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England and Wales High Court (Administrative Court) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Administrative Court) Decisions >> Mavalon Care Ltd & Ors, R (on the application of) v Pembrokeshire County Council [2011] EWHC 3371 (Admin) (16 December 2011) URL: http://www.bailii.org/ew/cases/EWHC/Admin/2011/3371.html Cite as: [2011] EWHC 3371 (Admin) |
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QUEEN'S BENCH DIVISION
ADMINISTRATIVE COURT IN CARDIFF
2 Park Street, Cardiff, CF10 1ET |
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B e f o r e :
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The Queen on the application of (1) Mavalon Care Ltd (2) Forest Care Homes Ltd (3) Woodhill Care Ltd (4) Rickeston Care Home Ltd (5) Van Dyk Healthcare (Dragon) Ltd (6) Torestin Care Home Ltd (7) Canterbury House Residential Home Ltd |
Claimants |
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- and - |
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Pembrokeshire County Council |
Defendant |
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David Phillips QC and Andrew Green (instructed by Pembrokeshire County Council Legal Department) for the Defendant
Hearing dates: 15 - 16 November 2011
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Crown Copyright ©
Mr Justice Beatson :
The law
The 1948 Act
"(1) Subject to and in accordance with the provisions in this part of this Act, a local authority may, with the approval of the Secretary of State, and to such extent as he may direct shall, make arrangements for providing –
(a) residential accommodation for persons aged 18 or over who, by reason of age, illness, disability or any other circumstances are in need of care and attention which is not otherwise available to them…
(2) In making any such arrangements a local authority shall have regard to the welfare of all persons for whom accommodation is provided, and in particular to the need for providing accommodation of different descriptions suited to different descriptions of such persons as are mentioned in the last foregoing subsection…
…
(4) Subject to the provisions of section 26 of this Act, accommodation provided by a local authority in the exercise of their functions under this section shall be provided in premises managed by the authority…".
"(2) In deciding whether a person is in need of care and accommodation, an authority is entitled to have regard to its own limited financial resources. However, having set that threshold and found that a particular person surpasses it, an authority is under an obligation to provide care and accommodation in fulfilment of its section 21 obligations, which is a specific duty on the authority owed to an individual, not a target duty: lack of resources is no excuse for non-fulfilment of that obligation (R v London Borough of Islington ex parte McMillan [1995] 30 BMLR 20 at page 30; and R v Sefton Metropolitan Borough Council ex parte Help the Aged [1997] 4 All ER 532).
However, (see the Forest Care Homes case at [46(3)]) provided a local authority meets the minimum requirement under section 21 in some form, it has a wide discretion, both with regard to the nature of the accommodation and care, and its precise standard.
"Any arrangements made by virtue of this section shall provide for the making by the local authority to the other party thereto of payments in respect of the accommodation provided at such rates as may be determined by or under the arrangements…".
Government guidance
"Standard 1
Social services can demonstrate how commissioning plans have translated their commitments to local strategic plans into consistent high-quality linked or seamless services to meet the needs of local citizens
…
…
Commissioning plans are also essential to enable local providers to develop their business plans. They should be public documents and should contain sufficient detail to signal the authorities intention to potential service providers.
…
Standard 2
Commissioning plans have been based upon sound evidence and reflect national policy and guidance, local strategic plans, research and best practice. They include comprehensive population needs, service, market and resource analyses.
Commissioners need to have a rationale for their commissioning plans, and need to be able to explain to service users, carers, councillors, taxpayers, providers and inspectors, how they arrive at their commissioning decisions.
…
Representatives of service providers need to be engaged at each stage of the analysis process as they can make valuable contributions towards identifying changes in need and with regard to the existing capacity to deliver services and options for future developments.
…
Standard 4
Commissioning plans have been developed with partners and have involved all key stakeholders including users, carers, citizens and service providers in the statutory, private and third sector.
…
It is essential that users are able, with assistance if necessary, to contribute their views…
…
Arrangements should ensure that care providers can participate fully in planning activities without conflicts of interest, this may be best facilitated through representative bodies…".
….
Standard 7
"The local authority has ensured that its Financial and Contract Standing Orders allow social are commissioners to be efficient and effective in developing the local social care market.
Local authorities should keep their Financial and Contract Standing Orders under review to ensure that they are fit for purpose to secure social care services of the quality required.
…
In developing services that are responsive to citizens' needs, it is important for local authorities to have financial regulations which allow them to support the development of a sustainable economy of care across the public, private and third sectors.
Sustainable means that short term considerations should not threaten medium to long term service delivery. Unrealistic fees, for example, may ease the pressure on the budget of the commissioner this year but if the service ceases to operate due to financial difficulties the savings will prove self defeating. Equally, the continued investment in services which may undermine independence or fail to promote independence may prove to be unsustainable both in financial and workforce terms."
…
Standard 10
"Commissioners have understood the costs of directly provided and contracted social care services and have acted in a way to promote service sustainability.
Commissioners will have to take into account the full range of demands on them and their strategic priorities, as well as the resources they have at their disposal in developing their commissioning strategies. As stated earlier the financial outlook is going to be very challenging for some time to come. This makes the commissioning framework more important.
In seeking long term value for money and determining the budget available for specific social care services it is necessary for commissioners to take into consideration a whole range of factors, for example:
- The national or local economic environment may be making it difficult for some provider organisations to remain financially viable.
- A requirement to improve the quality of services may put a short-term strain on resources.
- The move to an outcomes-based approach may pose serious cultural as well as financial challenges.
- Recognition of the need for service providers to be able to recruit employees with the skills and aptitudes necessary to deliver good quality care, to provide them with the training they require to obtain qualifications relevant to their duties and to facilitate continuing professional development to extend their abilities.
- The need to re-train the workforce to respond to more up-to-date practices may have transition cost and service implications.
Thus, it will be important for commissioners, in contract, fee and service level negotiations, to recognise the financial and service challenges that are having an effect on providers, and consider both short and longer term scenarios.
Local authorities need to have mechanism in place to discuss costs and performance with providers. 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. The fees need to be adequate to enable providers to meet the specifications set by the commissioners together with regulatory requirements.
Registered providers also have an obligation to ensure that the income which they receive for providing the service is sufficient to meet the cost of delivering a service which complies with all statutory requirements, contractual conditions and specified service standards.
Commissioners should have a rationale to explain their approach to fee setting. The primary concern is that services operate safely and effectively to promote the welfare of service users and carer and meet regulatory requirements."
"(4) … The 2010 Guidance associates better decision-making process with better outcomes, emphasising the crucial nature of the former. It requires good decision-making process, and identifies how that is to be achieved. In times of public financial constraint, the importance of proper process is compounded. Unless an authority has compelling reasons for departing from that Guidance, it is bound to follow it. The greater the departure from the Guidance, the more compelling the reasons for the departure must be.
(5) The Guidance requires the authority to plan commissioning, strategically and transparently, over at least the medium term: and to make individual decisions (i.e. all decisions other than those I have described as "strategic") in the light of both the Guidance and that plan. It must not make short-term individual decisions which might adversely impact upon its longer term strategic plan, without proper consideration and compelling explanation."
(6) In making strategic or individual decisions, an authority must have proper regard to the consequences such decisions will or may have on both providers and, especially, the residents of care homes. As with any such assessment, the authority must have regard to both the nature of potential adverse consequences, and the chance of such consequences coming about. A potential, or even actual, adverse consequence for providers or residents or both will not necessarily be determinative of a decision – an authority does not have to guarantee that its decision will not have adverse consequences for some interested party – however, an authority cannot make a decision that may have such consequences without proper consideration and compelling reasons. That requires an authority to identify any relevant risks, and then assess those risks in terms of the chances of the adverse event occurring and the seriousness of the potential consequences if it does.
….
(7) The 2010 Guidance requires strategic plans to be publicly available. Without placing a disproportionate burden on authorities, the essential reasoning of individual decisions should also be recorded in writing, and given to interested parties including, where appropriate, providers. The 2010 Guidance has transparency as a hallmark. It requires a commissioning authority to work "in partnership" with providers (as did the 2003 Guidance), and that can only be achieved if providers are aware of the reasoning behind commissioning decisions important for them. Providers also need to know to reasons for a decision affecting them to enable them to consider the legality of the decision, and to challenge it if they consider it to be unlawful and they wish to pursue that course."
The new decision
PriceWaterhouseCoopers' report
"[W]ith funded demand across the residential care sector falling broadly between 6 – 8% in recent years…there is a surfeit of capacity. Consequently, in today's market it could be argued that it is more appropriate to consider the cost of sustaining the current portfolio, rather than seeking to expand or replace it".
It also referred to the inclusion in Laing and Buisson's "toolkit" of an element to facilitate upgrading the physical environment. However, it stated that "to gauge the relevance of this within [Pembrokeshire's] independent sector portfolio would require a series of site visits together with an understanding of how the improvements were to be funded and the apportioned annual cost", and "to understand the true cost structure of the Pembrokeshire portfolio would require access to the funding (interest and capital repayment) arrangements of the individual operators", but this information is not available. Accordingly, "it is therefore not possible to positively assess to what degree the notional rate of return of 12%, hitherto incorporated in the RSM [Tenon] adaptation model, truly reflects the cost of sustaining the current portfolio over and above a rate needed to encourage further market growth".
The decision letter
"I accept that an adequate return on capital for care home operators is key to achieving a stable independent sector of sufficient size and appropriate quality to meet the Council's commissioning needs together with those of our NHS partner."
The letter then set out the assumptions upon which the Laing and Buisson toolkit was based. It stated:
"The toolkit is based on the assumption that new or replacement care home capacity is required, and that Councils need to set fee rates so as to; (a) incentivise existing operators to continue to offer services and to upgrade their physical assets where they are below national minimum standards for newly registered homes, attract investment in new care home capacity to replace that which is being lost, and compete with private payers and residents funded by other public sector agencies for available care home places."
It also referred to Mr Laing's 2008 statement that "Councils should ideally set 'spot-purchase' fees at levels sufficient to offer providers a return on capital of 12%.
"I do accept the need to incentivise a proportion of existing operators to continue to offer services. I also accept the need to upgrade physical assets.
I also accept a limited requirement for investment to prevent certain homes closing. However, I do not accept the need to attract investment in new care home capacity, and I do not accept that fees need to reflect the Council's ability to compete with private payers as we currently purchase less than 50% of current capacity.
I do accept that independent operators are the dominant source of care home supply in Pembrokeshire and are likely to remain so for the foreseeable future…However, at 91.73% occupancy there is capacity within the sector.
[The] PCHA submission is predicated on a target return of capital of 12% (Laing, 2008). However, this represents Laing's quite reasonable attempt to produce one simple formula for return on capital, which can be applied regardless of the capital structure of the home, and enable Councils to achieve the three outcomes detailed above.
I have concluded that if PCC accepts the 12% return on capital it is accepting the three principles, and is incentivising the sector for developments it does not strategically wish to commission. This does, however, need to be balanced with the need to ensure reasonable returns and maintain market stability.
…
Land values in Pembrokeshire have fallen by a third since 2009…I am also mindful that homes in Pembrokeshire are generally significantly smaller than 50 beds so the land requirement is reduced. I am also aware that as a result of the work of PriceWaterhouse Coopers LLP, that Christie & Co, the specialist care home agent, has recorded a fall of 25% in market values in the last 18 months.
With funded demand across the residential care sector falling broadly between 6 – 8% in recent years, due primarily to increased usage of domiciliary care solutions, there is a surfeit of capacity as illustrated by the fact that the Council purchases less than 50% of current capacity.
Consequently, in today's market it could be argued that it is more appropriate to consider the cost of sustaining the current portfolio rather than seeking to expand or replace it.
It is my considered view that a 12% return on capital is likely to be very generous.
For the reasons set out above, I have concluded that a reasonable target return on capital should be 6%. This results in a total capital cost of £52 per resident per week, and a maximum capital cost adjustment factors for homes not meeting physical standards for new homes of £32."
"I have concluded that the most appropriate way to proceed is to assume that in the intervening years, all homes within Pembrokeshire meet the physical standards required, and as a result the capital cost adjustment factor will not be applied. I have concluded that this return of £52 per resident per week (6%) provides a reasonable rate of return at current prices and economic environment. I am also of the view that there is scope for operators to increase their rate of return by adopting more efficient operating practice.
…
I now need to consider whether this will impact on the quality of life of current residents, sustainability of the care home sector, quality of life of other residents of Pembrokeshire, and the sustainability of other service sectors within the county.
The key issue for current residents and their families is whether or not this fee provides stability within the market. Data available on those businesses which are limited companies from the website www1.checkkit.co.uk suggests that at the current fee of £390 prw 8 of the 9 businesses generate a profit after tax and other appropriations. They also appear to have positive profit and loss reserves.
The data available on www.carehome.co.uk, which provides the fees charged by homes, indicates, within a wide range which means that the data may be relevant but not necessarily statistically reliable, that a fee level of circa £430 per resident per week for nursing and £410/£415 per resident per week for residential is reasonable. It should be noted that data from all homes in Pembrokeshire, irrespective of size, were considered.
There is no evidence available to me to suggest that this guide fee rate would destabilise the sector, and therefore it would not create a negative impact upon the quality of life of current residents."
Discussion