Home Support Pricing 2019/20: FAQs

Work towards implementation of the Cost of Care Model in Norfolk, which incorporates a banding structure, will have three potential outcomes for your service, depending on the type of contract you have at present. The questions below reflect some of the queries we anticipate being asked and the responses as of April 2019.

Q1: I am a spot contracted home support provider what does this mean to me?

A1: All spot contracted business with effect from April 2019 will be paid at a rate which is no lower than the existing spot rate of £18.24.  This rate is reviewed, at least annually, against the inputs to the cost of care model.

Q2: Why have we taken this decision for spot contracted providers?

A2:  Spot contracts were intended to be used as a back-up to block contracted provision where block contracts were unable to meet needs. It was not intended for spot contracts to replace block contracts, unless providers opted to tender for block contracted business. At present, the nature of a spot contract does not offer the Council any contractual commitment in terms of supply and the ability to terminate packages with 28 days notice does not wholly support a stabilised market place.

Q3: I am a provider who has a range of contracts, what does this mean to me?

A3: If you provide services under a spot contract you will be paid at a rate which is no lower than the existing spot rate of £18.24.  The final rates were recommended to Adult Social Care Committee in January 2019, before going to Full Council in February 2019 for agreement.

If you provide services under a block contract then you will remain on the tendered price which formed part of the formal competitive process and on which the contract awarded, and subject to any conditions within that contract.

If you are operating as a provider under the Framework agreement, you will be paid using the investment banded pricing which is dependent on the location of the person you are providing care to.

Q4: I am operating on the Framework in North Norfolk / Norwich / South Norfolk, what does this mean to me?

A4: You will be paid using the banded pricing which is dependent on the location of the person you are providing care to.

We will be writing to each provider organisation and highlighting the new banded rates which came into effect 8 April 2019

Q5: When will the Framework be re-opened in North Norfolk / Norwich / South Norfolk?

A5: The current Framework model is under review and a decision on the future and any further development of the model will be made in conjunction with providers already operating under the Framework in those localities. Ongoing discussion with non-Framework providers is also taking place. The current plan is to refresh the Framework during 2019 and as soon as the process for doing this is agreed, we will share the plans with providers.

Q6: When will the Framework be implemented in West Norfolk and East Norfolk?

A6: At this stage we do not have any definitive plans in place. In order to assess any possibility of making changes we need to be clear on the aims and appraise all options including impact. Many of you will be aware that block contracts were awarded in these areas in 2015 and 2016 and price formed part of the tender evaluation process. If you provide services under a block contract then you will be paid at the tendered rate, on which the contract award was made, and subject to any conditions within that contract.

We are committed to using the cost of care model to assess any business who approaches us outlining concerns over their business model and pricing strategies.

Q7: I am a block provider in West Norfolk / East Norfolk, what does this mean for me?

A7:  Many of you will be aware that block contracts were awarded in these areas in 2015 and 2016 and price formed part of the tender evaluation process. If you provide services under a block contract then you will remain on the tendered price, which formed part of the formal competitive process and on which the contract was awarded, and subject to any conditions within that contract.

We are committed to using the cost of care model to assess any business who approaches us outlining concerns over their business model and pricing strategies.

Q8: Why did the Council take this decision to have different pricing for each type of contract as opposed to a single price?

A8: We had to consider the basis upon which contracts were awarded and the price formed part of the tender evaluation criteria for each type of contract.

Spot contracts were intended to be used as a back-up to block contracted provision where block contracts were unable to meet needs. It was not intended for spot contracts to replace block contracts, unless providers opted to tender for block contracted business. At present, the nature of a spot contract does not offer the Council any contractual commitment in terms of supply and the ability to terminate packages with 28 days notice does not wholly support a stabilised market place.

We committed to review the pricing strategy during the Framework Accreditation Process in 2017.

Q9: My business costs are not fully reflective of the cost of home support model the Council have outlined, what can I do?

A9: We would always encourage you to raise any concerns about risk to the Council at the earliest possible stage.

We are looking at what provision needs to be put in place to assist businesses in reviewing their cost and operating models. As soon as we have more detail regarding this we will let you know.

Q10: What has influenced the cost of the home support model published by the Council?

A10: We committed to reviewing our pricing approach for those services which were successful as forming part of the Framework.

Throughout 2018 colleagues reviewed the market pressures in order to ensure we are able to support a marketplace which takes into account all of the, sometimes competing, pressures.

The research base used to look at the costs of providing home support included:

  • UKHCA
  • CIPFA – Commissioning and Costs of Care June 2018
  • Review of other Local Authorities
  • Work with local providers in Norfolk.

Q11: The Council has only used some GP practices as the base for determining the banding, why is this?

A11: We have used GP practices as our starting point and then looked at the level of need around those areas. Our analysis evidenced that the volume of need differed depending on geography. We have therefore looked at reflecting a reasonable price for what could be presented as a challenge in terms of lower volume and reach.

Q12: Do your bandings assume that workers and organisations have a start base close to a GP practice?

A12: We recognise that the operational delivery of organisations and individuals may not fully replicate what is presented and we have therefore looked to mitigate this through paying a minimum of £0.75 per hour (Band 1) based on a relative mileage of £0.25 per mile.

Q13: What happens next?

A13: We will continue to progress work to stabilise and develop the home support market to help keep people at home and this will be achieved via the following market interventions:

  • Adjustment – secure a sustainable strategic home support market via paying a fair price paid to care workers which makes a job in the Care Sector a serious consideration, and presents a foundation:
    • The primary focus is on quality of provision which enables people to remain independent, resilient and well.
    • The distraction and risk of competitive pricing is removed through the introduction of a cost model for Norfolk.
  • Shaping – efficient provision around GP practices which reduces competition for capacity through fewer strategic providers working in agreed locations and reduces the level of unmet care needs.
  • Development – integrated approach to avoidable admissions, specialist care support and ability to respond to social breakdown/crisis respite .

Q14: How have you considered Service User choice as part of your pricing decisions?

A14: Part of our responsibility under the Care Act is to ensure there is both diversity and quality in the provision that our service users can choose from.  By removing the distraction and risk of competitive pricing from the market, we can concentrate more fully on the quality and efficiency of the care we commission.  We expect providers to use the investment we are putting into the market to strengthen the skills and quality of their workforce and by offering service users a choice of good quality services.  We will continue to place packages of care with our Framework and block providers where possible, with service users able to access a direct payment where they want to choose their own provider.

Q15: How have you considered your other duties under the Care Act as part of your pricing decisions?

A15: There are duties on us, as the local authority, under the Care Act to promote the efficient and effective operation of a market in services for meeting care and support needs. By removing the distraction and risk of competitive pricing from the market we can concentrate more fully on the quality and efficiency of the care we commission.  By recognising the true cost of travel for your care workers, we hope to enable our providers to create more efficient and effective rounds, which maximise the amount of time carers spend with clients, rather than traveling.  We expect providers to use the investment we are putting into the market to strengthen the skills and quality of their workforce and also offering service users a choice of good quality services.  This will ensure a more sustainable workforce and a more sustainable market in which we can drive continuous improvement.

Q16: Which areas fall into which band?

A16: Please see our banded pricing map available here:  Home Support price band identification tool