Agenda item

The Committee considered a report of the Director of Adults and Communities presenting the proposed changes to the way in which the Council set prices for residential care and nursing care.  A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

Arising from the discussion, the following comments were raised:

i)             In response to a question concerning out of county placements, it was stated that this totalled approximately 300, many of which were in Leicester City.  The majority of people in Leicestershire self-funded their own care placement, and it was noted that there may be resource implications for these arising from a fee increase, although the fees that the Council set were not necessarily those which a self-funder would pay, as providers could charge a fee which had not been set by the Council.  The main implications would be for those whose relatives paid a third party top up.

ii)            Assurance was given that the proposed increase in fees would not have a direct impact on the charge to the service user.  A means test was undertaken so the person contributed the maximum that they had been assessed as being able to afford, and this would not increase.  Providers would not have a guaranteed level of fee as when the Council reviewed its rates, it would determine what it thought was a fair price for care.  If the Council felt that it was paying more than the actual cost for care, it would need to enter into negotiation with the provider to agree a fee which was fair for the individual, and this would form part of the transitional arrangements.

iii)           The third party top up fee was determined by the local authority as well as the provider.  Where families or representatives chose to top up the fee paid by the Council, the local authority would pay the gross amount to the provider and would then collect the contribution from the resident – this ensured that the third party contributors were protected from the provider later charging a higher amount.

iv)           The report referred to the proposal to change the five banded rates system to a more simple two band system.  The majority of older adults were currently split between the categories of dependent older people and highly dependent people/physical disability.  The definition of the two new bands would change and would more clearly define the level of care required by an individual.  Residential care was largely now for people who were very frail and were unable to access the support they required in their own home.  It was noted that the length of time people spent in a residential care home was reducing.  The new bands would reflect these trends.

v)            It was possible that a provider could receive different fees for individual residents, in particular those who funded their own care.  The Council based its fee on what it considered to be fair and what the actual cost of care was.  The County Council was also in a position to negotiate a standard rate for what it paid due to the fact that it was a bulk purchaser of care.  For an annual fee, it was possible for the Council to undertake an assessment and to commission a placement on behalf of someone who self-funded their own care.  The Council had a certain duty of care to ensure that self-funders were not over charged.

vi)           Those who had been assessed as being eligible by the NHS to receive nursing care received a standard payment which paid for part of that care.  The fee received from the NHS was a set national sum and it would not increase in proportion with any increase in Council fees.  It was noted that Leicestershire had a low number of nursing care placements.

The Committee was presented with the draft consultation document including questions for Stage 1 of the consultation process.  A copy of the document is filed with these minutes.  This was welcomed by the Committee, in particular the Frequently Asked Questions document.  The consultation was due to commence on 14 November and an update on the responses would be provided to the Committee before proceeding to Stage 2 of the consultation.

RESOLVED:

(a)  That the report be noted;

(b)  That an update on the outcome of the stage 1 consultation be provided to a future meeting of the Committee.