The Director of Adult Services will discuss with the Sub-Committee the position around charge levels for care beds if a resident is in hospital.
Minutes:
The Director of Adult Services confirmed that the Council’s rates were reviewed each year and the Council would currently pay for example £471.51 per person per week for frail elderly beds. A service user’s family could be asked to top up this charge, depending on financial circumstances. If a resident had savings in excess of £23,000, they would be expected to pay for their care themselves. A placement in a care home would cost £26-30k annually and there were 500-600 Havering residents currently in long-term care. Care homes for people under 65 had still higher charges. The Director would forward details of which care homes currently accepted the Council’s rates.
It was noted that Havering care charges were cheaper than the average for both London and Essex and that some care homes in Essex charged £1,000 or more per week. If people were placed in a Havering care home from outside Havering then charges were paid by the home borough.
If a care home resident was in hospital for up to 4 weeks then the care home was still paid the full rate. If a client died during their care home placement, the provider was required to advise the Council within one working day. The Council then allowed a further five days on the placement to allow the person’s family to make arrangements etc. It was possible that this could be reduced to three days on cost grounds. Equivalent arrangements in other Councils varied between 1 and 5 days for this period.
If a client remained in hospital etc after 4 weeks then the Council would only pay 60% of care fees for the remainder of the absence or until notice was given. Adult Services would normally be aware of any top up arrangement but this was a separate arrangement between the care home and the provider. Members felt that 4 weeks was a considerable period to pay the full rate if a client was not resident at the home and that this should be reviewed. Officers felt that there was no reason to rule anything out around reducing these costs. A NELFT officer added that many contracts with residential homes were outcomes-based with penalties for e.g. patient falls or failure by the home to follow an end of life care plan.
The Director of Adult Services felt it was important to balance lowering of fees paid with the risk of providers leaving the market. The outcomes based model and use of incentives for high quality care seemed a good way forward. A lot of work was under way in preparation for the funding reforms in the Care Act. Officers were seeking to break down the various components of care home charges in order to help the Council to deliver savings.
Members felt that other issues that could be considered included releasing home equity to pay care bills and paying family members to care for relatives. This was being considered at national level but officers felt that it would be unaffordable in Havering due to the large number of carers already in the borough. Additionally, direct payments could not usually be given to family members.
It was AGREED that updates on this area should be given at subsequent meetings of the Sub-Committee.