Agenda item

Adult Social Care Fees 2022/23

Report of the Executive Director of Adult Social Care and Health

Minutes:

The Cabinet considered the report of the Executive Director of Adult Social Care and Health that sought to enable Cabinet to determine the fees payable for Sefton Adult Social Care Service sectors during the financial year period 2022/23 and for Direct Payment Recipients who buy their services directly from a Care Quality Commission (CQC) registered agency and to outline the future strategic direction for services in Sefton, linked to wider national work, linked to national policy issued by the Department of Health and Social Care.

 

Decision Made:

 

That

 

the contents of the report be noted and having given full consideration to the options outlined in the body of the report and the associated Appendices, including the responses to the consultation and the Equality Impact Assessments, the implementation of the following fee increases be authorised, which are higher than those originally consulted upon, having taken into account a range of factors including the response from providers, national context, risks raised in relation to additional costs, regional averages and any other information available at the time of the consultation:

 

(1)      Residential & Nursing Care

 

Residential Care

EMI Residential

Nursing

EMI Nursing

2022/23 Fee

£561.10

£634.85

£576.98

£641.26

2021/22 Fee

£523.51

£592.32

£538.33

£598.30

Weekly Increase

£37.59

£42.53

£38.65

£42.96

% Increase

7.18%

7.18%

7.18%

7.18%

 

 

 

 

 

Originally Proposed 2022/23 Fee

£558.11

£631.47

£573.91

£637.85

Originally Proposed Weekly Increase

£34.60

£39.15

£35.58

£39.55

Originally Proposed % Increase

6.61%

6.61%

6.61%

6.61%

 

(2)      the fact that for Residential and Nursing care services any existing placements which are costed based on an individual Service User assessment are increased based on the same percentage uplifts detailed in the table above, be noted;

 

(3)      Domiciliary Care

 

Duration / Service Element

2022/23 Rate

Originally Proposed 2022/23 Rate

2021/22 Rate

1 Hour

£17.89

£17.82

£16.68

45 Minutes

£13.42

£13.37

£12.51

30 Minutes

£8.95

£8.91

£8.34

15 Minutes

£4.47

£4.46

£4.17

Sleep-in (8 Hour Night)

£87.40

£87.40

£81.97

Waking Night (8 Hour Night)

£143.12

£142.56

£133.44

 

(4)      Direct Payment recipients who access an Agency - the above Domiciliary Care hourly rate be implemented and rates for night services be increased to the following:

 

Duration / Service Element

2022/23 Rate

Originally Proposed 2022/23 Rate

2021/22

Rates

1 Hour

(Domiciliary Care & Community Support)

£17.89

£17.82

£16.68

Sleep-in (10 Hour Night)

£109.25

£109.25

£102.47

Waking Night (10 Hour Night)

£178.90

£178.20

£166.80

 

(5)      Direct Payment recipients who utilise a Personal Assistant - the following rates be held apart from an increase to the Sleep-in rate:

 

Duration / Service Element

2022/23

2021/22
Rates

1 Hour

£13.00

£13.00

Sleep-in (10 Hour Night)

£109.25

£102.47

Waking Night (10 Hour Night)

£130.00

£130.00

 

(6)      Community Support Services

 

Duration / Service Element

2022/23 Rate

Originally Proposed 2022/23 Rate

2021/22

Rates

1 Hour

£17.89

£17.82

£16.68

 

(7)      Supported Living

 

Duration / Service Element

2022/23 Rate

Originally Proposed 202/23 rate

2021/22

Rates

Hourly Rate

£16.76

£16.72

£15.56

Sleep-in (9 Hours)

£98.33

£98.33

£92.22

Sleep-in (10 Hours)

£109.25

£109.25

£102.47

Waking Night (9 Hours)

£150.84

£150.48

£140.04

Waking Night (10 Hours)

£167.60

£167.20

£155.60

 

(8)      Extra Care Housing Services - the rate be increased in line with the proposed increase to the Supported Living hourly rate to:

 

Duration / Service Element

2022/23 Rate

Originally Proposed 2022/23 Rate

2021/22 Rate

Hourly Rate

£16.76

£16.72

£15.56

 

(9)      Individual Service Funds be increased based on the proposed 7.71% increase awarded to Supported Living and Extra Care services:

 

Duration / Service Element

2022/23 Pilot Project Rates

Originally Proposed 2022/23 rate

Current Pilot Project Rates

1 Hour

£17.58

£17.54

£16.32

Sleep-in (9 Hour Night)

£98.33

£98.33

£92.22

Waking Night (9 Hour Night)

£158.22

£157.86

£146.88

 

(10)    the method applied to the calculation and payment of sleep-in services be maintained under the current Domiciliary Care, Direct Payment and Individual Service Fund contractual and policy guidelines and are in line with pilot project arrangements which is based on the expectation that Providers / Direct Payment recipients pay staff the hourly rate calculated within these rates; and

 

(11)    the fact that a specific workstream will be progressed in the 2022/23 financial year regarding the implementation of gross payment arrangements for Residential and Nursing care homes, and further reports will be submitted to the Cabinet on the outcome of this report and any associated recommendations for decision, at a future date, be noted.

 

Reasons for the Decision:

 

To enable the Council to set the fees payable for services, during the financial year period 2022/23.

 

Alternative Options Considered and Rejected:

 

1.       Not awarding increases – this option was rejected in relation to all service areas as there is a requirement to ensure that fee levels are increased to consider the outcome of consultation in relation to the increase to Provider’s costs.

 

2.       Awarding fee increase originally proposed in the consultations – this option was considered but rejected following the analysis of the consultation responses and wider impacts, principally current Consumer Price Index (CPI) estimates.

 

3.       Awarding higher increases to all the service areas which are recommended for decision – this option was considered but was rejected as it was determined that the proposed increases were correct within the current context, but as referenced in this report, there is a requirement to continue to review fee rates (including through ongoing cost of care exercises) in line with national requirements within the People at the Heart of Care: adult social care reform policy paper and to inform the delivery of the future vision for Adult Social Care services in Sefton.

 

4.       Amending the proposals for increases to Sleep-in rates – this option was considered and rejected as it was felt that the current rate calculations should be maintained under current contractual and Direct Payment arrangements. However, this is based on the continued expectation that Providers and Direct Payment Recipients are paying Staff / Personal Assistants the hourly rate calculated within these rates and if this is evidenced that this is not the case, Council Officers are authorised to review current contractual, Direct Payment and pilot project arrangements and adjust payments if appropriate.

 

5.       Awarding an increase (aside from an increase to the Sleep-in rate) to Direct Payment Recipients’ who utilise a Personal Assistant – this option was considered but rejected as the current rate is considered sufficient, following the Council conducting benchmarking work on rates in place in other regional Local Authorities.

 

6.       Not seeking to progress workstream on implementation of Gross payments for Residential and Nursing homes – this option was considered and rejected as there is a need to ensure that this workstream is progressed, particularly to ensure that the Council continues to meet Care Act obligations, and as part of ongoing work to support the sector.

 

Supporting documents: