DIRECTOR OF ADULT SOCIAL CARE
PO Box 20 Council House
Solihull West Midlands B91 9QU
Tel: 0121 704 8292 Fax: 0121 704 8129
Minicom: 0121 704 8058
Email:
www.solihull.gov.uk
Your Ref: / Please ask for: Simon Barton
Our Ref: SJB / Date: 7th February 2013
Dear Colleague,
FEE RATES IN 2013/14
INTRODUCTION
I write to you as a contracted provider to begin consultation on arrangements by which to determine fee rates to be set by SMBC for:
· registered residential and nursing care homes
· non-registered support services
My colleagues Karen Murphy and Simon Barton, of the Business Transformation Directorate, SMBC, attended the consultation event on 6th February 2013 at the Fordbridge Centre kindly arranged with the assistance of the Enable’s Solihull Care Forum, Solihull Not for Profit Group and the Solihull Workforce in Care Development Association (SWICDA).
Thank you to those who were able to attend. Consequently, I would like to extend this opportunity to consult and ask for comments on the proposal by which to determine future fee levels.
The period of consultation is extended until Thursday 7th March 2013 and your responses used to inform the final decision of the Council.
BACKGROUND
At this stage I would emphasise that:
· no decision has yet been made for 2013/14 and beyond on the fee rate to be set by the Council for registered residential and nursing care homes in 2013/14, nor for non-registered support services
· however, the current domiciliary care rates would apply until the commencement of the new contract on 8 April 2013
· and Supporting People services are currently subject to a complementary set of discussions in light of the decision of the Council to reduce expenditure on the programme by 20% by March 2015.
PROPOSAL
At the consultation event on 6th February my colleagues presented a proposal which is intended to further enhance the partnership between the Council, providers and residents and their family members and so seek new and fresh arrangements whereby we can co-develop a fee structure and quality framework.
A copy of their presentation is attached but the proposal is set out in the attached Appendix: Fees Proposal.
NEXT STEPS
I would welcome your responses to this consultation either as individual providers and/or collectively. I have set out the timescale below:
· The deadline for responses to this consultation is by 5pm, Thursday 7 March 2013 (30 days) and please send your comments to
· SMBC will then consider and analyse your responses and I will announce a decision in week commencing 18 March 2013
· If a decision is taken to proceed with the ‘fees project’ it will commence immediately, with Step 1/Framework concluded and recommendations to myself as the Director of Adult Social Services (DASS) and Cabinet Member for Health and Wellbeing by September 2013, and a decision to take effect from 1 October 2013; and Step 2/Procurement and Step 3/Validation to be concluded by March 2014.
I would on behalf of Solihull Council like to underline our clear intention to continue to work with yourselves as key local partners to pursue the proposal set out in this letter. We believe the proposal will lead to benefits for all parties particularly residents and their family members. I do hope you will be able to respond to this consultation with the benefit of your expertise and experience.
Best wishes
Ian James
Director of Adult Social Care
cc Karen Murphy, Service Director, Planning, Performance and Commissioning
Business Transformation Directorate
APPENDIX
SMBC FEES PROPOSAL, FEBRUARY 2013
Introduction
This proposal is firmly rooted in:
· SMBC’s Adult Social Care Objectives, Putting Solihull People First is one of the Council’s top 5 priorities
· The Strategic Context and the support provided to our Objectives by a range of Council and joint strategies
· An understanding of the current service provision and financial context.
Challenges
The proposal of the Council seeks to address a number of challenges, most notably:
· Demographic: increasing demand for services
· Funding: constrained resources on part of Local Authorities and providers
· Quality: increasing aspirations of all to improve quality standards
· Legal: to ensure due regard to actual costs of care
· Market: improve oversight to ensure quality, safety and financial viability
· Scope: recognition that registered and non-registered services form a significant area of adult social care investment.
Principles
The Council’s proposal is based on a number of principles:
· Partnership and co-development of a fee structure and quality framework; incorporating a dialogue between SMBC and Providers to achieve improved transparency and a greater awareness of how much things cost
· Contribution from service users and carers will be essential
· The proposal will be supported by an independent 3rd party
· Consultation will continue throughout the process
· The key outcome will be to achieve a sustainable longer term settlement, namely
– a fair price that is affordable, but is…
– neither a cost that SMBC cannot afford…
– nor a price that would put homes out of business
· Quality improvements which are incentivised and supports the delivery of positive outcomes
· Enable the fulfilment of equalities obligations: to promote equality of opportunity, good relations, positive attitudes; to eliminate harassment and unlawful discrimination and to anticipate consequences of proposals and minimise/eliminate negative impacts
· The proposal will initially apply to residential and nursing care homes for older people but its potential wider application will be considered at a later date.
Proposal: 3 steps
Step 1: Framework
The key aspects of this step are:
· Providers would be requested to declare your actual costs: direct, indirect, capital
· Costs should be attributable to Solihull locally based (and not regional/national) services
· An analysis of returns will form the basis of the fee structure
· The methodology has yet to be fully defined and this will feature as an important part of the co-development approach
· To set a fee for each category of:
o registered residential care for older people
o registered residential care for older people with dementia
o registered nursing care for older people
o registered nursing care for older people with dementia
· and for each of the above there will be a separate fee for meeting ‘core standards’ plus a higher ‘enhanced’ rate if additional quality standards met
· Subsequent inflationary awards would be aligned to demonstrable increases in direct/in-direct costs only
· A Quality Framework would be co-produced, cross refer to development of a contract/specification, and incorporate simple, clear, attainable standards with incentives.
Step 2: Procurement
The key aspects of this step are:
· To undertake a Procurement exercise to create a framework agreement
· Local Solihull based services would be eligible
· The tender process would assess whether each service met ‘core standards’
· If a service does not achieve ‘core standards’ and a place on framework, placements can still be agreed consistent with user choice but a lower fee below that of the ‘core standards’ is proposed.
Step 3: Validation
The key aspects of this step are:
· Validation of the quality standards and associated fee
· Pursue on-going monitoring of quality by Council officers
· To receive feedback from residents and family members, including compliments, complaints and comments and for these to inform monitoring
· Continue and integrate this exercise into joint work with the NHS and CQC for the benefit of the wider health and social care economy
Benefits
The Council would propose that there are a number of benefits to this approach, to:
· secure a partnership and co-develop arrangements which can maximise future sustainability, stability and good value from a significant investment
· provide assurance to, and safeguard the interests of, residents and of families
· improve quality and tailor care to deliver person centred outcomes for residents
· co-develop a quality framework, standards and a fee structure
· develop and retain a local skilled and motivated workforce
· reduce the threat of legal challenge
· better understand our local market and so improve decision making by anticipating demand pressures
· further improve relationships
· and politically to achieve greater oversight, improved understanding and accountability and so assist elected members to better able represent constituents.
Process
The process proposed by the Council to undertake this exercise would be based on:
· agreed governance arrangements and infrastructure to support the exercise
· co-development and consultation, including contributions from:
o provider staff: front line staff, managers and trustees/directors
o residents and family members
o commissioners and partners
SMBC’s Current Offer
This comprises:
· 0% for all registered residential and nursing care services and non-registered support services for 2013/14
· Undertake the ‘fees project’ for residential and nursing care for older people, including dementia, (Step 1/Framework) for conclusion and recommendations to DASS and Cabinet Member by September 2013
· Decision on fee settlement wef 1 October 2013 for 4 ½ year period (until 31 March 2018)
· Backdating under consideration
· Registered residential and nursing care home services for adult mental health, learning and physical/sensory disabilities…0% will apply except where the outcome of a care funding calculator exercise and/or review of high cost placements determines otherwise
· ‘Fees project’ Steps 2 and 3 to conclude by March 2014 for implementation in 2014/15…including further consideration of wider application.
SJB February 2013