Agenda item

The Cabinet considered a report of the Director of Adults and Communities which detailed the findings of the two-stage consultation exercise on changes to the way in which the Council agreed prices for residential care and residential nursing care and sought approval for the implementation of a process for calculating fee rates. A copy of the report, marked ‘Agenda item 8’, is filled with these minutes.

Mr. Blunt said that the proposed increase in fees paid by the Council would support the sustainability and viability of service providers, ensuring that sufficient care and support services continued to be provided in the County.

RESOLVED:

a)    That the feedback from the two-stage consultation exercise on the proposals for a fee model for residential care and residential nursing care be noted;

b)    That the fee levels detailed in paragraph 58 of the report, for placements in Leicestershire be approved and implemented from 8 April 2019, in summary:

• Older Adults Residential base rate - £579 per week;

• Older Adults Residential Plus base rate - £638 per week;

• Working-age Adults - £727 per week;

• Supplementary Need Allowance - £11.81 per hour;

c)    That an annual uplift to the fee levels at (b) above be applied, calculated using a split of 57/43 for staffing and non-staffing costs with Average Weekly Earnings used for the staffing element, and Consumer Price Index for non-staffing costs, and amended as necessary to take account of any additional pension contributions be applied to placements within Leicestershire and to bespoke packages for working-age adults created using the Care Funding Calculator, noting that changes to the National Living Wage or fees may require this uplift to be reviewed in future;

d)    That with regard to Supplementary Need Allowance hours, the staffing uplift be applied to give an increase of 3.96% on the hourly rate given in (b) above;

e)    That each existing contracted provider of residential care and residential nursing care be required to sign the revised Core Contract, Specification, and Individual Placement Agreement in order for the revised fees to be paid;

f)     That Quality Assessment Framework premium payments to providers of residential care and residential nursing care cease as part of the implementation of the new fee rates, contract and specification;

g)    That it be noted that the Council will continue to pay fees for out-of-county placements in line with those of the local authority in which the accommodation is located;

h)    That the above changes, expected to cost £7 million, be resourced from corporate contingency funds earmarked for service cost increases;

REASONS FOR DECISION;

The Care Act 2014 places statutory duties on councils to establish a usual price for the care home placements they fund. This price needs to give due regard to ensuring that there are sufficient care and support services in the local market to meet the needs of all people who require care and support.  It also places a duty on councils to give due regard to ensuring provider sustainability and viability to enable them to meet their employer duties and responsibilities and provide the agreed quality of care.

The Adults and Communities Department undertakes an annual fee review process with the residential and nursing care market, but it has not fundamentally reviewed its pricing structure since 2011.  It is recognised that there have been significant changes to the way care and support is delivered since this time and that the demographic of people moving into residential care arranged by the Council is now different.  A fundamental review of the Council’s fee structure and fee levels was therefore necessary to ensure this remains fit for purpose and supports a sustainable care market across the County.

Following approval by the Cabinet in October 2018, the Council engaged in an open, inclusive and thorough consultative process to establish the proposed fee model and contractual documentation to reach a set of proposals that are fair and sustainable for both the Council and providers.