To seek a decision on the usual price the council pays for the purchase of residential and nursing home care for older people (persons aged 65 or over) with assessed eligible needs.

The Cabinet Member, Health and Wellbeing, introduced a report explaining the calculation of fees for residential and nursing homes for older people.

He reported that following Cabinet discussion on 20 June 2013, a full procurement exercise and consultation had been carried out by the Director of Adults Wellbeing through delegated authority, leading to new recommendations for best value.

The Director for Adults Wellbeing and the Chief Financial Officer presented the report, the main points of which were:

·                A review of the Open Book process had taken place and an Overview and Scrutiny Task and Finish Group had reviewed the consultation. Representatives from the Clinical Commissioning Group joined the project board and feedback had been gathered. Advice from external legal counsel had been sought regarding the legislative framework.

·                The rationale for the fees included Best Value considerations. There would be a significant impact on other services should fees increase above the annual expenditure of £10 million to provide for 400 people.

·                26 care homes participated in the review, with the fee being based on the average cost of care. It was noted that some local authorities based prices on the lowest cost of care. It was further noted that there was no correlation between price and quality of care.

·                Local factors meant that demand for places was significant and this was expected to double during the next 20 years. There were a high proportion of self-funders in Herefordshire. There was a local and national decrease in residential care and the council’s strategy is to increase reablement support for those in need of adult social care.

·                There was a responsibility to make the best use of resources and implement the new fee from 1 August 2014. However, people currently in care would not see a change in price.

·                The aim was to provide genuine choice and meet Care Quality Commission requirements.

·                Risks have been considered and mitigated, with advice taken together with consultation and engagement. The Health and Social Care Overview and Scrutiny Committee would be asked to provide updates on progress of implementation.

Officers and Members were commended for work undertaken as a good example of how significant decisions were consulted upon.

RESOLVED  THAT:

The usual price for the spot purchase of publicly funded places in residential care homes and nursing homes for older people be set as follows:

I)          Residential care and residential care with dementia - £452.93 per week

II)         Nursing home care - £518.00 per week;*¹

the implementation plan set out in paragraph 8.21 of the report be agreed; and

the Health and Social Care Overview and Scrutiny Committee be requested to undertake regular progress reviews in implementation.

*¹ providers will also receive a further payment for funded nursing care (currently £112.70 per week from the NHS)