Agenda item

Cabinet Member: Adult Social Care

Forward Plan Ref: 2015/101

Contact: Andrew Colling, Quality & Contracts Service Manager Tel: (01865) 323682

Report by Director of Adult Social Services (CA6).

The services that care homes provide within Oxfordshire play an important role in helping to meet the needs of vulnerable adults. Oxfordshire County Council makes a significant investment in care home services on an annual basis and it is the largest single purchaser within the County.

In relation to care home services for older people, providers have generally expressed concern that the prices paid by local authorities do not reflect the true cost of care. During the last several years there have been a number of legal challenges in other parts of the country made by care home providers against the way that some local authorities have undertaken their annual reviews of the rates they pay for services delivered.

This report is brought to Cabinet to:

(a) Describe the process the Council has undertaken to review the amount it pays for care homes this year; and

(b)Agree the Target Banding Rates to be applied for 2016-17

The Cabinet is RECOMMENDED that in view of the above:

for 2016/17 to revise our Target Banding Rates from April 2016 and

     (i).          Increase the Target Banding rate for the Residential-Extensive Specialist Category to £493 per week for new placements.

   (ii).          Increase all existing weekly Residential payment rates that are currently paid below £493 per week to £493 per week

 (iii).          Increase  the Nursing-Extensive Target Banding Rate to £605 per week

  (iv).          Increase all existing weekly Nursing Extensive that are currently below £605 per week to £605 per week

    (v).          Increase  the Nursing-Specialist Target Banding Rate to £662 per week

  (vi).          Increase all existing weekly Nursing Extensive and Substantial rates that are currently below £662 per week to £662 per week

(vii).          Increase the above rates to reflect the increase in Funded Nursing Care once this is announced later in April 2016.

(viii).          Increase all other existing Care Home placements to reflect the increase in Funded Nursing care once this is announced later in April 2016

  (ix).          Continue to use these rates as a guide to secure a care home placement  at a funding level as close to the Target Banding Rate as possible. 

    (x).          The above to apply from April 2016 and for care home placements in Oxfordshire.

  (xi).          The Council undertakes a review to understand the impact of National Living Wage.

The services that care homes provide within Oxfordshire play an important role in helping to meet the needs of vulnerable adults. Oxfordshire County Council makes a significant investment in care home services on an annual basis and it is the largest single purchaser within the County.

Cabinet considered a report that described the process the Council had undertaken to review the amount it pays for care homes and gave agreement to the Target Banding Rates to be applied for 2016-17.

Mark Taylor (Proprietor, Banbury Heights and Julie Richardson Nursing Home) spoke against the proposals highlighting the funding gap that existed in respect of wages that made up 70% of costs. He expressed the view that the ADASS model used was not sufficient and a costing model was needed. He added that providers in Oxfordshire did not believe that the current model represented actual costs. He outlined issues with the current model and highlighted the requirement to set to assessed need.

In response to questions Mr Taylor indicated that he was a member of OCA but was speaking for himself. Mr Taylor was asked to comment on the fact that the Oxfordshire rate compared favourably with elsewhere, being the 13^th highest. He replied that this figure was based on average provision and included block contracts. Spots fees however compared unfavourably with elsewhere.

Councillor Brighouse, Opposition Leader, urged greater transparency over actual costs and highlighted that there was an issue around the different sizes and operating models of care homes. She referred to the issue of incontinence payments also raised by Mr Taylor and sought further information on that. She noted that consideration needed to be given to how we contract for the beds and how to achieve less spot purchasing. Councillor Heathcoat, Cabinet member for Adult Social Care refuted that there was not transparency in the papers. She had previously* met with Mr Taylor and providers and a summary of the consultations was provided.

Councillor Heathcoat introduced the contents of the report and publically acknowledged the role of care homes in adult social care provision. The Council was aware of its duty to be aware of sustainability and suitability; our duty to meet assesses need and our duty of providing choice. In proposing the recommendations Councillor Heathcoat noted that the report contained an incorrect figure for the current Nursing Specialist rate 2015/16 and the proposed Nursing Specialist rate for 2016/217. The correct figures and the resultant amended recommendation was set out in the addenda before members.

John Jackson, Director for Adult Social Services responded to the detailed points raised by Mr Taylor and in particular stressed that there had never been any suggestion of a legal challenge to the proposals.

During discussion Councillor Carter commended the extra care housing available in Thame but recognised the need for more such housing. Councillor Heathcoat referred to the reliance on planning applications at District Council level and problems raised by developers around economic viability and site appropriateness.

RESOLVED:             for 2016/17 to revise our Target Banding Rates from April 2016 and

(a)             increase the Target Banding rate for the Residential-Extensive Specialist Category to £493 per week for new placements.

(b)             increase all existing weekly Residential payment rates that are currently paid below £493 per week to £493 per week

(c)             increase  the Nursing-Extensive Target Banding Rate to £605 per week

(d)             increase all existing weekly Nursing Extensive that are currently below £605 per week to £605 per week

(e)             increase  the Nursing-Specialist Target Banding Rate to £680 per week

(f)              increase all existing weekly Nursing Extensive and Substantial rates that are currently below £680 per week to £680 per week

(g)             increase the above rates to reflect the increase in Funded Nursing Care once this is announced later in April 2016.

(h)             increase all other existing Care Home placements to reflect the increase in Funded Nursing care once this is announced later in April 2016

(i)               continue to use these rates as a guide to secure a care home placement  at a funding level as close to the Target Banding Rate as possible. 

(j)               the above to apply from April 2016 and for care home placements in Oxfordshire.

(k)             the Council undertakes a review to understand the impact of National Living Wage.

* Minute amended, at the meeting of Cabinet on 19 April 2016, by the addition of the word ‘previously’.