Agenda item - PROPOSED FEE INCREASE FOR ADULT SOCIAL CARE PROVIDERS 2018/19

Resolved:

1)         That the Health & Wellbeing Board approved the fee increases as set out in table 1 in section 3.

48.1    Officers introduced the report which set out the recommended increase in fees paid to adult social care providers from April 2018.

48.2    The Chair stated that he had received a representation from Mr Graham Dean on behalf of the East Sussex, Brighton & Hove Registered Care Home Association:

“The East Sussex, Brighton & Hove Registered Care Association (RCA) feel that the proposed increase of 2.68% to the set fee is inadequate.  The RCA has requested that the increase should be 3.95% to £578 per week.  This takes into account CPI inflation, the National Living Wage increase to £7.83 per hour from April 2018 and the increased employer contribution from 1% to 2% from April 2018 for pension auto-enrolment.

This increase represents no more than to match inflation and whilst we do appreciate the City Council’s financial difficulties it is important that this minimum uplift be agreed. Particularly to maintain the profitability of care homes that rely mostly upon placements from Brighton & Hove City Council.

Laing and Buisson regularly update their benchmark fee rates and the lowest figure for frail elderly 2017/18 is £609 per week.  This floor figure represents older converted buildings.  The Laing and Buisson floor figure for dementia is £652 per week.”

48.3    The Executive Director, Health and Adult Social Care responded to the representation from East Sussex, Brighton & Hove Registered Care Home Association:

“As you may be aware I have met with the Care Homes Association and other stakeholder on a number of occasions. This is part of our regular engagement with key stakeholders where we discuss a range of issues including:

Opportunities for market development

The support and training we provide to the Care Homes at no costs to support a quality offer for residents.

They will be also part of the Market Position Statement as we work in assessing the future needs for residents in this key area.

The Head of Commissioning has discussed with all stakeholders the recommendation in the fees report and whilst understandably they would like more, our rationale was explained and accepted. Whilst a significant percentage of our spend they are only one provider and suggesting a blanket increase of 3.95% would undermine our position elsewhere in the market. . In 16/17 the Council uplifted fee rates significantly and we compare very favourably with our neighbours. Please note this comparison does not include the additional support and training we provide which CQC have been very complimentary of and is not provided universally elsewhere.”

48.4    Councillor Page stated that the care home market was fragile and that the short term gain of offering a fee increase under the 3.95% increase recommended by Laing and Buisson may be outweighed by the risk to the market. Councillor Page also stated that if there was an ambition to require the care home staff are paid the Brighton & Hove Living Wage care homes fees may have to increase.

48.5    Councillor Barford stated that the RCA were valued partners in the city and were currently working with the council and other partners to produce a market position statement. However without additional funding the council would not be able to increase fees by 3.95%. Councillor Barford also stated that the fees did not include all the additional support offered to care homes.

48.6    Dr Sikdar stated that two of the greatest costs to the health system were non-elective treatments and delayed transfers and asked if officers had investigated any link between investment in care homes and a reduction in these costs.

48.7    Officers responded that it was a priority to examine this as part of the Caring Together programme.

48.8    Resolved:

1)         That the Health & Wellbeing Board approved the fee increases as set out in table 1 in section 3.