Free Personal and Nursing Care: Methodology and background information, 2022-23

Care Homes

(including resident counts and expenditure)

Numbers of individuals in Care Homes quoted in this publication represent snapshots at the end of each financial year. Likewise, quarterly figures, available in the accompanying tables, represent snapshots of the final week of each financial quarter. As numbers of residents aged 18-64 receiving FNC have historically been very low, comparable information from the Quarterly Return has not been published for years prior to 2021-22.

Expenditure on FPC and FNC payments to care home residents is estimated based on these snapshots of the number of recipients at the end of each quarter. As this method assumes that numbers of individuals receiving payments for all weeks within the quarter are the same as those provided for the final week, estimates for expenditure may not reflect any variation within each quarter. Annual figures for expenditure are the sum of all four quarterly figures, as explained in 'Obtaining Annual Estimates' in the Data Quality section.

Due to the large number of admissions and residents leaving the care home population throughout the year, these figures do not necessarily represent the number of people receiving FPNC for the full year. In the year to 31 March 2022, there were 15,090 long-stay admissions to Care Homes for adults, and 14,620 long-stay admissions to Care Homes for older people in Scotland (PHS Care Home Census). This represents an average of around 289 long-stay admissions to Care Homes for adults and 280 long-stay admissions to Care Homes for older people every week.

Care at Home

As with data for care home residents, numbers of clients receiving personal care services at home quoted in this publication provide a snapshot at the end of each financial year. Quarterly figures available in the accompanying tables again represent snapshots of the final week of each quarter.

From 2009-10 to 2016-17, the Home Care Census (and from 2012-13 the Social Care Survey) had been used to provide the number of Care at Home clients at the end of March each year. Since 2017-18, the Scottish Government Quarterly Monitoring Return has been used for this purpose. As a result, any comparisons with prior years should be treated with caution.

Similar to data for care home expenditure, data for quarterly expenditure for those receiving Care at Home represents a snapshot of the final week of each quarter. Annual figures for expenditure as quoted in the publication again represent the sum of all four quarterly figures.

Expenditure data

In keeping with the 2021-22 publication, which presented data on FPNC provided to those aged 18-64 and 65+ in the same publication for the first time, the 2022-23 publication again sourced expenditure data for both age groups from the Quarterly Monitoring Return.

However, the exact method of obtaining this expenditure data is different for Care Homes and Care at Home:

• Care Homes: expenditure is estimated by multiplying the number of persons receiving each payment, as provided in the return, by the weekly FPC or FNC payment amount set for that financial year (these are listed in Figure 1 in Appendix 1: FPNC Payment Amounts)
• Care at Home: weekly figures of expenditure on personal Care at Home are directly provided by Local Authorities within the Quarterly Monitoring Return. The instructions in the 2022-23 return stated that ‘this should be based on the average/generic cost for your area’

The fact that expenditure data for those aged 65 and over is now derived from the Quarterly Return means that all variables are now aligned to the same timeframe and source for both age groups. However, due to the change in source, this means that estimated expenditure figures for those aged 65 and over are not directly comparable to figures from 2020-21 and earlier.

In editions of this publication from 2020-21 and earlier (available on the Scottish Government website), estimates of overhead costs for FPNC expenditure for those aged 65 and over were made. Due to the new methodology introduced last year, estimates of overhead costs are no longer included in expenditure figures. For each of the most recent three years when overhead costs were estimated (2018-19 to 2020-21), estimated overhead costs represented on average 6% of the total expenditure of each Local Authority on FPNC.

For context, in publications from 2020-21 and earlier, expenditure data for those aged 65+ was taken from the Local Financial Return 03 (LFR03). However, data on expenditure for those aged 18-64 has been estimated from the Quarterly Monitoring Return since it was first published in the Extension to Free Personal Care publication (2020-21).

While there are small differences in the methodology used in producing annual expenditure figures between the Extension to Free Personal Care publication (2020-21) and subsequent publications combining 18-64 and 65+ data, figures are broadly comparable between these publications.

Comparable information on total expenditure for Care Homes and Care at Home services is not provided within the Quarterly Return – but only expenditure on personal Care at Home is directly reported in the return. Expenditure estimates from this source are not available, however total expenditure is still available in LFR03 returns, published as part of the Scottish Local Government Financial Statistics publication.

Please see Appendix 2: Collected and Calculated Variables for more details of the calculations to produce annual expenditure estimates, and the Data Quality section of this document for more general information about how raw data from the Quarterly Monitoring Return are processed.