National Care Home Contract

Care Home Fees Proposal for 2010 / 2011

General Principles

  1. As part of a developing partnership approach, both COSLA and Scottish Care will be open to renegotiation should one of the parties request this. However, this does not commit the other party to agree a new deal.
  2. The general approach of incentivising quality should continue via the Care Commission’s Quality Assessment Framework (QAF);
  3. Any staffing standards applied to the independent sector should also be observed in local authority run care homes;
  4. In the longer term, the NCHC quality approach should become more outcome focussed, in order to advance the strategic fit with SOAs;
  5. A partnership agenda will be advanced in such a way that encourages the sector to diversify in the face of demographic trends;

2010-11

Inflationary Uplift

  1. A 2% general uplift will be applied to the standard residential and nursing care base rates for 2010-11. This gives a headline figure of £474.12 per resident per week for residential care and £550.77 for nursing care.

Basic Quality Award

  1. If a care home receives a QAF score of 2 or less in any themed area, this will trigger a Local Authorityreview/discussion with the care home, which could lead to the withdrawal of the quality award.
  1. Similarly, if a care home falls below the agreed staff training threshold, 50% of the basic quality award could be withdrawn. The schedule for qualified care staff targets will be:
  1. 31/12/09 - 60% of care staff excluding registered nurses listed on the Care Commission staffing notice, who are qualified at SVQ2 in care (or above). If more than 50% have achieved the reward providers will not be penalised.
  2. 31/12/10 – 65%of care staff excluding registered nurses listed on the Care Commission staffing notice, who are qualified at SVQ2 in care (or above). If more than 60% have achieved the reward providers will not be penalised.
  3. 31/04/11 - 65% of care excluding registered nurses listed on the Care Commission staffing notice, who are qualified at SVQ2 in care (or above).This standard will be consolidated into the NCHC, with the audit undertaken in December 2011.

Enhanced Quality Award

  1. In order to create additional incentives to improve the quality of care, an enhanced quality award will be available to the best performing care homes. Specifically:
  2. For Care Homes with nursing, an additional £2.00 per resident per week will be available if a QAF grade of 5 or 6 is achieved in ‘Quality of Care and Support’ and a minimum of grade 3 in the other categories. A further £1.00 per resident per week will be available to homes that achieve a QAF grade of 5 or 6 in ‘Quality of Care and Support’ and a minimum of a 5 in any one other category.
  3. For Residential Care Homes, an additional £1.50 per resident per week will be available if a QAF grade of 5 or 6 is achieved in ‘Quality of Care and Support’ and a minimum of grade 3 in the other categories. A further £1.00 per resident per week will be available to homes that achieve a QAF grade of 5 or 6 in ‘Quality of Care and Support’ and a minimum of a 5 in any oneother category.
  1. Performance will be judged across two 6 month periods within the financial year: April to September, and October to March. Any enhanced quality award payment will be backdated from the point of inspection to the beginning of the most recent 6 month period.Similarly, where a care home’s QAF rating is downgraded, resulting in a reduction in the quality reward, this should also be backdated from the point of inspection to the beginning of the most recent 6 month period.

2011-14

  1. Councils are currently planning for a real term reduction of 12% in their budgets. As such, there will be no additional finance available to the care home sector during this period and there should be a joint planning mechanism established to begin to prepare for this scenario;
  1. Work will nonetheless continue around developing a new model of care, involving more specialised care, differentially rewarded on the basis of staffing numbers, quality and outcomes. Work will also be undertaken to develop joint commissioning models between NHS Health Boards and councils with respect to high dependency health and social care.

NCHC Fee breakdown from 2008/09 to 2010/11

Nursing / Residential / Notes
2008/09 Headline Fee / £523.35 / £450.45
Less Share of £6M / £6.81 / £1.76 / (1) Only available 08/09, 09/10 & 10/11
£516.54 / £448.69
Less 08/09 DWP / £102.90 / £102.90 / (2) = Pension Credit Minimum Income Guarantee (124.05) - Personal Expenses Allowance (21.15)
Base Fee for Inflation (including QA £18.62) / £413.64 / £345.79
+ 2.8% Inflation Uplift / £11.76 / £9.27
£425.40 / £355.05
Plus Share of £6M / £6.59 / £1.71 / (3) Adjusted from 08/09 amount due to changes in Care Home Demographic
£432.00 / £356.76
Plus 09/10 DWP / £108.10 / £108.10
09/10 Headline Fee (3.2% overall) / £540.10 / £464.86
2009/10 Headline Fee / £540.10 / £464.86
Less Share of £6M / £6.59 / £1.71 / (4) Only available 08/09, 09/10 & 10/11
£533.51 / £463.15
Less 09/10 DWP / £108.10 / £108.10 / (5) = pension credit (130.00) - PEA (21.90)
Base Fee for Inflation / £425.41 / £355.05
+ 2.0% Inflation Uplift / £8.51 / £7.10
£433.92 / £362.15
Plus Share of £6M / £6.59 / £1.71 / (6) Adjusted from 08/09 amount due to changes in Care Home Demographic. May require further adjustment
Base Fee 2010/11 / £440.51 / £363.86
Plus DWP Element / £110.26 / £110.26 / (7) 09/10 DWP Pension Credit Standard Minimum Guarantee uplift of + 2.0% (PBA 8/12/09).
September 2009 RPI was -1.4% and ROSSI was +1.8%.
2010/11 Headline Fee (2% overall) / £550.77 / £474.12 / (8) see notes 6 & 7 above
Overall Uplift / £10.67 / £9.26 / (9) Plus any applicable Quality Reward