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Sixty Second Interview with Martin Green

By Josephine Hocking

Martin Green is chief executive of the English Community Care Association, whose members are voluntary and private sector residential and nursing care home providers for adults. ECCA published a poll about fee increases by local authorities this week.

What did your poll on fee increases by local authorities reveal?

The increase in fees from local authorities to independent sector providers is at best meagre, and at worst negligible. 105 care providers voted in our poll. 71% received a fee increase of one to two per cent and nearly 10% said they did not get an increase. 

 
Is the continuing shortfall between provider costs and what local authorities pay sustainable?

There is a significant shortfall and massive variations between local authorities. We must ensure that self-funders are not subsidising the state. 
Underfunding demeans any sector and care homes are particularly vulnerable because they have so many costs. Our poll tells us that in many instances the recent rises in the cost of Criminal Records Board disclosures, inspection fees, and national minimum wages have not been reflected in local authority fee increases. 
We do recognise that our members need to be better skilled at contracting with local authorities. 
ECCA works hard to embrace better relationships and partnerships between local authorities and the independent sector.  Our report on a fair price for care and models of costs of care illustrates that once some arrangement and understanding is reached on the real costs of care, the parties are able to work together on other issues in a much more productive way.
 
Can the private and voluntary sector providers deliver quality services at current fee levels?

It is high time that commissioners took on board the link between quality and cost and rewarded accordingly Members of ECCA pride themselves on delivering high quality care; however there has to be a correlation between quality and fees. We have seen how independent sector care homes continually undercut local authority providers and how they utilise efficiencies. ECCA offers a whole host of cost savings for members, including e-procurement, but there comes a time when members don’t have the margins and are not able to continue.  

 
Do inspectors take enough account of the importance of quality services?

The Commission for Social Care Inspection has made huge inroads in implementing a new inspection regime and focusing on outcomes.  Inspection is not consistent enough, however we are conscious that CSCI is taking clear steps to improve this. It is essential for us to work with CSCI and enable them to put their changes into effect, especially when it merges with the Healthcare Commission, as proposed.

You say that councils “could find themselves without a care sector available to meet future needs.” Is the situation that bad?

The new minister with responsibility for care homes, Ivan Lewis, has talked about the need for partnerships between health care, social care, independent and statutory sectors. If this rhetoric can be filtered down to all local authorities and turned into reality then care homes will continue to deliver high quality. In the absence of political will, adequate funding and good commissioning strategies, the local authorities will be seriously stuck in years to come, especially with the predicted demographic changes. 
 
How would you respond to local authorities who say they lack resources and cannot afford fee rises?

Send me in the for the day and I will find some cost savings!