1. Presentation to OSC on Care Home and Domiciliary Care Markets
Adult Services
Presentation to OSC on Care Home and Domiciliary Care Markets
17th October 2016

2. Care Home Market – local issues
24 homes (Older people/ physical disability)
Easier market to mange than larger geographical areas
Closure of council’s own homes has boosted occupancy in the independent sector (currently 95%)
Quality assurance scheme has helped raise quality and drive out poorer quality
Change programme has led to a reduction in long term placements – BwD now 10th highest in the region rather than 23rd (of 23!)
Shortage of nursing beds becoming problematic
Reliant on staff on or slightly above the National Living Wage
High users of the unplanned health system
“Fair price for care” exercises in 2012 and 2015
New inspection regime from CQC form 2015
Each Step scheme on infirmary site (64 beds) with 88 beds proposed on Eleanor Street
Legal challenges nationally centre on Councils’ understanding and regard for the true cost of providing care vs. “arbitrary” fee setting

3. Care Home Fair price for care exercise
“The comparison of costs from the 2012 review and the 2015 review show that there has been an overall increase in costs of 5.7% over a three year period. Since the first review there has been a 3.5% uplift to fees in 2012 which goes part of the way to covering the increase in costs. In order to fill the rest of the gap in funding some care homes have had to increase the fees that they charge to private residents when historically they have charged the same fees as Blackburn with Darwen Council. Some care homes have introduced an additional fee to residents to cover the costs of the hairdresser, toiletries etc.
Since this review commenced there has been an uplift of 1.5% to the care home fees for 2015/16 which has been the first uplift since the outcome of the last review in Care home providers have expressed their frustrations with the freeze on fees and a genuine concern for their future when the Living Wage Rise takes effect from April The Living Wage Rise brings a 7.5% increase to the majority or care and ancillary staff who are currently paid at minimum wage. In addition to the Living Wage Rise, 2016 brings a additional 1% increase to the employers pension contributions”.

4. Fees

5. Capacity and occupancy – Feb 2016

6. Domiciliary Care
Long term financial viability of the sector is a concern with some national providers withdrawing (Mears, Housing 21)
Impact on hospital discharge (not BwD)
Local wage economy means providers are able to recruit
4% uplift in 16-17
Margins for providers are very low
BwD rates lower than a number of North West Authorities
4 preferred providers with the bulk of commissioned hours
Strategy has been to place more work with fewer providers to mitigate price freezes
Wider list of accredited non-preferred provider issues
Common issues include timeliness and duration of visits, consistency of care with large packages of care
Demand for the service is growing (particularly 2 handed packages of care)
Retendering for an April 2017 implementation with a fair price for care exercise to take place alongside this
The tender will include a structured means for fully taking into account user views and experience in relation to service quality
OSC involvement from a pre-decision point of view is welcome

7. Eligibility criteria under the Care Act (2014)