Agenda item

The Committee considered a report of the Director of Adults and Communities which detailed the responses received during the first stage of the consultation on the proposed changes to the way in which the County Council agreed prices for the spot purchase of residential care and residential nursing care.  The Committee’s views were sought on the second stage of the consultation.  A copy of the report marked ‘Agenda Item 8’ is filed with these minutes.

Arising from the discussion, the following comments were raised:

i)             The Director informed the Committee of an error in the report – in paragraph 9, it should have stated that ‘fourteen providers, representing 35 care homes attended consultation meetings and commented on the proposals using that mechanism’.

ii)            Feedback at stage 1 of the consultation had been received from more providers supporting older adults than working age adults.  This had been expected as there was a greater number of providers for older adults and any proposed changes to the banding structure would have a greater impact on this group.  For working age adults, most complex placements were now made on a bespoke fee and this arrangement would continue.

iii)           In response to a query, it was reported that the Supplementary Needs Allowance (SNA) payments would not be capped.  Where required, these would continue to be paid at a standard hourly rate.  For working age adults, it had been the intention to continue using the care funding calculator.  Currently, different rates were applied to providers, principally in relation to non-staffing costs.  The County Council was of the view that there should be a consistent methodology for payments for providers and it was the intention that a Leicestershire standard band for working age adults would be developed.  Developing a standardised methodology would mean that financially, there would be some who would benefit and some who would lose out, but the County Council would pay what it considered to be reasonable costs for the non-staffing elements of care.

iv)           In relation to out of county placements, there was no standardised rate across local authorities and it was therefore difficult to make direct comparisons.  Providers generally felt that it was fair for Leicestershire to continue paying the local market rate for out of county placements and there was no appetite to changing to the Leicestershire rates.  It was noted that the County Council was a minority purchaser of residential care – the majority in Leicestershire were self-funders.  There was a market rate and if the County Council paid too far below this, it would be difficult to find places.

v)            In response to a question around assessing the eligibility of current service users, it was envisaged that the majority of people would automatically transfer onto the new fee bands.  Assurance was given that where someone was paying an assessed charge based on their income, for most people any increase in the fees would not have an impact as the person would only be expected to contribute what they could afford.  If a person was paying the full cost of their care, for example through a deferred Payment Agreement, it was possible that they could experience an increase due to the County Council paying more.  Those paying a third party top-up could potentially benefit from the fee increase due to the difference between this and the cost of care decreasing.

vi)           The proposal for consultation 2 had been circulated to the Committee – a copy of the document marked ‘Appendix D’ is filed with these minutes.  It was possible that the start of the second consultation would be slightly delayed.  Due diligence was currently being completed in order to agree the proposed revised fees and the second consultation could not commence until these were known.  A request was made that, once the fees had been agreed, they be circulated to the Committee.  It was the intention that the consultation period would begin before the end of March and would be active for six weeks.  It was anticipated that there would be a greater response to the second consultation and providers would be actively encouraged to take part.

vii)         It was noted that, subject to the Cabinet’s approval, implementation of the new rates would be back dated to 8 April 2019.  Confirmation was given that sufficient provision had been made in the Medium Term Financial Strategy to account for this.

RESOLVED:

That the report be noted.