National Care Home Contract – Negotiation Group

Note of Mtg – Tuesday 10th November 2009

Present: Ron Culley (COSLA)

Stuart Johnston (COSLA)

Vicki Bibby (COSLA)

Teague McFadden (NCHC Project Officer, COSLA)

Tom Barrie (ADSW)

Marie McGinley (ADSW)

Lynn Brown (Directors of Finance Group)

Ranald Mair (Scottish Care)

Bob Deeming (Scottish Care)

Rob Harper (Scottish Care)

Kenny Simpson (CCPS)

Apologises: Nick Kempe (ADSW)

Dorothy Cowie (Scotland Excel)

Kenny Valentine (Scottish Care)

Mark Wilson (Scottish Care)

1) Ron Culley welcomed everyone to the meeting with round table introductions.

2) Review of 2009/10

Ron opened discussions by reiterating both sides positions; Politicians would have to endorse any position agreed by COSLA and Scottish Care members would have to endorse any agreement struck by the ‘Providers’.

The Group reflected on the two year deal and stated their respective views. The following points were noted:

a)  The two year agreement was reached to create stability within the sector but also to allow for a more focussed approach on the reshaping older people’s care work.

b)  Every local authority honoured the 09/10 headline figure rise which was positive.

c)  Free Personal Care is acting as a barrier as it is impacting on the flow of finances to providers. Although Scottish Governments recent agreement to meet with 6 weeks of assessment was acknowledged.

d)  The application of in-between and additional or specialist rates within some Local Authorities (Enhanced Residential, Specialist Nursing Care). It was suggested that this might best be routed to the National Contract discussion.

e)  Progress has been made on the Additional Care Charges guidance but it has proved difficult to conclude. Both parties are still committed and working hard in partnership to agree an amicable outcome. It was noted that Nursing and Residential standard care needs to be defined before it can be established what ‘additional care’ is.

f)  Ranald confirmed that one local authority has chosen not to accept the flexibility agreed, with respect to no funding being withdrawn, if a care home still achieves at least 50% of care staff qualified. Providers are keen to maintain as much consistency within the contract as possible.

g)  The Cost of Care Study has been delayed but this matter is still in hand.

h)  It was noted that the next audit around the Quality element is in December and everyone should be working towards that over the next two months.

i)  It would be important to apply the same quality standards to LA care home to ensure independent care homes are not unfairly penalised.

j)  It was agreed to invite Marcia Ramsay (Care Commission) to future meetings as the Care Commission influence costs by setting the benchmark for staffing levels etc.

(Action: Stuart Johnston)

3) Dependency Levels of Residents

Scottish Care indicates an increase in dependency levels with length of stay reducing.
Ron advised that he was keen to explore the funding and costs context.

Marie McGinley referred the Group to the ’SHRUGs/SCRUGS’ report on measuring relative need which was commissioned by NHS for care homes and hospitals in Inverclyde and had a national view from hospitals, care homes and individuals in their own home. Marie highlighted that this could be an evidence base to get discussions started.

Ranald expressed his reservations about the report but was happy for it to be tabled at the next meeting. It was agreed it would be useful to invite Pete Knight (Scottish Government) to explain in detail the findings from the report.

(Action: Stuart Johnston)

Ron advised that it would be useful if providers could provide some facts that costs for care homes continue to rise, as he needs to provide members with hard evidence which highlights the pressures provider’s are under. It was agreed to pursue Kenny Valentine for an evidence base around the increasing level of dependency of residents in care homes over the last year.

(Action: Kenny Valentine)

4) High Level Principles

Ron referred the Group to his paper ‘National Care Home Contract’, previously circulated.

The Group agreed that in the spirit of partnership both COSLA and Scottish Care will be open to renegotiations should one of the parties request this. It was agreed to clarify whether a clause should be inserted in the contract to this effect.

2009-10

Following a wide ranging and robust discussion the following points were agreed:

a)  A 2% general uplift will be applied to the standard residential and nursing care rates.

b)  If a care home receives a QAF score of 5 or 6 in the themed areas then the care home will receive an additional 0.7% on top of the 2% general uplift. It was agreed that this would drive up quality but also reward the ‘good’ care homes.

c)  It was broadly agreed that this is the direction to progress the negotiations but that representatives from both sides should meet to discuss this is in further detail before the next meeting. (Action: Teague McFadden)

d)  It was noted that this is an issue which could also be raised with Marcia Ramsay if she can attend the next meeting.

2011-14

The Group agreed that there should be a slight amendment to the wording in bullet point one by replacing ‘freeze’ with ‘scenario’.

It was agreed to merge bullet points two and three together as this ties in with the reshaping older people’s care work.

It was noted that bullet point four should be deleted.

5) Scope, Content and Timeline of Future Negotiations

The Group agreed to meet again the week commencing 14 December – Stuart will canvass

for dates.

The meeting closed at 1200hrs.

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