APPENDIX A

Isle of Wight Council

Directorate of Social Services & Housing

Fairer Charging for Home Care and Other Non-Residential Services

GOVERNMENT GUIDANCE	THE COUNCIL’S DRAFT PROPOSALS
1. Councils have discretion whether or not to charge for non-residential services. Where service users are asked to contribute a charge towards the cost of non-residential social services, this can raise additional income, which should be used to develop services.	(Proposals in italics are subject to consultation) The council spends all of the income raised from charges on providing more services for people and if we did not, it would not be possible to help everyone who needs it. The Council proposes to continue charging for services.
2. After-Care Services provided under Section 117 of the Mental Health Act may not be charged for, and Councils may not charge for providing advice about the availability of services or for assessments, including assessment of community care needs. The Government also requires that sufferers of any form of Creuzfeldt Jacobs Disease (CJD) should not pay charges.	The Council does not charge for these services and has no intention of introducing charges.
3. Service Users who receive more than one service should have the impact of charging for one of these services on their income taken into account in assessing whether the charges should be made on another service.	The Council will carry out a financial assessment (means test) to identify how much a Service User can afford to pay and make sure that charges are not more than this. NB: this will not include meals at home or in Day Care (see 5 below).
4. Other than for meals, flat rate charges that take no account of ability to pay or levels of service are unlikely to be reasonable.	The Council takes in to account ability to pay for Home Care through a financial assessment, and takes in to account levels of service by charging a value determined by the users disposable income and number of hours provided up to the maximum that the financial assessment shows that a Service User can afford to pay. The Council also currently makes a 2-tiered charge for day care services. The statutory guidance as set in this draft policy will make many day care users exempt from charging and, for the remainder, any day care charge will have to be linked in a package to other means tested charges eg home care (note 3 above). The current system for charging does not allow for this and it is proposed that the day care charge is abolished.

5. Charges for meals at home or in Day Care can be a flat rate charge without the need for a means test, as such charges substitute for ordinary living costs.	The Council proposes a standard flat rate charge of £2.50 per day for refreshments, including lunch, provided in Day Care with no charge for those who do not wish to avail themselves of the refreshments. The current charge for meals at home of £1.70 is much less than most Councils charge. Whilst it is accepted that the cost of providing a meal at home is less than in a day care establishment, it is still considered that these flat rate charges should be brought more in line. It is proposed that the charge for meals at home should be raised over a 3 year period as follows: 03/04 £1.80 04/05 £1.90 05/06 £2.00
6. Service Users should have as a minimum Basic Income Support plus an extra 25% to meet their normal costs of living. Basic Income Support is the Income Support Personal Allowance and Age and Disability Premiums, but not Severe Disability Premium. At current rates this will be £122.70 per week for those over 60 and £96.19 per week under 60. This does not include charges for meals at home and in Day Care.	The Council will reassess all Service Users who have been financially assessed to ensure that anyone whose income is at or less than the figures quoted, do not pay charges for all services other than meals at home and in Day Care. These allowances apply to all users irrespective of whether they are in receipt of Income Support.
7. Councils may choose to set a maximum percentage of disposable income, which may be paid in charges. In some Councils this is set as a proportion of typical local residential care charges to ensure that there is no incentive for Service Users to leave their own homes and enter residential care.	The Council is committed to helping people to remain in their own homes where this is possible and proposes setting a maximum charge of 75% of residential care charges, which would mean that no-one would pay more than £180 per week. It should be noted that to pay £180 per week in charges would mean that a Service User would have weekly disposable income of at least £100 per week and more than 20 hours of service each week. The maximum charge for most people will be considerably lower.
8. Income Support disregards £10 per week of War Disability Pensions and all of War Widows Supplementary Pension. These should at least be applied by Councils and also any higher disregards applied for Housing Benefit and Council Tax Benefit.	The Council proposes to apply these disregards, ie, ignore them as assessable income, and seek information from Revenues Section on specific disregards for Housing Benefit and Council Tax Benefit.

9. Severe Disability Premium Attendance Allowance, Disability Living Allowance, Constant Attendance Allowance, and Exceptionally Severe Disablement Allowance may be taken into account as income, though it is open to Councils not to do this. If taken into account charges must not reduce income below Basic Income Support plus 25%, and allowance must be made for costs of disability.

The Council proposes to include these benefits as income. However, the more generous allowances prescribed by the guidance mean that Service Users are not required to pay as much towards their care from these benefits as previously.

10. Councils are expected to assess disability related expenditure specifically for all Service Users whose disability-related benefits are taken into account as income. Councils should also consider and specifically consult Users on any need to do this for other Users, who may have disability-related expenditure. In assessing such expenditure Councils should include the following:- – Payment for any community alarm system. – Costs of privately arranged care, cleaning, domestic help, and garden maintenance. – Specialist washing powders or laundry. – Additional costs of food due to illness or disability. – Additional costs of bedding due to incontinence for example. – Any heating or water costs above the average for the area. – Purchase, maintenance, and repair of disability-related equipment. – Other transport costs over and above Mobility Allowance that may be paid as part of Attendance Allowance or Disability Living Allowance. Evidence of actual expenditure may be requested at the Councils discretion, eg, receipts and bills.

The Council will carry out an assessment of disability-related expenditure to allow these costs before charges are calculated based on the items shown and any other items identified by Service Users. This will be carried out by specially trained staff and the Council proposes that it be offered to all Service Users whether they have the benefits or not. This is because we will be helping Service Users to claim benefits that they may be entitled to. The Council proposes that evidence should be produced to support claims for extra costs caused by illness or disability.

11. Attendance Allowance and Disability Living Allowance are paid at the highest rate only if a Service User needs help both day and night, and there are similar arrangements for Constant Attendance Allowance and Exceptionally Severe Disability Allowance. It would be wrong for Councils to take into account the part of a benefit for night care if it does not provide services at night. Night services clarified as the period from which the household closes down for the night but dressing in the morning and undressing before going to bed are daytime activities.	The Council will disregard that part of Attendance Allowance or Disability Living Allowance that is paid in respect of night time care.
12. Councils should offer benefits advice to Service Users at the time of a financial assessment for charges. It will normally need to be carried out by personal interview in the Users own home by appropriately skilled staff. The service should include advice about entitlement, help with completion of benefit claims, and follow-up action if the User wishes.	The Council currently uses Visiting Finance Officers to gather financial information from Service Users and specialist Finance Assessment Officers to carry out financial assessment work. It also has a small Welfare Rights Team to deal with appeals and specialist advice. The Council proposes to extend the role of the Visiting Finance Officers to offer on the spot benefits advice and support at the time of financial assessment. There would still be a specialist service for supporting Service Users who wish to appeal when claims are turned down by the Benefits Agency.
13. Councils may take account of Users capital or savings, but are not obliged to do so. Savings may be taken into account to give a weekly income on the same basis used for Residential Services, ie, £1 per week for every £250 or part of £250, and using the same capital limits, ie, £11,750 lower limit and £19,000 upper limit. Users with savings above the upper limit may be asked to pay the full cost of the service. Councils may wish to set higher savings limits but should not set lower limits. The value of the main home should not be taken into account for charges.	For home care users, the Council currently applies two capital limits - £12,000 for an individual and £19,000 for a couple, above which service users are required to pay the full cost. It ignores the first £6,000 of savings (lower limit), and takes into account as income a tariff of £1 per week for every £250 between the lower and higher capital limit. In order to comply with the guidance the Council must increase the lower limit to £11,750 and the upper limit to £19,000 (£38,000 for a couple) and this will reduce the income currently taken into account of many users. The Council has never taken the main home into account for charging. For day care, there is currently no capital limit and the maximum that any user can pay is £6.30 per session. To be consistent with home care, day care users with capital in excess of the upper limit should be charged the full cost of the service. However, this will mean a significant increase in charge that may have individual risk effects. It is considered more appropriate to introduce a charge of £7 per session to these users.
14. Provision should be made for charges to be reviewed at regular intervals where savings are being used up by charges.	The Council will make sure that every service user is offered an opportunity to have their charge re-assessed at annual intervals.
15. The law assumes that Councils will only take a Service Users income and savings into account in assessing ability to pay. Councils may wish to consider in individual cases where a Users means may include resources not held in that person’s name, usually for married or unmarried couples. If the Council has some reason to believe that the User does have access to other resources a request may reasonably be made for the User to disclose his or her relevant resources. Some benefits are assessed jointly for couples and savings may be jointly held. In cases where only the Users means are assessed, no assumption should be made that the whole of the person’s disposable income is available for charging, eg, Income Support paid at the rate for a couple should not be taken into account without also taking account of the expenditure needs of both partners. Jointly held savings should be treated as divided equally unless it can be shown that this is not the case.	The Council will only assess the Service User, but where an assessed charge for an individual user would reduce a couple or household below basic levels of Income Support + 25% buffer, then an assessment will be applied on the basis of the household. The overall principle to be applied is one where a “better off” assessment is calculated in the favour of the service user. Some benefits, eg, Attendance Allowance and Disability Living Allowance, can be claimed without the disclosure of a partner’s income and savings, but a full welfare benefits check cannot be completed without full disclosure of both partners’ financial details. The Council will offer a full welfare benefits check but will explain that this can only be carried out with full disclosure. Partners will have the right not to disclose though they will have to accept that the welfare benefits check will not be carried out. If a service user wishes to include household expenditure that includes the partner then the Council will expect full financial details to be disclosed.
16. The Government believes it is right that Councils should disregard all earnings in calculating assessments including for Carers. This includes Working Families Tax Credit and Disabled Persons Tax Credit.	The Council will disregard the earnings of Service Users and Carers and the benefits listed.
17. It is a matter for Councils to decide whether to levy a contribution to costs or to seek the full costs of the service. Charges that are based on hours of services provided are generally preferable to charges based on broad usage bands. Where costs vary it is for the Council to decide whether to have a notional charge for Users with the same means.	The Council pays its providers different rates and it would be extremely complex to charge Service Users the precise rate for the service dependent upon the provider that is used. Consequently, a single hourly rate as a maximum charge for care at home has been proposed. The banding system used for charging reduces this maximum charge proportionately in line with the Service Users ability to pay.

18. Users may be charged for services provided to them and Carers only for services provided to them under the Carers and Disabled Children’s Act 2000. Councils may not decide that a Carer is the service recipient and be charged purely on the grounds that a User is exempt from charges or has less income than the Carer. All of the parts of this guidance apply to charges for services provided to Carers.	The Council will comply with this requirement.
19. Councils should treat people receiving direct payments as they would have treated them under the Council’s charging policy and in accordance with this guidance.	The Council will comply with this requirement.
20. Intermediate Care is specially arranged short-term packages of care and should be free at the point of use.	The Council will make sure that Service Users receiving care under Intermediate Care arrangements are made aware at the care assessment stage that the services are free for the short period, but that charges will apply if service continues.
21. Clear information about charges and how they are assessed should be readily available for Users and Carers. Written information on the actual charge assessed as payable should be given to Service Users promptly. This should normally be done before sending a first bill. Charges should not be made for any period before an assessment of charges has been communicated to the User, although this may be unavoidable where the User has not co-operated with the assessment.	The Council will review all of its information leaflets about charging to make sure that the new charging policy, when agreed, is fully explained. The Council will set targets for arranging visits to carry out financial assessments and in normal circumstances charges will be notified during the visit and confirmed in writing. Charges will not be made until the service user has been informed of the charge.

22. The assessment of care needs is very different to the assessment of charges and service must not be withdrawn because the User refuses to pay the charge. The Council should continue to provide the service, while pursuing the debt, if necessary through the Civil Courts. If a User refuses to provide information for a charge assessment it may be reasonable to require payment of a full charge.	The Council will make this point clearly in its information leaflets and services will not be withdrawn if Service Users refuse to pay. The debt will be pursued using the Civil Courts if necessary. Service Users who choose not to provide financial information will be required to pay the full charge.
23. Information for charge payers should make clear that they may either seek a review of their assessed charge or they may make a formal complaint.	The Council already operates a fast-track review of any individual’s charges considering firstly on whether the charging policy has been applied properly and secondly, whether there are any particular circumstances that justify special discretion being exercised. All Service Users receive a copy of the Social Services Complaints Leaflet, explaining how to make a formal complaint.
24. The Department of Health will investigate the feasibility of collecting information on levels of arrears of charges and the costs of collection to enable Councils to compare their performance for Best Value purposes. The flowing categories of information could be used to measure performance:- – Client numbers and service levels. – Clients refusing/cutting down on services as a result of charging or asking for charges to be reviewed. – Levels and reasons for arrears. – Levels of client incomes, in particular, the take-up of different benefits. – Cost of collection as a percentage of income.	The Council will set up systems where they do not already exist, to measure performance as outlined.