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Tuesday, Aug 16, 2022

‘How can it cost £20k a week to look after one child?’: a care home manager explains

‘How can it cost £20k a week to look after one child?’: a care home manager explains

A worker in the sector claims local authorities cost taxpayers money by going for the cheap option first
Council bosses in England are sometimes having to pay seven-figure sums annually in order to house a child with complex needs. Many local authorities currently have at least one child whose care costs £10,000 a week or more, with providers increasing their prices further in recent weeks and blaming the cost of living crisis. Here, a care home manager* explains how care can cost £1m a year:

“When we meet with local authorities, they ask us to give a breakdown of costs. When they realise how we have to cost our services, they start to understand. The high costs are almost always for placements that are made in an emergency after a child has gone through 10+ other placements which have been bought on the cheap and haven’t been able to meet their needs. The biggest scandal is that local authorities always try and use the cheapest placement first. When children’s needs aren’t met, that’s what ends up costing the taxpayer a fortune.

“How can it cost £22,000 [a week] to look after one child? Let me explain. Imagine you own an empty three-bedded children’s home. It has a manager on £50k and three staff on £27k. The company also has a responsible individual (legal requirement), administrator, HR, finance, QA [quality assurance], referrals. Salaries attributed to the home are around £100k (est £2,000 a week).

“Now imagine that you are asked to accommodate a 13-year-old child. They must have three staff with them at all times. This means you have to employ six extra staff. There can be no other children in the home. The child needs to move in three days. The authority are desperate. You want to help. But the only way you can do so is by using agency staff (you don’t have six spare staff standing by). Two agency staff for a 24-hour shift at £40 an hour is going to cost £1,920 a day (that’s £13,500 a week). You’ll charge the LA [local authority] at cost and make no profit on this. There’s also property costs, vehicle, insurance, training, maintenance, equipment, adaptations, resources, food & activities for child and staff. There’s regulation, monitoring. You also have to factor in risks of unknown costs. For all that you add another £2,000 a week.

“Now let’s say that the council say they only want the child to stay for 28 days (this is pretty common). You don’t take the risk of recruiting staff with no guarantee of the arrangement continuing. This means you have to factor in the continued use of agency. On top of all this you have to operate your business with an estimation that for some parts of the year the home will be empty (there is never any guarantee of business) so you have to include a payment for vacancies. And while dealing with all this you are acutely aware that you are responsible for a high risk service. If anything goes wrong, despite your best efforts, your entire business could be closed down in a heartbeat. You will need to pay off debts and manage the risks and future.

“There will be a very small number of providers who may take the mickey but hardly any, as most of us are in this for the long haul and know the value of positive relationships with local authorities.”

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