Section 5 - Expenditure on Free Personal Care for Care at Home clients

This section presents estimates of expenditure by local authorities on free personal care, for people receiving personal care as part of their Care at Home services. It presents estimated annual total expenditure, calculated from quarterly data supplied by the local authorities in the Quarterly Monitoring Return; and the estimated average annual spend per client receiving personal care at home. There is more information on how these expenditure estimates are calculated in the data quality section of the accompanying methodology and background information document.

It also presents some factors that may be associated with the changes in estimated expenditure over time.

Full data is available in the accompanying tables, both at Scotland and local authority level.

Data quality notes for estimated expenditure on Free Personal Care for Care at Home clients

The following estimates of total expenditure are likely to be under-estimates of the true total spend.

One reason for this is that three local authorities (Fife, Scottish Borders and South Ayrshire) have been unable to provide data on expenditure on personal care for Care at Home clients for several years. We do not have sufficient information to estimate their missing spend. Together these three local authorities account for around 11% of the total population of Scotland, according to the National Records of Scotland (NRS) mid-2024 population estimates. These three areas have been excluded from the calculations of average estimated expenditure per client, as explained in the sub-section on estimated, missing and revised data in the data quality section.

Another reason the total expenditure estimates are likely to be under-estimates is that some local authorities have difficulty in providing estimates of expenditure on personal care provided through certain kinds of self-directed support (SDS). There is more information on this in the data quality section.

The changes in estimated expenditure between 2023-24 and 2024-25 are likely to have been caused, in part, by reported changes to reporting processes in three of the 29 local authorities who submitted data in 2024-25. East Renfrewshire, Falkirk and Midlothian all reported making changes to their reporting on Care at Home clients for 2024-25, in order to provide a more complete picture of the numbers of clients supported, the hours of personal care provided and estimated expenditure. As they were unable to submit revised historic data, the numbers they submitted for 2024-25 showed increases from 2023-24, which are likely to have been caused (at least in part) by their reporting changes. Together these three local authorities make up around 6% of Scotland’s total population. We are unable to quantify how much of the change in their submitted data is directly due to their reported changes in reporting processes. However analysis of data from the 26 other local authorities which did not report changes to their reporting processes showed an overall increase in spend between 2023-24 and 2024-25. And that increase was larger than was seen between 2021-22 and 2022-23, and between 2022-23 and 2023-24. See the sub-section ‘Factors associated with rising expenditure on personal care for Care at Home clients’, below, for more information.

The reported changes in reporting processes across those three local authorities in 2024-25 may also have affected the figures for estimated average spend per client presented in this section, if the types of clients for whom expenditure was submitted had also changed as a result of the reporting changes. This is likely to have been the case in at least one of the local authorities (Falkirk). We did not receive equivalent information from the other two.

Please see the data quality section for more information.

Age 65 and over

Total estimated spend

Across the 29 local authorities who submitted expenditure data, an estimated £538 million was spent on free personal care services for Care at Home clients aged 65 and over in 2024-25. This is a 14% increase from the estimated £473 million spent the previous year, across the same 29 local authorities.

This annual increase in estimated spend is higher than we have seen in other recent years. Between 2021-22 and 2022-23, estimated expenditure across those 29 local authorities rose by 6% (from £417 million to £443 million). And between 2022-23 and 2023-24 it rose by 7% (from £443 million to £473 million).

Estimated average spend per client

Between 2023-24 and 2024-25 there were also rises in the numbers of clients aged 65 and over who received personal care at home. However, the rising number of clients does not fully explain the rise in total estimated spend. Across the 29 local authorities who submitted expenditure data, the number of Care at Home clients aged 65 and over who were reported as receiving personal care rose by 2% between 2023-24 and 2024-25 (from a reported 42,460 to a reported 43,260). But the total estimated cost of providing personal care to Care at Home clients aged 65 and over rose by 14% between 2023-24 and 2024-25, across the same 29 local authorities.

The estimated average annual expenditure on free personal care for Care at Home clients aged 65 and over who received personal care (across the 29 local authorities who submitted expenditure data) was around £12,400 in 2024-25. This is a 12% increase from the estimated average annual spend of around £11,100 per client in 2023-24.

Again, this annual increase in estimated spend per client is higher than has been seen in other recent years. Between 2021-22 and 2022-23, estimated average annual expenditure per client aged 65 and over rose by 3% (from £10,600 per client to £10,900). And between 2022-23 and 2023-24 it rose by 2% (from £10,900 per client to £11,100 per client).

Figure 4. The estimated average spend on personal care per client aged 65 and over in 2024-25 was £12,400, which was 12% higher than the estimated average in 2023-24 (£11,100). The estimated average spend per client rose by a greater amount (both in number and percentage) between 2023-24 and 2024-25 than it did between other years since 2021-22.

Estimated average annual spend on personal care, per Care at Home client receiving personal care and aged 65 and over, from 2021-22 to 2024-25, across the 29 local authorities who submitted expenditure data each year. Calculated from the estimated total annual expenditure each year, and the reported number of clients in the final week of Q4. The percentage numbers in brackets above each bar show the percentage increase in total estimated spend since the previous year.

Source: Scottish Government Quarterly Monitoring Return.

Please note: before 2021-22, data on expenditure on free personal care for Care at Home clients aged 65 and over was sourced from the LFR03 return. Since 2021-22, we have used data supplied in the Quarterly Monitoring Return to estimate this expenditure. Data from before 2021-22 is therefore not comparable with data since 2021-22. See expenditure data under ‘limitations of data and further background’ in the methodology and background information document accompanying this publication for more information.

Age 18 to 64

Total estimated spend

Across the 29 local authorities who submitted expenditure data, an estimated £303 million was spent on free personal care services for Care at Home clients aged 18 to 64 receiving personal care in 2024-25. This is a 14% increase from the estimated £266 million spent the previous year, across the same 29 local authorities.

This annual increase in estimated spend is higher than we have seen in other recent years. Between 2021-22 and 2022-23, estimated expenditure across those 29 local authorities rose by 9% (from £237 million to £258 million). And between 2022-23 and 2023-24 it rose by 3% (from £258 million to £266 million).

Expenditure on personal care for Care at Home clients aged 18 to 64 has increased by 70% from an estimated £179 million in 2018-19, the last year before Frank’s Law extended Free Personal Care to all adults assessed as needing it. This is an average increase of just over 9% per year.

Estimated average spend per client

Between 2023-24 and 2024-25 there were also rises in the numbers of clients aged 18 to 64 who received personal care at home. However, the rising number of clients does not fully explain the rise in total estimated spend. Across the 29 local authorities who submitted expenditure data, the number of Care at Home clients aged 18 to 64 who were reported as receiving personal care rose by 7% between 2023-24 and 2024-25 (from a reported 11,840 to a reported 12,680). But the total estimated cost of providing personal care to Care at Home clients aged 18 to 64 rose by 14% between 2023-24 and 2024-25, across the same 29 local authorities.

Per client, the estimated average annual expenditure on free personal care services for Care at Home clients aged 18 to 64 receiving personal care was £23,900 in 2024-25. This is a 6% increase from the estimated average of £22,500 per client in 2023-24.

Again, this annual increase in estimated spend per client is higher than has been seen in other recent years. Between 2021-22 and 2022-23, estimated average annual expenditure per client aged 18 to 64 rose by 2% (from £22,100 per client to £22,500). And between 2022-23 and 2023-24 it remained the same, at an estimated £22,500 per client in both years.

Figure 5. The estimated average spend on personal care per client aged 18 to 64 in 2024-25 was £23,900, which was 6% higher than the estimated average in 2023-24 (£22,500). The estimated average spend per client rose by a greater amount (both in number and percentage) between 2023-24 and 2024-25 than it did between other years since 2021-22.

Estimated average annual spend on personal care, per Care at Home client receiving personal care and aged 18 to 64, from 2021-22 to 2024-25, across the 29 local authorities who submitted expenditure data each year. Calculated from the estimated total annual expenditure each year, and the reported number of clients in the final week of Q4. The percentage numbers in brackets above each bar show the percentage increase in total estimated spend since the previous year.

Source: Scottish Government Quarterly Monitoring Return.

Data on expenditure for those aged 18 to 64 has been estimated from the Quarterly Monitoring Return since 2018-19 (first published in the Extension to Free Personal Care publication (2020-21). See expenditure data under limitations of data and further background in the methodology and background information document accompanying this publication, for more information.

Factors associated with rising expenditure on personal care for Care at Home clients

Estimated total expenditure on personal care for Care at Home clients has risen since 2018-19 (for clients aged 18 to 64) and since 2021-22 (for clients aged 65 and over), across the local authorities who have been able to submit expenditure data. The estimated average annual expenditure per client has also risen, for both age groups, in most years since 2021-22.

The rise in total estimated expenditure seen in 2024-25 may be due, in part, to the reported changes in reporting practices by three of the 29 local authorities who submitted expenditure data (as per the data quality sub-section, above). However analysis of data from the 26 other local authorities which did not report changes to their reporting processes showed an overall increase in spend between 2023-24 and 2024-25. And that increase was larger than was seen between 2021-22 and 2022-23, and between 2022-23 and 2023-24. Across those 26 local authorities:

• An estimated £498 million was spent on providing free personal care to Care at Home clients aged 65 and over who received personal care, in 2024-25. This is a 13% increase from the estimated £439 million spent across the same local authorities in 2023-24.
• For comparison, estimated total expenditure across those same 26 local authorities rose by 6% between 2021-22 and 2022-23 (from an estimated £391 million to an estimated £415 million) and by 6% again between 2022-23 and 2023-24 (from an estimated £415 million to an estimated £439 million).
• The estimated average spend on personal care per client aged 65 and over in those 26 local authorities also rose by 13%, between 2023-24 and 2024-25.
• An estimated £288 million was spent on providing free personal care to Care at Home clients aged 18 to 64 who received personal care, in 2024-25. This is a 12% increase from the estimated £256 million spent across the same local authorities in 2023-24.
• For comparison, estimated total expenditure across those same 26 local authorities rose by 9% between 2021-22 and 2022-23 (from an estimated £230 million to an estimated £249 million) and then by 3% between 2022-23 and 2023-24 (from an estimated £249 million to an estimated £256 million).
• The estimated average spend on personal care per client aged 18 to 64 rose by 7% in those 26 local authorities, between 2023-24 and 2024-25.

There are several factors which may be associated with rising expenditure on personal care to Care at Home clients over time. These include:

• An ageing population, leading to rising total demand for social care among those aged 65+.
• An increased emphasis on providing care through Care at Home services rather than in care homes, where possible, leading to a rising demand for Care at Home services.
• Changes to pay provision for staff, including the introduction of the real Living Wage, introduction of equal pay provision, and other wage inflation, resulting in higher wage costs.
• Increased use of agency staff and over-time payments, where there are challenges with regular staffing.
• Inflation of other costs included in providing personal care services, such as transport fuel and the cost of consumables. The values presented in this publication are not adjusted for inflation.
• A focussing of Care at Home provision towards clients who have critical or substantial needs, and who may require more hours of care, and/or more expensive care.
• Changes to reporting practices by local authorities which may have led to clients with larger average care packages being included in the data submitted on expenditure on personal care to Care at Home clients (likely to have affected the data from at least one local authority in 2024-25).

During 2024-25, while there were increases in the reported numbers of clients receiving personal care as part of their Care at Home package compared to 2023-24, inflationary pressures on service costs and changes in pay provision for adult social care staff to align with the real Living Wage are likely to have been influential factors in increasing the estimated total spend, and spend per client, of provision of personal care.