We have co-developed a Homecare Cost of Care Toolkit with ARCC-HR Ltd. The Excel-based toolkit will help councils and partners obtain a shared understanding of the costs of providing home care. The toolkit is open access and so can be freely used by all councils and providers.
Toolkit and guidance
There is a helpdesk available for this Tool which will respond to all technical queries about the tool at email@example.com. A regularly updated FAQ and other support materials, such as instructional videos, will shortly be available at www.costofcaretoolkit.co.uk
Please note: the helpdesk is unable to provide intensive and ongoing one to one support to any particular user or check, review or verify completed data submissions, nor address questions around the policy or process of the Fair Cost of Care exercise. These will be passed onto the CHIP team who can be contacted at firstname.lastname@example.org.
How has this toolkit been developed and tested?
In developing the toolkit, we utilised extensive experience of people from the sector, including home care provider organisations and council commissioners, and knowledge of how home care providers are structured and operate, the way council’s commission home care and the impact these factors have on the costs of delivering care. The toolkit has since been tested and further developed with a wide range of council and provider colleagues and used as part of an end-to-end cost of care process in two council areas.
Below is a summary of the engagement, testing and development.
Test version developed
In the spring and summer of 2021, CHIP engaged with various partners to demonstrate the Toolkit including home care providers and their representatives, Department of Health and Social Care (DHSC), Care Quality Commission (CQC) Market Oversight Team, Skills for Care and others such as developers of other cost of care tools, to make them aware of this toolkit and its purpose.
Test version demonstrated
From August 2021 to November 2021, the test version was demonstrated to each Association of Directors of Adult Social Services (ADASS) region and individually to over 30 councils attended by over 300 commissioning and finance colleagues. Further sessions held exclusively for home care providers, with over 150 care provider colleagues attending. Also tested as part of a full cost of care process in two local authorities.
Final version approved
From December 2021 to January 2022, further developments were made as a result of helpful feedback from partners. The final version was approved and shared with all councils and partners.
Cost of care context
Councils have responsibility for understanding the costs providers incur in delivering care in a local area and this should be considered within the fee setting approach and process. In most cases, a local authority will set specific fee rates and will decide how to do this and what these rates are.
In December 2021, DHSC shared information on the Market Sustainability and Fair Cost of Care Fund as part of the Local Government Financial Settlement. This has been described as the first stage of a move "towards a Fair Cost of Care". This information set out additional funding available to councils to support its programme of reform, requirements on councils in relation to cost of care and section 18(3) of the Care Act 2014 and conditions on councils to receive this funding. They were that by 30 September 2022, councils should have:
- Undertaken a cost of care exercise for home care (for people aged 18+)
- Undertaken a cost of care exercise for care homes (residential and nursing for people aged 65+).
- Completed a Market Sustainability Plan.
How will this toolkit support the sector?
CHIP commissioned this toolkit to support councils in their efforts to better understand cost of care, to inform strategic and operational commissioning approaches and to meet expected DHSC requirements in relation to cost of care. As we know, many councils have undertaken these exercises and here is a summary of just some of the benefits they have seen and are expected to be achieved through the use of this toolkit.
- Obtain knowledge about actual costs of delivering care:The toolkit has been made freely available to all councils and providers to support improvements in the level and quality of information about the costs of care. It is hoped that the toolkit will provide a basis for joint working between providers and commissioners and the development of a jointly understood and accepted set of information and evidence about actual costs incurred by care providers delivering care on behalf of councils.
- Inform commissioners operational and strategic planning and decision-making by supporting commissioners to understand the complexities in the home care market in relation to the way care providers operate and their structure and costs associated with providing care. This is expected to inform:
- Fee-setting exercises: The toolkit will support commissioners and home care providers arrive at a shared understand of actual costs and this is expected to support evidence-based decisions about fees, increase transparency around how fee decisions are made and help partners identify and deal with specific cost pressures, for example, relatively high cost of short visits).
- Market and provider viability: The challenges associated with market and provider viability are complex and no single approach or toolkit can resolve these. However, the principle behind this toolkit is that shared evidence and understanding of actual provider costs can be valuable in informing future decisions that affect, and support, provider viability and service quality.
- Market shaping: As with market viability challenges, this toolkit will not solve all market shaping related issues, but it will provide an understanding of how providers operate within the sector and the specific impact commissioning approaches and decisions have on the way care is provided. Experience shows that cost of care exercises are an effective way for partners understand not only where improvements are needed, but how these can be implemented.
- Create a toolkit by councils for councils: Other cost of care tools and model exist, but none of these have been specifically designed or produced for the benefit of councils, nor can they be used in full and free of charge by councils to calculate the actual costs of delivering the care and support they commission.
- Support councils to meet legislative requirements.