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Keith M Lewin

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Title: LINks What will they mean to you Author: andrew.dawson Last modified by: Keith Lewin Created Date: 10/28/2009 9:10:39 AM Document presentation format – PowerPoint PPT presentation

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Title: Keith M Lewin


1
  • Keith M Lewin

2
Transfer of residents, fee negotiators and
other stuff...
  • Keith M Lewin

3
Keith M Lewin
  • Partner and co-founder Brunswicks LLP
  • Specialising in representing social care
    providers
  • Whole time for 11 years, part time for 30 yrs
  • Advisor to Action on Elder Abuse 2005-7
  • Trustee Action on Elder Abuse 2007 to date
  • Editor Brunswicks Healthcare Review 2005 to date
  • Brunswicks LLP
  • 56 Hamilton Square, Birkenhead, CH41 5AS
  • keith.lewin_at_brunswicks.eu
  • 08455 190 695
  • 07779 128 599
  • 07855 855 588 24 hours, 365 days

4
Keith M Lewin
  • keith.lewin_at_brunswicks.eu

5
You?
  • Background care home owner, manger, former care
    worker, social worker, etc. ?
  • Experience all Learning Disability providers ?
  • Your service care homes, domiciliary, etc.
  • What do you want from this presentation ?
  • Availability of these slides ? Future contact...

6
Transfer of service users
  • Introduction

7
Transfer
  • Needs Assessment
  • Financial Assessment (already done)
  • Criteria for assistance
  • Council must arrange care, if no one else
  • Does SU have capacity to make decisions ?

8
Transfer
  • Council should give SU copy of
  • Needs Assessment
  • Care Plan setting outcomes identified by Needs
    Assessment
  • Named person responsible for implementation
  • Review date
  • Agree ? Sign date

9
Transfer
  • Councils promoting
  • Direct payments
  • Independent living
  • Choice ???
  • Reduced use of care homes
  • Have referrals to your service fallen ?
  • Is it time to remodel your service ?

10
Transfer
  • S 11 Disabled Persons (Services, Consultation and
    Representation) Act 1986
  • DH 14th Report to Parliament - forgot for 7 yrs
  • Vision
  • Empower people to live independently
  • Offer safe/effective care when where needed
  • Empower choices
  • Tackling inequality

11
Transfer
  • Choice of accommodation directions (1992)
  • W.e.f. 09.11.2009 direct pmnts to people who lack
    capacity
  • New
  • Learning disability transfer of funding and
    commissioning of social care for adult with LD
    from NHS to local government consultation
  • Closed 06.10.2010
  • Spending Review today!

12
What if SU doesnt want to move?
  • What does resident really want?
  • Choice of accommodation directions (1992)
  • Family ?
  • MPs, Councillors ?
  • Costs youre too expensive! Are you, really ?

13
What if SU doesnt want to move?
  • Is the SU capacitated ?
  • If not, any removal without applying MCA 2005 is
    unlawful
  • Role of IMCA
  • Role of Court of Protection G v E others
  • Kidnapping !

14
The nuclear option!
  • GJ v The Foundation Trust , The PCT The Sec of
    State for Health, 2009
  • Ct of Protection has power to grant Order to
    authorise removal of incapacitated adult from
    domestic premises to be taken to care home or
    elsewhere if in best interests.

15
The nuclear option!
  • G v E A Local Authority F - March 2010
  • Facts young man lived with carer, called her
    mum. LD very challenging behaviour.
  • LA concerned carer might be physically violent
    towards him.
  • Pleaded at school not to be shut in wardrobe.
  • Safeguarding investigation inconclusive
  • Nevertheless LA kidnapped and placed him in
    supported housing!

16
G v E A Local Authority F
  • 10 issues in case from question of capacity to
    did LA have to prepare for E to return home!
  • Key Learning Disability issues
  • Supported housing may result in deprivation of
    liberty
  • Ct of Protection should be asked for order
    before removal from family home
  • Engage with carers to guard against Article 8
    infringm

17
G v E A Local Authority F
  • Key issues continued
  • Maintain contact with family
  • Family may well include unrelated carers with
    whom strong emotional bond
  • Some supported housing projects should be
    registered as care homes
  • Hearsay of incompetent witnesses are admissible
    in Ct of Protection

18
  • Fee Negotiators?

19
Fee Negotiators
  • If a council asked for financial info would you
    provide it?
  • If a business said they were appointed by the
    council..?
  • If a competitor asked for detailed financial
    info, what then?

20
Fee Negotiators
  • Philosophical viewShould council be interested
  • in the cost of toilet rolls
  • Services and supplies
  • Consumables
  • Argument seeking value for money
  • - protecting public funds

21
Fee Negotiators
  • Philosophical view
  • Private providers of all kinds charitable,
    not-for-profit and for profit organisations from
    owner/managed businesses to the large national
    providers do it cheaper than councils
  • Older care costs - 200/300 a week more!

22
Fee Negotiators
  • If the sector provides it cheaper why put you
    through such a process ?
  • Commissioner could simply compare prices
  • This is not yet a nationalised industry, but
    getting close you take the risks with your
    capital
  • Alternative view-point open book

23
Fee Negotiators
  • Typically seek to persuade provider to complete
    an Excel spreadsheet
  • Review and salami-slice expenditure
  • Assert 4-6 return on profit is appropriate
  • Laing Buisson 12 to 14 older services

24
Typical Tactics
  • Request, persuade
  • Untruthful
  • Brow-beat/bully
  • threaten
  • Slash fees

25
What to do...
  • First principles whats in the contract ?
  • Status of business/person making approach
  • Data Protection Act
  • Erect proper hurdles/barriers
  • What if threatened ?

26
Southern Cross
  • Appointed lawyers and merchant bankers to
    renegotiate its loans
  • Wrote to 150 LAs asking to discuss fees
    strategic partnerships
  • Quality comes at a cost

27
Fee Brokers, whats in it for them?
  • In June 2010 - 200/300 a day for individual
  • of saving
  • Ask for their detailed contractual info
  • They dont like it up em!

28
Top Tips
  • Get help early, when is early ?
  • How should I respond ?
  • Can I go it alone ?
  • I cant afford the advice of a lawyer !
  • Is it ever too late ?

29
Other threats to profitability
  • Local Authorities simply seeking to cut payments
  • PCTs seeking to cut payments
  • Purchasing cartels
  • How to approach

30
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34
New Regulations
  • Regulation 13 Care Quality Commission
    (Registration) Regulations 2009
  • ...the service provider must take all reasonable
    steps to carry on the regulated activity in such
    a manner as to ensure the financial viability of
    the carrying on of that activity for the purposes
    of
  • (a) achieving the aims and objectives set out in
    the statement of purpose and
  • (b) meeting the registration requirements
    prescribed pursuant to section 20 of the Act...

35
And remember - Kipling
  • If you can keep your head when
  • all about you are losing theirs

36
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37
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38
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39
Keith M Lewin
  • Brunswicks LLP www.brunswicks.eu
  • 56 Hamilton Square, Birkenhead, CH41 5AS
  • keith.lewin_at_brunswicks.eu
  • 08455 190 695
  • 07779 128 599
  • 07855 855 588 24 hours, 365 days
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