Adult Social Care Market Position Statement

Co-production

Co-production means collaboration, where we work together in partnership with people drawing on care and support, their carers and families, to shape, deliver and evaluate services. It is "working with", not "doing to".

Our commitment to co-production

We are committed to expanding and strengthening co-production across Adult Social Care and we expect our providers to share this commitment. It is our goal for co-production and co-design to be embedded in all of our commissioning, service developments and practice.    

In 2024 we established a Making It Real Board. This is a strategic co-production board where people with lived experience work with the Council to ensure that people with lived experience are central to shaping services for care and support in Stockton-on-Tees.

Some of the work completed through the Making It Real Board to date includes:

• a co-produced Local Account for the Council's Adults, Health and Wellbeing Services
• a co-produced accessible summary for the Stockton-on-Tees Health & Wellbeing Strategy
• co-producing the new Adult Social Care Strategy 2026 to 2030

We have also recently established a Learning Disabilities co-production partnership called We Are Here Stockton! and we will be co-producing a new Learning Disabilities strategy.

Key principles of co-production

We will be guided by the five key principles of co-production set out by the Social Care Institute for Excellence (SCIE):

1. Equality. All participants are equal partners in the process. This means recognising and valuing the contributions of everyone involved - people accessing care and support and providers of services - and ensuring that no one group holds more power than another.
2. Diversity. We will value and embrace diverse perspectives and experiences so that we encourage the inclusion of different voices, particularly those from marginalised or under-represented groups, to ensure that services are designed to meet the needs of the entire community.
3. Accessibility. Through co-production we will create spaces and processes that are accessible to all participants. This includes removing barriers to participation and ensuring that everyone has the opportunity to contribute meaningfully.
4. Reciprocity. This principle highlights the mutual benefits of co-production where all parties gain something from the collaboration. It emphasises the importance of giving back to the community and recognising the value of shared experiences.
5. Respect and empathy. Building relationships based on respect and empathy.

Co-production in commissioning

We will create a culture of co-production where:

• co-production is reflected in all aspects of our commissioning, service design and delivery
• we actively involve our citizens, those accessing services and their carers when we plan, design and evaluate services to ensure that people's voices are heard and contribute to shaping services
• we upskill our workforce and stakeholders on the co-production principles and putting these into practice so that we have a shared understanding of what co-production is and how we will work together in Stockton-on-Tees

Our future plans

• embedding co-production into provider contracts, performance and monitoring frameworks. We intend to review co-production activity and how this has impacted on service delivery
• offering training and support to providers across the market on co-production best practice
• supporting community-led innovation through micro-commissioning

We expect providers to:

• actively involve people with lived experience, their relatives and carers in service design and delivery
• create opportunities for collecting feedback which is used to inform continuous improvement and evidencing this
• value the lived experience of individuals, families, and carers
• embed co-production and co-design into their organisational culture and workforce development
• engage in opportunities for sharing co-production activity with the council and how co-production has shaped their service delivery

How we will support providers

We will support providers to embed co-production through:

• training and resources on co-production principles and practice
• co-ordination of networks
• inclusion of co-production expectations in contracts and tenders

How we will measure success

• evidence of the involvement of people with lived experience in service planning and review
• feedback from people accessing services, their relatives and carers
• outcome-based commissioning that reflects what matters to people the most
• evidence that feedback and the involvement of people with lived experience and their carers has shaped services

Shared Lives

Shared Lives is an alternative to traditional types of care and support available to adults with care and support needs. In Shared Lives, a person lives, or stays with a Shared Lives carer within the local community. The Shared Lives carer provides the care and support in their own family home and as part of their own family and community network.

Current market intelligence 

The Stockton Shared Lives Scheme was brought in-house in January 2022, transferring existing provision from the previous provider.

We currently have 20 active shared lives schemes.

Shared Lives is a fantastic alternative to some of the more traditional services. Providing an opportunity for people who require care and support to live independently in the community and can be an alternative to living in a care home, housing with care or housing with support.

The Shared Lives scheme matches people who need care and support with an approved carer. The carer shares their family and community life and gives care and support to the person with care needs. Some people live with their Shared Lives carer, while others are regular day-time visitors. Some people combine day-time visits with overnight stays.

How we propose to shape the market

We propose to grow the provision by a further 10 Shared Lives placements over the next three years.

How we will achieve this

A robust recruitment campaign, targeting different audiences as we want to attract potential new carers into the service, including people who are already employed in the care sector, who may be able to provide a short break or respite support, whilst receiving some additional income.

The service will actively promote the benefits of both working as a Shared Lives carer and for service users utilising the scheme via partners and amongst the general public.  

The service will develop robust training and support package for shared lives carers to enable them to develop and retain them within the sector.

We are working alongside Shared Lives Plus (SL Plus) and Social Finance to look at Shared Lives as a model for respite for informal carers looking after those on the dementia pathway. If successful, Shared Lives could be used as a model to meet the needs of those living with dementia and their carers in an alternative environment to residential care, providing support on a one to one basis that is personalised and cost effective, producing positive outcomes for all involved.

Housing with Care

Housing with Care combines accommodation with care and support services. It comes in many forms, from small communities of flats and bungalows to retirement villages. The facilities and care provided will vary, but Housing with Care schemes usually include self-contained flats or bungalows.

Current market intelligence 

In Stockton-on-Tees there are four Housing with Care Extra Care schemes for older people and two Housing with Care Supported Living schemes for people with complex care and support needs (which will be part of a future Supported Living framework along with a number of smaller Supported Living schemes).

As of April 2025, there were 173 occupied Extra Care units of accommodation.

There is currently a nominations process managed by our Strategic Housing Team. The current nominations process started in 2021.

In 2021 there were 27 referrals to the waiting list.

In 2022 there were 67 referrals to the waiting list.

In 2023, 63 referrals were received. Five referrals were out of area.

In 2024, 88 referrals were received. One referral was out of area.

How we propose to shape the market

In October 2024, the four existing schemes were recommissioned under a new Housing with Care Extra Care service specification.

The Housing with Care Extra Care services specification was produced in conjunction with the people who access these support services, their families or carers, and stakeholders. Engagement has taken place with residents regarding what is important to them about living in Housing with Care Extra Care schemes, which is reflected within the revised specification.

We have a consistent waiting list for Housing with Care Extra Care placements (with priority always given to those that can demonstrate a local connection to Stockton-on-Tees). As of April 2026 there are 54 individuals on the waiting list for Extra Care services who are awaiting referral to a scheme.

We are currently working to develop a model for Housing with Care Supported Living and we have been working with people who access these support services in order to produce an agreed specification, specific to Housing with Care Supported Living services.

We have growth in the aged population and referrals for Housing with Care Extra Care are generally people over 55 years, but referrals are considered based on assessed support needs.

We do recognise a slightly younger cohort of customers who otherwise would be eligible and suitable for Housing with Care Extra Care provision. We are committed to developing more supported accommodation and we would be interested in looking at options for developing additional Housing with Care Services, Extra Care and Supported Living, potentially with flexible approaches to meet the needs of a range of people.

Any enquiries regarding the development of additional Housing with Care services should to be directed to the Strategic Housing Team at strategichousing@stockton.gov.uk in the first instance for Housing Due Diligence processes to be undertaken. Read the Adults Supported Housing Market Position Statement August 2024.

Mental health

Mental health residential care home provides accommodation together with personal care providing 24-hour care and support.

Current market intelligence 

Stockton-on-Tees has six homes offering 81 beds. All of these currently come under the Residential Care for Older People framework and the Specialist Mental Health Accommodation Framework. 

There are also 21 Supported Living Schemes where people with a range of support needs, including mental health support needs and learning disabilities, live as independently as possible.

There are a number of people with long term placements within these Mental Health accommodation settings. In addition, there is a recognised need for additional significant and highly complex mental health residential support for individuals within the Borough.

In 2023 to 2024, 261 Mental Health Placements were made (excluding Discharge Support Services and Respite) which included supported living and care at home. 35 of these were out of Borough placements and 37 placements were made to Mental Health Residential settings in Stockton-on-Tees.

All our Mental Health Registered Care Homes in the Borough were rated as 'Good' by CQC in 2019 to 2020. When comparing this to 2021 to 2022 one home has now been rated as 'Inadequate'.

How we propose to shape the market

Following a review of the current provision for those individuals with significant and highly complex mental health support needs a new specification was produced and agreed and went to the market in March 2024.

The framework is aimed at support provision for people who require significant and highly complex mental health residential support services. The aim of this framework is to support commissioning work with interested suitable providers to deliver small scale schemes set around the agreed specification to meet individual support needs. This work will also link to the Housing LIN Report recommendations.

We will continue to work with our existing Mental Health Residential Care Homes and Older People's Care Homes to ensure the standards are improved and maintained where necessary and to ensure that they are providing the right residential environment for those individuals who live within them.

We will continue to work with providers across the market to design services to meet the needs of people within Stockton-on-Tees.

We work closely with our Strategic Housing, Public Health and Voluntary and Community Sector colleagues to help develop and support mental health initiatives and services including a Stockton-on-Tees Wellbeing Hub which will provide wellbeing support in the community following its launch in summer 2024.

We are looking to bring our Supported Living Schemes under a specific framework to ensure consistency where possible while still maintaining person centred care across these services.

Learning disabilities

Learning disabilities residential care homes provide accommodation together with personal care providing 24-hour care and support.

Current market intelligence

Stockton-on-Tees has 16 homes offering 137 beds, with a total of 84 people accessing support in 2023 to 2024 in the Borough and 49 people accessing support out of Borough.

There will be an estimated 2,827 adults with a learning disability aged 18 to 64 years living in Stockton-on-Tees. This number is not expected to increase significantly over the next five years. Autism is the largest associated condition among children with learning disabilities coming into adult services, followed by physical disability.

The Council has engaged with the market twice in 2022: once across Tees Valley with neighbouring local authorities and the other to engage with providers on the local requirements for 2023 and beyond.

How we propose to shape the market

The Council is looking to use the existing Learning Disabilities Residential Framework to work with existing providers and encourage new entrants to the Stockton-on-Tees market to address needs in:

• settings with dedicated and bespoke support that work to support a person to move to greater independence at all points of the individual's life course
• specialist or autism specific setting for individuals with the most complex needs
• all-female unit for sexual disinhibition or personality disorder or autism with complex behaviours
• option for an all-male forensics' unit
• planned local emergency respite provision

We are currently working to bring our Supported Living Schemes under a specific Supported Living framework. This is to ensure consistency where possible while still maintaining person centred care. There are currently a range of schemes differing in size and model but all of which provide care and or support to people to enable them to live in their own homes. We have developed a single specification which has been shaped by the views of people who access Supported Living services to ensure what matters to people is at the heart of the services going forwards. We plan to bring this framework to the market in late 2025 and follow a phased approach to the process to ensure the range of services are included.

Older people's residential care

A care home is a residential setting where a number of people live, providing care and support 24 hours a day.

Current market intelligence

The market for older people's residential care in Stockton-on-Tees remains one of contrast: whilst older people's care home providers are delivering good quality in the main, the market has too many beds for our local population needs which is impacting on overall occupancy, service improvement and viability of some homes.

There are a total of 31 older people's care homes in Stockton-on-Tees, offering 1,602 beds. In 2024 to 2025 Stockton-on-Tees Borough Council had 882 people in residential and nursing care.

Overall quality, when compared to the national averages for April 2024 (77.7%), demonstrates Stockton-on-Tees has a slightly higher percentage (77.8%) of care homes awarded Good or Outstanding by CQC. 

How we propose to shape the market

As of April 2026, 29 residential care homes are commissioned under the framework for residential and nursing care. 

Stockton-on-Tees Borough Council continues to work in partnership with care providers to ensure that older people have access to safe, high-quality residential care that meets a range of needs. We support providers through regular engagement, provider forums, and collaborative approaches to service development.

The Council remains committed to ensuring that the market continues to offer the right types of provision to support people with varying and complex needs, including culturally appropriate and inclusive models of care.

All providers within the framework are expected to deliver high-quality care that is person-centred, safe, and responsive. The Council works closely with providers to monitor performance, support continuous improvement, and ensure that services meet regulatory standards and the expectations of residents and their families.

Care at home

Stockton-on-Tees Borough Council commissions care at home services through a framework agreement divided into three distinct Lots, each targeting different levels of need and service types:

• Lot 1: Standard Care at Home (Domiciliary Care)
• Lot 2: Enhanced Care at Home for people with learning disabilities and autism
• Lot 3: Specialist and Enhanced Care for individuals with behaviours that challenge and complex conditions

Stockton-on-Tees Borough Council recommissioned its Care at Home Framework in November 2024. This a closed framework and will run from 2024 to 2029 with the option of a 2-year extension.

The framework allows flexibility and responsiveness to changing care demands across the Borough.

The Council monitors service quality through regular inspection, reviews and feedback mechanisms.

Current market intelligence  

In 2024 to 2025 we supported approximately 1,383 people to live independently at home, delivering over 60,000 hours annually at a gross cost of £18m. One provider also provides Care at Home for people currently residing in the prison system at a gross cost of approximately £100,000 per year. 

The Care at Home Framework providers deliver home care services and community support for older people, people with physical health and cognitive impairments, learning disabilities and mental health conditions (with some providers maintaining offices within Stockton-on-Tees or the wider the Tees Valley). Of those providers on the framework, 96% who have a current CQC rating were assessed as Good or Outstanding. 

Challenges in the market

Consistency in recruitment and retention continues to affect the Care at Home market, and if not proactively addressed can risk compromising both the quality of care delivered to residents of Stockton-on-Tees and the long-term sustainability of service providers.

Aligned with national policy drivers, Stockton-on-Tees Borough Council recognises the opportunity to invest in technology-enabled care to enhance connectivity, improve quality, and increase flexibility in service delivery. By leveraging digital solutions, individuals can be better linked to wider support networks, helping to address challenges such as social isolation. We also acknowledge the need to support the Care at Home market in further developing its maturity and capability in this area.

How we propose to shape the market 

Within the development of the new Framework, we made a commitment to continue to provide support to our Care at Home service in a range of areas, including to:

• continue to support recruitment and retention in the care sector using a variety of mechanisms, including continuation of our Sector-Based Work Academy Programme (known as the Care Academy) which is an introduction to working in the care sector with local providers offering guaranteed interviews to candidates
• direct recruitment through the Employment and Training Hub which offers tailored support for job seekers and learners aged 16 and over, including CV writing, interview preparation, training, apprenticeships, and access to local vacancies. It works in partnership with local services to improve employability and connect people to opportunities with a specific project targeted to support recruitment into Adult Social Care vacancies
• secure funding from the Tees Valley Combined Authority for a Care and Health Recruitment and Training Coordinator to be based in Stockton-on-Tees and to support the wider Tees Valley (role anticipated to commence January 2025)
• develop and continue to grow education and training provision including partnerships with Stockton Learning and Skills Service, Stockton Riverside College, Teeswide Safeguarding Adults Board and relevant partner organisations
• continue to develop our Ambassador Programme with providers to advocate for promoting career opportunities in the sector in schools, colleges and other relevant organisations 

Support and engage providers with the use of Technology Enabled Care (TEC)

We will:

• provide information and advice from our One Call services around availability and utilisation of existing TEC Solutions available within the Borough to support people accessing Care at Home services
• work with providers to identify and pilot TEC solutions technology with a focus on TEC as a preventative tool. We will explore different ways it can be used to deliver care and support to maintain people at home for longer including the use of Activity Monitoring to support care planning and responsiveness
• foster an open-door policy, good relationships and streamlined referral process to ensure access to TEC is easily accessible to the sector

Day opportunities

Day opportunities is a package of community-based day time activities which will engage adults with a learning, physical and or sensory disability, providing person-centred support and maintaining people's independence.

Current market intelligence

In Stockton-on-Tees, day opportunities for adults are currently provided in three ways: 

• Stockton-on-Tees Borough Council's in-house day services
• Stockton-on-Tees Borough Council's commissioned day services from the independent or voluntary sector
• support purchased directly by individuals from the independent and voluntary sector using a direct payment

Day opportunities can be either building or community-based and offer opportunities for social connections, activities which promote wellbeing, skills development and greater independence, and respite or breaks for informal carers.

Day opportunities are accessed by individuals with a range of needs including older people, people with learning disabilities, autism, physical disabilities, and mental health needs.

The two highest primary support reasons for individuals accessing in-house and commissioned day opportunities are for people with a learning disability (68%) and support with personal care (14%).

How we propose to shape the market

Between Autumn 2021 and Spring 2022 the Adult Social Care and Health Select Committee completed a scrutiny review of day opportunities for adults in Stockton-on-Tees.

The report and recommendations produced by the Committee were agreed by Cabinet in May 2022. The full report can be found on the Performance Review and Audit Select Committee document.

We propose to implement the recommendations from the review and to grow the range of options for community-based opportunities.

Transition into adulthood

Current market intelligence

Not all young people will require support from the Council when they turn 18. Upon transitioning to adulthood, what an individual receives will depend on their needs. The Council's aim for all young people is to maximise their independence, build on their strengths and networks of support, promote individual wellbeing, and enable them to maximise choice and control over their own lives. 

The number of children and young people looked after has reduced by 2% over the last five years from 578 in 2020 to 2021 to 564 in 2024 to 2025.

The number of children and young people looked after within the 10 to 15 year age group has remained stable over the last five years, at 230 children in 2020 to 2021 and 230 children in 2024 to 2025.

As a percentage of the total cohort, 10 to 15 year olds has increased by 1% over the last five years from 39.7% in 2020 to 2021 to 40.8% in 2024 to 2025.

The number of young people looked after within the 16 and over age group has changed by 35.6% over the last five years from 90 in 2020 to 2021 to 122 in 2024 to 2025.

As a percentage of the total cohort, the 16 and over age group has increased by 38% over the last five years from 15.6% in 2020 to 2021 to 21.6% in 2024 to 2025.

9.1% of children in need have a recorded disability (as of 31 March 2025) which is lower than the England average 13.6%.

In 2024 to 2025, the percentage of pupils with Special Educational Needs (SEN) is higher than the mean for all unitary authorities. This is in terms of primary mainstream schools for children with a moderate learning disability (12.1% for Stockton-on-Tees and 10.4% for unitary authorities), secondary mainstream (17.7% for Stockton-on-Tees and 14.7% for unitary authorities) and for special schools (17.5% for Stockton-on-Tees and 4.8% for unitary authorities).

How we propose to shape the market

Work is underway between Children and Families and Adults, Health and Wellbeing commissioners and social care teams to explore opportunities for young people going through the transition process to have a route into appropriate accommodation and support. 

Following an assessment of the market with the Housing Learning and Improvement Network (LIN) in 2022, we have established working groups to focus on identifying Registered Social Landlords or Housing Providers to provide high quality affordable accommodation for young people transitioning into adult services.

Specialist Housing Needs Assessment (2022) identified:

• up to 10 units of accommodation for vulnerable young people at risk or recovering from homelessness (by 2027)
• there is a need for move on accommodation in the form of one-bedroom flats when care leavers are ready to live independently, these properties need to be located in safe areas where young people will not be at risk of exploitation

The current Tees Complex Care and Support framework is designed to support people transitioning from children's services to adulthood. Commissioned in April 2023, we will continue to work with the market to ensure this delivers the right outcomes and timely support people need.

Reduce or eliminate use of short-term emergency provision, for our young people due to their vulnerabilities.

Have a clear pathway of accommodation options to meet the range of needs for young people 16 plus to assist them into early adulthood with stability and support.

Support providers who are skilled as advocates for young people, promoting their independence and self-care while supporting their journey into adulthood. Support providers who are adept at-risk management during transition.

Technology

Current market intelligence

Our current Technology Enabled Care (TEC) service is One Call. The service includes the lifeline unit and pendant, or the enhanced service that includes relevant assistive technology to enable the client to live independently. There are currently 5,131 people (as of September 2025) receiving this support and it includes a mobile response service.

The Council is committed to an ambitious programme that will introduce new and innovative technologies and digital approaches, which enhance the experience and the outcomes the people who use the service.

How we propose to shape the market

Our approach to the provision of technology solutions for care and support needs to reflect the changing requirements in our population and the rapidly evolving market of technology.

The current gaps we believe technology could be an enabler and positive influence for change include:

• improving the consistency of technology enabled care as primary consideration as a means of achieving key outcomes or people through Strengths Based assessment planning
• increase the profile of technology solutions as an integral means of achieving care and support outcomes
• regular reporting to partners detailing the impact of timely and appropriate technology solutions as a means of achieving optimised care and support outcomes
• working with stakeholders to ensure that our catalogue of solutions is both currently appropriate to meet the needs of our client group and that it is sufficiently forward thinking that we will be able to maximise service user and self-funder independence
• supporting local partners to develop and pilot innovative care solutions alongside Stockton-on-Tees Borough Council
• work with our partners to educate stakeholders and the general public of available solutions to home automation, smart homes and care and support technology to ensure that products are well understood and adopted

How we are currently adopting digital technology into practice

Exploring and adopting digital technology can significantly enhance the efficiency and responsiveness of Adult Social Care services. Some ways in which we are currently using technology to support people include:

• utilising 'Magic Note' Artificial Intelligence (AI) transcription to enable social workers to capture and organise key information during interactions and assessments, transforming notes into structured summaries or action plans. It supports faster decision-making and clearer communication and leads to more timely interventions and improved outcomes for people
• a newly developed "feedback" app, which empowers Adult Social Care services to respond swiftly to the needs and concerns of people, their families, and staff. By capturing insights instantly, it enables early identification of issues, continuous improvement, and more personalised care
• remote monitoring and technology enabled care through our One Call service, which provides live information on a person's daily living activities and health conditions for families, communities and health and social care practitioners, so that changing behaviours can be tracked, and escalating needs are supported