Agenda item

Joint report of the Executive Director of Adult Social Care and Health and the Executive Director of Corporate Resources and Customer Services

 

A petition has been submitted by Mr. Jonathan Cunningham, a Care Home Provider containing 25 signatures which states:

 

We the undersigned believe, “the proposed Sefton social care fees increase of 8.02% is inadequate to cover the true cost of care and request that Sefton Council reconsider and increase this fee.”

 

Prior to the Cabinet’s consideration of the report, Mr. Cunningham will be allowed to address the Cabinet on the content of the petition for a period of 5 minutes.

Mr. Jonathan Cunningham, a Care Home Provider, spoke in support of a petition containing 25 signatures which stated:

 

We the undersigned believe, “the proposed Sefton social care fees increase of 8.02% is inadequate to cover the true cost of care and request that Sefton Council reconsider and increase this fee.”

 

The Cabinet then considered the joint report of the Executive Director of Adult Social Care and Health and the Executive Director of Corporate Resources and Customer Services requesting the Cabinet to determine the fees payable for Sefton Adult Social Care services for the financial period 2024/2025. The fees proposed included a range of care and support services to adults, including Direct Payment Recipients.

 

The following appendices were attached to the report:

 

·       Appendix A – 2024/25 Fee Increase consultation letters

·       Appendix B – Provider Responses to the consultations

·       Appendix C – Notes from the consultation events held with Providers

·       Appendix D – Care Home Initial Equality Impact Assessment

·       Appendix E – Domiciliary Care Initial Equality Impact Assessment

·       Appendix F – Supported Living Initial Equality Impact Assessment

·       Appendix G – Extra Care Housing Initial Equality Impact Assessment

·       Appendix H – Community Support Initial Equality Impact Assessment

·       Appendix I – Day Care Initial Equality Impact Assessment

 

Decisions Made: That

 

(1)      the petition be noted;

 

(2)      the contents of the report be noted and having given full consideration to the options outlined in the body of the report, which includes the associated Appendices, the responses to the consultation from a wide range of care and support Providers, and the Equality Impact Assessments undertaken as part of the work, the implementation of the following fee increases set out below from 1 April 2024 be authorised, which for some sectors 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 and other information available at the time of the consultation and the availability of financial resources;

 

(3)      Residential & Nursing Care – the following rates be implemented:

 

	Residential Care	Residential Dementia	Nursing	Nursing Dementia
2024/25 Fee	£701.81	£794.04	£721.67	£802.06
2023/24 Fee	£649.70	£735.09	£668.09	£742.51
Weekly Increase	£52.11	£58.95	£53.58	£59.55
% Increase	8.02%	8.02%	8.02%	8.02%

 

(4)      it be noted 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, unless where it is identified that the fee rate is sufficient for the placement. It also be noted that the above fee rates are not the sole funding route to agree a fee rate with care homes as there can be negotiated additional payments to reflect the complexity of care to support individuals when they are placed in a care home setting, which is directly negotiated as part of placement and Care Act assessment activities;

 

(5)      Domiciliary Care – the following rates be implemented for contracted / Pseudo Dynamic Purchasing System (PDPS) Providers:

 

 

*Any call duration outside of this framework will also be uplifted. It be noted that the consultation letter sent to Providers highlighted the Council’s ongoing commitment to not commissioning 15-minute visit durations;

 

(6)      Community Support Services

 

 

(7)      Direct Payment recipients who access a CQC Agency for Community Support - that the above Community Support hourly rate be implemented:

 

 

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

 

 

(9)      Direct Payment Recipients who utilise a Personal Assistant for Domiciliary Care or Community Support:

 

 

(10)       Direct Payment Recipients who utilise Day Care / Day Opportunity Services:

 

 

(11)    Supported Living – the following rates be implemented which are higher than those originally proposed at the commencement of the consultation exercise (apart from the sleep-in rates):

 

 

(12)    Extra Care Housing Services - the following rates be implemented which are higher than the rate originally proposed at the commencement of the consultation exercise:

 

 

(13)    Individual Service Funds – the following rates be implemented which are higher than those originally proposed at the commencement of the consultation exercise (apart from the sleep-in rate):

 

 

(14)       Day Care – the rates be increased by 9.15% (original proposal consulted on was for an increase of 8.57%);

 

(15)    Shared Lives – the rates be increased by 9.15%;

 

(16)    based on the average inflationary increases awarded to Providers and/or calculated required increases to existing agreements/contracts, that inflationary increases also be awarded to Voluntary, Community and Faith (VCF) grants, contracts for the delivery of Carers services and contracts with Partner Providers;

 

(17)    the method applied to the calculation and payment of sleep-in services be maintained under the current Domiciliary Care, Direct Payment, Supported Living and Individual Service Fund contractual and policy guidelines which is based on the expectation that Providers / Direct Payment recipients pay staff the hourly rate calculated within these rates. In the event that it is evidenced that this is not the case, Council Officers be authorised to review current contractual, Direct Payment and pilot project arrangements and adjust payments, if appropriate;

 

(18)       further to Decision (5) above, relating to the Domiciliary Care rate, this rate be used to formulate a rate to be implemented as a ‘guide price’ / hourly rate for any additional 1:1 care commissioned for individual care home placements to support people to remain safe and achieve their assessed needs, and as part of a policy and process relating to the provision of 1:1 care. The ‘guide price’ / hourly rate be formulated by using elements of the Domiciliary Care rate and that decisions on the ‘guide price’ / hourly rate formulated be delegated to the Executive Director of Adult Social Care and Health in consultation with the Cabinet Member – Adult Social Care and the Executive Director of Corporate Resources and Customer Services;

 

(19)    it be noted that fee rates will also be reviewed as part of future commissioning / procurement work for certain sectors. Final decisions on any such revised fee rates will be agreed as part of the associated procurement exercise decision-making processes and subject to their assessed affordability. Such decisions be delegated to the Executive Director of Adult Social Care and Health in consultation with the Cabinet Member – Adult Social Care and the Executive Director of Corporate Resources and Customer Services;

 

(20)    the ongoing fee modelling approaches outlined in the report, particularly with respect to the Real Living Wage, be noted; and

 

(21)    it be noted that with respect to the Residential and Nursing sector, the above work will link into the wider market work taking place, such as the development of a new commissioning framework for which a separate report will be submitted to the Cabinet on this matter at a future date, and work taking place to update Sefton’s Market Position Statement and Market Sustainability Plan.

 

Reasons for the Decisions:

 

To enable the Council to set the fees payable for services, during the financial year period 2024/25.

 

Alternative Options Considered and Rejected:

 

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

 

2.      Awarding originally proposed fee increases for some sectors – this option was considered and rejected following an evaluation of the consultation responses and wider market analysis work, which resulted in the revised proposals being recommended in the report.