“2. Where a local authority have assessed a person undersection 47 of the National Health Service and Community Care Act 1990 ... and have decided that accommodation should be provided pursuant to section 21 of the [1948 Act] … the local authority shall, subject to paragraph 3 of these Directions, make arrangements for accommodation pursuant to section 21 for that person at the place of his choice within the United Kingdom … 3. Subject to paragraph four of these directions the local authority shall only be required to make or continue to make arrangements for a person to be accommodated in his preferred accommodation if – … (b) the cost of making arrangements for him at his preferred accommodation would not require the authority to pay more than they would usually expect to pay having regard to his assessed needs ...”
“… paragraph 3(b) of these Directions shall not apply to a local authority who makes arrangements which cost more than the local authority would usually expect to pay in order to provide a person with their preferred accommodation if a third party’s contribution to that person which is treated as that person’s resources as assessed under theNational Assistance (Assessment of Resources) Regulations 1992 [SI 1992 No. 2977] is such that he can reasonably be expected to pay for the duration of the arrangements an amount that is at least equal to the difference between – (a) the cost that the local authority would usually expect to pay for accommodation having regard to the person’s need, and (b) the full standard rate for that accommodation as specified insection 22(2) of the National Assistance Act 1948 … or pursuant to section 26(2)2(4) of that Act …”
“Providers have become increasingly concerned that some commissioners have used their dominant position to drive down or hold down fees to a level that recognises neither the costs to providers nor the inevitable reduction in the quality of service provision that follows. This is short-sighted and may put individuals at risk. It is in conflict with the Government's Best Value policy. And it can destabilise the system, causing unplanned exits from the market. Fee setting must take into account the legitimate current and future costs faced by providers as well as the factors that affect those costs, and the potential for improved performance and more cost-effective ways of working. Contract prices should not be set mechanistically but should have regard to providers' costs and efficiencies, and planned outcomes for people using services, including patients.”
“2. Preferred Accommodation … (b) Cost 2.5.4 …[The usual cost] should be set by Councils at the start of a financial or other planning period, or in response to significant changes in the cost of providing care, to be sufficient to meet the assessed care needs of supported residents in residential accommodation… In setting and reviewing their usual costs, Councils should have due regard to the actual costs of providing care and other local factors. Councils should also have due regard to best value requirements under theLocal Government Act 1999 . 2.5.5 Individual residents should not be asked to pay more towards their accommodation because of market inadequacies or commissioning failures. Where an individual has not expressed a preference for more expensive accommodation, but there are not, for whatever reason, sufficient places available at a given time at the Council’s usual costs to meet the assessed care needs of supported residents, the Council should make a placement in more expensive accommodation. In these circumstances, neither the resident or a third-party should be asked to contribute more than the resident would normally be expected to contribute and Councils should make up the cost difference between the resident’s assessed contribution and the accommodation’s fees. Only when an individual has expressed an interest for more expensive accommodation than a Council would usually expect to pay, can a third-party or a resident be asked for a top-up (see paragraph 3.1) … 2.5.7 Councils should not set arbitrary ceilings on the amount they expect to pay for an individual’s residential care. Residents and third-parties should not routinely be required to make up the difference between what the Council will pay and the actual fees of a home. Councils have a statutory duty to provide residents with the level of service they could expect if the possibility of resident and third-party contributions did not exist. 2.5.8 Costs can vary according to the type of care provided …. … 3. More Expensive Accommodation … 3.3 When setting its usual cost(s) a Council should be able to demonstrate that this cost is sufficient to allow it to meet assessed care needs and to provide residents with a level of care services that they can reasonably expect to receive if the possibility of resident and third-party contribution did not exist.”
“[T]o arrive at the “usual cost” of care it was necessary to establish the cost of delivering care in Torbay, as well as accommodation related costs and appropriate contribution to the cost of capital. The proportion of beds in the market currently purchased by local authorities, the level of vacancies, capital abatement, land values and profit multiples were taken into account.”
“Is the Council relying on cross-subsidisation from private residents? The Council is proposing a usual cost, or price it will pay, for care. In doing so it is taking a market based approach in recognition of the fact it is not the only purchaser of care home bed spaces in Torbay and the historical tendency for home owners to charge different fees for privately and publicly funded residents.”
“[I]t is not possible for TSDHCT and the Council to set fees at levels that eliminate all risk of home closures, or that meet all the aspirations of all home owners to make substantial returns on their investments. There is an over-supply of bed spaces within Torbay, and the market will have to adapt to ensure efficiency. This may mean that some homes choose to close. As custodians of public money, Torbay Council and TSDHCT need to obtain value for money with its statutory duties, and can not compensate for an oversaturated and/or inefficient market. It is important to note that closures are not anticipated to occur as a result of the level of fees paid.”
“… Adopting all the cautions I have applied to my decision on ground 1 I cannot, with the best will in the world, see that the Defendant provides any justification for departing from the plain wording of the Circular. Guidance is, of course, just that and a decision maker is free to depart from it if there is a good reason to do so and if the decision maker articulates that particular reason. What the decision maker, it seems to me, cannot do is to say "I shan't comply with the guidance because I don't agree with it." Nor can the decision maker fail to take into account the guidance because it considers its duty lies elsewhere. Whilst referring to best value principles the guidance is utterly explicit as to what can and cannot properly be taken into account. The local authority's approach here failed to take any proper account of the guidance concerned and therefore fails to take into account a highly relevant matter. On the facts of this case I am convinced, as HHJ Belcher was in similar facts, that taking these fees into account in the cost analysis does not pay due regard to actual cost and amounts to a significant error in the decision making process.”
“Clearly guidance is less than direction, and the word 'general' emphasises the non-prescriptive nature of what is envisaged… In my judgment Parliament… did not intend local authorities to whom ministerial guidance was given to be free, having considered it, to take it or leave it. Such a construction would put this kind of statutory guidance on a par with the many forms of non-statutory guidance issued by departments of state, … in my view Parliament by section 7(1) has required local authorities to follow the path charted by the Secretary of State's guidance, with liberty to deviate from it where the local authority judges on admissible grounds that there is good reason to do so, but without freedom to take a substantially different course.”
“… is not to be equated with a statutory duty imposed by an enactment and as would be expected in the case of guidance, it does not prescribe any particular methodology, whether "structured" or otherwise which local authorities must adopt in order to have had "due regard" to the actual costs of providing care”. (d) The approach to judicial reviews in challenges to the determination by a local authority of the “usual cost” it will pay for providing care to supported residents: One of the earliest challenges was R (Birmingham Care Consortium) v Birmingham City Council[2002] EWHC 2188 (Admin) ,[2003] BLGR 119 . Stanley Burnton J (as he then was) stated (at [14]) that: “The [1992] Direction assumes that the rate payable by a local authority will be relevant to a number of homes and will be based on what it pays or expects to pay to a number of homes, having regard to the assessed needs of the resident in question. I see no reason to depart from the literal wording of the Direction. It does not require a local authority to determine whether the cost of arrangements for accommodating a person is fair or reasonable. It simply entitles it to refuse to comply with an indication of preferred accommodation if the cost of it is more than the local authority would usually expect to pay, having regard to assessed needs.”
“The determination of a fair cost is by no means straightforward. Assumptions have to be made as to occupancy rates and returns on capital. Occupancy rates will depend in part on the local authority’s placement policy: a policy to use out of town placements will of course tend to lower occupancy rates in town. Where there is no finance charge incurred by the home, the fair return on the value of the property itself may be controversial, given that in current economic conditions its capital growth may provide a substantial return of itself.”
“When setting its usual cost(s) a council should be able to demonstrate that this cost is sufficient to allow it to meet assessed care needs and to provide residents with the level of care services that they could reasonably expect to receive if the possibility of resident and third party contributions did not exist.”
“7A Directions by the Secretary of State as to exercise of social services functions (1) Without prejudice to section 7 of this Act, every local authority shall exercise their social services functions in accordance with such directions as may be given to them under this section by the Secretary of State. (2) Directions under this section– (a) shall be given in writing; and (b) may be given to a particular authority, or to authorities of a particular class, or to authorities generally.’”
“1.3 If the individual concerned expresses a preference for particular accommodation (“preferred accommodation”) within England and Wales, the council must arrange for care in that accommodation, provided: The accommodation is suitable in relation to the individual’s assessed needs (see paragraphs 2.5.1 to 2.5.3) To do so would not cost the council more than it would usually expect to pay for accommodation for someone with the individual’s assessed needs (see paragraphs 2.5.4 to 2.5.8). This is referred to throughout the guidance as the usual cost. The accommodation is available (see paragraphs 2.5.9 and 2.5.15) The provider of the accommodation is willing to provide accommodation subject to the council’s usual terms and conditions for such accommodation (see paragraphs 2.5.16 to 2.5.17) 1.4 If an individual requests it, the council must also arrange accommodation more expensive that it would usually fund, provided a third party or, in certain circumstances, the resident is willing and able to pay the difference between the cost the council would usually expect to pay and the actual cost of the accommodation (to ‘top up’). These are the only circumstances where either a third party or resident may be asked to top up (see paragraph 3).”
“2.5.4 One of the conditions associated with the provision of preferred accommodation is that such accommodation should not require the council to pay more than they would usually expect to pay, having regard to assessed needs (the ‘usual cost’). This cost should be set by councils at the start of the financial or other panning period, or in response to significant changes in the cost of providing care, to be sufficient to meet the assessed care needs of supported residents in residential accommodation. A council should set more than one usual cost where the cost of providing residential accommodation to specific groups is different. In setting and reviewing their usual costs, councils should have due regard to the actual costs of providing care and other local factors. Councils should also have due regard to Best Value requirements under theLocal Government Act 1999 . 2.5.5 Individuals should not be asked to pay more towards their accommodation because of market inadequacies or commissioning failures. Where an individual has not expressed a preference for more expensive accommodation, but there are not, for whatever reason, sufficient places available at a given time at the council’s usual costs to meet the assessed care needs of supported residents, the council should make a placement in more expensive accommodation. In these circumstances, neither a resident nor a third party should be asked to contribute more than the resident would normally be expected to contribute and councils should make up the difference between the resident’s assessed contribution and the accommodation’s fees. Only when an individual has expressed a preference for more expensive accommodation than a council would usually expect to pay, can a third party or a resident be asked for a top up (see paragraph 3.1). Costs of accommodation should be compared on the basis of gross costs before income from charging. Given the different amounts that councils will recover from individuals by way of charges, it would not be appropriate for a council to determine a usual net cost it would expect to pay. 2.5.6 For the cost of placements in other councils’ areas see paragraph 2.3. 2.5.7 Councils should not set arbitrary ceilings on the amount they expect to pay for an individual’s residential care. Residents and third parties should not routinely be required to make up the difference between what the council will pay and the actual fees of a home. Councils have a statutory duty to provide residents with the level of service they could expect if the possibility of resident and third party contributions did not exist. 2.5.8 Costs can vary according to the type of care provided. For example, the cost a council might usually expect to pay for short-term care might be different from its usual cost for long-term care. There are also a number of situations where there may be higher costs incurred in providing residential care, be it long or short-term. Examples include specialist care for specific user groups with high levels of need or where necessary to prepare special diets and provide additional facilities for medical or cultural reasons. Councils should be prepared to meet these higher costs in order to ensure an individual’s needs are appropriately met.”
“When setting its usual cost(s) a council should be able to demonstrate that this cost is sufficient to allow it to meet assessed care needs and to provide residents with the level of care services they could reasonable expect to receive if the possibility of resident and third party contributions did not exist.”