PAPER C
For Decision
REPORT
TO THE EXECUTIVE
Date : 12 MARCH 2003
Title : CHARGING POLICY FOR
NON-RESIDENTIAL CARE SERVICES
(FAIRER CHARGING)
REPORT OF THE PORTFOLIO HOLDER FOR
SOCIAL SERVICES AND HOUSING
IMPLEMENTATION DATE : APRIL 2003
SUMMARY/PURPOSE
1.
This report is to seek members’ approval of a new
Charging Policy for Non-Residential Care Services. This new Charging Policy has
been developed in line with statutory guidance issued by the Department of
Health, commonly referred to as Fairer Charging, and is attached as Appendix 1.
BACKGROUND
2.
Members received reports in November 2002 and January
2003 that detailed the background to Fairer Charging and approved a range of
draft proposals.
3. The draft proposals were made the subject of a widespread consultation exercise and an analysis of this is set out in this report.
STRATEGIC CONTEXT
4.
Fairer Charging is statutory guidance that was
developed by the government in response to the May 2000 Audit Commission report
“Charging with Care”. This report identified significant variations in policy
between authorities and described how the most vulnerable users of home care
with high levels of need and low incomes were disadvantaged.
5. The power to levy charges for non-residential care services remains discretionary for local authorities, however, the income raised is significant in most authorities (including the Isle of Wight) and this has presented real challenges in formulating the new Policy.
6.
A key part of the guidance is for local authorities to
set up systems that will maximise benefits take up for users and carers as part
of the financial assessment process. This will benefit users and carers and
maximise income to the Council, thus reducing the overall financial effect of
Fairer Charging.
7.
The new Charging Policy has been developed with
recognition to the Community Strategy and Corporate Plan in that social
exclusion and deprivation will be reduced through making specific allowances
for expenses related to disability and offering a benefits advice service to
users who are receiving a home care service. Evidence gathered from a full
review of users’ charges undertaken in October 2002 has shown that
approximately 40% of users have a prime face case for further benefits and a
phased programme is being worked through to assist users make such benefit
claims if they wish. This will be extended once a further, full, review of
users’ charges is undertaken in line with the new guidance from April.
8.
Members will be aware of the Key Performance
Indicators C26 (reducing admissions to residential care) and C28 (increasing
intensive home care packages). The new Charging Policy reflects these targets
by ensuring that a maximum charge is established that ensures that there is not
an incentive for users to seek residential care on the grounds of charges.
CONSULTATION
9.
Following the approval of the draft proposals on
charging by the Social Services and Housing Select Committee, a widespread
consultation was undertaken. The main consultation points were as follows:
·
Is it fair to charge?
·
Should charges relate to both ability to pay and level
of service provided?
·
Should a maximum charge be established?
·
How much should this be?
·
Should expenses related to disability be allowed for
all users?
·
Should people with more savings pay more for their
care?
10.
A questionnaire was issued to nearly 300 home care
users and 60 stakeholders and groups representing users and carers. A summary
of the responses received is set out in Appendix 2. The level of response from
users was particularly high (57%), reflecting the importance that users place
on charging issues.
11. The consultation with users produced only one area where the response differed from the draft proposals. This related to the setting of a maximum charge where users considered it more appropriate to have a maximum weekly charge that was limited to 50% of the cost of residential care. This is a very important aspect of Fairer Charging in that the statutory guidance requires authorities to set charges at a level that do not act as a perverse financial incentive for users to enter residential care rather than remain in their own homes. It is calculated that this would create a maximum weekly charge for non-residential care of £160 per week, and this would only apply to users who have capital in excess of the threshold level (£19,500) and who have a care package of more than 16 hours per week (not including night sitting). Records show that this would currently affect only 3 users and have a minimal impact on income. However, there may be users who currently fund their own home care and, if this exceeds £160 per week, they may be attracted to receive their service through the Council. Should this be the case, the financial effect cannot be predicted at this stage.
12. Consultative discussions have also been held with a number of stakeholder groups.
FINANCIAL/BUDGET IMPLICATIONS
13.
It is extremely difficult to accurately forecast the
financial impact that the new Charging Policy will have. A sum of £400,000 has
been set aside in the Directorate’s budget for 03/04 to offset the reduced
income that the new statutory guidance will allow the Council to receive.
However, following the full review of users’ charges in October 2002, the loss
was found to be less than originally considered and was reported in detail to
Select Committee in January 2003 as a loss of £283,000. Further detailed
consideration of the new Charging Policy has slightly adjusted this loss of
income to approximately £300,000.
14.
This loss of income can be partly offset in two ways:
·
Increasing the home care charge to users for 03/04
above the level of inflation;
·
Increasing the income to users through benefits advice
and support, thus increasing their potential ability to pay higher charges. As
reported above, this is a statutory requirement of Fairer Charging guidance.
15. It is considered appropriate to increase home care charges by approximately 11% for 03/04, particularly as the cost to the Council of providing home care services is increasing by some 20% from 1 April 2003. This increased cost has been considered necessary to stimulate the home care market to ensure that care provision is maintained.
16. An increase of 11% in charges for home care in 03/04 will increase income by approximately £57,000.
LEGAL IMPLICATIONS
16. The Council has a discretionary power to charge adult recipients of non-residential services under Section 17 of the Health and Social Services and Social Security Adjudications Act 1983.
17.
The new Charging Policy meets the requirements of the
statutory guidance, issued by the Department of Health under Section 7 of the
Local Authority Social Services Act 1970, and contained in Local Authority
Circular LAC (2001) 32 dated November 2001. This guidance is commonly referred
to as “Fairer Charging”.
18.
The recommendations contained within this report are
compatible within the provision of the Human Rights Act.
OPTIONS
19.
To approve the scale of charges as set out in
Appendices 3, 4, and 5. This will minimise the overall immediate financial loss
by approximately £57,000.
20. To consider a different scale of charges that complies with the statutory guidance set out in Fairer Charging (ie charge must not exceed the cost of providing the service).
21.
To approve the new Charging Policy as set out in
Appendix 1. This Policy meets the requirements of Fairer Charging and is
considered to be manageable within the resources available.
22.
There is no alternative option available that would
meet the statutory guidance and consultation requirement.
EVALUATION/RISK MANAGEMENT
23.
Failure to approve a new Charging Policy that is
effective from 1 April 2003 will be in breach of the statutory guidance.
24.
There is an immediate financial risk to the Council.
It is not possible to accurately forecast the exact financial loss but
estimates have shown that it should be kept well within the original sum set
aside.
25.
The new Charging Policy has been developed with the
broader objective of promoting independence and enabling individuals to remain
in their own homes. The Council’s performance is judged on the number of people
helped to live at home with intensive home care packages. Members will have to
ensure that any amendments to the proposed Charging Policy do not work against
this objective.
26.
It is intended to start the review of users’ ability
to pay as soon as the new Charging Policy has been approved. Any delay with
this approval would mean that users will potentially be overcharged and will
have to have any overpayment refunded to them at a later date.
27.
In order to maximise income in 03/04 it is necessary
to apply a new scale of charges from April. Existing users have to be informed
of the new charges, as well as the review of their ability to pay, and this
will need to be done before the end of March.
RECOMMENDATIONS 28.
Members are asked to approve the Scale of Charges as
set out in Appendices 3, 4 and 5. 29.
Members are asked to approve the new Charging Policy
as set out in Appendix 1. |
BACKGROUND PAPERS
30.
Department of Health’s Local Authority Circular LAC
(2001) 32 dated 23 November 2001.
Department of Health’s Fairer Charging Policies for Home Care and other non-residential Social Services – Practice Guidance (August 2002)
ADDITIONAL INFORMATION
APPENDIX 1 New Charging Policy
APPENDIX 2 Summary of Consultation
APPENDIX 3 Home Care Charges from 6 April 2003
APPENDIX 4 Night Sitting Charges from 6 April
2003
APPENDIX 5 Scale of Charges for
Non-Residential Care
Contact
Point : Dawn Cousins Ext. 2236
|
J
DOYLE Acting
Strategic Director Social
Services and Housing |
R
MAZILLIUS Portfolio
Holder for Social
Services and Housing |