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Fair Cost of Care 2022/23

Cost of Care Context

In April 2022 Essex County Council commissioned an independent specialist consultancy firm called LaingBuisson to support the delivery of our Cost of Care Exercise across Essex. This statutory requirement issued by Central Government primarily focused on domiciliary care providers for Adults over the age of 18 and residential and nursing providers for Adults over the age of 65.

The council submitted returns to Government on the 14th October 2022 which included our median rates from the cost of care exercise with our methodology and approach. Alongside this exercise a draft market sustainability plan has been developed to summarise our current domiciliary, residential and nursing markets, the potential impact of the social care reform and our next steps.

Since October 2022, the Council have been working to review the outcome of the Cost of Care exercise to ensure we have a robust cost of care rates. This also includes a review of our supported living and extra care markets.

In December 2022 the Council met with our Essex Care Association to provide high level feedback on our median rates and the potential impact to our markets as a result of implementing the Social Care Reform in October 2025.


Fair Cost of Care exercise outputs

The Council has a requirement to publish our “Annex B” reports. Annex B provides are the detailed approach, methodology and calculations to our median rates for residential, nursing and domiciliary care:


Market Sustainability Plan

As part of the Cost of Care exercise the Council is required to complete a Market Sustainability Plan (MSP) to support the outputs of the Fair Cost of Care exercise. The Market Sustainability Plan includes:

  • Current market position of our residential, nursing and domiciliary markets
  • The potential impact of the Social Care Reform (SCR) on our social care markets
  • Plans to address market sustainability within our residential, nursing and domiciliary markets over the next 3 years.

The final Market Sustainability Plan was approved at Cabinet on the 21st March 2023. This has been submitted to Central Government on the 27th March 2023. 


The Council are already engaging with the Essex Care Association (ECA) and Care England on our Cost of Care exercise. We are scheduling a series of sessions either through existing forums or specific webinars to give providers an opportunity to understand the exercise, our findings and collaborate on our next steps.

February 2023

The Council will be hosting the following webinars on the outcome of the exercise. To ensure all providers are able to attend, we have scheduled 2 sessions on the same topic, the dates were:

  • Webinar 1 - Fair Cost of Care Outcomes for Providers - Tuesday 21st February 11:00-12:00
  • Webinar 2 - Fair Cost of Care Outcomes for Providers - Thursday 23rd February 11:00-12:00

Information on the webinar and answers to questions asked during the workshop:

March 2023

The Council will be hosting engagement sessions on the Market Sustainability Plan to offer providers an opportunity to understand the content prior to formal sign off, the dates for this are:

  • 8th March 2023: Engagement session on the draft Market Sustainability Plan and Market Shaping Strategy with ECA - 12-13:30
  • 21st March 2023 - Provider Webinar on the draft Market Sustainability Plan & Strategy - 14:00 - 15:00

Information on the webinar are: 

April 2023

The Council will be hosting sessions on the final Market Sustainability Plan and how this aligned to the Market Shaping Strategy, and Social Care reform objectives. The dates for this are:

  • 6th April 2023: Engagement session 1 on the Market Shaping Strategy with Adults with Lived Experience 10:30 -11:30
  • 19th April 2023: Stakeholder Engagement session with providers and all our partners 13:00 - 15:00
  • 26th April 2023: Engagement session 2 on the Market Shaping Strategy with Adults with Lived Experience 15:00 - 16:00

Other Engagement

The Council will be working with our existing forums to ensure information is shared at all opportunities. If you have any questions or would like to provide feedback on these topics or sessions please let us know through our Engagement Tool, which you can access by clicking here.

The Council are currently reviewing how best to allocate the additional grant monies received by Government across the Council and more specifically how much funding is available for our Adult Social Care.  Clarification of how this funding will be allocated is currently being finalised, however any increases including inflationary updates or moving rates towards the Fair Cost of Care will link into our Market Shaping Strategy and Market Sustainability Plan. Further information on specific markets will be issued through existing communications.

Detailed below are key dates (Subject to Governance)

  • 31st January 2023: finalising the Cost of Care rates for 2023/24 for supported living, extra care housing, Residential, Nursing and Domiciliary Care.
  • 1st February 2023: Statutory requirement to publish the Councils Annex B
  • 21st March 2023: Cabinet decision on the approval of the Market Sustainability plan
  • 31st March 2023: Publish the Market Sustainability Plan
  • 1st April 2023: Supported Living and Extra Care Housing Financial annual uplift of packages
  • 1st June 2023: Integrated Residential and Nursing Care annual refresh implementation
  • 25th June 2023: Live at Home annual refresh implementation

What is the difference between the Median Rate and Cost of Care rate?

The Median Rate is a calculated figure from providers that have completed the cost of care tool. The median rate is the midpoint range of a series of numbers/figures. As part of this calculation figures that are well above or well below may be discounted is they are proportionally out of range of what is known as an allowed tolerance.

How do you calculate the Cost of Care rate?

The Cost of Care rate is a validated figure as a result of reviewing the analysis of provider submissions and the median rates, previous cost of care tools, financial factors such as inflation and our commercial prospective of the market.  

How do you apply the Cost of Care rate into future procurement or refreshes?

Each service or contract will use the intelligence provided by the Cost of Care exercise and financial envelope within our Adult Social Care budget.  The Team will work with stakeholders to agree if any financial uplifts are required for that specific contract and will make recommendations on any strategic uplifts across a service or contract.

For an annual refresh this process is usually started in September/October each year and implemented in the following April.  For any annual refreshes it is subject to the financial envelop provided by Central Government.

Is the Market Sustainability Plan the same as your Market Shaping Strategy?

The Market Sustainability Plan is document developed specifically for Central Government to provide assurance that as a local authority we have a clear understanding of our existing market and the direction of travel we plan to implement over the next 2/3 years. Our Market Sustainability Plan was actually developed at the same time as our Market Shaping Strategy. Our Market Shaping Strategy will be issued in February 2023. 

The Market Sustainability Plan does also include a section on the potential impact of the Social Care Reform to the Council and our social care market. The impact has been identified and the Council will be working with our providers to understand the full impact to day-to-day market activity and shape the delivery of the Social Care Reform for October 2025.

Last updated: 28/02/2023