Issue details
Care Providers Annual Fee Review 2024-25
Local Authorities have a duty under the Care
Act 2014 to meet assessed eligible care and support needs. The Care
Act 2014 also places a duty on Local Authorities to shape markets
and enable a sustainable and diverse range of care providers to
deliver innovative and cost effective services that promotes the
wellbeing of people who need care and support.
In line with contractual obligations, the council must review fees
paid to Social Care providers on an annual basis.
Legal precedent indicates that whilst there is a need for Councils
to have due regard to the cost of care this is not a singular
factor in the setting of fee rates for services. In addition, there
are expectations that Councils also consider factors such as:
Experience of local care agency closures, lack of closures
Over / under supply of provision
Rates paid by other comparable LA’s
Consideration of management accounts from providers
The position of those providers with whom it has been able to reach
agreement
Change or lack of change as CQC ratings
Localised cost movements e.g. locally advertised job rates, staff
turnover etc.
The Council must balance its duty under the Care Act 2014 with its
legal duty to set a balanced budget when considering fees for care
providers.
The proposed recommendations balance the need for the Council to
meet its duties under the Care Act within financial resources
available.
In determining uplifts and new fee rates for 2024/25 the council
has considered the impact of increases in the cost of wages and
other cost increases.
The Council has also considered benchmarking information regarding
current fee rates for councils in the West Midlands (14 Councils).
It has also considered latest intelligence regarding
councils’ proposals for fee rate increases for 2024/25 within
the region.
It is also important to note that this review has considered other
challenges faced by provider, informed by their feedback to
commissioners. Areas identified include:
• Recruitment and retention
• Increases in NLW
• Agency staffing costs
• Utilities
• Fuel / Travel costs
• Cost of living impact on running costs
• Cost of Voids (supported living)
• Insurance
• Training
Care Homes
The market for care home provision in Herefordshire is buoyant,
there have been no care home closures in the last 12 months and
planning requests are being received for the development of new
homes in the county.
Regional benchmarking of 14 councils information indicates that
Herefordshire Council’s standard fee rates are mid-range
compared with other Councils’ rates within the West
Midlands.
It has been decided that an increase of7% is applied to all care
home provision with effect from 1 April.
Home Care
New arrangements for commissioned home care have been in place
since November 2021. In November 2022 a decision was taken to
introduce a secondary framework to address sufficiency challenges
in the market. As a result of this the waiting list for home care
has reduced from over 100 in April 2023 to under 10 in February
2024.
Regional benchmarking information indicates that
Herefordshire’s urban rate is the 4th highest in the region
and its rural rate is 2nd highest across the region.
It has been decided that an uplift of 7% is applied to both urban
and rural rates for Home Care with effect from 1 April 2024.
Supported Living
A new framework for Supported Living is currently out to tender
with the market. The new framework maintains the current fee
structure in relation to a lower hourly rate that applies to core
hours and waking nights in 24/7 properties; a higher hourly rate
that applies to additional 1:1 hours and the new sleep-in rate of
£135 (based on a 9 hour sleep-in) which will be introduced
from 1 April 2024.
The new sleep in rate that will be introduced from April 2024
brings Herefordshire Council approach in line with the majority of
other Local Authorities across the region and country in relation
to payment of a lower level of fee for sleep-in support.
Effectively this reduces the hourly fee rate for sleep-ins from
£17.04 in 2023 to £15.00. At £15.00 per hour
however, this rate remains significantly above the average level of
sleep in payments across the region.
In relation to the lower and higher rates in Herefordshire it is
difficult to make direct comparisons with other Councils in the
region as only Warwickshire council operates a similar 2 rate
system, with most Councils operating a single rate.
In order to mitigate risks to the sustainability of the market in
relation to Supported Living as a result of the impact on providers
of the implementation of a reduced rate for sleep-ins an uplift of
8.33% is to be provided for the lower and higher rates from 1 April
2024.
Community Activities
The Council does not operate standard fee rates for community
activities. Rates vary for individuals services based on the type
of provision and level of needs of the individuals supported.
A new framework for Community Activities is currently out to tender
with the market. Existing services that transfer onto the new
framework will continue to be paid on the basis of current fee
rates subject to any agreed annual uplift determined by the Council
to be applied from 1st April 2024.
It has been decided that an uplift of 7% is applied to all fee
rates for community activities with effect from 1 April 2024.
Shared Lives
Shared lives services remain an important part of the service offer
in Herefordshire, with plans to further develop and expand services
in the future.
Whilst benchmarking information relation to 2022/23 indicates that
Herefordshire rates are lower than a number of other councils in
the region, it is noted that the morale of shared lives carers has
improved over the last year as a result of them having received an
uplift in line with other services (which had not been the case
previously). They also received an increase in board and lodging
payments in 2023/24 with a commitment to review these annually in
line with benefits increases.
It has been decided that an uplift of 7% is applied to fee rates
for shared lives with effect from 1 April 2024.
Direct Payments
Direct payments can be used to fund a range of different services,
with varying fee rates.
It has been decided that Direct Payments are increased by 7% from
April 2024 in line with other proposed uplift levels (with the
exception of supported living which is not a service routinely
secured through the use of direct payments).
Standard processes will be followed where individuals in receipt of
a direct payment have surplus or insufficient funds to meet their
care needs.
Decision type: Non-key
Decision status: Recommendations Approved
Notice of proposed decision first published: 21/03/2024
Decision due: 21 March 2024 by Corporate Director - Community Wellbeing
Contact: Hilary Hall, Corporate Director Community Wellbeing Email: Hilary.Hall@herefordshire.gov.uk.
Decisions
- 21/03/2024 - Care Providers Annual Fee Review 2024-25