The brief

C.Co was commissioned by Wirral Metropolitan Borough Council to undertake an independent and objective fair Cost of Care exercise to provide assurance on both the approach taken to setting local rates and the costs being considered. This was aimed at informing how the Council sets future fee levels and commissions care for services in scope of the review.

Services in scope included:

  • Supported Living
  • Residential, Nursing and EMI Care
  • Specialist Residential Care
The approach

The approach undertaken to carrying out this fair cost of care exercise was both collaborative, with commissioners and providers; and evidence- driven, based on provider data, benchmarking and research.

A pertinent aspect of the approach undertaken was the local focus and the necessity to capture data which represented local providers, their costs, challenges and service delivery irrespective of income source. The C.Co tool was utilised to capture the data required from Providers. The data captured is all-encompassing, ensuring data on costs, cost drivers, cost pressures and broader context is captured in an accurate and reliable way.

A series of workshop sessions and 1:1s were undertaken to support the approach to capturing data from providers.  A questionnaire was then issued to providers to capture data pertinent to the review. This data was subsequently analysed, in the context of the benchmarking and research undertaken, to inform the local cost of care.

The outcome

C.Co identified that the Council has a robust and comprehensive costing model for the in-scope types of care, meaning that C.Co’s approach was not to produce a new and alternative model, our standard end deliverable, but to use benchmarking and the data provided by providers to verify the existing models, the underpinning assumptions and outcomes to suggest adjustments where necessary.

Supported Living

The review confirmed that Wirral has a detailed fee model for determining the Supported Living hourly day rate, and night rate. On that basis, the data from provider returns was used to verify the model, and its assumptions, and to suggest adjustments if necessary.

Residential & Nursing Care

As with supported living, Wirral has an existing fee model for Residential Care which gives separate fee rates for General Residential, Residential EMI, General Nursing and Nursing EMI care. Given that this exists, C.Co’s approach was to use the data from provider returns to verify the model, and its assumptions, and to, again, suggest adjustments where necessary. Specific suggestions, detailed within our final report, relate to:

  • Management allowances – specifically on-costs and salary payments to non-care staff
  • Care staff – hours worked and associated payments and salary
  • Return on activity (profit) – as a percentage of all cost, this changes as other elements change.

Based upon the analysis of provider returns, a key finding was that care staff hours are understated to some extent but validate the other elements of the model.

Specialist Residential

As part of its commission, C.Co reviewed alternative models for assessing specialist residential care needs from both the cohort of statistical neighbours and from its knowledge and work with other local authorities in similar cost of care exercises. Consistent with our views of the model for both supported living and residential/nursing, Wirral has one of the most comprehensive and robust models for assessing specialist residential care needs that we have encountered.

‘C.Co’s expertise really helped us to get a true picture of the local cost of care for our area.’

Jayne Marshall, Lead Commissioner, Community Care Market, Wirral Borough Council

Contact our team of professionals to see how we can work with you in carrying out a fair cost of care exercise.