Issue details

Proposed decision – To approve thecommissioning of an All Age Homecare Service for adults and children to include Homecare, Care and Support in Prisons and Community Support Services for children.

Reason for the decision

Homecare services for adults and children support the Council in discharging its statutory duties including under the Care Act 2014, the Children Act 1989 and the Special Educational Needs and Disability (SEND) Code of Practice, by enabling people to receive appropriate care and support within their own homes. These services play a critical role in promoting independence, improving quality of life, preventing the escalation of need and the requirement for more intensive interventions, reducing the risk of family and carer breakdown, and supporting timely discharge from hospital for individuals who are medically fit. Homecare represents one of the least restrictive and most proportionate ways of meeting a person’s assessed care and support needs.

Homecare services for adults and children are currently delivered through a closed service contract under the Care and Support in the Home (CSiH) contract. There are two contract periods relating to this contract:

• SC18032 started in April 2019 for 4 years (with an optional extension of +2 years and another +2 years). The adults’ provision is part of this contract period.
• SC19012 started in June 2020 for 4 years (with an optional extension of +2 years and another +1 year). The disabled children service is part of this contract period and began in February 2022.

Both extensions have been applied and therefore the contracts expire in March 2027 (for adults) and June 2027 (for disabled children). There is no provision for further extensions beyond these dates. It is therefore necessary to commission a new service which will continue to provide Homecare services across Kent.

Moving forward, this commissioning activity has been scoped to ensure strategic alignment with other key services delivered by the Council. This commissioning activity will therefore seek to provide the following services:

• Homecare (regulated care in a person’s home),
• Care and Support in the Prison setting,
• Community Support Services for children. 

This commissioning activity is being undertaken jointly between Adult Social Care and Health Directorate and Children’s, Young People and Education Directorate with the aim to ensure a smooth and well-supported transition for young people approaching adulthood.

The Supporting Independence Service and Extra Care Support elements of the current Adults Care and Support in the Home contract will be commissioned as part of the Supported and Residential Living contract.

The proposal to commission an All Age Homecare Service across Kent offers the most effective balance between market control, affordability, service quality, and provider sustainability. It enables the Council to strengthen value for money through improved commissioning leverage, clearer pricing and quality expectations, and better alignment with assessed need and strategic priorities. Commissioning an All Age Homecare Service also supports a scalable and sustainable model which can respond to increasing demand, promote prevention and independence, and ensure robust oversight and market resilience into the future.

Background

There are currently over 55,000 hours of Homecare delivered to over 4,500 Adults and over 2,000 hours on Homecare delivered to over 200 Children each week across Kent. The current combined planned annual spend for Homecare in 2025/26 is £87m as follows:

a)    £82m on Homecare for Adults

b)    £125k on Care and Support in Prisons

c)    £4.9m on Homecare and Community Support for Disabled Children.

Over the life of the contract, the social care and health landscape has experienced significant change, including increased acuity of need, workforce pressures, hospital flow challenges, and demographic growth. These factors have had a direct impact on both demand and the cost of delivery.

Throughout 2025, demand for services has increased significantly and is forecasted to continue to rise in future years. The demand for adults requiring Homecare has increased by nearly 10% during 2025 and the demand for children requiring Homecare and community support has increased by nearly 25% during 2025. This reflects both demographic growth and the Council’s strategic commissioning intention to support more people to remain living independently in their own homes for as long as possible, reducing reliance on more restrictive and higher-cost care settings such as residential care.

It is the Council’s priority to establish new arrangements which deliver high-quality, person-centred care in a way which represents clear value for money. This will include aligning service models with assessed need, reducing reliance on higher-cost and more restrictive forms of care, supporting timely and effective hospital discharge, and promoting prevention and early intervention to avoid escalation of need and associated cost pressures.

Co-production will be embedded in service delivery to ensure care and support is responsive, proportionate and outcomes-focused, enabling the Council to achieve the best possible outcomes while making effective use of public funds.

This commissioning exercise will secure sustainable pricing which supports workforce stability and market resilience balanced against appropriate competition across the market. It will also ensure there is sufficient contracted capacity across Kent to meet current and future demand, while supporting a diverse and resilient local care market.

The expectation is for the new service to commence no later than April 2027.

Options (other options considered but discarded)

Option 1: Do nothing - Maintain the existing contracts for Homecare until contract expires on 31 March 2027/ June 2027.

Not recommended - This option would not address existing and emerging pressures within the Homecare market, including increasing demand, rising costs, workforce challenges, and limited commissioning leverage. Continuing without change would reduce the Council’s ability to shape the market, improve value for money, or strengthen quality and performance oversight, increasing financial and operational risk.

Option 2: Extend the current Homecare contracts past the 2027 expiration dates.

Not recommended - There is no contractual provision for further extensions beyond the current end dates. In addition, extending the contracts would perpetuate existing cost pressures, constrain the Council’s ability to introduce improved service models, and limit opportunities to rebalance capacity, pricing, and performance expectations in line with current and future needs. This option would not represent value for money.

Option 3: Provide an in house service and remove the need for externally commissioned providers.

Not recommended as a primary model - While an in-house offer could provide greater direct control, this option would require significant upfront investment, ongoing workforce recruitment and management, and substantial operational infrastructure. It would also present scalability and resilience risks given fluctuating demand. Overall, this option would carry a high financial and resource burden and would not offer the flexibility or value for money required at scale. However, the Council will continue to keep delivery models under review and may consider a targeted in-house provision in the future where this would address specific capacity or market sustainability issues.

How the proposed decision supports the Council’s Strategic Statement

The recommissioning of Homecare provision for adults and children and community support for children will align with the Council’s Strategic Statement by prioritising prevention, independence, and value for money. By investing in Homecare and community-based support, we enable people to maintain care at home, reduce reliance on costly residential placements, and build independence.