Care home owners seek to raise fees using delayed discharge

Fears are growing that care home providers will want a share of
this year’s £50m delayed discharge grant before agreeing to
take in new residents from councils.

Peter Tempest, assistant director of adult services at Suffolk,
said that in his area nursing and residential home owners are
pressing for more money because “they know they have us over a
barrel from January”.

He said the private sector wants a £35 a week increase in
nursing home fees. This is because under the delayed discharge
fines system, which begins operating fully from January, social
services will be fined £100 a day or £120 in London
unless beds are found within three days of clients being assessed
as needing one.

However, the £50m, of which Suffolk has been allocated
£650,000, is intended to pay for expanding preventive services
and the number of beds. In some areas, local agreements have been
reached between social services, hospital trusts and primary care
trusts for the money to be pooled to improve services.

Tempest said care home owners wanted one-off payments to accept
people who have been waiting for a long time for a care bed. Some
homes already refuse to take social services referrals and others
could follow suit if fees did not increase. “It is a real threat
when negotiating for next year’s fees.”

He said no sum for the payments had been set, but thought it “not
outside the bounds of possibility” that it could be three months’

Tempest said NHS acute trusts, unhappy at the prospect of patients
continuing to block hospital beds, have also “hinted” that they are
prepared to use the money raised from fining social services to
contract directly with care homes for beds. “The council pays
£385, while some homes want £420 – a price we can’t
afford – but trusts could be prepared to pay it,” he added.

Tempest said this was strengthening the care homes’ hand further by
giving the impression “there is more than one player in terms of
commissioning and more than one rate”.

“The private sector will take the highest price and this could
create an unintended competitive edge distorting the pricing
strategy and costing millions of pounds that would not be spent on
developing the alternatives,” he said.

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