Buckinghamshire Council: setting clear budgets for care packages

Local authorities need to have a firm grip on adult social care package budgets in order to understand changes in need and expenditure and to avoid overspends. This is particularly important in a time of rising need, increasing complexity of need and tightening budgets. Effective monitoring helps spot pressures early and ensures that the public pound is directed towards maximising improved outcomes for people who draw on care and support.

The challenge

We found that budget holders did not understand why they had been given the budget that they had for care packages and were unclear whether this was enough for the year ahead. This presented a problem, as budget holders were unwilling to sign off their budgets at the beginning of the year.

With a budget of over £220m, we needed to identify a way to clearly monitor whether budgets were on track throughout the year. The first step was to divide the budget up into manageable chunks, or categories.

These categories needed to reflect spending of a similar nature, so we largely based this on the categories that are reported on through the adult social care finance return (ASC-FR) but summarised some areas, eg primary support reason (PSR), and expanded others, eg included extra care and shared lives.

The other issue was that in the past the costs would increase, but we had challenges in identifying the reasons why. We had growth in the budget and savings, but we could not tell if any overspends were because of demand growth being higher than expected, costs being higher than expected or savings not being delivered, as all these things were mixed together.

We needed a way of separating them out, so that if costs started increasing beyond the budget, we would know which categories to look at and what action to take – for example, whether it was because there were more people than we were expecting or whether the costs were higher.

The action

Step 1

Using data from the final position of the previous financial year, we identified categories of spend that we wanted to measure. We chose two different divisions:

1. Age grouping: 18–64, 65+
2. Type of care: nursing, residential, supported living, home care, day care, extra care, shared lives, direct payments.

Step 2

We identified how many people were in each category and what the average unit cost is (we measure in FTE, so if someone is there for six months, they count as 0.5 FTE). This produces a base budget for each area. At this point, budget pressures are identified where there is not enough funding to meet current need. At this stage, we also incorporated client income and income from section 117.

Step 3

We then inflated the unit costs for the rate of inflation and added growth. There are two types of growth:

• Demand (ie the number of clients, therefore increasing FTE) – if you have £0.5m of growth to add to an area and each FTE costs £50k for a full year, you know you can add ten more FTE.
• Complexity (ie large packages or more complex needs) – if you have £0.5m of complexity budget for 1,000 FTE with a current unit cost of £350 per week, you can increase the unit cost to £360 per week.

Step 4

Incorporating savings – you need to decide whether they will reduce FTE or reduce unit cost.

You then have an overall budget to measure against.

The outcome

As a result of the budget-setting process outlined above, we had a clear budget that allowed us to produce the graph below. This graph allows us to measure progress in a very simple way and shows whether we are on track or not.

We produce tables on a monthly basis, which show whether we have overspent or underspent in the different categories.

The weekly graph reflected the fact that most of the growth occurs in the first half of the year, as people who join in April tend to be there for almost a full year, whereas people who join in February will only be there for a few weeks.

Reflection

Having clear building blocks in how the budget was constructed helped in understanding where the pressure areas were and what actions could be taken to address the overspends.

Summarising it all into one graph means that managers can get an instant view of whether they are on track or not. However, there is a lot more detail behind the data.

In future, we would like to develop it further by moving to Power BI and including the primary support reason categories of learning disability, mental health and “other” (which includes physical disability, sensory support, etc).

7 July 2025

Contact information

Emma Wilding

Head of Finance, Adults and Health 
emma.wilding@buckinghamshire.gov.uk

Ruth Cover

Head of Strategy and Governance, Adult and Health
ruth.cover@buckinghamshire.gov.uk

Social care finance in focus themes

Building trust through governance and assurance

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