Paying for Care 03/16
version number 1
Effective date / 29 November 2016
Category / Finance
Summary / This document provides a guide to Adults’ Health and Care policy and procedures for contributions to personal budgets for social care services that support people to live at home and contributions towards the cost of care in a care home setting
Keywords / Paying for Care
Approved by / Karen Jackson, Assistant Director
Date Approved / 29 November 2016
Procedures cancelled or amended / 09/15
Author / Nicky Millard, Customer Care Manager
Sponsor / Nicky Millard, Customer Care Manager
Contact / Dawn Field, Strategic Commissioning Manager,
01962 832150
Signed
Designation
Date / Karen Jackson
Assistant Director
Version control change record
Date / Version Reviewed / Author / Reason for change / Approved by
Purpose
To outline Adults’ Health and Care policy and procedures for contributions to social care services that support people to live at home and contributions towards the cost of care in a care home setting. This includes those that pay the full cost of their care
The County council has the power to charge for services, under the Care Act 2014, whether the services are delivered in a care home, a person’s home or in any other setting in which care is provided.
Scope
The paying for care policy and procedures apply to all adult non-residential social care services and residential care services for which the council has discretionary powers to charge. Contributions will not be sought where legislation prohibits this.
References
Exec Member for Adult Social Care 21 October 2016
Exec Member for Adult Social Care and Public Health 11 March 2015
Authority to vary
Director Adults’ Health and Care
Contents
Main Chapters / Page numberDirect Payments / 9
The process / 11
Changing the Service User’s weekly contribution / 17
Services / 19
Safeguarding the interest of the Service User / 22
Duties/responsibilities/roles
Adults’ Health and Care, or a person acting on behalf of Adults’ Health and Care, will assess individuals’ needs and eligibility for services and will put care and support services in place to meet eligible needs. They will advise service users about the Council’s Paying for Care Policy and refer service users who are eligible for chargeable services to the Corporate Services Financial Assessments and Benefits Technical Team (FAB) in Corporate Services.
The Financial Assessments and Benefits Technical Team will undertake the financial assessment in accordance with Department of Health guidance; issue invoices and receive payments, in accordance with the Care Act 2014.
Operational Finance will provide information and challenge to the Adults’ Health and Care budget management process in relation to the chargeable rates for the Council’s own services; and for income monitoring.
Introduction
The County Council has the power to charge for services whether the services are delivered in a care home, a person’s home or in any other setting in which care is provided by the Council under Clause 14 of the Care Act 2014.
The Council charges in accordance with the Care Act 2014, including regulations and statutory guidance.
See appendix A for the single policy for Paying for Care approved by the Executive Member for Adult Social Care and Public Health 11 March 2015 and amended by the Executive Member for Adult Social Care and Public Health 21 October 2016.
Equality impact assessments (EIA)
An Equalities Impact Assessment was completed for the Executive Member for Adult Social Care and Public Health report ‘Single Policy for Paying for Care’ on 11 March 2015
DEFINITIONS
Carer / An adult who provides or intends to provide care for another adult (an “adult needing care”)Contribution / The payment made by the service user towards the care they receive
Care Practitioner / The person within Adult Services who assesses service users social care needs and eligibility to receive services and arranges services to meet eligible needs
The Council / Hampshire County Council
The Department / Adults’ Health and Care
Direct Payment / Payment by the Council to service users, or appropriate adult, with which they arrange and pay for services to meet their eligible needs, in accordance with the Care Act 2014 and The Care and Support regulations.
Intermediate Care / Reablement services offered free for up to six weeks to service users at risk of hospitalisation, or at the point of hospital discharge. The local authority must not make a charge for these services under section 8.11 of the Care Act 2014 guidance.
Financial Assessment / An assessment of the service user’s finances to determine their maximum weekly contribution to the chargeable services within their Personal Budget... The team will offer information about welfare benefits entitlement and support to claim these
Financial
Assessments and Benefits Team (FAB) / County Treasurer’s team who carry out the financial assessment and calculate the maximum weekly contribution (the most a service user will pay for their care each week).
Managed Services / Care services organised and managed for the service user by the department
Personal Budget / A Personal Budget is a statement that shows;
i) how much it costs the Council to meet the service user’s needs, this includes the chargeable services and the non-chargeable services (those excluded from charging either by legislation or Hampshire County Council local decision)
ii) how much the service user contributes towards the cost of their care as determined by their financial assessment – their maximum weekly contribution
iii) how much the Council contributes towards the cost of the service user’s care
Representative / Someone with the legal authority to manage the service user’s finances. They will have been granted power of attorney, or appointed as Deputy or be a DWP Appointee.
Respite Care / Gives service users a break from their home circumstances and/or enables a carer to have a break from the caring role.
For short term residential respite care this is up to 8 weeks.
Needs Assessment. / Assessment and supporting planning of the service user’s needs and how these will be met
Service User / Someone who has received, or is likely to receive, a social care service from the council
Telecare / Equipment that senses risks such as smoke, floods and gas and can prompt a service user to take action (such as medication reminders or doors left open).
Welfare Benefits / The range of benefits provided by the Dept. for Work and Pensions.
CONTENTS
Section / Page1. National Context / 7
2. Hampshire County Council Policy / 7
3. Personal Budgets for Social Care / 7
4. Funding the full cost of care at home / 8
5. Funding the full cost of care in a care home / 9
6. Direct Payments – for care at home including supported living / 9
6.1 General information / 9
6.2 How are Direct Payments paid / 10
6.3 Contributions / 10
6.4 Mixed packages / 10
7. The Process / 11
7.1 The needs assessment stage / 11
7.2 Two carers for care at home / 14
7.3 Capacity / 15
7.4 The financial assessment / 16
7.5 Residential care – top ups / 17
8. Changing the Service User’s weekly contribution during the year / 17
8.1 National Policy / 17
8.2 Service user contribution to chargeable care received / 17
8.3 Local Policy / 18
8.4 Making payments / 19
8.5 Service user’s review of their financial circumstances / 19
9. Services / 19
9.1 Rates for non-residential and residential care services / 19
9.2 Shared Lives / 20
9.3 Extra Care Housing / 20
9.4 After Care Services for people previously detained under the
Mental Health Act / 20
9.5 Care Services which are privately arranged by the service user / 21
9.6 Respite Care / 21
10. Safeguarding the interests of service users / 22
10.1 Mental Capacity, Attorney, Deputy or Appointee / 22
10.2 The Client Affairs Team (CAT) / 22
10.3 Suspicion of abuse / 22
10.4 Debt and arrears / 23
10.5 Duty to assess and provide services; and refusal to pay / 23
10.6 Welfare benefits checks / 23
11. Other organisations who purchase services from the council / 23
12. Compliments and Complaints / 24
13. Equalities Impact Assessment / 24
14. Performance Standards associated with this procedure / 24
Appendices
Appendix A Hampshire County Council’s Single Policy Framework for Paying for Care / 25
Appendix B List of chargeable and non-chargeable services (non-exhaustive) / 30
Appendix C Flow diagram of Paying for care process / 36
1. National Context
1.1 The Care Act 2014 provides a single legal framework for charging for care and support. It enables a Local Authority to decide whether, or not, to charge a person when it is arranging to meet a person’s care and support needs or a carer’s support needs.
1.2 Where the Local Authority arranges care and support to meet a person’s needs, it may charge the adult, except where the Local Authority is required to arrange care and support free of charge, People should only be required to pay what they can afford. People will be entitled to financial support based on a means-test and some will be entitled to free care.
1.3 The principles of the approach that the Local Authority should take in respect of charging for care and support are set out in chapter 8 of the Care and Support Statutory Guidance issued under the Care Act 2014. .
2. Hampshire County Council Contributions Policy
Social care is not a free service and national funding arrangements make it clear that contributions from service users to help fund the cost of services are essential to the Council’s financial strategy. A copy of Hampshire County Council’s policy for charging for care, approved by the Executive Member for Adults’ Health and Care on 21st October 2016 is attached as Appendix A.
Service users have the choice to manage their own services, or to ask the Council to do this for them. This does not affect their entitlement to an assessment of needs, nor to access to advice and information provided by the Council.
Service users who have a financial assessment which indicates the Council needs to pay for some or all of their services can choose to have a Direct Payment. The policy and procedure applies equally to all service users who ask the Council to manage their services, use a Direct Payment or use a combination of these.
The policy applies to service users who are ordinarily resident in Hampshire and meet the eligibility criteria under the Care Act 2014. Service users ordinarily resident in another council area will be subject to the contributions policy of that authority. Hampshire County Council will recover the full cost from other organisations for services it provides or arranges on their behalf. Appendix C sets out the rates for Hampshire County Council run services. These rates will also apply to service users in Hampshire who use these facilities and pay the full cost of their care services.
Hampshire County Council Adults’ Health and Care Department aims to promote independence and choice, be fair and equitable, and give service users more power and control over their lives. The procedures outlined below are to help ensure the Council seeks timely, fair and equitable contributions from service users.
3. Personal Budgets for Social Care
The Care Act 2014 defines Personal Budgets as a statement that shows; how much it costs the Council to meet the service user’s needs, how much the service user contributes towards the cost of their care as determined by their financial assessment and how much the Council contributes towards the cost of the service user’s care.
As above with service users, carers can also have a Personal Budget; however Hampshire County Council has taken the decision not to charge carers for their services.
There are other services that are not charged for under this policy, either through legislation or Hampshire County Council local decision. Therefore each service user will have the cost of their chargeable and non chargeable services listed on their Personal Budget statement.
The cost to the Council to meet the service user’s care and support needs is the total of both the chargeable and non chargeable services – however the service user will only be asked to contribute towards the chargeable services they receive.
A non-exhaustive list of chargeable and non chargeable services can be found in Appendix B.
Service users can pay the full cost of their chargeable services or request an assessment of their financial means. The financial assessment will work out their Maximum Weekly Contribution (MWC), the most they will pay towards their care each week. This will also be on the service user’s Personal Budget Statement.
There are three possible outcomes from their assessment:
o the service user is assessed as having insufficient money to contribute, so the maximum weekly contribution is nil = the department funds the full cost.
o the maximum contribution is lower than the cost of chargeable services = the service user pays the maximum weekly contribution and the department funds the balance.
E.g. Chargeable Services = £500 a week. Max Weekly Contribution = £100 a week. Service user pays £100 a week. The department pays £400 a week.
o the maximum weekly contribution is higher than the cost of chargeable services = the service user pays the full cost.