Care minister Norman Lamb has been challenged by the Registered Nursing Home Association (RNHA) to say how much he thinks local authorities should be paying nursing homes so that residents who qualify for public funding receive the level of care they need.
Allowing for regional variations in the costs of land and property, the RNHA has called on the minister to undertake a fair and accurate assessment of what level of fees nursing homes should expect to receive from the councils that purchase places with them.
Said RNHA chief executive officer Frank Ursell: “The root problem rests with local authorities paying less than they should be, which puts pressure on nursing homes and residents’ families alike.
“Both Mr Lamb and his Parliamentary colleague Paul Burstow have apparently been making public statements about the thorny issue of ‘top up’ payments made by families. But if the local authorities do not pay enough to enable their relative to live in a nursing home close to their local area, or of a good enough quality, it forces many families to bridge the funding gap themselves.”
He added: “We agree with the Independent Age charity which said recently that a council should not set an arbitrary limit on the amount it is prepared to pay and, if there are no care home places available at the standard rate which are capable of meeting someone’s assessed needs, the council should be flexible enough to pay a higher rate in that instance.
“Some families are complaining that their council is expecting them to fork out top up payments even for the ‘basic’ level of care the council normally specifies in its contracts. That is not what top up payments are meant to be. The government is passing the funding baton to families, which is not acceptable.”
The RNHA’s view is that the fees generally paid by local authorities for nursing home places are generally on the low side and often do not cover the actual costs incurred in delivering the care required, including staff time, food, accommodation, heating, lighting and equipment.
Said Mr Ursell: “We know that it can cost up to around £2,200 a week to keep an older patient in a Birmingham hospital bed. Yet Birmingham City Council doesn’t even pay £600 a week for a nursing home place. Some budget hotels charge about £45 a night in the city, which works out at £315 a week for just bed and breakfast.
It doesn’t take a genius to calculate that delivering round the clock care for very dependent older people, many with multiple and complex conditions, is likely to cost a great deal more than that.
“We must also remember that a number of important court judgements over recent years have laid down that it is unlawful for local authorities to decide to pay nursing homes less than the cost those homes incur in providing the care required from them. So far, this does not appear to have spurred ministers into doing something.”
The RNHA will now be writing to the care minister to ask him to mount a special investigation into the gap between the costs of care and the prices that local authorities are currently willing to pay for it.
“We have heard a lot from the regulators about what good care looks like,” said Mr Ursell. “We would now like to hear Mr Lamb tell us what good care costs.
“If, as the minister is quoted as having said, there is exploitation going on, it is the exploitation caused by inadequate public funding of care, which means families being called on to pay top ups and care staff having to work for the minimum wage. They are the ones paying the price.
“So let us see the government telling local authorities what they should be paying so that the need for top ups can be averted in most cases and so that the staff at the frontline of care are properly rewarded for their dedication in looking after some of society’s most vulnerable people.”