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Non-Residential Charges: Paying towards the cost of your care and support at home

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Disability Rights UK Factsheet F3 

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The Care Quality Commission (CQC) have recently launched their new ‘Tell Us About Your Care’ partnerships with a number of national charities, of which Disability Rights UK is one. This involves Disability Rights UK gathering feedback from disabled people about their experiences of using health and social care services. The CQC would welcome feedback on your experience of using any of the services they regulate. Please click here to do so.

Charging for your care and support needs in England

The new Care Act for adult care and support cancels the Fairer Charging Guidance and the Charging for Residential Accommodation Guidance (CRAG), however there is little change in the present social care funding system, as the biggest funding reforms, that were initially intended to be introduced in April 2016, have been postponed to April 2020.

The previous guidance documents of Fairer Charging Guidance and CRAG have come to an end on 1st April 2015. The statutory guidance on charging for care and support under the Care Act 2014 is found in the Care and Support Statutory (CASS) Guidance published in October 2014. The Care Act broadly maintains the existing charging system. This guidance will be reviewed regularly and there is a new version of the CASS guidance that is being prepared to take account of the changes.

Local Authorities’ powers to charge

Previously, councils were allowed to charge for domiciliary care under Section 17 of the Health and Social Services and Social Security Adjudications Act 1983. As the Care Act 2014 maintains this arrangement, local authorities have powers to charge for care and support, as per the Care Act, to cover the costs they incur when contracting for care and support. Local authorities have discretion to have more generous charging rules than those set out in the regulations. Local authorities will continue to draft their own domiciliary charging policies subject to the Guidance.

The councils carry out a financial assessment to determine how much individuals can afford to pay towards their care and support costs. If you are receiving care and support from your local authority, you may be subject to a charge towards the cost of your care. Unlike NHS, care and support is not a free service, so your local authority have the right to request a contribution from you depending on your financial circumstances.

While the councils have the power to charge individuals receiving social care, the Act specifies that people will only be asked to pay what they can afford. Under the existing legislation, the councils may not at present, nor will they be able to in the future, charge you more than the actual cost to the local authority of care to meet your needs.

Assessing how much you should pay

Local authorities may charge you for domiciliary services you receive from social services. The charges are means tested so you may be expected to pay towards the cost of your care and support needs following a financial assessment.

It is crucial that you are given in writing the amount you are expected to pay and how your contribution is worked out. The local authority should only assess your resources (resources of the cared for individual or their share of joint resources) when deciding how much to charge. The council should not consider the assets owned by another person.

Local authorities have the right to include in the amount, you are charged, any administrative costs (or recurring costs due to court action) incurred on the councils as part of debt recovery.

If you are faced with any arrears of charges that are substantial, you should not be expected to pay it all off at once, but you should be given a reasonable length of time in which to pay the money gradually.

Conducting the financial assessment

Local authorities can draft policies that are more generous than the minimum requirements set out in regulations and statutory guidance. The Care and Support Statutory Guidance includes a number of instances where the guidance is that local authorities should disregard sums which are not disregarded in the regulations. The CASS set minimum requirements for things such as disregards however local authorities can be more generous if they wish.

The charging arrangements of the Care Act are broadly similar to the rules that preceded it. Local authorities may not assist you towards the cost of your care and support if you have more than £23,250 in savings but if they wish to provide support to you even if you have over the minimum limit of £23,250, then they can use their power to do so.

Savings Credits are disregarded for people receiving care and support. Local authorities should disregard working tax credits in the calculation of your income. Your earnings from employment should be ignored in any assessment. You cannot be charged for services provided by the NHS, such as those provided by a district nurse. Community equipment is also free, and minor adaptations costing less than £1000 which you or your carer are assessed as needing will be provided.

Personal injury compensation placed in a personal injury compensation trust is fulling disregarded under the CASS Guidance, just as it was the case under section 8 of the Fairer Charging Guidance.

Previously, the Fairer Charging Guidance made a distinction between day and night care, as well as the three different rates of DLA, and higher rate and lower rate of the AA. This has now changed because DLA is being replaced by PIP which has two rates and there is no distinction between day and night care as stated in paragraph 47 of the guidance.

Disability living allowance care component can be taken into account but a local authority is not allowed to count an award for night needs where they are only providing day time care (and vice versa). The treatment of day and night care is reflected in paragraphs 37 and 38 of Annex C of the CASS Guidance. Under the Care Act, local authorities will treat either day or night care that is not being provided by the local authority, as being included in the list of the adult’s disability-related expenditure (DRE).

Local councils should make an assessment of your disability-related expenditure and allow you to keep enough benefit to meet any needs not being met by the council. The local authority needs to take into account any Disability Related Expenses (DRE) you have when carrying out the financial assessment. The DRE is any additional expenses incurred because of your disability. This can include laundry costs due to incontinence, high heating bills (if, for example, you have poor blood circulation), accessible taxi fares costs, equipment, essential dietary requirements costs, special clothing (because of wear and tear), internet costs, therapies. You should try and make a full list of all your disability related expenses if you are having a local authority assessment. Any requested contribution to costs needs to be reasonably practicable for you to be able to pay.

Appealing against the local authority’s decision

You have the right to appeal against the local authority’s decision if you are not happy with the amount of contribution you have been asked to pay. Local authorities cannot cease funding your care package while you are disputing the charges you are expected to pay. Please refer to factsheet no. 6 for information on how to make a complaint.

What is the present social care funding system?

Currently, you are expected to be a self-funder if you have savings above £23,250, i.e. you are expected to pay for all of your care costs – you are not entitled to receive any social care funding. If you have less than £14,250 in savings, you don’t need to make use of these savings to pay towards the cost of your care and support needs.

If you have got savings between£14,250 and £23,250, you pay an amount towards your care following a financial assessment conducted by the financial assessor and involving you (or your nominated person).

If you have £23,250 in savings, you will continue paying towards the costs of your care package till your savings reach below £14,250.  However, all this will change because of the Care Act. The Care Act changes the rules about who qualifies for support from the council as well as the charging for care.

When will these changes in England take place?

Initially, the government intended to introduce the £72,000 cap in April 2016 as stated in the Care Act 2014 (that came into force in April 2015) but then it has been decided to delay these funding reforms till 2020. The government’s policy to cap social care costs in England under the Care Act has been deferred following the request of councils to postpone it due to enormous funding pressures faced by local authorities. The cap formed a key manifesto commitment for the government that was due to come into force in April 2016.

What are the changes that will take place under the Care Cap?

At present, the elderly and disabled people with assets above £23,250 do not receive help from local councils towards care costs. Those who have under £23,250 in savings get social care funding towards their costs while those with assets above the set threshold are expected to be self-funders.

The funding changes would have brought up this figure to £118,000, a more generous social care system that would have benefited a lot of elderly and disabled people.  The government has proposed lifetime costs, a limit on how much people in England should pay towards meeting their eligible support needs in their lifetime.

A cap of £72,000 will be introduced from April 2020 to determine what people are expected to pay towards care and support needs. The Care Act brings in new crucial changes to the funding rules that councils must adhere to when supporting people with social care needs. Once your ‘care account’ reaches a certain figure (i.e. the Care Cap), your local authority must take over most of your care costs.

Where can I get more help or information?

This factsheet is a basic overview of non-residential charges. You can find out more detailed information in our Disability Rights Handbook. This and all our other publications are available from our shop at https://www.disabilityrightsuk.org/shop. You can also place orders by contacting Disability Rights UK

For further help and information please contact our Advice Line - 0300 555 1525.

You can get more information about where to get personal advice from our Factsheet F15 - Getting advice. All our factsheets are free to download on our website at disabilityrightsuk.org. We have a number of independent living factsheets.

Banane Nafeh
16 March 2016

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