To ask the Minister of Health, in relation to the policy on third party contributions contained in his Department's 2010 charging guidance, to detail the factors considered in each case when deciding which care home accommodation is appropriate.

In relation to placement in a residential care home or nursing home (under Circular HSC (ECCU) 1/2010 - Care Management, Provision of Services and Charging Guidance), case managers will need to ensure, that:

• the home has the necessary skills to support and to care for the service user particularly where challenging behaviours are known to be present and risk management processes, where needed, are in place;

• appropriate follow-up and access, by the home, to advice and support from HSC Trust staff experienced in managing challenging behaviours is available in relation to the placement and afterwards for as long as is considered necessary;

• care plans developed within the home, including management and back-up strategies, are fit for purpose and reviewed on a regular basis dictated by the need of the service user and any presenting risks; and

• the home is operating in compliance with relevant regulations and associated standards which will be informed by Regulation and Quality Improvement Authority (RQIA) inspection reports.

HSC Trusts must contract for placements at the most competitive rate available, which they consider suitable for meeting the individual’s assessed need even where this is not obtainable at the regional rate.

Should a service user select accommodation which is more expensive than other appropriate accommodation which the commissioning Trust can secure at a lower rate (for example, because they wish to have a better room in a particular home or a more expensive care home closer to family), that Trust will facilitate that choice, but the additional cost must be met by a third party such as a family member or friend. This is known as a top-up.

Whilst the aim should always be to facilitate choice for service users’, Trusts have a parallel responsibility to secure the best value for money and protect the public funds for which they are accountable. Likewise, Independent Care Home providers are entitled to set a level of fee which they believe is financially viable and reflects the service provided by them.