Update on: The Surrey LD Leadership Forum The Market Development Group The L&B Cost of Care Project

1. Update on:The Surrey LD Leadership ForumThe Market Development GroupThe L&B Cost of Care Project David Holmes Ashcroft/SCA/SLDLF 28 February 2013

2. SLDLF activities • Regular SLDLF meetings and discussions • Analysis of SCC budgets • Assessment of impacts on sector • Meeting with Sarah Mitchell and Anne Butler • LD Market Development Group • MDG project workstreams • Presentation to Adult Social Care Select Committee • Meeting with Sally Marks, Chair of ASC Select Committee • Meeting with David McNulty, CEO of SCC

3. Market Development Group Workstreams 1. Cost of Care To establish the true costs of care being incurred by providers of residential care and supported living in Surrey Jo Poynter • To create a dynamic culture and a robust process where providers and SCC work together to produce improved outcomes and value for money by: • The strategic configuration and management of resources • Increased cooperation over market efficiency and the use of shared services • Use of technology • Exploring opportunities for partnership working 2. Market Efficiency Mark Packer 3. Market Impact • To ensure that the Surrey market for LD care and support services is able to deliver services of appropriate quality to people with assessed needs in the long term. • Identify the range of policy, regulatory and economic drivers of change • Assess the likely impact of each of the key drivers on the market. • Mitigate negative market impacts as appropriate Andrew Price/David Holmes

4. The L&B Cost of Care Project – Objectives Overall Objective To establish the true costs of care being incurred by providers of residential care and supported living in Surrey Subsidiary Objectives • To understand the relative costs of different housing settings, including residential homes of different sizes • To understand different unit costs for people with different levels of requirement • To consider the accuracy of current fees • To provide a basis for calculating sustainable cost and fee levels in the future • To provide benchmarks to help providers operate economically and efficiently

5. The L&B Cost of Care Project: Key finding 1 – What Residential Care costs in Surrey

6. The L&B Cost of Care Project: Key finding 2 – What Supported Living costs in Surrey

7. The L&B Cost of Care Project: Key finding 3 – Profitability of services Residential care Supported living Average loss = 8.1% Average profit = 0.4% Underfunding on basis of 10% mark-up: 18.1% 9.6% “The fact that the average level of mark-up is negative when most providers need a certain minimum mark-up to continue in business is a cause for concern” “At face value this seems slightly less an adverse overall situation than in residential care”

8. The Challenge for Surrey LD Providers and SCC The challenge for Surrey LD Providers and SCC is: How to eliminate the funding gap in the provision LD services whilst meeting demanding budgetary targets, but without resorting to unacceptable cuts to services and quality. This requires Providers and SCC to work innovatively and flexibly in true partnership. Current cost of LD services 2012 L&B Cost of Care project determined that, on average, service costs significantly exceed fees. Challenge: Close the funding gap Future SCC LD Budget = Future cost of provision (in future structure) Current SCC LD budget CDH, 4/2/13

9. Objective 1: Reduce the cost of LD provision in Surrey (without impacting quality)

10. Objective 2: Increase the SCC LD budget (and ensure it is spent wisely)