Agenda item

(To receive a report from the Executive Director – Adult Care and Community Wellbeing which invites the Executive to approve the rates for residential and nursing care fee levels within Adult Social Care)

1.    That the rates set out in the table at paragraph 5.6.1 of the report be approved as the Council’s Usual Costs for both new and existing Learning Disability service users in respect of residential and nursing care with effect from 1 April 2022 for the financial year 2022/23

2.    That the rates set out in the table at paragraph 5.6.2 of the report be approved as the Council’s Usual Costs for both new and existing Older People service users in respect of residential, nursing and high dependency care with effect from 1 April 2022 for the year 2022/23

3.    That the rates set out in the table at paragraph 5.6.3 of the report be approved as the Council’s Usual Costs for both new and existing Physical Disability service users in respect of residential and nursing care with effect from 1 April 2022 for the year 2022/23

4.    That the rates set out the table at paragraph 5.6.4 of the report be approved as the Council’s Usual Costs for both new and existing Mental Health service users (aged 18 – 65) in respect of residential and nursing care with effect from 1 April 2022 for the year 2022/23

5.    That the proposed contractual updates set out in section 6 of the report be noted

6.    That the use of £1m from the Adult Care Grant Reserve to establish a fund for the making of payments to providers of residential care and residential with nursing care in Lincolnshire suffering hardship as a result of cost volatility relating to utilities costs and insurances be approved

7.    That authority be delegated to the Executive Director – Adult Care and Community Wellbeing in consultation with the Executive Councillor for Adult Care and Public Health to determine the detailed conditions governing the fund including the criteria for the making of payments.

The Executive Director – Adult Care and Community Wellbeing introduced a report which outlined the requirement for the Council to set a framework for Usual Costs for three levels of service: residential, nursing and high dependency across all types of need (older people, physical disability, learning disability and mental health).

The Executive was advised that Residential and Nursing services represented one of the Council’s highest spend and highest risk areas with an annual total of approximately £125m gross spend.   The Head of Commercial Services – People Services detailed a number of elements of the report to the Executive including an outline of the key activities which had been undertaken by officers, the Council’s Usual Cost model process, Fee Setting Methodology, the collection and analysis of Lincolnshire data by Care Analytics, the Actual Cost Modelling Process, the Council’s Proposed Rates, Market Consultation, the Council’s Response to the Feedback and Recent Developments and Contractual Updates.

The Chairman of the Adults and Community Wellbeing Scrutiny Committee presented the comments of the Scrutiny Committee following its consideration of this item at its meeting on 23 February 2022.  The Executive was advised that the Committee had supported the recommendations and the rates proposed, and were satisfied that extensive research had taken place, and the Council had engaged with the Care sector.  Issues raised included the rate of inflation at 4% used in the calculation of the rates, and whether this was a fair reflection.  The Committee also questioned whether the level of funding in the hardship fund would be sufficient.  However, LinCA was supportive of the fund, and felt that the funding level was appropriate.  It was also highlighted that there was a belief that new build care homes seemed to be larger and more focused on self-funders, and there was a need to be aware that some of these homes may need help to diversify.

During discussion by the Executive, the following points were noted:

·       There was a hope that as much of the sector as possible would adopt this, however the majority of the market would be sufficient to satisfy the legal requirements.

·       In relation to the Hardship Fund, assurance was sought that risks to the Council would be minimised in terms of putting money into businesses which may be failing, and it was queried what protections were being put in place to counteract this.  The Executive was advised that one of the key elements in this proposal was the length of relationship that Lincolnshire had with the care sector.  Meetings were held weekly, which was very important in making the right decisions and supporting those homes to improve quality.  This ensured the Council was investing in sustainable businesses and giving people a choice of home within a reasonable distance of their home.

·       It was confirmed that there were criteria in place for the allocation of funds from the Hardship Fund, and there would be an oversight programme for those homes which wished to apply.  Evidence would also need to be provided on how the funding had been used.  It was noted there were a number of processes in place which monitored compliance in terms of quality and finances.  There were a number of triggers which would indicate that there were concerns about the financial stability of a provider.

·       It was noted that the Hardship Fund would be managed in a similar way to the sustainability fund set up to assist providers during the pandemic. 

·       Clarity was sought regarding the open book accounting, and it was confirmed that the Council would have access to the provider’s full accounts.  Requests for usage of cash reserves were also made.

·       It was noted that residential homes could fail very quickly, but Executive members confirmed that officers were monitoring homes that were experiencing problems and were working with them and the CQC.

·       As infrastructure was already set up through LinCA, the Council was able to have a single strategic conversation.  This made it much easier to collaborate with the sector. 

RESOLVED

1.    That the rates set out in the table at paragraph 5.6.1 of the report be approved as the Council’s Usual Costs for both new and existing Learning Disability service users in respect of residential and nursing care with effect from 1 April 2022 for the financial year 2022/23

2.    That the rates set out in the table at paragraph 5.6.2 of the report be approved as the Council’s Usual Costs for both new and existing Older People service users in respect of residential, nursing and high dependency care with effect from 1 April 2022 for the year 2022/23

3.    That the rates set out in the table at paragraph 5.6.3 of the report be approved as the Council’s Usual Costs for both new and existing Physical Disability service users in respect of residential and nursing care with effect from 1 April 2022 for the year 2022/23

4.    That the rates set out the table at paragraph 5.6.4 of the report be approved as the Council’s Usual Costs for both new and existing Mental Health service users (aged 18 – 65) in respect of residential and nursing care with effect from 1 April 2022 for the year 2022/23

5.    That the proposed contractual updates set out in section 6 of the report be noted

6.    That the use of £1m from the Adult Care Grant Reserve to establish a fund for the making of payments to providers of residential care and residential with nursing care in Lincolnshire suffering hardship as a result of cost volatility relating to utilities costs and insurances be approved

7.    That authority be delegated to the Executive Director – Adult Care and Community Wellbeing in consultation with the Executive Councillor for Adult Care and Public Health to determine the detailed conditions governing the fund including the criteria for the making of payments.