Agenda item

Report of the Director of Adult Services and Housing

The Cabinet considered a report of the Director of Adult Services and Housing, which sought approval for the use of monies available to the Council for 2022/23 in respect of the Fair Cost of Care (FCoC) reform.

A corresponding private report detailing confidential financial matters was also submitted for consideration (Minute 45 below refers).

Fair Cost of Care is one of a series of reforms to Adult Social Care which were contained within the White Paper ‘People at the Heart of Care’ published in December 2021 with other key reforms including the introduction of oversight of Adult Social Care by the Care Quality Commission from April 2023 and the introduction of a Care Cap and revised charging thresholds from October 2023.

The FCoC is the first of the new reforms to be implemented.  The primary purpose of the fund was to support local authorities to prepare their markets for reform, including the further commencement of Section 18(3) of the Care Act and to support local authorities to move towards paying providers a fair cost of care.  Section 18(3) would allow new self-funders accessing care homes the right to access the same rates that councils pay from October 2023 and existing self-funders by April 2025.  The Department for Health and Social Care (DHSC) have confirmed that, in practice, they expect that actual fees to be paid will be ‘informed’ by the FCoC process. However fee rates would continue to be based on sound judgement, evidence and through a negotiation process, as is the case currently. This means there would still be variation in the rates providers are paid to reflect quality, level of service, personalisation and wider market circumstances. The ultimate goal is to achieve a sustainable market.

To comply with the requirements of FCoC the Council was required to complete a FCoC exercise related to home support for those aged 18 and over and residential / nursing care for people aged 65 and over.  The requirement also includes the production of a provisional Market Sustainability Plan (MSP) by October 2022 with a final MSP required by February 2023.  The results of the FCoC exercise (in the form of a Cost of Care report) and provisional MSP were required to be submitted to the DHSC by 14 October 2022.  Following submission, the returns would be subject to a national review process by DHSC, and once that review process is complete, they will instruct local authorities to publish their cost of care reports. In addition, the Council is required to commit to ‘moving towards’ a FCoC.

National funding is available for FCoC.  This is £152m for 2022/23 rising to £600m for 2023/24 and 2024/25.  From the 2022/23 national amount the City Council had received an allocation of £1.047m with future years funding to be allocated pending the outcome of the FCoC exercise nationally.  FCoC funding was not expected to contribute to annual increases resulting from inflation or other cost of living expenses, nor the additional costs associated with demographic changes, these existing annual changes are expected to be met from other local authority resources.  For the Council to receive any future years funding it is required to comply with the FCoC requirements of DHSC. 

As the outcome of the process would not be confirmed until the subsequent review by DHSC, the draft outcome for submission was contained within the private report, and would be made public in line with DHSC guidance.  There was the option to reduce or close any gap by contributing additional Council resources to the FCoC but given the challenging position of local government finances and the fact that the introduction of FCoC is an additional burden as a result of government policy, using additional council resources to fund FCoC is not recommended.  The Council was nevertheless required to determine how the resource available for 2022/23 would be used to support moving toward a FCoC.  Further work would be required, including further engagement with adult social care providers, to enable finalisation of the MSP by February 2023 in order to understand the impact of this funding difference in the context of the local care market. 

RESOLVED that, the Cabinet:

1.  Approve that the FCoC funding provided be used to fund an additional increase for eligible contracted providers of home support for adults aged 18 and over, and residential/nursing care for people aged 65 and over for 2022/23 where the price paid is less than the FCoC.  This represents an additional fee increase of circa 3%

2.  Delegate authority to the Director of Adults Services and Housing, following consultation with Cabinet Member for Adult Services, to finalise the Market Sustainability Plan for February and submit the final report, subject to any further guidance received, by the submission date

3.  Support submission of the Cost of Care reports detailing how the exercise was completed, the results of the exercise and how the resource available for 2022/23 will be used

4.  Support the FCoC reform intent to move towards paying social care providers a Fair Cost of Care using govt resources provided to fund this reform