Decision details

Market Sustainability Plan and approach to care fees

Decision Maker: Adults and Health Committee

Decision status: Recommendations Approved

Is Key decision?: Yes

Is subject to call in?: Yes


The report seeks approval for the publication of a Market Sustainability Plan for Cheshire East. The plan will set out how the Council will use Market Sustainability funding to make tangible improvements in Adult Social Care services. The publication of a Market Sustainability Plan is the second requirement of the Department of Health and Social Care to secure the Council's funding allocation under the Market Sustainability and Fair Cost of Care fund. The first requirement was the publication of the Local Cost of Care. Adults and Health Committee approved the publication of the Local Cost of Care on 23rd January 2023.




The Committee considered a report which sought approval to publish the Market Sustainability Plan for onward submission to the Department of Health and Social Care (DHSC) and publication on the Council’s website. The report was a follow up to the Cost of Care report which was brought to the 23 January Adults and Health Committee.

The Market Sustainability Plan was the second requirement to securing funding and must be submitted and published on the Council’s website by 27th March 2023 and that no special dispensations would be considered by the DHSC to extend the deadline.


The Market Sustainability Plan related to a segment of the market which included registered domiciliary care for people over the age of 18 and registered residential and nursing care for people over the age of 65.


In response to questions and comments raised by Members, Officers reported that

-       In relation to the differentials of rates between areas a lot of work had been undertaken in analysing the market in respect of the current capacity in domiciliary care and what was required to build on that capacity in order to provide a service across the borough. There was a proposal to invest more money in the areas where it is difficult to access care capacity, including rural areas, and where recruitment was challenging in order to deliver care at home, and this was the main reason behind those rates. However, it was acknowledged that there was challenge around health inequalities and that the best way to address those was to invest in good jobs and good salaries where possible and within budget.

-       The cost of the commissioned independent consultants had partly come out of grant funding and commissioning consultants had saved time on the Council’s workforce.

-       There was no process in place to ensure providers report back on how they direct fee uplifts directly to the workforce, however, as result of the cost of care exercise there was some insight provided on what providers were spending the hourly rate on i.e. staff costs/salaries

-       Fee uplifts as a result of the 2023/24 Market Sustainability Grant have not yet been implemented  therefore the outcomes in relation to the objectives have not been seen yet.  However, there had been a mixed response from providers in response to proposals, and  it was hoped that it would be seen as an opportunity for some providers to expand outside Crewe.

-       Investment in fees for the supported living sector would take place this year with an aim to do the same the following year. However, the Market Sustainability Grant criteria means that it  is not intended for the supported living sector, it is for registered care and specifically those over the age of 65 and domiciliary care.


The Council had been allowed to keep some of the money received upfront from the DHSC for being a trailblazer, and for early implementation of the policy and this would run for the current financial year. Negotiations in respect of some of the costs that would run in to the next financial year were ongoing.


RESOLVED (Unanimously) :


That the Committee:-

1          Approve the Market Sustainability Plan for onward submission to the Department of Health and Social Care (DHSC) and publication on the Council’s website in accordance with grant conditions;

2          Note that the Market Sustainability Plan follows a format that has been prescribed by DHSC guidance.


Publication date: 30/03/2023

Date of decision: 27/03/2023

Decided at meeting: 27/03/2023 - Adults and Health Committee

Effective from: 07/04/2023

Accompanying Documents: