Activity and unit costs

For long term support, unit costs are calculated for each PSR and by age group, for both residential care and nursing care. For short term support the unit cost calculation is for each PSR and by age group for short term care to maximise independence only. Further guidance is included in the ‘Activity recording’ section below.

Unit costs for home care are no longer calculated in terms of total cost divided by total hours delivered, but by the average standard hourly rates for personal care. There are two rates to be collected, one for the average standard hourly rate for internally provided home care and one for the average of all standard hourly rates by externally provided domiciliary care providers. This may require applying a weighting across a number of care providers to obtain one average hourly rate.

To calculate the unit costs additional information is required in terms of the number of resident weeks provided during the year for each PSR and age group. This is collected in the ‘Activity’ worksheet within the ASC-FR.

This worksheet contains data to support the calculation of unit costs for more information on what should be included please see the activity section of this guidance.

The Activity worksheet has two columns which ask for in house provision and external provision. For long term support, you need to enter the number of weeks in these columns. For short term support, you need to enter the number of hours. Failure to do this will lead to unit costs being calculated incorrectly.

Data should be provided for all cells, and all data requested are mandatory.

A number of row groups are requested as follows:

• long term support – broken down by age breakdowns and primary support reason.
• home care (Average standard hourly rate).
• short term support – broken down by age breakdowns and primary support reason.

There is an additional question at the bottom of the worksheet. This is mandatory, regarding whether the authority has been affected by capital or other revaluations.

As with previous worksheets there is a count of mandatory items completed. Consult the validation worksheet in order to investigate any issues. Also ensure that any extra context is provided via the feedback cells at the bottom of the Activity and or Unit costs worksheet.

The principles underlying the recording of activity data as part of the ASC-FR. For example, the same definitions of what constitutes “long term residential care” and “long term nursing care” should be used in collecting care weeks for the finance.

The ASC-FR additional activity that relates to long term care weeks should exclude care weeks associated with fully NHS-funded clients, self-funded clients, or Section 256 clients - consistent with the inclusion and the above general guidance.

Where a client receives services provided or commissioned through Adult Social Care where there are several sources of funding, apportion the activity accordingly and report only the proportion funded by social services. If the individual has no Adult Social Care funding at all, then exclude them entirely from the activity base.

Full cost clients

A full cost client is one who pays the full direct costs of the services they receive but whose support is arranged by the CASSR which includes regular reviews, support planning. CASSRs will be interested in the social care outcomes achieved for these clients and their continued involvement with the local authority provides an opportunity to capture this here.

Self-funded clients

A self-funded client is one who pays the full direct cost of the services they receive, and they decide not to take up any offer of support planning / care management (for example regular reviews) offered by the CASSR.

We realise that social services provide other preventative services to people in the community, for example through grants or service agreements. However only those clients who have been assessed by the CASSR or by a legally delegated NHS health partner under Section 75 arrangements and receive support specified in their care/support plan can be included in the long-term measures.

There should be no double counting - individuals should be counted only once, i.e., the sum of rows and columns equals the number of clients in that row or column. This is unlike the old RAP return where multiple components of a service could be recorded for a single client.

Long term calculation (residential and nursing care)

To enable unit costs to be calculated to show the cost of residential and nursing care for each primary support reason, additional information is required in terms of the number of resident weeks provided by the CASSR between 1st April and 31st March of the financial year being reported on.

The total number of weeks each primary support reason service user was supported in residential and nursing care during the year including breakdowns between nursing placements, own and externally provided residential placements are requested, split into the following age groups: 18 to 64 and 65 plus. 

Clients whose social care support does not incur resource costs for the CASSR for its social care components (for example, Supported People, s256, self-funded, and health funded clients) are excluded from the measure, while ‘full cost’ clients are included.

Calculating number of weeks provision

Within the activity worksheet we ask councils to provide the number of weeks provision. This needs to be calculated by the council relative to a full week’s care i.e., if a client received 5 hours of care per day, then that would be calculated in terms of weeks provision as follows:

5 hours * 7 days = 35 hours per week

35 hours / the number of hours in a week so 35/168

This client has therefore received 0.21 weeks provision per week

This then needs calculating to show the weeks provision over the full year. If the client received care as detailed above for half of the year i.e., 26 weeks then the full weeks provision for the year would be calculated as follows:

0.21 weeks provision per week for 26 weeks of the year

0.21 * 26 = 5.46

This client has therefore received 5.46 weeks provision during the year.

Short term calculation (ST-Max)

The number of hours included in the activity measure should reflect the guidance for Short Term Support to Maximise Independence:

This includes all episodes of support provided that is intended to be time-limited, with the intention of maximising the independence of the individual and reducing/eliminating their need for ongoing support by the CASSR. At the end of the support a review or assessment for ongoing care will take place to determine what will follow

Note that there is no requirement to know what will follow in order to be counted in this measure.

While episodes of respite care may also be time limited, the support is usually provided as part of a longer-term support package for a client, is commissioned only because of the existence of a carer who needs support, and should therefore be excluded.

Emergency support (i.e., not short-term care to maximise independence or ‘reablement’ but a crisis support service) should be included in Short Term

Education placements are generally categorised as temporary stays and should be included in Short Term Support – Other short term.

The total number of hours each service user was supported in short term support to maximise independence during the year including breakdowns between own provision and provision by others, are also requested both by primary support reason and by age groups: 18 to 64 and 65 and over.

Home care average standard hourly rates

Previous unit costs have been based on the total expenditure on home care services divided by the total number of hours delivered, but this is not reflective of the actual hourly rate paid to providers of external home care services.

Unit costs will now be based on the actual hourly rate paid for the provision of home care. There will be two rates: one for the hourly rate of in-house home care provision and one for the average hourly rate paid to external providers of home care services. The rates should be based on the cost of an hour of personal care. There is no requirement to analyse the rate further by primary support reason or age group.

It is possible for a CASSR to have a number of different providers and to have a variety of rates paid to those providers along with differing rates for part hour care. These need to be averaged out and weighted according to the number of providers or volume of hours per provider to produce a meaningful average hourly rate with which comparisons can be made with other CASSRs.

The hourly rate should be the standard hourly rate used for personal care and not the rate used for waking nights, sleeping in, or 24-hour care. This will enable unit cost comparisons to be made across CASSRs.

As the ASC-FR data will be used nationally to analyse the changes in the volume of home care hours over time, the hourly rates and cost data included in the return will be used to calculate the total hours of home care delivered.

How unit costs for home care are treated

Unit costs for home care are no longer calculated in terms of total cost divided by total hours delivered, but by the average standard hourly rates for personal care. It is possible for CASSRs to have a number of different providers and a variety of different rates paid to those providers, along with differing rates for part hour care. These need to be averaged out and weighted according to the number of providers, or the volume of hours per provider, not simply the total cost divided by total number of hours as before.