Decision details

On 1^st October 2020 the Department for Health & Social Care (DHSC) published details of the ADULT SOCIAL CARE INFECTION CONTROL FUND ROUND 2 RING-FENCED GRANT 2020.

Surrey County Council (SCC) is receiving £15.8m of Infection Control Fund (ICF) round 2 funding.  ICF round 2 is to support infection control across ASC care provision in Surrey and is for use in the period 1^st October 2020 – 31^st March 2021.  It cannot be used to fund costs before or after this timeframe.

ICF round 2 comes on the back of ICF round 1 which covered the period 13^th May – 30^th September 2020.  Surrey’s ICF round 1 allocation was £19.2m, so the £15.8m ICF round 2 allocation means Surrey is due to receive £35m in total of infection control funding from DHSC.

ICF round 2 is split into three elements as follows:

1.    £9.8m is ringfenced for care homes in Surrey and the grant conditions propose that funding is allocated to care homes based on the number of registered beds in each home.  In order to receive funding care homes must complete the national capacity tracker at least weekly.

2.    £2.8m is ringfenced for home based care, supported living and extra care community care providers.  Funding can only be paid to providers who are registered in Surrey (those providers who provide care services for Surrey residents but are registered in neighbouring local authorities should receive funding from their host authority).  The grant conditions propose that funding is allocated to community care providers based on the number of service users each provider supports.  In order to receive funding providers must complete the CQC homecare survey at least weekly.

3.    £3.2m is for discretionary use within the terms of the grant conditions.

SCC is required to report how grant funding has been deployed to DHSC monthly from November 2020 through to April 2021.  This includes confirmation of how grant funding paid to ASC providers has been spent across a range of infection control categories.  ASC providers are required to report back how they have spent their grant funding allocations monthly to ensure the grant has been spent in line with the conditions, and to enable SCC to complete the monthly returns to DHSC.  If ASC providers do not provide this information or they stop complying with other grant conditions (e.g. completion of care home capacity tracker / CQC homecare survey) then they will be required to repay the funding to SCC (and depending on when this happens SCC may then have to repay this funding to DHSC if it cannot be redistributed to other providers to offset eligible costs they have incurred up to 31^st March 2021).

The funding is being paid to SCC in two equal instalments.  The first instalment was paid in October 2020.  The second instalment is due to be paid in December 2020, although this is dependent on the government being satisfied that the first instalment has been spent in line with the specified grant conditions.

The grant conditions enable local authorities to take alternative approaches to allocate the ringfenced care home and community care funding to providers as long as the alternative approaches:

·         are consistent with the intention of the funding to provide an equitable level of funding among providers of community care, including those with which the local authority does not have existing contracts.

·         have been consulted upon with the local provider sector.

DHSC makes it clear that alternative approaches are “carried out at the local authority’s own risk”.

ASC has worked closely with the Surrey Care Association (SCA) to agree a proposed plan for how the ICF round 2 should be deployed.  A key point of discussion has been how to distribute funding fairly to community care providers. 

For ICF round 1, funding to home care providers was allocated based on the number of Full Time Equivalent care workers they employed to support Surrey residents at the end of March 2020 (including residents who fund their own care), and funding to supported living providers was allocated based on SCC’s annual expenditure on ASC care packages commissioned with each provider as at the end of March 2020.

ASC and the Surrey Care Association both agree that the per service user allocation method proposed by DHSC for community care is not a good methodology to use because:

Ø  the available data on service users is flawed and getting more accurate data would likely significantly delay the time by which payments could be made to providers.

Ø  allocating based on service users does not take account of differing acuity of care needs between residents.  Two providers could support the same number of residents, but the cost of care provision for these residents could be very different due to their level of needs.  The FTE care worker and SCC expenditure methods employed for round 1 for home care / supported living are deemed to be much more equitable bases for allocation.

This delegation decision paper confirms how SCC will deploy the ICF round 2 funding that is paid by DHSC.

It was agreed that SCC would utilise the £15.8m of Infection Control Fund round 2 that is due to be received as follows:

Ø  The £9.8m of funding ringfenced for care homes will be allocated to all care homes that comply with the grant conditions on a per registered bed basis.  If any care homes fail to comply with the grant conditions, their share of the funding will be added to the funding for community care providers.

Ø  The £2.8m of funding ringfenced for community care providers will be allocated to all community care providers that comply with the grant conditions.  Funding will be allocated to home care providers based on the number of FTE care workers they employ to support Surrey residents and to supported living providers based on SCC’s annual expenditure on care packages commissioned with each provider as at the 31^st March 2020 (before the main impact of the COVID-19 pandemic).

Ø  The £3.2m of discretionary funding will be allocated as follows:

o    £0.7m will be paid to day care providers.  Providers will receive 83% of the ICF round 1 funding allocations they received in line with reduction in Surrey’s total ICF round 2 funding compared to round 1.

o    Funding will be paid to supported housing and organisations that provide broader ASC services in the community and who demonstrate a need for funding to support infection control.  It is estimated around £0.15m of funding will be used for this purpose.

o    A small proportion of funding will be used to cover the cost of PPE purchased by SCC and distributed to ASC services in October 2020.  It is estimated that this will be a little over £0.1m.  ASC providers should be accessing free PPE through the government’s national portal, and so from 2^nd November if ASC providers place orders from SCC for PPE that SCC has purchased, SCC will charge providers for this PPE.

o    The balance of discretionary funding (likely to be around £1.9m - £2.2m) will be added to the community care ringfence and paid to community care providers.

To support COVID-19 infection control in ASC services across Surrey and ensure SCC is compliant with DHSC’s grant conditions.

SCC must spend the Infection Control Fund grant in line with the grant conditions and all funding must be fully spent by 31^st March 2021.

There are only two areas where SCC could have taken an alternative decision.

Firstly, the methodology for allocating funding to community care providers.

Secondly, how the discretionary funding is spent.

In both cases, the decisions reflected in this paper are considered the most appropriate to support ASC providers in Surrey based on market intelligence and through conversations with the Surrey Care Association.

None.