Call to Action on Government Cost of Care Process
Revised 3rd July 2022
You all know that your four local commissioning authorities are required to provide central Government with data that demonstrates the cost of care in relation to Domiciliary Care for the 18+ age group and for Residential & Nursing Care for the over 65’s for 2021/2022. The date for all submissions to be in with the local authority is July 15th or 18th depending on which LA you are working to.
This blog sets out how C&SW is approaching the process and how we can support you. We know you remain pressured by the continuing COVID situation and that staffing (i.e. the lack of it or the difficulty in retaining those you have) is a fundamental challenge for you. In those circumstances it seems reasonable to us that you might find this cost-of-care exercise is not at the top of your “to-do” list.
You as providers of care of all people involved in adult social care also know that the costs you experienced in 2021/22 continue to be on the rise and just providing those will not capture the “real” cost of care for now and the future. This is why we created our “Cost Considerations” report and circulated it to you and to all your LA commissioning managers.
It is our firmly held view that this is an opportunity for your voice to be heard loud and clear and that you should all participate in the cost of care exercise and provide for the LA data which allows them to challenge Central Government in terms of the level of funding they each receive to support your services.
I know that all your commissioning authorities are keen to engage with you to not only capture the 2021/22 data but also the added and increasing costs you are experiencing so that they can make their October 2022 report to Government a real-time statement of the situation you and they find themselves in and to make the case to Government for more funding to be available to each LA.
I also know that the best outcome as far as Central Government is concerned is that the reports they receive indicate the data collected was minimal. This will allow them to take the view that the situation in adult social care cannot be too dire because not many provider organisations completed the toolkit as a result of which the Local Authority report is not a challenge to their view that no further funding need be made available to the sector.
Below is an extract from the Government Market Sustainability and Fair Cost of Care fund 2022 to 2023 Guidance
Cost of care exercise
A process of engagement between local authorities, commissioners and providers, data collection and analysis by means of which local authorities and care providers can arrive at a shared understanding of the local cost of providing care. The cost of care exercise will help local authorities identify the lower quartile, median and upper quartile costs in the local area for a series of care categories.
Fair
For reporting purposes for this fund, and in terms of understanding the cost of care, fair means the median actual operating costs for providing care in the local area (following completion of a cost of care exercise) for a series of care categories. This must include and evidence values for return on capital and return on operations, and also travel time for domiciliary care. Together this is what is described as the ‘fair cost of care’ and is, on average, what local authorities are required to move towards paying providers.
In the context of specific rates for care paid, fair means what is sustainable for the local market.
For providers, this means they will be able to cover the cost of care delivery and be able to make a reasonable profit (including re-investment in their business), surplus or meet their charitable objectives.
Data collection tool
This is a spreadsheet or web-based system for use by each care location participating in the cost of care exercise to work out their breakdown of costs (per resident per week or per contact hour) for submission in the cost of care exercise. The spreadsheet or web-based system will contain pre-programmed formulas to help providers calculate these costs in a consistent way.
Data return
This is the return which will enable local authorities to record and submit:
full cost of care results tables for both 65+ care homes and 18+ domiciliary care
how the cost of care exercise outcome compares with average fee rates (Improved Better Care Fund (iBCF) definitions)
a breakdown of how spend has been allocated (in line with the fund purpose)
key strategic risk for both 65+ care homes and 18+ domiciliary care
Cost of care report
A PDF or Microsoft Word document explaining how the results in the cost of care data table were arrived at, including but not limited to, the contents described in Annex B. Separate reports should be produced for 65+ care homes and 18+ domiciliary care due to their very different cost bases. Local authorities are required to submit these reports to DHSC and publish them on their GOV.UK website.
Call to Action from C&SW
Like you, I am aware that no matter how much data you provide via this cost of care process there is a distinct possibility that Government will in any event decide not to increase funding support for adult social care.
However, can I urge you not to give Government an easy way out --- it is within your power to make sure your LA has all the information they need to create a robust and reality-based real-time report which makes the case for increased funding. Tell me, tell the LA, tell the organisations collecting the date the real situation you find yourself in.
Tell them that without increased funding your business will not survive and they (the LA) will have to pick up the pieces under their legal Duty of Care and provide from within the services their citizens are rightfully entitled to.
Make you voice clear, make it loud, MAKE IT NOW!!
David Smallacombe and Deian Glyn
On behalf of the C&SW Board of Directors
June 20th 2022