Mental Health
Care Homes
Care providers tend to develop care homes that can meet the needs of older people, including any mental health support needs. Consequently, it can be difficult to analyse the specific care home placements available for people with mental health support needs.
The data we have produced within our Market Sustainability plan includes information on care homes that support people with mental health support needs. There are 3 care homes, providing 162 rooms specifically registered with CQC to support people with mental health support needs.
During 2022/23 there has been an increase on the number of mental residential and nursing care home placements.
The budget for mental health residential / nursing care for 2022/23 is £10.995m, with the forecast out turn for the year being £13,047m (January 2023).
The cost of new placements for residential care has increased from £635 in April 2022 to £800 in January 2023, with the highest monthly cost for new placements being September 2022 of £2117.
The average cost for new placements in 2022/23 was £1,437. The average weekly cost for residential care home placements n 2021 was £843 in April 2021 rising to £996 March 2022. There is an average increase for residential care placements of £173 or a 17% increase on March 2022 compared to March 2023.
The cost of new placements for nursing care has increased from £650 in April 2022 to £2157 in January 2023, with the highest monthly cost for new placements being November 2022 of £2028. The average cost for new placements in 2022/23 was £1,169. The average weekly cost for nursing care home placements in 2021 was £999 in April 2021 rising to £1,274 March 2022.
The Council uses the national care home capacity tracker. As of 4th April 2023, the national tracker showed:
- Mental Health Residential – there were 6 (13%) vacancies.
- Mental Health Nursing – there were 0 vacancies.
Somerset Council require a diverse mix of services that can offer high quality residential and nursing care, and in the future, we need:
- To work with providers to ensure people are supported to be as independent as possible.
- To ensure residential and nursing homes can meet the needs of residents with complex and challenging support needs.
- More placements for people with a forensic history who require a care home placement.
Community support
There is limited provision of supported housing for people of working age for people with a mental health need. Due to limited specialist supported living schemes people are either supported in learning disability/ mental health schemes or are waiting long periods for appropriate placements. Recently opened is Thorne House, Yeovil, that supports up to 16 people with complex mental health support needs.
For 2022/23 the Council spent just over £5m supporting people in the community with mental health support needs. This support was across:
- Home care
- Supporting Living
- Day care
- Direct Payments
The average total Home Care Hours commissioned was 4,715 (November 2022) compared to 3,769 (December 2022).
The average number of Home Care hours per person was 17 (November 2022) compared to 15 (December 2022).
During 2022/23 the former District Councils, Somerset County Council and key stakeholders and housing providers have been developing a “Better Future’s program’. The program is looking to support the most vulnerable people who tend to have the most complex support needs. Some people will have adult care assessed needs while the majority will have support and housing needs. The Better Futures project is about taking a coordinated preventative approach to support people.
Analysis during early 2023 highlighted there are 500 people who would benefit from the program. Not everyone will have mental health support needs.
The Better Futures program will:
- Offer a greater focus on the barriers to people moving on from supported accommodation and a whole system approach to overcoming these. This could free up sufficient supported accommodation for those who need it.
- Provide a shift in the levels of support available in some settings to enable those with higher levels of need and specialist support needs to be accommodated safely.
- Provision of treatment accommodation to support those who want to recover from drug and alcohol misuse.
- Review of the need for and options to deliver step-down accommodation for those discharged from hospital, pending appropriate resolution of their housing needs.
- An increase in the number of units that are accessible for people with mobility difficulties. A shift towards more units with self-contained bathroom and kitchen facilities.
Home care for people with learning disabilities is commissioned using the Learning Disabilities Open Framework. The Framework is in the process of being recommissioned with the new arrangements commencing in April 2024. It is the Council’s intention that the new framework will be used to commission bespoke support for anyone who needs it and will therefore not be limited only to people with learning disabilities. Where someone does not require this type of support their home care will be commissioned using the home care service described above. It is preferred that providers will operate from a location that allows a physical presence in Somerset.
Somerset Council will develop the “Better Futures” program to ensure that people with complex needs are supported.
There is a very limited supply within Somerset of supported living schemes to meet the needs of people with mental health and / or complex care needs. During the next few years, the Somerset Council will prioritise working with care and housing providers who can:
- Demonstrate they can deliver opportunities for supported living for people with mental health support needs.
- Demonstrate they can deliver opportunities for supported living for people with complex care needs including drugs and alcohol.
Demonstrate they can deliver opportunities for supported living for people with offending history.