Current Issues

Further information on any of the current issues affecting members can be found on the Newsletters page of this website. Comments and suggestions are very welcome and any member wishing to make a contribution should send an email to info@nottinghamshirecare.co.uk or ring/fax or SMA 01158 24 23 22

Fair Price for Care

Update on Nottingham County Social Services negotiations
The 2010/11 Council Quality Inspections are usually completed in the first half of the year.  We expect the reports and any changes to bandings to be sent to homes in October.

Fee rates, audit tool and background information is available in this websites InfoBank.

We were hoping that the Council would fully implement the 2008 Pinders Report fee level by 2011, however they continue to claim they cannot afford higher fees (However they do still fully fund their own care homes)  and are discussing with your representatives a review of the scheme and possibly asking Pinders Report to update the 2008 report. ( The Association commissioned a local surbey of East Midland care home costs from Laing & Buission in October 2010.

The Association's Response to Nottinghamshire County Social Services
Whilst welcoming the progress made so fair in the council meeting our full and fair costs we have met with the Councillor and officers of the council and reemphasized the fact that we entered into an open book exercise with them and that identified the costs of an efficiently run home back in 2008. Despite us supporting quality audits, council intitiatives the full costs have not yet been met.  We have submitted a proposal for their consideration in their 20011/12 budget . Click here for a copy of that submission

We are pressing for the full recommended fees to be implemented this year and we cannot recommend the signing of contracts until the full fee is implemented.

Also the contract proposed does not include the inflation indexation of the fees and we are currently working with the council on agreeing a mechanism.

Update on Nottingham City Social Services
The City have taken a similar line to the County although their fees and quality audits are slightly different. The City tend to audit later in the year.

Background
The Association had for some years been trying to get the councils to adopt FPC; changes in senior management at the City and leadership at the County led to them both agreeing with us to work towards FPC in partnership. Independent consultants, Pinders, were appointed to review homes and undertook visits to all homes to assess facilities. A representative selection of homes were chosen by City and County to have audits of their costs with the results, anonimised, available to show the real costs involved in running care homes.

As well as agreeing to the principle of FPC, both councils accepted the advantages of having a form of quality payment to reward better homes.

Social Services Contracts
The Association has yet to finalise contract terms with both local authorities. Please do not sign any contracts until we are in a position to recommend the contracts to you.

The county has said very clearly that even without the contract they are trading legally. However their internal auditors want them to have full contracts in place. We also wish to include in the contract terms relating to the Fair Price for Care which has not yet been agreed. There is also some debate on the length on contract that members and the councils would like to implement and whether there will be a mechanism to link prices to inflation.

Continuing Healthcare

The local PCTs are tring to impose  the "Any Willing Provider" process on Continuing Health care clients, up to date information can be found by clicking this link.

Current Contract
Continuing Healthcare/PCT Contracts 2008 (3 year contract) and Fee Structure

The core of the proposal was included in the July 2009 newsletter.

In 2010/11 Nottingham City PCT matched the local authority raise in the nursing element of the fee but imposed a 0% uplift on the "plus" elements.

In 2010/11 Nottingham County PCT did not matched the local authority raise in the nursing element of the fee and imposed a 0% uplift on the "plus" elements.

The Association has instructed our solicitor, on members behalk, to write the PCTs requesting this be reviewed as this action may be in breach of the contract and the NHS guidance on commissioning.  We will keep members updated in the newsletter.

The 2008 round of negotiations with both the County and City PCTs  resulted in the following.

■ The new schedule of nursing bands, Band A and B would start to be used for new residents (see the last newsletter for details)
■ In 2008/9 the social care element would be based on the fee the Social Services are now paying for the social care element. (So based on your quality band, the type of care and the new updated fee rate): But not the full Pinders rate.
■ A new rate called Fast Track is introduced at a premium of £305 per week and will be paid for any resident who is admitted using the Fast Track route. Additional 1:1 support etc can still be negotiated. This rate lasts for the first 13 weeks and then the resident will need assessing with the DST as normal.
■ Confirmation that quality payments are back dated to 1st April 2008 for existing patients and new ones (Back dated information needs to be lead by patient – even if death occurs during that period quality payment can still be claimed)
■ Claims can be made up to 3 days following death as per current social services agreements
In return the PCTs want homes to sign a new 3 year contract

The Associations response to the 2008 PCT contract

1. That we were unhappy with using the current social services fee rates as the higher full Pinders rate more closely represented our true costs and if those costs were not paid - how would we pay our bills? Therefore we were very unhappy with a three year contract that had no automatic uplift mechanism and no written commitment to achieving a full fair fee
2.That we could reluctantly recommend this compromise contract but with the proviso that there would be a commitment to working towards Pinders recommendations from April 2009. This commitment was given in the meeting and is in the PCT minutes.