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| TX: 06.05.09 - Legal Action Care Fees PRESENTER: WINIFRED ROBINSON |
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| Downloaded from www.bbc.co.uk/radio4 THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY. ROBINSON You and Yours has discovered that 250 of Britain's care home companies are planning legal action against all 150 English local authorities, it's all about fees. The care home owners, everything from big corporates to small single homes, have got together to form a group that they're calling the Fairer Fees Forum and they want a judicial review of what councils pay for residents who are funded by the state. Ray Purewal is head of litigation at Aston Brooke Solicitors. What's wrong then with the fees that the councils are paying? PUREWAL The current fees being paid are far below the cost of actually providing that true care. If we look vaguely around some of the counties within the UK you're getting paid round about £400-£350 per week. Now some of the fees of say £350 a week average out about £50 a day, you can't even get a bed and breakfast - breakfast, accommodation for £50 a day whereas they're expecting - the local authorities are expecting the care homes to provide not only care but full time 24 hour care with three meals a day and on top of that, in some cases, some of the residents actually need nursing and other sort of expectations from the local authority. ROBINSON Does anybody know though - can anybody say what is a fair fee for this kind of service? PUREWAL The fair fee has been - there are a few models that have been issued. Joseph Rowntree Foundation instructed Langham Bruce to produce a report in 2002, I think a new one was just done in 2008, and that itself takes into account quite a few varieties and sort of scales back with regards to salaries, the land costs and what's actually being put into the business itself. And from there it does actually produce a figure. Now the figure varies depending on which area you're in - the UK - you're in, whether you're in inner London, outer London, it varies depending upon whether there's staff - easy issue of staffing etc. etc. ROBINSON But it's about how much? PUREWAL Well the figures will vary depending on - well inner London you're looking round about £463 - sorry outer London £463 to £538. Inner London it's £574 to £648 ... ROBINSON A week. PUREWAL A week. ROBINSON Now are there any local authorities in England coming way below that? PUREWAL There are a few that are coming way - everyone's coming below that. ROBINSON Give us a couple - they're all below, way below? PUREWAL They're all below. Norfolk County Council comes in around about £299 to £311 for basic residential care. With regards to nursing they come in around about £417, £429, which is far below the figure that's required. Now this isn't just the local care homes asking for more money because of the sake for want more money, they actually need the money to keep the business alive. We may be in the middle of a recession, so some people may be arguing why should these guys ask for more money when actually the country's in a recession itself. We've had this downturn in the healthcare industry for years, they've been grossly under funded for the last decade at least. With the fees reducing in some cases, as in the example of Wirral, are going to carry on in that rate with regards to the other care home - local authorities providing less fees you'll find there aren't going to be any care homes available. ROBINSON Well Jenny Owen can speak for the social services departments because she's the president of the Association of Directors of Adult Social Services. Jenny Owen you get what you pay for, don't you, are you expecting these care providers to do more for less? OWEN Good afternoon. No, no we're not asking people to give more for less. I mean if I can just give you a bit of context here. Last year we increased the fees nationally, on average, by 2.8% and we're expecting to do the same again this year. So that's pretty good in the current climate. And we have about 2% less people year on year for the last five years who are going into residential care but our costs are 5% more. So in other words we're paying more for less people because people's care is becoming more complex, that's absolutely the case. ROBINSON But how can you justify all of the fees coming in at lower than what the independent accountants said the costs are? OWEN Well let's just go back to how these fees are set up. Fees are determined at a time when we either take out contracts with the independent sector providers, so they could have been quite a long time ago or they could be very recent or we could be purchasing a place today, tomorrow for individuals. And at that time those fees are negotiated and agreed. And when the local authority pays for a large number of places, so we may, for example, purchase half of the capacity for residential care homes in a particular area, then we do give that provider a certain degree of security, so they have a good trading opportunity there. So in that way we do get perhaps a lower price because we are paying - we're buying in bulk and we're guaranteeing the supply. So that happens in large parts of the country. So I think the issue is that we are not wanting at all to have the risk of poorer quality care, it's in all our interests - it's in the interests of the people who are providing and buying the care for and the providers and the local authorities that the quality of care is good. And we are trying but in very difficult circumstances for local authority budgets to give a reasonable uplift on the fees that have been negotiated. ROBINSON You say a reasonable uplift last night Wirral Council, for example, ratified that fees there will be cut by 1.3% on the previous year and they say some of their care homes currently operating with as little as 70% occupancy, which shows there's an over provision of care home beds in Wirral, I mean that level of fees will drive some of them to the wall. OWEN Yes I think there's two things there: one is that it's absolutely right that this is a very difficult market now, it's highly competitive. In the last 10 years a lot of new providers have come in, building new homes, and it's made it very difficult. So in some areas, like the Wirral, there is an over supply of places - 400 empty beds - so that means the market situation is difficult. But one of the reasons I understand why Wirral made that decision was when they looked comparatively at what they were paying against what everybody else in that region was paying they're paying 12% above the regional average. So that was why those decisions were made and they have been talking to their local provider associations to try and reach agreement, as we all do in all our local authorities. ROBINSON Ray Purewal, is legal action really the best way to try to sort this out? PUREWAL Well they've tried all other approaches. The Wirral, as an example, in the last couple of years they did suggest that if you provide a higher care - higher level of care we will pay for the service, hence they have been for the last couple of years. I agree with the fact that the neighbouring local authorities have been paying less and hence the Wirral has decided that they shouldn't pay as high. Rather than the neighbouring local authorities increasing their fees in line with Wirral they've reduced it. So that in itself shows that if one local authority does decide to take the lead and does decide to actually pay the true cost of care the other local authorities aren't going to follow. ROBINSON Jenny Owen, you talked about this as a negotiation but in Northumberland the care home owners there went on a sort of strike, didn't they, they refused to take council funded residents unless the fees were fair. The potential is for this to happen again in other parts of England and if it carries on then you really would have a problem wouldn't you? OWEN Well I think that would be a really difficult situation for everybody, including - thinking mostly - of the people who require that care. And the point I think we've got to think about is what sort of model of care do we want in the future and if we want to support more people where they would like to be, which is often - often at home, then that actually might allow us to have more money to put into the care for those individual placements in residential care when they're required. But we need to be shifting that model of care and we need a really good debate in this country about how much we want to pay for good quality care. The government is promising a consultation paper later in the summer on the future - how support and care will be funded and how it will be managed - and I really welcome that because at the moment I think we're between a rock and a hard place. ROBINSON Ray Purewal, when this case comes to court - when will that be? PUREWAL We're looking at six to eight weeks from now, we're still - we're gathering the information to local providers. We must make it clear - it isn't an intention to actually go straight to court, that wasn't our first reaction, it only has been because the local providers have been trying to get in touch with the local authorities and trying - well I think we talk about negotiations, negotiations haven't really been happening. ROBINSON Thanks very much both for taking part. And we want to say this legal action's been planned against English local authorities and according to the independent care analyst Laing and Buisson the grievances by care providers in Wales are similar to those in England. There's a bit less concern in Scotland, where homes have worked with the Confederation of Scottish Local Authorities, that's called COSLA and the Northern Ireland, where there are only four authorities to deal with. Back to the You and Yours homepage The BBC is not responsible for external websites |
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