Decision Maker: Corporate Director of Health and Adult Services
Decision status: Recommendations Approved
Is Key decision?: Yes
Is subject to call in?: Yes
To approve fees and annual uplift level for
The proposed fees for Residential, Nursing,
Domiciliary Care and Community Based Services have been agreed for
(i) That fee increases to care homes for both residential and nursing will be as below:
a) There will be four Actual Cost of Care (ACOC) rates and these include an amount for return on investment.
Nursing with Dementia 826
Residential with Dementia 784
b) The Cost of Care rate will be implemented for existing packages over three years. In essence that means that each package would receive 1/3rd of the difference between the current rate and the ACOC rate, reaching full ACOC by April 2024. However we will commit to reviewing this position and subject to funding, look to move remaining packages to ACOC levels in 2023/24. This review will look at funding available, including any unspent grants, plus the amount of packages still above ACOC level.
c) Each year the ACOC rate will be inflated.
d) For those below the ACOC rate, inflation will be applied at the full level.
e) For those above the ACOC rate, no inflation will be applied.
f) For those already above ACOC and not receiving inflation, a safeguard will be put in place to ensure they do not drop below the ACOC rate (as this is inflated each year).
g) All new packages will be paid the ACOC rate, except in exceptional circumstances and where agreed otherwise.
(ii) A 3.1% increase for all non-residential services and learning disability residential services. This will include day opportunities.
(iii) For domiciliary care:
• A flat rate increase of £1.68 to contracts currently at or below £21.52
• This will reduce by 1p for every 1p currently above £21.52. In effect every package currently between £21.52 and £23.20 will now be at UKHCA rate of £23.20
• A flat rate increase of 36p for rates currently between £23.20 and £25
• A flat rate increase of 20p for rates currently between £25 and £25.40, up to maximum of £25.40
• Any rates above this to have 0% inflation, pending the domiciliary care ACOC
(iv) Increases to supported living care packages will also be targeted to support those currently receiving lower fee rates. The offer for 2022/23 is below:
• 5% to those packages currently paid below £19 per hour
• 3.1% to those above that rate
(v) For placements of people in care homes outside of North Yorkshire County Council we will honour an uplift agreed by the host authority where they have undertaken an Actual Cost of Care exercise, and will consider individual business cases where there is no Actual Cost of Care exercise in place
(vi) For placements of working age adults in care homes within North Yorkshire County Council area 3.1% will be applied to all residential/nursing placements.
(vii) That a review with the Independent Care Group (ICG) to begin no later than 30 September 2022 to look at the impact of this award on providers and, subject to grant conditions, the distribution of any additional funding from government. This review will also look at those packages receiving the inflation award of 3.1%, such as Supported Living.
The Council has a commitment to review fee
levels on an annual basis. The Council has always had an obligation
to take account of the market pressures and to consult with
providers on fee levels but from April 2015 new statutory
responsibilities under the Care Act 2014 require the Council to
shape and sustain its markets.
Consultation has taken place with providers through the Independent Care Group (ICG) and an agreed way forward is set out in the report.
Publication date: 14/03/2022
Date of decision: 11/03/2022
Effective from: 22/03/2022