Charging Reforms and Fair Cost of Care
The Government is planning reforms to charging for social care services. They have also instructed all local authorities to carry out Fair Cost of Care exercises and publish the findings.
This operational framework is intended to provide local authorities in England with information on the Department for Health and Social Care’s approach to enhanced monitoring and support, and statutory intervention in adult social care. The Secretary of State is able to intervene where they are satisfied that authorities have failed or are failing to discharge Care Act functions to an acceptable standard.
Data and analysis of fees paid to care providers by local authorities, reported as part of the Market Sustainability and Improvement Fund.
This explanatory note sets out further detail on the Social Care Grant, Discharge Funding, and the Adult Social Care Market Sustainability and Improvement Funding to enable local authorities to plan for 2023/24.
Local authorities can make use of around £2 billion in additional grant for social care through the settlement for 2023/24 compared to 2022/23.
The Autumn Statement confirmed that the government is delaying the rollout of adult social care charging reform from October 2023 to October 2025.
Key sections from the Autumn Statement:
“The NHS performance also relies on the adult social care system, so the government will make available up to £2.8 billion in 2023-2024 in England and £4.7 billion in 2024-2025 to help support adult social care and discharge. This includes £1 billion of new grant funding in 2023-24 and £1.7 billion in 2024-25, further flexibility for local authorities on council tax and, having heard the concerns of local government, delaying the rollout of adult social care charging reform from October 2023 to October 2025.
“£600 million will be distributed in 2023-24 and £1 billion in 2024-25 through the Better Care Fund to get people out of hospital on time into care settings, freeing up NHS beds for those that need them.
“£1.3 billion in 2023-24 and £1.9 billion in 2024-25 will be distributed to local authorities through the Social Care Grant for adult and children’s social care.
“£400 million in 2023-24 and £680 million in 2024-25 will be distributed through a grant ringfenced for adult social care which will also help to support discharge.”
A one page summary about the government’s planned Charging Reforms.
The adult social care sector in England is in an increasingly fragile position that will only worsen without substantial central investment and reform. The key issues facing the entire social care sector relate to workforce recruitment and retention challenges with one in ten posts vacant, inadequate funding the gap being in excess of £7bn, and the rising costs of living adding to the structural instability we face.
This briefing outlines the concerns and calls for action of the Care Provider Alliance and our members.
Fair Cost of Care§
CPA letter to Helen Whately, Minister for Care at the Department of Health and Social Care.
CPA’s analysis of councils’ Fair Cost of Care Reports reveals that in 2021/22, the government paid at least £2.88 billion less than the actual cost of delivering care to people in their own homes, and in care homes for over 65s. The government's commitment of £162m Fair Cost of Care funding per year for the next two years is nowhere near enough to bridge the chasm identified by their own exercise. But the real deficit in funding for social care is even higher. The Fair Cost of Care exercises were based on out-of-date and incomplete figures which do not reflect the full range of care services, or future needs and pressures.
Local authorities have been required to publish the findings of their Fair Cost of Care exercises on their websites by 1 February 2023. This document collates links to all reports.
This note is intended to update the sector on the next steps for year one of the Market Sustainability and Fair Cost of Care Fund 2022-23, including details on the DHSC review process, and the submission and publication of final Market Sustainability Plans and Cost of Care Reports.
This Tool was commissioned by the Care and Health Improvement Programme (CHIP, jointly delivered through ADASS and LGA), and its development was supported by CPA and a wide range of providers and commissioners. The Tool has been developed by iESE, who have previously developed the Care Cubed Tool that many of you may be familiar with.
The CPA guided providers to helpful information and support materials and how to register and use the CHIP Care Home Tool. A presentation overview can be found here with all the key initial information, along with a detailed guidance document in the registration section below.
To register for the CHIP Tool for Care Homes, you will need to first identify a Primary User within your organisation, and this person is responsible for registering your organisation, which may be a single care home or a group of care homes. If you are part of a group of care homes, then this will likely be a person at the head office.
The Primary user can set up multiple users for your organisation but take overall responsibility for the response.
To register on the CHIP Tool, click here. There is a helpful video here and walk thorough PDF here to support registration. If you have any technical support requirements, please email firstname.lastname@example.org.
Fair Cost of Care for Care Homes
Fair Cost of Care for Homecare
Local authorities are required to complete a separate exercise for home care services for adults. See video from Homecare Association below.
Fair Cost of Care for Homecare§
The Care Provider Alliance (CPA) is working with the Department of Health and Social Care (DHSC) in respect of the Fair Cost of Care (FCC) exercise and Market Sustainability Plan across both the home care and care home sector. Read letter sent to care providers.
The Fair Cost of Care (FCoC) process has been accepted by some care providers as an essential part of evidencing the true cost of providing adult social care (ASC) and rejected by others as another cost of care exercise which will see councils negotiate rates below the actual cost of provision. Providers felt the exercise didn’t accurately reflect the past or the future and asked the CPA to coordinate a paper to share their views with councils ahead of their FCoC Annex A, Cost of Care Report and Market Sustainability Plans being submitted to the DHSC. This report outlines the findings from 5 workshops with providers.
Market Sustainability Plans§
All local authorities Councils are required to publish a Market Sustainability Plan which is also returned to the Department of Health and Social Care (DHSC). Reviewing these returns will support DHSC's understanding of the key issues facing 65+ residential and 18+ domiciliary care in different local authority areas. This helps DHSC to understand market sustainability and risk with regards to these services and will be used to help inform their policies moving forwards.
The Market Sustainability Plan requires local authorities to identify the key risks to market sustainability for the 65+ care home market and the 18+ domiciliary care market and to establish plans to address any issues identified, including how market sustainability funding will be used over the next three years.
The plans are now complete and includes detail on how fees will be reviewed and inflated in 2023-24.