Free Personal and Nursing Care: Methodology and background information, 2023-24

Care homes

(including resident counts and expenditure)

Numbers of individuals in care homes quoted in this publication represent snapshots, as at the last day of each year. Likewise, quarterly values, available in the accompanying tables, represent snapshots of the final week of each quarter.

Quarterly 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 is the same as those provided for the final week, estimates for expenditure may not reflect variation within each quarter. Annual expenditure values are the sum of all four quarterly values, 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 values do not necessarily represent the number of people receiving FPNC for the full year. In the year to 31 March 2024, there were 14,429 long-stay admissions to care homes for adults, and 13,861 long-stay admissions to care homes for older people in Scotland (PHS Care Home Census for 2014-2024). This represents an average of around 277 long-stay admissions to care homes for adults and 266 long-stay admissions to care homes for older people every week, in 2023-24.

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 as at the week at the end of each financial year. Quarterly values available in the accompanying tables again represent snapshots of the final week of each quarter.

From 2012-13 to 2016-17 the Social Care Survey was 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 of care at home data for years before 2017-18 and since 2017-18 should be made with caution.

Similar to data for care home expenditure, data for quarterly expenditure on personal care for clients receiving Care at Home represents a snapshot based on the final week of each quarter. Annual values for expenditure as quoted in the publication and accompanying tables again represent the sum of all four quarterly values.

Some local authorities do not distinguish between personal care at home and Care at Home in general, classing all Care at Home as personal care. This may have artificially inflated the national percentage of Care at Home classed as personal care reported in the FPNC publication.

People receiving Care at Home have choice around how they receive their social care. This gives them control over what they receive and how it is paid for. This is known as ‘self-directed support’. There are four options for self-directed support. There is more information about these four options on the Scottish Government’s webpage about the extension of FPC to adults under the age of 65.

Depending on which options their clients receive, and how this is recorded, local authorities may find it difficult to report accurately on the number of hours of personal care provided, or the estimated spend on personal care, to Care at Home clients, in the Quarterly Monitoring Return.

Expenditure data

As in the 2021-22 and 2022-23 FPNC publications, expenditure data for both age groups of cients in 2023-24 was calculated from data provided in the Quarterly Monitoring Return.

However, the exact method of obtaining this estimated expenditure data is different for care home residents and Care at Home clients.

For care home residents, we estimate FPNC expenditure by multiplying the number of residents receiving each payment, as provided in the return, by the weekly FPC or FNC payment amount set for that year. These amounts are listed in Figure 1 in Appendix 1: FPNC Payment Amounts.

For personal care to Care at Home clients, weekly estimates of expenditure in the last week of the quarter were directly provided to us by local authorities within the Quarterly Monitoring Return. These weekly values are then scaled up to quarterly, by multiplying by 365/28 (= 365/7/4). The calculated variables section has more information about this calculation.

In editions of this publication from 2020-21 and earlier (available in the Free Personal and Nursing Care collection), expenditure data on FPC for those aged 65 and over, and expenditure on FNC, was taken from the Local Financial Return 03 (LFR03). In those publications, estimates of overhead costs for FPNC expenditure for those aged 65 and over were also made. In the new methodology introduced in 2021-22 (using the Quarterly Monitoring Return), estimates of overhead costs are no longer included in expenditure values. For each of the most recent three years when overhead costs were still estimated (2018-19 to 2020-21), estimated overhead costs represented on average 6% of the total expenditure of each Local Authority on FPNC.

FPC expenditure for those aged 18 to 64 has been estimated from the Quarterly Monitoring Return since it was first published in the Extension to Free Personal Care publication (2020-21).

The fact that expenditure data on FPC for those aged 65 and over, and on FNC, is now derived from the Quarterly Monitoring 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 from the LFR03 to the Quarterly Monitoring Return, estimated expenditure values for those aged 65 and over, and FNC expenditure, are not directly comparable to values from 2020-21 and earlier.

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

Total expenditure on adult social care, on care homes and Care at Home is still available at local authority level, 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 the raw data received in the Quarterly Monitoring Return is processed to produce the FPNC statistics.