Agenda item

Fees for Residential and Nursing Home Care

Minutes:

A report by the Director of Adult Social Services informed that Councils had to negotiate with residential and nursing home providers regarding fees paid for care services.  This would ordinarily take place during the Provider Forums on an annual basis.  There had, however, been two legal judgments in the last 12 months which had resulted in the need to take account of the actual cost of providing services.  There must now be a transparent and informed consultation process relating to fee setting.

 

The Council introduced new contracts for residential and nursing home care in April 2011.  The contract included a clause relating to the annual review, and the setting of fees.  The process required consideration of changes in the market and cost pressures in the local economy for both home providers and for the Council.

 

The majority of homes provided residential places for Older People.  Feedback from residential homes that provided places for people with learning or physical disabilities or mental health issues and their resistance in signing a contract with the Council had led officers to conclude that fees for these Adult residential homes needed to be considered separately.  At present 70% of residential places for Adults with learning or physical disabilities or mental health issues were purchased on a bespoke cost basis. A detailed review of how these costs were determined, focussing on delivering greater consistency and transparency was to be the subject of a consultation exercise.

 

A process of consultation and engagement with care home providers, service users and stakeholders had therefore been put in place in order to minimise the risk of challenge, particularly through Judicial Review proceedings, in relation to how the Council had set its fees for 2012/13.  In order that effective consultation could take place, Members were advised that the consultation would extend beyond the Budget Setting Council meeting in February 2012, with fees backdated to April 2012 (if necessary).  Until such time that a definitive position on the fees was reached by the Council, the current fees would continue to be applied.

 

In order to ensure that the process complied with statutory obligations it was necessary to develop a model of best available “indicative actual costs” as a basis for consultation with care home providers.  This would be informed by data to be provided by the care home providers during the consultation period demonstrating the actual costs incurred by them.

 

The suggested timeline to meet these new requirements was outlined in the report.

 

An area of concern had been identified in relation to compliance with legal advice and best practice, regarding the collection process for “third party top ups” i.e. additional private contributions to the cost of an individual’s care fees.  Members were advised that the Directorate would need to realign procedures in order to ensure that vulnerable people were safeguarded in relation to this process.  Financial risk in relation to payment of “top ups” would transfer to the Council in the event of a defaulting third party.

 

RESOLVED: That

 

(1)  the Consultation process as outlined in Appendix 1 be approved and the Director of Adult Social Services, in consultation with the Cabinet Portfolio for Adult Social Services, be authorised to undertake such steps (including a fee proposal) considered necessary to ensure effective consultation with all relevant providers, partners and other stakeholders;

 

(2)  approval be given to revising the process for payment and collection of third party top ups; and

 

(3)  a further report be to be presented to the Cabinet at its meeting in in June 2012 to agree the new fee levels and implementation of the revised third party top ups payment and collection process; and, in the interim, the current fee arrangements shall continue.

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