Issue - meetings
Care Homes Fees
Meeting: 26/02/2013 - Adult Services Scrutiny Committee (Item 9.)
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John Jackson,
Director of Social and Community Services, will introduce the proposals on the
directorate position on Care Home Fees. It has been proposed that the directorate
should:
- Confirm the
interim payment 3% already paid to care homes in 2012/13 and
- Increase the
payments for residential homes and for the lower band for nursing homes
from 1st April 2013.
The report is
currently out for consultation. The committee are invited to comment on the
proposals.
Meeting: 29/01/2013 - Cabinet (Item 5)
Cabinet Member: Adult Services
Forward Plan Ref: 2012/116
Contact: Andrew Colling, Quality & Contracts Manager Tel: (01865) 323682
Report by Director for Social & Community Services (CA10).
The Council has a
statutory duty to make arrangements for persons aged 18 or over who it assesses
are in need of care and attention which is not otherwise available to them.
Consequently the Council pays for approximately
1,700 older people in care homes for older people at any one time, at a cost of
circa £48m per annum.
Each year we set a rate for care home fees – in
Oxfordshire we have bandings representing different payments for different
levels of client need.
Recently Care Home providers have mounted
successful and unsuccessful challenges to the way their local authority set the
fee rate. Judgements were made on:
• the
consultation process;
• the Service and
Community Impact Assessment;
• the assessment
of the cost of care.
As a result there
has been debate nationally about the ‘usual cost of care’ and the extent to
which local authorities can take account of both their own resources and of
market factors, such as the number of private payers (who generally pay more),
when setting the rates.
There is no
nationally agreed methodology for calculating the cost of care but the
Association of Directors of Adult Services is developing its own model.
This paper
proposes that the Banding System in Oxfordshire be simplified.
It proposes that
we should
a. Confirm
the interim payment 3% already paid to care homes in 2012/13 and
b. increase
the payments for residential homes and for the lower band for nursing homes
from 1st April 2013.
The cost of the
proposed increases in 2013 /14 is £405,000 which will increase the pressures on
the Older People pooled budget next year.
We are not
offering a general inflation increase for 2013/14 in the light of the 3%
increase earlier this year (cost to the council was £900k).
Our new rates are
within the range of neighbouring authorities, but remain considerably below
what we routinely pay for care in Oxfordshire today.
We will be carrying out further consultation
with our providers on these proposals.
Any provider who is not happy with the rate has the option of trying to
challenge us through the courts if they have grounds for believing that we have
acted unreasonably.
The Cabinet is
RECOMMENDED that in view of the above:
(a) for 2012/13 and for Care Home Placements in
Oxfordshire to:
1.
Confirm
the 3% uplift agreed as an interim payment for all existing placements in care
homes from April 2012.
2.
Confirm
the 3% uplift agreed as an interim payment for all new placements in care homes
from April 2012.
(b) for 2013/14 to:
·
Revise
our Target banding Rates from April 2013 and
(i).
Delete
the Residential-Substantial Target Banding Rate
(ii).
Increase
the Target Banding rate for the Residential-Extensive Specialist Category to
£452 per week for new placements.
(iii). Increase all existing weekly Residential payment rates ... view the full agenda text for item 5
Minutes:
At this point
Cabinet agreed to vary the order of the agenda to take the next two items
before the Service & Resource Planning report.
The Council has a
statutory duty to make arrangements for persons aged 18 or over who it assesses
are in need of care and attention which is not otherwise available to them. Consequently the Council pays for approximately
1,700 older people in care homes for older people at any one time, at a cost of
circa £48m per annum. Each year we set a
rate for care home fees Cabinet considered a report that proposed that the
Banding System for Care Home Fees in Oxfordshire be simplified.
Councillor Jenny Hannaby, Shadow Cabinet Member
for Adult Services, stated that at the last review when there had been a
reduction in fees concerns had been expressed at the Scrutiny Committee about
the possible impact on the quality and viability of homes and on the quality of
nursing and care. She welcomed the current review and the efforts to consult
providers. She noted the disappointment of officers at the lack of response to
the consultation and queried whether this was either a lack of interest in what
was being offered by the Council or a feeling that their views would not be
taken on board. Councillor Hannaby expressed concern
that Homes would top up their income from self funders. She referred to the
letter from OCA that expressed the concerns she also had.
Responding to questions from Cabinet Members Councillor Hannaby clarified that she was not saying that self funders
should be subsidised but rather that a business would need to cover its costs
and someone would pick up the slack and that this could be the self funders.
She could not confirm that the Liberal Democrat would pay more indicating that
they were putting their budget proposals together.
Councillor Fatemian, introduced the contents
of the report emphasising that extensive work had been undertaken to come to a
robust answer. He noted that through out the country self funders pay more than
local authority users. He accepted that care homes needed to make a profit and
that they kept a close eye on homes; overall Oxfordshire care homes were
financially healthy. He expressed disappointment that more care homes did not
take part in the consultation. They did not engage and did not share data. The
model used was based on the National model and he proposed the recommendation
to Cabinet as the right solution for Oxfordshire.
John Jackson, Director for Social and Community Services, detailed the
contents of the report. He explained that the report set out a
number of factors that had been considered including the results of the
consultation. He highlighted the issues
and key points set out in the report. These included:
(1) The Council had received very limited information from only 5
providers. As a result there is not sufficient information to justify the
significant increase that providers are seeking.
(2) The County ... view the full minutes text for item 5