Complex home care packages for adults aged 18+ - Find a freedom of information request

I would like to request the following information regarding complex home care packages for adults aged 18+, except for questions 1, 2, 4 and 7 where information is required for both adults aged 18+ and children aged 0-18 years old.

I'm aware that there are differing definitions of 'complex' home care across local authorities but that the council may categorise a care package as 'complex' based on:

Number of Hours: Some authorities may define complex home care based on the number of hours of care needed per week or per day. For instance, if a person requires a significant amount of care each day, involving multiple interventions and skilled nursing, it may be considered complex home care.

Health Conditions: The presence of certain health conditions or combinations of conditions may also define complex home care. This could include chronic illnesses, severe disabilities, or a combination of physical and mental health needs that require ongoing support and monitoring.

Interventions and Procedures: Complex home care may involve the need for specialized procedures, medication management, wound care, monitoring of vital signs, or other skilled nursing tasks that go beyond basic home assistance.

Functional Limitations: Individuals with significant functional limitations, such as those who are bedridden, wheelchair-bound, or have limited mobility, may require complex home care due to the level of assistance needed for daily activities and health maintenance.

Risk Factors: Local authorities may also consider factors such as the risk of complications, hospital readmissions, or the need for emergency interventions when defining complex home care. Individuals with complex medical needs that require close monitoring to prevent health crises may fall into this category.

If you can't make a classification using the above list generally I would be looking for anything above 100 hours per week.

Home care refers to packages of care delivered in the individuals' own homes (not in care homes or residential facilities).

Please provide data for the following financial years: 2020/21, 2021/22, 2022/23, 2023/24 and 2024/25 (projected) except questions 5 and 6 which require a current snapshot (instead of projections for 2024/25), and question 7 which only requires data for 2023/24. If any data for 2023/24 is not available, please provide budgeted figures for the year or the latest snapshot data that is available.

Where possible, please kindly include responses on the attached spreadsheet.

1. Please could you supply the name, email address and telephone number of the commissioner with responsibility for packages of complex home care for (a) adults aged 18+ and (b) children aged 0-18 years old.

2. Please provide the number of people in receipt of complex home care packages (all active packages during the year including those which started prior) for (a) adults aged 18+ and (b) children aged 0-18 years old.

3. Please provide the total number of complex home care hours delivered for adults aged 18+.

4. Please provide the total gross expenditure on complex home care packages during the year for (a) adults aged 18+ and (b) children aged 0-18 years old.

5. Please provide the lowest, mean and highest hourly rate for complex home care packages for adults aged 18+ for 2020/21 to 2023/24 as well as a current snapshot.

6. Please provide the lowest, mean and highest weekly fee for complex home care packages for adults aged 18+ for 2020/21 to 2023/24 as well as a current snapshot.

7. Please provide a list of the 10 providers who received the greatest amount of funding for complex home care packages. Please provide data for the last financial year 2023/24 for (a) adults aged 18+ and (b) children aged 0-18 years old.

i. For each provider, please provide the number of complex home care packages in 2023/24 (all active packages during the year including those which started prior).

ii. For each provider, please provide total expenditure in 2023/24 related to complex home care.

I can confirm that the information requested is held by Lincolnshire County Council. I have detailed below the information that is being released to you.

1a N/a b. All queries regarding commissioning of domiciliary care for children should be addressed to LCCPlacements@lincolnshire.gov.uk

2a. N/a 2024/25: 2

2023/24: 0*

2022/23: 2*

2021/22: 0*

2020/21: Information not available*

* NB: During these years, Children's Services operated a block contract for up to 450 hours per week via a commissioned service to meet the needs of the majority of children requiring domiciliary care. It is possible that some children may have required more than 50 hours per week, but information is not readily available in a suitable format to validate this. The block contract was alongside the purchase of domiciliary care via an Open Select List of providers, which the above numbers refer to for 2021/22 to 2023/24.

NB: prior to 2021/22, Children's Services did not operate an Open Select List for domiciliary care.

3. N/a

4. a) N/a

(b) 2024/25: £38,117

2022/23: £30,970*

5-6. Adults don’t have any complex homecare cases according to the definition of 100+ hours per week

7i. N/a

ii.

Children’s Services

Lincolnshire County Council's Contracts Register is available via:Contracts Register- Search Results

Here, you can export the Contracts Register for Lincolnshire County Council, filter the Department by Children's Commissioning and use the term 'Domiciliary' to search the Title of the contract to ascertain the suppliers used by Children's Services and the value of the contract. NB: this will be in relation to all domiciliary care activity.  Given the low numbers of children involved, we would not want to identify the specific suppliers delivering the care in excess of 50 hours per week.