Decision

The Committee considered a report of the Director of Integrated Care and Health (DASS) and Place Partnership Director, which sought approval of the Out-of-Area Placement Guidance and Care Home Top-Up Policy.

The Director of Commissiong Adult Social Care and Prevention presented the report and responded to questions and comments from Committee Members.

The Senior Officer informed that the documents established a clear, consistent and legally compliant framework for managing out-of-borough care arrangements and top-up fee arrangements, including those linked to cash budgets (direct payments).

Together, the documents would strengthen the Council’s approach to managing placement and funding decisions, ensuring alignment with statutory duties, improving transparency, and supporting consistent and defensible decision-making.

The report also set out a change in practice in relation to how the Council managed the cost of out-of-area care arrangements where individuals chose higher-cost provision outside Rochdale, including residential placements and services arranged through cash budgets (direct payments), where suitable provision exists in-borough.

Resolved:

1. That the adoption of the Out-of-Area Placement Guidance and Care Home Top-Up Policy as formal Adult Social Care policy be agreed;
2. That it be agreed that the change in practice whereby, where an individual chooses an out-of-area care arrangement that is more expensive than Rochdale’s standard rate and their needs can be met in-borough, the additional cost is managed through a top-up rather than being met by the Council;
3. That it be agreed that this approach would apply to new arrangements only and would not be applied retrospectively to existing out-of-area care arrangements;
4. That delegated authority be given to the Director of Health and Care Integration, in consultation with the Cabinet Member for Adult Care and Wellbeing, to finalise and implement the documents.

Reason for decision:

Recent legal advice and operational experience have identified the need for clearer, up-to-date policy frameworks to support decision-making in complex care placement scenarios. Out-of-area arrangements present challenges in relation to ordinary residence, funding responsibility and dispute management, whilst top-up arrangements require consistent and compliant application to avoid unlawful charging and reduce the risk of challenge. The proposed guidance and policy address these issues by establishing a clear legal and operational framework, defining roles and responsibilities, and supporting consistent application of statutory duties across Adult Care.

Alternatives considered and rejected:

Maintaining the current position has been considered. However, this would retain variation in practice, limited clarity in decision-making, and continued exposure to financial pressure and legal challenge arising from inconsistent application of policy.

An alternative approach would be to not apply a top-up to the difference between Rochdale’s standard rate and host authority rates for out-of-area placements. While this would maintain simplicity, it would not address the underlying issue of funding higher-cost, preference-based placements and would continue to create avoidable financial pressure.

A further alternative would be to apply this approach retrospectively and require individuals currently in out-of-area placements to meet the additional cost through a top-up. This has not been recommended as individuals were not consistently offered a choice of suitable in-borough provision at the time of placement, and top-up arrangements were not applied consistently historically. Applying this retrospectively would therefore create inequity and increase the risk of challenge. On this basis, maintaining the current position or adopting either of the above alternatives is not recommended.