is a form of care and support mainly for younger adults with learning disabilities or mental health needs, within their own home or within specialist accommodation. Accommodation is usually shared and care provision is often centred around personal care or supporting people to live as independently as possible. This can often be delivered flexibly to meet changing needs and is tailored to each person.

We commission supported living services from around 20 care providers. Most care providers are charities (some locally-based and some national). Cumberland Care also provides supported living.

Cumberland Care and three of the independent sector providers make up around 75% of the supported living market, with the remaining 25% delivered by smaller providers.

Current provision is mainly in Carlisle, with gaps in many other smaller areas.

Find out more information about supported living for vulnerable adults

Market strengths

Mixed market (small, local providers, national charities and Cumberland Care).

Integration of people supported into the community, increasing their quality of life.

Market challenges

Gap in housing market to meet accommodation needs (for example, detached properties with own front door, noise abatement space, single floored accommodation without stairs).

Small amount of specialist provision available which has led to out of area placements.

Limited availability of accommodation to support people with physical disabilities or sensory needs.

We offer a wide range of assistive technology and tech enabled care services to help individuals live independently and safely within their own homes for longer. We work with individuals to assess their technology needs and to make sure that they can consent, understand, retain and weigh the options around technology, before communicating their choice and preferences.

These services have been used to provide long-term support and also as a preventative measure to prevent, reduce and delay the need for additional care services.

We have identified assistive technology and tech enabled care as a key area of transformation over the next three years and are currently exploring a number of opportunities to enhance these services across the Cumberland. This includes working with our existing assistive technology provider and developing a number of pilot schemes to better understand how technology services can best support the market.

The current assistive technology service includes a telecare and monitoring system which monitors personal alarms, fall detectors and other monitoring devices, and alerts carers / family members in case of emergencies.

Market strengths

Massive advancements in technology available in market to make sure individuals with different needs can find suitable solutions.

Market challenges

Limited awareness of what assistive technology solutions are available and how best these can meet different needs.

Accessibility of digital solutions in the most remote and rural locations.

Delays in implementing digital solutions, with high usage of analogue devices.

Direct payments (DPs) and individual service funds (ISFs) in Cumberland are designed to give individuals more control over their care and support. They can be used to hire personal assistants, pay for care services, purchase equipment or arrange other support that meets their assessed needs. There are only a small number of ISFs across Cumberland. The council will be reviewing this to better understand the position.

If eligible, people can either manage the payments themselves or appoint someone else to manage this on their behalf. We use a prepaid card system to support DPs. These cards function in the same way as debit cards, allowing people to pay for services and equipment directly. We are pleased to see an increasing number of residents opting for DPs. This trend reflects customers’ desire for greater choice, control, and flexibility in how care services are delivered, which we hope will continue.

In order to support the care market and to increase the options available to individuals who choose to arrange their own care via DPs, we have worked to develop a number of micro enterprises to deliver highly personalised care across Cumberland. These small businesses have been established in areas where we have previously struggled to commission care (often rural and remote areas). We have worked with Community Catalysts to facilitate this.

For people who self fund their care, we have a duty to shape the care market that they purchase from. Research has shown that people who send their care often do so with lower level needs than publicly funded alternatives. It is likely that more people self fund their care in less deprived areas, although data on this is limited.

Market strengths

Growing number of micro enterprises and DP users.

Market challenges

Limited availability of providers within certain parts of Cumberland who are willing or able to accept DPs.

The closure of a number of charity and voluntary organisations has led to a reduction in the level of support widely available to individuals to manage their DPs.

Lack of accurate data on self funded market.

Equipment can help people to live more safely at home. It is a key service for preventing or delaying care needs and helping people with mobility issues.

There are three main ways we provide community equipment for our eligible residents. These are:

• simple aids commissioned via a framework agreement from four local retailers
• specialist equipment provided from the council’s in-house community equipment service (hoists, beds, mattresses)
• a minor adaptations service commissioned through a single provider contract

Some specialist equipment for people who are deaf or hard of hearing are provided in a separate agreement.

Market strengths

Range of equipment services available across a number of contracts.

Market challenges

Disruptions and price increases in the supply chain

Challenges in commissioning equipment services in more rural and isolated locations.

To commission adult social care services, we use the ‘commissioning cycle’.

Monitoring

We will monitor:

• lessons learnt
• customer feedback
• continual assessment of the market
• contract monitoring

Procurement

• contract award
• evaluation
• competition
• define procurement approach

Planning

We will:

• identify needs
• analyse demand
• conduct market analysis
• provide consultation and co-production
• design services

Our people, whether they are customers, adult social care workforce or our general residents will always be at the centre of this process.

Procurement of services is usually done via The Chest online portal.

Once services are in place, contracts are monitored via a standardised process, which for regulated services includes oversight from our quality team.

Useful links

To find out what working with the council is like and for some further useful information.

Procurement and working with the council:

• Procurement, social value, tenders and contracts information
• Current opportunities on The Chest (the North-West’s local authority procurement portal)
• The Chest guidance page
• Procurement Act 2023 guidance (for contracts tendered on or after 24 February 2025)
• Public Contracts Regulations 2015 guidance (for contracts tendered before 24 February 2025)

Council documents:

• Cumberland Council’s constitution (please see part 3, section 7 for contract procedure rules)
• Cumberland Council plan 2023 to 2027

Relevant legislation:

• Care Act 2014 explanatory notes
• Care and support statutory guidance (GOV.UK)
• Public Services (Social Value) Act 2012 explanatory notes

Local population and care staff statistics:

• Cumbria Intelligence Observatory
• Skills for Care adult social care workforce data by local area 2023 to 2024

For local safeguarding adults policies go to Cumbria Safeguarding Adults Board website

We would welcome your feedback on this document. If you would like to share your thoughts, email us.

Email: strategic.commissioning@cumberland.gov.uk