Agenda item - Fees to Providers (Care Homes) 2016

19.1    Jane MacDonald, Adult Social Care Commissioning Manager, introduced the report, telling members that this was the most important such report to date. Currently, the local care home provider market is extremely fragile and it is important that commissioners take every step to ensure its sustainability. It is also the case that the fees paid by the public sector for care home beds are insufficient, meaning that publicly-funded care home beds are effectively subsidised by private funders. This is an inequitable situation and one which must be addressed.

19.2    It has therefore been decided to provide an uplift in fees and to simplify the fees system. The premium for people with dementia has also been discontinued as the majority of care home residents have dementia, meaning that dementia-sensitive care is now the norm. The increase in costs will be funded by the 2% Council Tax precept.

19.3    The planned changes are intended to stabilise the local care home market, maintaining city capacity and ensuring that local people continue to have a choice of provision.

19.4    Cllr Barford told the Board that she fully supported these plans. It was important to note that officers had worked closely with providers in formulating the plans. There is still an aspiration to move in time to a funding level that will enable care home workers to be paid the Brighton & Hove Living Wage, although this is not immediately achievable.

19.5    Cllr Norman told the Board that he fully supported the recommendations. Cllr Norman queried where the decision to raise fees would ultimately be taken. Denise D’Souza explained that it would be for Budget Council.

19.6    In response to a question from Cllr Page on how far behind the Laing Buisson calculations of sustainable fees the uplift would leave us, Ms MacDonald noted that this information was included as Appendix 2 to the report. It was important to recognise that we are moving in the right direction here, even if we have not yet achieved the Laing Buisson recommendations.

19.7    In reply to a question from Cllr Page on whether increasing fees to providers might help reduce delayed transfers of care from hospital, Ms D’Souza told the Board that the more local providers who could be persuaded to stay in the market the better. However, this is not just about fee levels, but also about additional support for providers which is not necessarily available in other local authority areas. Providers and ASC and CCG officers should be commended for the way that they work constructively together.

19.8    The Chair endorsed this sentiment, thanking the Brighton & Hove Residential Care Association, as well as Peter Kyle MP for his recent work on this issue.

19.9    RESOLVED – the Board agreed that:

(1)  the fees payable to care homes and care homes with nursing providers be increased as set out below with effect from 5 September 2016

£543 per week care homes

£656 per week care homes with nursing (including Funded Nursing Care)

(2) the payment of premium rates for dementia in care homes and care homes with nursing is discontinued.

(3) the Council when making a placement outside the city match the applicable host authority’s set fee rates for new and existing registered care home and care home with nursing placements.

(4) the Executive Director of Health and Adult Social Care be authorised to initiate a procurement exercise in order to identify suitable providers of care homes and care homes with nursing to be appointed to a framework or contract and to enter into all agreements and undertake any ancillary matters necessary to achieve the award of contracts for care for eligible persons on appropriate terms.

 (5) the Executive Director of Health and Adult Social Care be authorised to award block contract(s) to care homes and care homes with nursing.

(6) the Council continues to provide  additional  benefits  currently available to providers free of charge which include the provision of a range of training and targeted advice sessions eg fire evaluations and health and safety support and advice. 

(7) the Board notes that it is the intention of officers to recommend a further increase in the rates set for care homes and care homes with nursing to be applied from April 2017 when it is anticipated a further increase in the National Living Wage to £7.70 will take effect.  This is dependent on funding being agreed by the Council from the Adult Social Care Precept.  A further paper on fees will be brought to the Health & Wellbeing Board with appropriate recommendations.