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Approaches to charging in extra care housing

Report, case studies | February 2010

This report, produced by the Institute of Public Care for the Housing Learning and Improvement Network, examines approaches to charging for services in extra care housing (ECH), with a particular focus on social care.

Using data drawn from existing research, supplemented by phone interviews with case study organisations, it looks at common models for configuration of service provision within ECH, the advantages and disadvantages of different contractual arrangements for social care, and ways of charging service users within those contracts. The emphasis throughout is on commissioners maximising flexibility for the service user, consistent with coherent, financially viable provision.

Having first addressed the types of service likely to be provided – housing management, housing-related support and social care – and the merits of integrated or separate provision, the report focuses on social care. In particular, it examines the limitations of the block contract, which guarantees a dependable volume of provision but permits minimal user choice, and assesses as a potential solution a core contract including overnight care, topped up with additional ‘spot’ purchased hours or services.

Charging options examined include banding according to level of need, which may fit with an overall ECH vision that includes a ‘balanced community’ of care needs, or charging for a core service with ‘top-up’ services available.

Implications of increasing levels of self-funding and self-directed care are also considered.

The report concludes with three case studies – two county councils and a borough council – examining their approaches to contracting and charging, and any obstacles encountered.