Newham Council Work with Valuing Care to Help Them Meet the Conditions of the Market Sustainability and Fair Cost of Care Fund

Newham Council Work with Valuing Care to Help Them Meet the Conditions of the Market Sustainability and Fair Cost of Care Fund

The DHSC published guidance in December 2021 that set out conditions to access funding. 

Among others, these conditions included the need to:  
  • Conduct a cost of care exercise to determine the sustainable rates and identify how close they are to it
  • Engage with local providers to improve data on operational costs and number of self-funders to better understand the impact of reform on the local market (particularly the 65+ residential care market, but also additional pressures to domiciliary care)
  • Strengthen capacity to plan for, and execute, greater market oversight (as a result of increased section 18(3) commissioning) and improved market management to ensure markets are well positioned to deliver on our reform ambitions

Newham were keen to meet the requirements and were also aware that it had been some while since they had conducted a full local cost of care survey.

Following discussions, Valuing Care set out a bespoke project plan that took the DHSC guidance and combined this with Newham Council’s local needs. In addition, given the timescales, they were keen to bring in a company with experience based on previously completed projects of this nature.

The cost of care project will include the following client groups:

  • Market Surveys & Analysis – A robust and systematic approach to engage care providers to collect underlying cost data and validate reported costs. Sound statistical techniques to identify usual the costs of care within a locality.
  • Benchmarking – Valuing Care have used the collective intelligence from previous surveys to construct a range of cost models that calculate fair prices for services, reflecting local staffing costs and property values. This facilitates benchmarking of the local survey results, providing commissioners with increased confidence in what constitutes reasonable cost.
  • Reporting – Clear and accessible reporting that provides Commissioners with clear recommendations on what constitutes a fair price for services within a particular area. Development of pricing models which calculate a fair price for bespoke packages of care.
In addition, the information collected will provide the Council with a dataset and methodology ready for setting the metered Care Cap rate. This comprehensive approach will be crucial for any scrutiny the new Care Cap rate will receive ready for its implementation in October 2023.  Finally, all data collected with be uploaded into Valuing Care’s cost modelling tools. The software will ensure their commissioners have the skills and information to manage the market during the initial 3-year funding timescales set out in the DHSC guidance.  

The project will leave Newham Council with all cases recorded on a central system with a detailed breakdown of their costs. Going forward commissioners will be able to:

  • Underlying cost details of their targeted residential packages
  • Staff rotas relating to each individual package 
  • Comparing this information to Valuing Care’s national and local models to provide a detailed breakdown of cost per package
  • Storing all of this information into their own environment within the Purchaser software so all information can be captured once and reused over future years 
  • Using Valuing Care’s software and models to manage inflation requests from providers

The project will leave Newham Council with all cases recorded on a central system with detailed breakdown of their costs. Going forward commissioners will be able to:

  • Continuously compare current costs to Valuing Care’s model costs
  • Uplift cases by inflation in a targeted manner ensure value for money and sustainability
  • Conduct their own surveys which include data collection and uploading tools
  • Conduct scenario modelling for key variable such as regional Living Wage indexes
  • For Working Age Adults, review individual cases with the greatest variance, either by Provider, profitability, or sustainability

To view a video of the Purchaser and Commissioner software see below. 

If you are interested in knowing more about the Cost of Care review project or Valuing Care’s software please contact us.

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24th January 2022 | Ray Hart
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The Upcoming Care Cap – Why What Councils Pay for Residential Care is so Important to the Metered Rate.

The Upcoming Care Cap – Why What Councils Pay for Residental Care is so Important to the Metered Rate

The introduction of the Care Cap is less than 2 years away and there have been many headlines regarding its implementation and the different financial ramifications this has for Councils and self-funding residents.

However, one aspect that may have been overlooked so far is the rate that Councils currently pay for residential care and how that is used to calculate the metered rate. If the Care Cap guidance become reality, then an example of a weekly contribution for a full self-funder will be as follows:

Council fee rate – £600
Daily living charge – (£200)
Amount counted towards the Cap – £400

Pretty easy so far……

However, what happens if a self-funder cannot or does not want to purchase a care home placement at £600 per week and instead chooses a different home at a more expensive rate? Then, in that scenario the additional fee above the Council rate does not count and those additional funds needs to come out of their pocket.

Again, this is fair if someone is buying a place in a home regardless of the choice available around them at the Council’s rate. Unfortunately, across a large swathe of the country, self-funders cannot buy a placement near them at the Council’s rate. Indeed, in many places the Councils themselves are having trouble buying at that rate too.

In that scenario the amount that counts towards the Care Cap looks much less fair and could well be open to a deluge of complaints by self-funders across the country. These are the same self-funders that were promised that they would meet the Care Cap when they spend £86,000.

With the Daily Living Charge being set nationally it is likely that the complaints would concentrate on the Council Residential Fee Rate putting the current Council process under scrutiny. 

How is the Council Standard Residential Fee Rate Set?

Most local authorities will have a standard residential fee rate that they will purchasing older people’s residential care already in place. This rate is usually set yearly and ratified at Cabinet meeting each February. In addition, a nursing fee rate is set that is normally the standard rate plus the Free Nursing Care element 

The rate could have been set based on a historical rate that has been uprated for inflation or following a cost of care exercise completed sometime ago. Either way, with the local residential fee rate being so crucial for the Care Cap, this figure needs to be right, transparent and defendable.  

If this local rate is not reviewed thoroughly it may open up the Council to challenge on whether the process was transparent, reasonable and timely. Given the immediacy of the Care Cap implementation, challenges could centre on 2 key aspects

1) Is the residential fee rate truly reflective of the cost of supply in the local market?

A lot has changed within the last few years regarding the cost of supplying care. There have been increases to staff rates, additional regulation, higher utility bills and much more. In many places in the country these costs have affected the sustainability of some providers and this needs to be reflected in the latest fee rate and not rely on a inflation estimate.

To get to an accurate figure It is highly likely that a survey of care home costs will be required. This is the best way to ensure that any local variations are taken into account and fully represented in the local rate. However when conducting a survey it is important that any costs reported are realistic and are truly reflective of the actual costs of providing care. Any template returns need to be scrutinised by experienced professionals with a sound statistical technique applied to any results.

In addition once a survey and the resulting calculations are complete independent benchmark analysis needs to be undertaken to ensure that the figures are within an overall acceptable range. This may be a comparison with neighbouring local authorities. 

2) Can any additional services or facilities by Care Homes over the standard rate be justified?

Even after the standard fee rate is set accurately it is likely that there will be a good proportion of the market’s fees will be greater than the Council rate. If a care home is still above the set rate how can this be set out in a transparent and equitable manner?

Under the Care Act the Council will have the duty to support self funders through this purchasing process and any differences may lead to confusion and anxiety. Council commissioners can help smooth this part of the process by working with private care homes to set out a menu of additional service prices over and above the standard fee rate. These could include:

  • Quantified premiums for larger rooms
  • Staffing levels over and above the standard requirements rates which have been built up through over 50 area wide surveys over the last decade
  • Additional Costs for non-standard facilities
  • Additional Costs for services not normally provided in ‘standard residential care’

Again this could be done as part of the initial survey or call off framework contracts for self-funders could be developed that enable new placements to be bought in a fair and transparent manner. At the moment this is an area that Councils have left to the market. The new duties of the Care Act no longer give commissioners that choice.

The Time to Start on The Care Cap Implementation is Now

When you consider the confusion of self-funders entering the market, the additional workload and the possibility of a large level of complaints arising in 2023, setting up a pre-emptive system to aid self-funders through the Care Cap process is crucial. Valuing Care can help with both key questions above and are currently working with their customers to implement solutions.

Contact us to find out more on what Valuing Care has to offer in regard to the Care Cap.

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28th January 2022 | Ray Hart
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Dorset Council Choose Valuing Care to help them better understand their residential Care Costs.

Dorset Council Choose Valuing Care to help them better understand their residential Care Costs.

With so many underlying pressures in the care market, Dorset Council recognised that they needed to tackle the situation through a detailed review of all their commissioned residential costs.

Looking across the market they concentrated on two key areas: 

  • Older People’s Residential and Nursing Care 
  • Learning Disabilities Residential, both in and out of the County

As market leaders in the field, they chose Valuing Care to work on both projects, taking a different tact in the two areas to ensure they got the most value added from the work.

Creating a Sustainable Learning Disabilities Cost Model using Valuing Care’s Purchaser Software

The Council wanted to create a sustainable framework for all their residential placements, one that could be used for both new placements and reviewing existing placements. In addition, with so many placements spread across the southwest they want to be sure that any model they used could be flexed to meet geographical variations. Based on this, they asked Valuing Care to collect information on all their current residential packages and load them onto their Purchaser software to create a Dorset specific cost model. 

By proceeding in this way Dorset Council created a long lasting and maintainable record that they could easily update going forward. 

Working in partnership with Valuing Care they are collecting:

  • Underlying cost details of their targeted residential packages
  • Staff rotas relating to each individual package 
  • Comparing this information to Valuing Care’s national and local models to provide a detailed breakdown of cost per package
  • Storing all of this information into their own environment within the Purchaser software so all information can be captured once and reused over future years 
  • Using Valuing Care’s software and models to manage inflation requests from providers

The project will leave Dorset Council with all cases recorded on a central system with detailed breakdown of their costs. Going forward commissioners will be able to:

  • Continuously compare current costs to Valuing Care’s model costs
  • Uplift cases by inflation in a targeted manner ensure value for money and sustainability
  • Review cases with the greatest variance, either by Provider, profitability or sustainability

Older People’s Residential and Nursing Cost of Care Review

Valuing Care conducting a full survey of all care homes for older people within the Dorset Council area. The company met with provider representatives to explain the process and answer any initial question they had. 

Following this they have sent their tried and tested templates to all providers and are currently collecting provider returns. Survey requests were due at the middle of December 2021 with the Council expecting the final report by the end of January 2022. 

 

This report will be used as the basis for setting fee rates for 2022/23 and will include:

  • Aggregated Provider survey returns analysed for reasonableness and reported using Median rate analysis
  • A comprehensive benchmarking exercise against Valuing Care’s independent model rates which have been built up through over 50 area wide surveys over the last decade

In addition, the information collected will provide the Council with a dataset and methodology ready for setting the metered Care Cap rate. This comprehensive approach will be crucial for any scrutiny the new Care Cap rate will receive ready for it’s implementation in October 2023.

If you are interested in knowing more about the Cost of Care review project or Valuing Care’s Purchaser software please contact us using the button below. 

Contact Us

If you are interested in knowing more about the project or Valuing Care’s Purchaser software please contact here. 

 

24th January 2022 | Ray Hart
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Central Bedfordshire work with Valuing Care to better understand their Care Costs.

Central Bedfordshire work with Valuing Care to better understand their Care Costs

Over time, Central Bedfordshire have worked with Valuing Care on a number of care costs projects to provide them strategic oversight and transparency of costs in their care market.

In 2021 they again called on the company to work on 2 key projects:

  • Cost of Care Review for Older People’s Residential and Nursing Care
  • Learning Disability Placement Review using Valuing Care’s Purchaser Software

Cost of Care Review

Valuing Care conducting a cost review of care homes for older people within the Central Bedfordshire area. The Council were keen to separate out the additional cost resulting from the COVID pandemic. To facilitate this, Valuing Care requested two years of cost data from care home providers, with aim of calculating the financial impact on operating costs. Valuing Care helped in the consultation with providers and the survey received a good response rate.

The Council are now in receipt of the report ready for budget setting in 2021/22. In addition, the information provided will help the Council with the strategic overview needed to implement a successful Care Cap framework.

 

Learning Disabilities Spot Placement Review Using Valuing Care’s Purchaser Software

In 2017 the partnership conducted an in-area review of the current Learning Disability provision and found that the rates paid by the Council were broadly in line with their market costs. In 2021, the Council wanted to go further and create a sustainable framework for all their spot residential placements. Based on this, they asked Valuing Care to collect information from a list of targeted providers.

Rather than just collect the information in Excel, Central Bedfordshire asked Valuing Care to load all the cases onto the company’s Purchaser software so that they had a long lasting and maintainable record going forward.

 

Working in partnership with Valuing Care they are collecting:

  • Underlying cost details of their targeted residential packages
  • Staff rotas relating to each individual package 
  • Comparing this information to Valuing Care’s national and local models to provide a detailed breakdown of cost per package
  • Storing all of this information into their own environment within the Purchaser software so all information can be captured once and reused over future years 
  • Using Valuing Care’s software and models to manage inflation requests from providers

The project will leave Central Bedfordshire with all cases recorded on a central system with detailed breakdown of their costs. Going forward the Council will be able to:

  • Continuously compare current costs to Valuing Care’s model costs
  • Uplift cases by inflation in a targeted manner ensure value for money and sustainability
  • Review cases with the greatest variance, either by Provider, profitability or sustainability

If you are interested in knowing more about the project or Valuing Care’s Purchaser software please click the button below.

Contact Us

If you are interested in knowing more about the project or Valuing Care’s Purchaser software please contact here. 

 

24th January 2022 | Ray Hart
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Managing Your Complex Care Packages During Rising Cost Pressures

Managing Your Complex Care Packages During Rising Cost Pressures

Budgetary spend on complex packages of care continue to grow with service demand and overall price increases across Continuing Health Care, Learning Disabilities, Physical Disabilities and Mental Health services.

The expectation is that this will grow again in 2022/23, beyond available resources as inflationary cost pressures from staffing, utilities and extra regulation push up provider costs.

With budget pressures so high it is very hard for commissioning managers to determine what the annual percentage increase in complex care packages should be. It can become extremely tricky to balance the need to ensure sustainability whilst also achieving value for money within such a tight inflation envelope.

Over the coming months providers will be writing to request a 5% or 10% increase, each demand will be supported with calculations to justify the uplift. Given the compelling reasons presented by providers it is hard to work out where the line should be drawn.

 

Historically the organisational approach has been to set a standard inflationary uplift which can favour some providers with excessive profits and penalise others that are operating at effective prices. Most authorities have been through a cost reviewing process at some point over the last few years, however the collected data quickly goes out of date if inflationary uplifts are not assigned on a line-by-line cost basis.

Valuing Care’s approach is to assess the value of the current price and assign an appropriate percentage on a cost line basis: the method is supported by the company’s Purchaser software which stores each case’s cost breakdowns and gives commissioners the ability to update cost lines for the relevant inflation, using Valuing Care’s model costs as a guide. 

 

Each case is stored within Purchaser so that details can be saved and uprated easily. Inflation increases can be accurate and reviewed, year on year. By assigning the correct inflation to the cases that need it most, packages remain sustainable and profit levels are capped elsewhere. So, the next time you receive a provider letter demanding an inflation increase on a care package where you do not truly understand the delivery costs contact us to see how Valuing Care’s Purchaser software can put you back in control of the increasingly challenging market.

 
21st January 2022 | Ray Hart
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Independent Age: Choosing the Right Care Home

Independent Age: Choosing the Right Care Home

People often find themselves doing this in a hurry when there’s a health crisis, but it’s a good idea to think about what you’d like sooner rather than later and discuss this with your family or friends.

Where to start
You should start by having a care needs assessment. This will give you more information about the care you need, and help you think about what support would be best for you. 

Choosing a care home to suit your care needs
There are various types of care home available, depending on the level and type of care you need. The outcome of your care needs assessment should give you an idea of which one would be right for you. If you’re moving as a couple, it can be more difficult to find a home to cater for both your needs

Residentail care homes
These offer personal care, including help with washing, eating and drinking, going to the toilet and taking medication. 

Care homes with nursing care
These offer personal care, but also have qualified nurses on duty at all times. They may specialise in particular illnesses or disabilities, such as dementia.

Care homes offering some residential and some nursing care places
These might be a good option if, for example, your condition is likely to deteriorate and you don’t want to move twice. 

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LocalGov -The Scrutiny of Foster Care Costs

LocalGov -The Scrutiny of Foster Care Costs

The cost of fostering has been in the press recently as figures have been published stating that independent foster agencies (IFAs) are increasing the cost charged to local authorities for placing children with families. 

According to one report the average weekly fee for council registered carers is £396, while it rises to a staggering £759 for IFAs; 92% higher. All of this embroiled against a backdrop of multi-million pounds dividends for investors and huge director salaries.

Such highly inflated fees give rise to one very important question; why aren’t foster care costs subject to the same level of scrutiny as other social care costs? To look at foster care prices we need to examine the market from a more traditional demand and supply angle. With all areas of care this feels uncomfortable as we are talking about real people and the good work that they are doing, in this case looking after vulnerable children. However, like all areas of care in 2018, there is private provision and this needs to be examined and controlled or the market will be the one controlling the price of care.

…

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The Telegraph – Care Costs could decimate your assets

The Telegraph – Care Costs could decimate your assets

Care costs threaten to decimate the wealth that elderly people have spent their lives accumulating, but what are the options available to keep costs down?  

 According to one report the average weekly fee for council registered carers is £396, while it rises to a staggering £759 for IFAs; 92% higher. All of this embroiled against a backdrop of multi-million pounds dividends for investors and huge director salaries. 

Such highly inflated fees give rise to one very important question; why aren’t foster care costs subject to the same level of scrutiny as other social care costs? Care costs threaten to decimate the wealth that elderly people have spent their lives accumulating, but what are the options available to keep costs down?

The price of care has risen in recent years, thanks to a combination of short supply, care home operators struggling financially, and cuts to local authority budgets. An individual in need of nursing care can now expect to pay over £50,000 a year on average, if they have income and assets that exceed the £23,250 threshold above which care has to be self-funded.

According to healthcare research firm Lang & Buisson, the average fee for self-funded nursing care – which includes medical care from registered nurses – is £1,000 a week. 

James Connington | 3 April 2018 | Subscription Required
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The Telegraph – How appalling upfront fees add up

The Telegraph – How appalling upfront fees add up

 ‘I paid £11,000 for six weeks of care’: how ‘appalling’ upfront fees add up A Sunrise nursing home in Winchester; one Telegraph reader was charged £6,000 in entry fees by Sunrise Elderly residents at two of Britain’s biggest care home operators are being forced to pay “administration charges” of up to £6,000 – just for moving in.  

The charges are ostensibly used to cover clinical costs ahead of a resident’s arrival, but industry insiders have described them as “appalling and unnecessary”. Barchester Healthcare and Care UK, which collectively have around 20,000 residents, both charge residents a fee equivalent to up to two weeks’ care before moving in.

Last year, the average cost of nursing care surpassed £1,000 a week for the first time. One Telegraph Money reader, who wished to remain anonymous, was charged £6,000 when her mother moved into a home operated by Sunrise Senior Living.

3 March 2018 | Subscription Required
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The Telegraph – ‘Care home charged £2,000 for nursing my mother – after she’d died’

The Telegraph – ‘Care home charged £2,000 for nursing my mother – after she’d died’

Grieving families whose loved ones die in a care home are being charged after-death fees, often totalling several thousands of pounds.  

The charges, which are ubiquitous across the industry, are ostensibly to cover lost income while rooms are cleared out and cleaned before another resident can move in.

10 February 2018 | Subscription Required
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