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Care homes to face more profit scrutiny in Treasury value for money drive

Politicians have asked for more scrutiny of care home profits in a new report to Government. Reforming adult social care in England published by the  Public Accounts Committee calls on Government to assure itself that funding for market sustainability and improvement has not just ended up increasing provider profit margins.

The report criticises the lack of clear DHSC strategy for pulling together data from across the sector and transparency of quality for the public and payors.  The report says: “We are concerned that the Department’s grasp of what it is getting for the £1.6 billion funding to support hospital discharge, is … vague.”

Other recommendations relating to value for money in social care include assessing the amount of additional capacity achieved by discharge funding.

The report places specific spotlight on Integrated Care Systems, which it says are yet to make a demonstratable difference to adult social care delivery. It says: “We remain concerned about under-representation of adult social care in health-dominated systems and are deeply sceptical about the feasibility of integrating health and care when they are funded so differently.”

In total, and supporting the delivery of value for money for the Treasury, the report makes six recommendations to the DHSC to reform care:

  • Deliver more information on outcomes in care to enable comparisons between different areas
  • In view of the 10-year vision for reforming adult social care, plan for more stable funding, and longer-term funding
  • Better leadership on recruitment and retention, including addressing disparities with NHS pay and the challenges of international recruitment
  • Provide clarity on the timescale for delivery of workforce projects and novel payments systems  
  • Set out a roadmap for delivering the DHSC vision for reform of social care charging.

Commenting on the report, Care England CEO Professor Martin Green said:
“The gauntlet has been thrown by this report. It’s about time we stop letting the government get away with marking its own homework. We need accountability and responsibility to rise to the challenge.”

In an overview of the sector, the report notes that in 2022–23, local authorities supported more than one million people with care needs, at a cost of £23.7 billion.

As at Autumn 2023, there were 470,476 people awaiting an assessment of their needs, care or direct payments to begin or for a review of their care plan. The sector employs around 1.6 million people and as at March 2023 there were 152,000 vacancies (9.9% vacancy rate), with the number of jobs in care expected to increase in future years.

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