Since the introduction of the Care Act 2014 and ‘National Payment Tarif System’ commissioners across Health and Social Care have a statutory duty to facilitate and shape the whole publicly-funded and self-funded care and support market. The legislation requires authorities to provide choice that delivers outcomes and improves wellbeing through a sustainable market with sufficient services for meeting the care and support needs of adults.
Local payment approaches must be in the best interest of patients and service users with prices reflecting quality, efficient costs, effectiveness and allocation of risk. It is however, well documented that care services in the UK are experiencing increased demands and increasing complexity of care needs as well as rising costs for care providers.
These pressures have a direct impact on the setting of care fees – whether this is in a Social Care context with the setting of Domiciliary Care, Residential Care, Supported Living, Extra Care or Direct Payment rates or in a Health environment in setting Continuing Health Care rates for Residential Nursing and Health Care at Home providers. Commissioners must assure themselves that fee levels for care and support services are appropriate to provide the delivery of the agreed care packages with agreed quality of care. If fees are set too low, commissioners risk provider failure, reduction in quality and standards and a destabilised market.
C.Co can support Local Authority and Health Commissioners to develop an understanding of the local provider business environment, and cost and quality of care of Residential or Domiciliary Care to ensure fees are set at a rate that support a buoyant provider market and support commissioning and budgetary decisions.
Good commissioning practice requires an understanding of both the market and the providers cost incurred in running the business. Critical to sustainable provision, providers need sufficient cash flow to service costs and a sufficient return to ensure continuation of the business in the long term – meaning the outcome of this exercise has to be affordable, reasonable and most importantly fair.
There are a number of models and approaches, which are recognised as best practise for establishing the local cost of care, however C.Co, in accordance with CIPFA’s From Cost to Price Guidance, strongly believe collaboration with providers is the optimum way of establishing accurate interpretations of local cost of care.
We believe locally informed cost and quality modelling based on the actual costs incurred and quality reviews is the most reliable.
We adopt the following principles when establishing cost of care:
- A collaborative approach with providers
- A consistent approach across all provision
- Quality Assessments of properties (Residential Care)
With this in mind C.Co have prepared options for both Local Authorities and Clinical Commissioning Groups.