EAST AYRSHIRE COUNCIL

CABINET – 8 MARCH 2017

EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP SOCIAL CARE CONTRIBUTION AND CHARGING FRAMEWORK AND

APPROVED CHARGES – 2017/18

Report by the Director of East Ayrshire Health and Social Care Partnership

PURPOSE OF REPORT

1. The purpose of this report is to seek Cabinet:

(i) Approval of annual alterations to approve charges and contributions for Social Care Services for the Financial Year 2017/18;

(ii) Approval of an updated East Ayrshire Health and Social Care Partnership Social Care Services Contributions and Charging Framework.

BACKGROUND

2. In East Ayrshire the Community Planning Partners are committed to support aspirations of people with health and social care needs to live at home independently, safely and for as long as possible. The Council commits a significant proportion of the annual revenue budget to this priority.

3. Charges are an important source of Council income and all income from social care service charges are reinvested through funding the Health and Social Care Partnership in order to maintain and develop services and in so doing are a means to help the Council deliver services within available resources. The legal basis for charging for non-residential social care services is the Social Work (Scotland) Act 1968, (as amended) and the Community Care and Health (Scotland) Act 2002. In October 2013 Audit Scotland published a report ‘Charging for Services: Are you getting it right?’ To support Self Directed Support Legislation it has been necessary to update the framework to align annual contributions with annual personal budgets. The proposals within this report for a clear Contribution and Charging Framework and annual review of charges brought to Cabinet for approval, support the Council to meet the recommendations of this report.

4. Charging and contributing for Services in East Ayrshire is based on the annual update of COSLA National Strategy and Guidance for Charging Applying to Non Residential Care Services. Within the national guidance there is scope for local interpretation and presented to Cabinet for consideration is updated Social Care Services Contributions and Charging Framework that incorporates national guidance. (Appendix 2).

5. In setting contributions and charges for 2017/18 cognisance has also been taken of the

agreement between Scottish Government and Councils of the parameters around utilisation of funding provided through NHS for social care.

6. The Contribution and Charging Framework explains how East Ayrshire Council considers and calculates the contribution and/or charge that people will be expected to pay towards the care services they receive from the Health and Social Care Partnership.

7. This report details inflationary adjustments to charges for social care services, which have been

reflected in the Health and Social Care Partnership Revenue Budget 2017/18 presented to East Ayrshire Cabinet on 22 February 2017 to seek Elected Member approval to increase thresholds for income disregards and maximum charges to service users for a range of Social Care services.

8. On an annual basis, review is undertaken of rates that we agree to pay for social care

services and this takes account of revised guidance available from COSLA, the Department for Work and Pensions and the Scottish Government. The Council remains integral to this process through COSLA involvement in national negotiating of fee rates and Council funding the IJB.

9. With the delegation of commissioning, overseeing and delivery of Social Work services to East

Ayrshire IJB from 2 April 2015 the responsibility for setting the rates paid by the IJB for Social Care services falls within that governance. EAST AYRSHIRE HEALTH AND SOCIAL CARE PARTNERSHIP SOCIAL WORK SERVICES CONTRIBUTIONS AND CHARGING FRAMEWORK

10. The Contribution and Charging Framework explains how East Ayrshire Council considers and calculates the contribution to care that people will be expected to pay towards the Social Care services they receive. Contributions and charges apply whether the service is provided directly from East Ayrshire Health and Social Care Partnership or by an external provider procured by the Council to provide services on the Health and Social Care Partnership's behalf.

11. East Ayrshire Council charges are set in line with statutory requirements and National Guidance and are approved by elected members on an annual basis, through the budget setting process.

12. The Framework is based on:

Fairness and equality

Consistent decision making

Transparency of cost of contributions and charges

COSLA National Guidance and Statutory requirements

13. The Framework is also based on the following list of principles:

People who use services will not be charged more than it costs to provide the services for which their contribution has been assessed.

Services will be provided in accordance with service users assessed needs and not on their ability to pay.

All people who use services will be offered access to a benefits check to provide them with information, advice and support to maximise their income.

People claiming their full benefit entitlement.

Service users who do not wish to claim benefits to which they have an entitlement, will be financially assessed as if they were in receipt of these benefits.

14. The Framework encompasses contributions and charges applied through models of care

delivered or arranged for non- residential, residential and self-directed support. REVISED CONTRIBUTION AND CHARGING FRAMEWORK

15. Under Self-Directed Support legislation which was implemented in April 2014, Councils are

required to identify a personal budget which will meet the agreed outcomes of the assessed person. The person can then choose how they wish this budget to be spent and this is not prescribed to traditional or existing services.

16. The new Act has required the development of a Resource Allocation System (RAS), the means of agreeing the amount of the personal budget allocated to each person. This takes account the personal circumstances of an individual and family carers to identify the personal budget.

17. In respect of applying the Framework to all options of Self Directed Support;

The income side of the financial assessment calculation is retained as per the existing Framework, however, it is converted to annual amount to align with personal budgets

If the assessable annual income is less than the annual income threshold figure, there will be no contribution for services other than the flat rate charges.

If the assessable annual income is more than the annual income threshold figure, the income based contribution will be a % (agreed annually) of the difference between the threshold income figure and a person’s assessed income.

East Ayrshire Council will not charge a service user more than 80% of their personal budget. The contribution will be the lowest between the percentage of the disposable income, 80% of the budget or the maximum yearly charge.

East Ayrshire Council sets a maximum charge, above which service users cannot be charged, irrespective of the income based charge or the indicative cost of the service/s provided.

The annual contribution will be converted to weekly for billing purposes

If the service user is absent from home on a short term temporary basis the contributions will continue and following reconciliation, credits if appropriate, will be applied to the service user contribution.

18. In respect of applying the Framework to those service users still in receipt of a traditional home care service, the weekly indicative cost to provide the service will be converted to an annual cost and they will be financially assessed in the same manner as those who have a personal budget. They will not be charged more than 80% of the cost to deliver the service.

19. The weekly indicative home care hourly rate is £15.10 until 30/4/17, thereafter the uprated indicative rate is £15.43.

20. This will ensure that the charging system remains equitable.

21. Align the capital disregard to those applied by the DWP, the disregard for those under pension age to reduce from £10,000 to £6,000.

22. Following consultation by COSLA and pending confirmation, the Charging Guidance will be amended to reflect a full disregard in respect of War Disablement Pension and compensation payments made through Armed Forces Compensation Scheme. East Ayrshire H&SCP’s share of the £7m allocated for War Pensions/Carers Act is £170,000. REVISION OF CHARGES AND APPROVED RATES Non Residential Charges – Community Health and Care Services

23. As with previous years it has been recommended that threshold levels and calculation of tariff

income increase in line with DWP Benefits and COSLA guidance to ensure that revised charges do not have an adverse effect on service user’s benefit increases. Appendix 1 outlines the revised maximum charges for 2017/18.

24. It is proposed that the maximum charge to an individual service user for non-residential social care services is £99.66 for 2017/18 (up from £97.23 in 2016/17). This represents an annual contribution of £5,196.56

25. The COSLA Charging Guidance recommends a differential in the income disregard between service users over and under Pension Age. This is aligned to DWP benefits available to people depending on their pension age and takes account disability benefits and a further buffer disregard of 25% to take account of other disability related expenditure. The buffer increased in 2016/17 from 16.5% to make allowance for people with disabilities living in poverty. It is proposed (subject to confirmation from COSLA) that in 2017/18 the thresholds for income disregards are:

Table 1

Service User Group Weekly Thresholds

2016/17

Weekly Thresholds

2017/18

Annual Thresholds

2017/18

Single People Over Pension Age £195 £200 £10,428

Couples Over Pension Age £297 £305 £15,903

Single People Under Pension Age £132 £133 £6,935

Couples Under Pension Age £201 £202 £10,533

26. If a person has income below these thresholds there will be no contribution for social care services other than the flat rate charges. In line with COSLA Guidance the Council also sets a rate of disregard of income above the thresholds, it is proposed that this is maintained at the 16/17 rate of 40% disregard. Non Residential Services

27. Council as part of the 2017/18 budget approved rates in respect of non-residential charges for Social Care Services as shown below: Table 2

Service 2016/17 2017/18

Blue Badges Flat Rate Charge £20.00 £20.00

Charges for Day care Services Flat rate Charge per day £3.08 £3.15

Community Alarm Weekly Charge £4.10 £4.20

28. The current daily cost of providing Adult Day Care is £45.69 and Older People Day Care is

£50.72, these rates will be uplifted for 2017/18 following budget approval.

29. The current weekly cost of providing the Community Alarm Service is £6.63, this will be uplifted for 2017/18 following budget approval.

30. For community meals it is proposed to continue the current subsidy of 40p per meal for the Meals at Home service. RESPITE CARE CHARGES Respite Care Charges (Young People)

31. The current and proposed weekly rates for residential respite care for young people are detailed in Table 3 below. Table 3 – Respite Care Charges (Young People)

Disability Living Allowance Care Component 2016/17 2017/18

Low Rate DLA £21.80 £22.00

Middle Rate DLA £55.10 £55.65

High Rate DLA £82.30 £83.10

Respite Care Charges (Adults)

32. Table 4 below highlights the current weekly charges for residential Respite Care for Adult service users. The rate is applicable from 10 April 2017. Table 4 – Respite Care Charges (Adults)

Service User Group 2016/17 2017/18

Adults (18-24) £64.35 £64.05

Adults (25-64) £79.55 £79.25

Adults (65+) £129.80 £132.95

33. For people under 65 the charge is determined by taking the Personal Allowance for the service user, adding the Disability Premium if appropriate, and then subtracting the Personal Expenses Allowance which is the amount that the law requires the service user to retain within a residential setting.

For example, for a person aged under 25 this would be £57.90 Personal Allowance + £32.55 Disability Premium = £90.45 - £26.40 Personal Expenses Allowance which equals a flat rate charge of £64.05 .

34. For a person aged over 65 years the applicable sum used is the minimum pension guarantee less the Personal Expenses Allowance, this would be £159.35 - £26.40 which equals a fixed rate charge of £132.95. RATES PAID FOR SOCIAL CARE SERVICES

35. Agreement on care home rates has yet to be finalised between COSLA, Scottish Care, and Scottish Government. The negotiations include not only discussion on annual uplift but also the agreement to increase wage levels for social care workers to the Living Wage from 1st May 2017 in line with Council’s agreement with the Scottish Government. This is intended not only to address low wages in the sector but also to support recruitment and retention and through this improve the quality of services provided. When the final recommendations are agreed through CoSLA Leaders they will be presented to the IJB for approval and Cabinet for endorsement through East Ayrshire Performs.

36. As a result of a national tender in respect of external foster rates, 15 foster care providers are recommended for contract award, for the national foster and continuing care framework contract. Scotland Excel (Centre of Procurement Expertise for Scotland's local government sector) advised that the National Framework fee variation negotiation has recommended a 0.4% fee increase.

37. Historical placements with external foster care providers not on the national framework contract are subject to individual contracts through East Ayrshire Council, and separate negotiations are taking place with each of these providers.

38. In respect of Secure Accommodation, Scotland Excel fee rate negotiations with providers have

been concluded at a national level for 2017/18 and it has been recommended that a 0.5% fee increase is awarded.

39. In respect of payments for internal child allowances, a report was presented to the IJB on 1 March 2017 recommending rates are not uplifted in 2017/18. LEGAL / FRAMEWORK IMPLICATIONS

40. Contributions and Charges made for services are in accordance with the Social Work (Scotland) Act 1968, chapter 49 (as amended) and the Community Care and Health (Scotland) Act 2002. Scottish Government Framework and COSLA recommendations have also be incorporated in the rates and charges for 2017/18. FINANCIAL IMPLICATIONS

41. This report, in conjunction with the Cabinet report dated 22 February 2017, fulfils the duty of the Director of the East Ayrshire Health and Social Care Partnership to review charges for services, as determined by section 7.1 of the Council’s Financial Regulations.

42. Elected members should note that, in cases of hardship, contributions and charges may be waived, in whole or in part, at the discretion of the Head of Service / Director of health and Social Care.

43. In line with benefit increases from Department for Work and Pensions it is recommended that increases take effect from the first full billing period after 11 April 2017.

44. The Contribution and Charging Framework amendments will result in minimal financial

implications. The desktop exercise (12% of those subject to a contribution) identified only two service users whose charge would change – both reductions, total annual reduction of £260 (see appendix 3). In addition to these two there are a further 15 service users whose contribution will reduce, total annual reduction is £655. COMMUNITY PLANNING

45. The provision of social services within a contribution and charging framework that reflects the ability to pay supports the Wellbeing theme of the Community Plan. RISK IMPLICATIONS

46. East Ayrshire Council requires to set appropriate rates and charges to support the Revenue Budget process whilst ensuring continuity of services to the most vulnerable people in our communities. For 2017/18 this also requires to be aligned with processes for the IJB.

47. In recognition that many people who have disabilities live in poverty COSLA increased the

threshold buffer from 16.5% to 25% in 2016/17 for those who service users who are receiving an assessed charge. There are also 3008 community alarm service users and 343 day service users who receive a fixed charge out with the above assessed charges.

48. It should be noted that the Local Government Ombudsman (LGO) found in favour of a pursuer in respect of taking both a husband and wife’s capital into account when financially assessing the husband to determine his contribution toward his home care charges. Our allowances are aligned to the DWP, claimants are treated as single or as couples. EQUALITY IMPACT

49. This report details the proposed charges and revised threshold levels for specified service user groups. The rates, contributions and charges take account of national and local Framework and through setting maximum charges the ability to pay. The issues outlined in the Risk paragraphs focus on equity between arrangements rather than inequalities in respect of one of the protected groups. RECOMMENDATIONS

50. It is recommended that Cabinet agree to: (i) Agree the updated East Ayrshire Social Care Services Contribution and Charging

Framework;

(ii) Agree the Framework update in paragraph 17 and 18, the contribution to be capped at 80% of the personal budget or the cost to provide the service;

(iii) Agree the updated Charges and thresholds detailed in paragraphs 23 to 34 of this report; (iv) Note that in relation to care home charges as COSLA, Scottish Government and Scottish

Care have not yet finalised the rate at this time; the Director will report to Cabinet, through East Ayrshire Performs once the final details are available;

(v) Note recommended fee increase in respect of the national foster and continuing care framework contract;

(vi) Note the recommended fee increase in respect of Secure Accommodation; (vii) Note the recommendation in respect of internal child allowances; (viii) Otherwise note the contents of this report. Eddie Fraser Director of East Ayrshire Health and Social Care Partnership 17 February 2017

LIST OF BACKGROUND PAPERS

1. COSLA National Strategy and Guidance for Charges Applying to Non-residential Social Care Services 2017/18;and

2. Cabinet Budget report 2017/18 dated 22 February 2017 Members requiring further information should contact Amanda McInnes, Senior

Manager Business Support, Tel No: 01563 576222

IMPLEMENTATION OFFICER: Eddie Fraser

APPENDIX 1

CHARGES FOR NON-RESIDENTIAL SOCIAL WORK SERVICES

APRIL 2017 BENEFIT RATES

REVISED THRESHOLD LEVELS BASED ON CoSLA RECOMMENDATIONS

Single People

2017/18 Maximised

Income

2017/18 Threshold

2016/17 Maximum

Charge

2017/18 Maximum

Charge

Minimum residual

Income after Care and

Housing Costs

60+ living alone with h/r AA, h/r DLA care or e/r PIP1 60+ living alone with l/r AA, M/R DLA care or s/r PIP2 60+ with h/r AA, h/r DLA care or e/r PIP 60+ with l/r AA, m/r DLA care or s/r PIP

£304.90 £277.45 £242.45 £215.00

£200.00 £200.00 £200.00 £200.00

£62.85 £46.53 £25.74 £9.42

£62.94 £46.47 £25.47 £9.00

£241.96 £230.98 £216.98 £206.00

Under 60 living alone with h/r DLA care or e/r PIP Under 60, living alone with m/r DLA care or s/r PIP Under 60, living alone with l/r DLA care

£267.10 £223.75 £127.65

£133.00 £133.00 £133.00

£79.95 £54.18

Nil

£80.46 £54.45

Nil

£186.64 £169.30 £127.62

Under 60 with h/r DLA care or e/r PIP Under 60 with m/r DLA care or s/r PIP Under 60 with l/r DLA care

£204.65 £161.30 £127.65

£133.00 £133.00 £133.00

£42.84 £17.07

Nil

£42.99 £16.98

Nil

£161.66 £144.32 £127.65

Under 25 living alone with h/r DLA care or e/r PIP Under 25 living alone with m/r DLA care or s/r PIP Under 25 living alone with l/r DLA care

£251.90 £208.55 £112.45

£133.00 £133.00 £133.00

£70.83 £45.06

Nil

£71.34 £45.33

Nil

£180.56 £163.22 £112.45

Under 25 with h/r DLA care or e/r PIP Under 25 with m/r DLA care or s/r PIP Under 25 with l/r DLA care

£189.45 £146.10 £112.45

£133.00 £133.00 £133.00

£33.72 £7.95 NIL

£33.87 £7.86

Nil

£155.58 £138.24 £112.45

Couples 2017/18 Maximised

Income

2017/18 Threshold

2016/17 Maximum

Charge

2017/18 Maximum

Charge

Minimum residual

Income after Care and

Housing Costs

60+ living alone, both with h/r AA, DLA care or e/r PIP 60+ living alone,1 h/r AA, DLA or e/r PIP,1 l/r AA, m/r DLA or s/r PIP

60+ living alone, both with l/r AA, m/r DLA care or s/r PIP 60+ both with h/r AA, DLA care or e/r PIP 60+ 1 h/r AA, DLA care or e/r PIP, 1 l/r AA, m/r DLA care or s/r PIP

60+ both with l/r AA, m/r DLA care or s/r PIP 60+ one with h/r AA, DLA care or e/r PIP 60+ one with l/r AA, m/r DLA care or s/r PIP

£534.35 £506.90 £479.45

£409.45 £382.00 £354.55 £326.35 £298.90

£305.00 £305.00 £305.00

£305.00 £305.00 £305.00 £305.00 £305.00

£97.23 £97.23 £97.23

£63.09 £46.77 £30.45 £13.71

Nil

£99.66 £99.66 £99.66

£62.67 £46.20 £29.73 £12.81

Nil

£434.69 £407.24 £379.79

£346.78 £335.80 £324.82 £313.54 £298.90

Under 60, living alone, both with h/r DLA care or e/r PIP Under 60, living alone,1 has h/r or e/r DLA care or PIP &1 has m/r or s/r

Under 60, living alone, both with m/r DLA care or s/r PIP Under 60, both with h/r DLA care or e/r PIP Under 60,1 with h/r DLA or e/r PIP, 1 with m/r DLA care or s/r PIP

Under 60, both with m/r DLA care or s/r PIP Under 60, one with h/r DLA care or e/r PIP Under 60, one with m/r DLA care or s/r PIP Under 60, both with L/R DLA care Under 60, one with L/R DLA care

£475.20 £447.75

£397.45

£350.30

£322.85 £272.55 £267.20 £216.90 £205.25 £183.25

£202.00 £202.00

£202.00

£202.00

£202.00 £202.00 £202.00 £202.00 £202.00 £202.00

£97.23 £97.23

£97.23

£88.20

£71.88 £42.00 £38.82 £8.94 £2.04

Nil

£99.66 £99.66

£99.66

£88.98

£72.51 £42.33 £39.12 £8.94 £1.95

Nil

£375.54 £348.09

£297.79

£261.32

£250.34 £230.22 £228.08 £207.96 £203.30 £183.25

1 e/r PIP – Enhanced Rate of Personal Independence Payment 2 s/r PIP – Standard Rate of Personal Independence Payment

Social Care Services Contribution and Charging

Framework

Date Completed: 10/9/2014 Last Updated: 04/02/2014 Date of Equality Impact Assessment: 23/09/2014 Date Review Due: February 2017 Lead Officer: Eddie Fraser

CONTRIBUTION AND CHARGING FRAMEWORK – CONTENTS PAGE

PARA PAGE

1 Section 1: Introduction 3

Section 2: Contribution and Charging for Non-Residential

Social Care Services

4

8 What are Non-Residential Social Care Services? 4

10 What Services cannot be charged for? 4

12 What Services does East Ayrshire Council Charge for? 5

15 How Are Contributions and Charges for non-residential social

care services calculated?

5

20 Financial Assessments 6

25 Income Disregarded in the Financial Assessment 6

28 Treatment of Capital 6

31 Temporary or emergency admissions to hospital or care

home/absence from home

7

32 Non-disclosure or incorrect information provided in respect of

financial assessment

7

34 Waiver of Contributions and Charges and Write off of Debt 7

Section 3: Charging for Residential Services 7

38 What Are Residential Services 8

42 How Are Charges for Residential Services Calculated? 8

44 Treatment of Income 8

47 Funding Thresholds 9

54 Treatment of Property 9

60 Deprivation of Capital 10

61 Hospital Admissions/planned absences 10

63 Annual financial re-assessments 10

65 Respite Care 11

67 Section 4: Charges to other Local Authorities 11

68 Public Information 11

Appendix 1: From CoSLA Guidance – Self Directed Support 11

Appendix 2: Maximum Charge Illustration 12

SECTION 1: INTRODUCTION

1. East Ayrshire Council is committed to support aspirations of people with social care needs to

live at home independently, safely and for as long as possible. The Council commits a

significant proportion of our annual budget to this priority but like all other Councils we work

within limited resources and face continuing financial pressure through increased costs,

financial constraints and demands on services. Charges and contributions are an important

source of Council income and are a means to help the Council through funding the Integrated

Joint Board deliver services. Income from service charges and contributions are reinvested

through the Health and Social Care Partnership in order to maintain and develop services.

2. This Contribution and Charging Framework explains how East Ayrshire Council considers

and calculates the contribution to care that people who use services will be expected to pay

towards the services they receive from the Health and Social Care Partnership. Contributions

and Charges apply whether the service is provided directly from East Ayrshire H&SCP, by an

external provider procured by the Council to provide services on the Council’s behalf or where

a person receives an individual budget under the Self Directed Support Legislation. (see

Appendix 1)

3. East Ayrshire Council contributions and charges are set in line with statutory requirements

and National Guidance and are approved by elected members on an annual basis through

the budget setting process.

4. This Framework is based on:

Fairness and equality

Consistent decision making

Transparency of cost of contributions and charges

COSLA National Guidance and Statutory requirements

5. This Framework is also based on the following list of principles:

People who use services will not pay a contribution or charge of more than it costs to

provide the services for which their contribution has been assessed.

Services will be provided in accordance with service users assessed needs and not

on their ability to pay.

All people who use services will be offered a benefits check to provide them with

information, advice and support to maximise their income.

People claiming their full benefit entitlement.

Service users who do not wish to claim benefits to which they have an entitlement, will

be financially assessed as if they were in receipt of these benefits.

6. It is the expectation of East Ayrshire Council that people who are in receipt of benefits for

specific purposes i.e. mobility allowance, attendance allowance, DLA Care Component/PIP

will utilise these benefits to mitigate the impact of disability including to support access to

services and/ or purchase care services.

7. This Contribution and Charging Framework aims to:

Provide a consistent framework for contributions and charging

Recover appropriate contributions towards the cost of service provision

Maximise service user income

Maintain essential services

Support a high quality of care within available resources

Monitor the impact of service contributions and charges on people who use services

SECTION 2: CHARGING FOR NON-RESIDENTIAL SOCIAL CARE SERVICES

What are Non-Residential Social Care Services?

8. Non-residential Social Care services are services which support people with a range of needs

to remain living at home safely and with dignity. These services are provided following an

assessment of need and are intended to assist people to meet their identified outcomes.

9. The legal basis for charging for non-residential social care services is the Social Work

(Scotland) Act 1968, (as amended) and the Community Care and Health (Scotland) Act 2002.

What Services cannot be charged for?

10. The following services are free and are NOT subject to a charge:

Criminal Justice Social Work Services

Information and advice

Needs assessment

Care management

Personal care for people aged 65 years and over

Intermediate Care and Enablement Service (I.C.E.S)

11. The following people cannot be charged for care services:

People with a mental illness who are subject to a Compulsory Treatment Order

under the Mental Health (Care and Treatment) (Scotland) Act 2003 or a

Compulsion Order under the Criminal Procedure (Scotland) Act 2003.

People aged 65 years and over leaving hospital who are assessed as requiring

Home Care and have been in NHS in-patient care for more than 24 hours for

treatment, assessment or rehabilitation or had surgery as an NHS day patient.

Home Care is free for a period of up to 42 days and this does not apply to people

who have been discharged following admission on a regular or frequent basis as

part of a person’s ongoing care arrangements or episodic treatment. Only new,

intermediate or additional services provided after the person comes out of hospital

will be free, services which were in place pre-admission and continue after

discharge will continue to be chargeable.

Where a person, aged 64 or under, has a progressive incurable disease and a

prognosis which indicates that she or he has less than six months to live. This

prognosis should be evidenced through the DS1500 form or a letter from the

patient’s General Practitioner or Hospital Consultant.

What Services do East Ayrshire Council Charge for?

12. East Ayrshire Council Social Work charge or a contribution is made for the following non-

residential social care services:

Care at Home (Home Care, including Housing Support) for those not transferred

to a Self Directed Support Personal Budget

Day opportunities (Day Care)

Smart Supports (Community Alarm and Telecare Equipment)

Blue Badge administration

Self Directed Support Personal Budget

13. East Ayrshire Council Social Work does NOT charge for the following services:

Sensory impairment services

Transport to access services

Children’s Services

Equipment and Adaptations

14. Whilst there is no charge for equipment, East Ayrshire Council will not provide small items of

equipment which are readily available for general purchase and expects these items to be

purchased privately by the service users. Some examples of small items of equipment are:

tap turners, pick up sticks, kettle, tippers and bottle/ jar openers.

How are Charges and Contributions for Non-Residential Social Care Services Calculated?

15. East Ayrshire Council operates 2 charging formats – a flat rate charge and a contribution

based on a financial assessment.

16. The following services are subject to a flat rate charge:

Smart Supports (Community Alarm and Telecare Equipment)

Building based Day Care

Blue Badge administration

17. Contribution to the services below are determined on an individual basis by completion of a

financial assessment. A member of the Health & Social Care Partnership staff will assist

service users in the completion of financial assessments which require to be undertaken prior

to the commencement of services and thereafter on an annual basis in conjunction with the

review of the support plan

Care at Home – the annual cost to provide the service will be the basis of the

calculation

Self Directed Support Annual Personal Budget

18. In addition to the above, East Ayrshire Council pays a subsidy per meal to the Meals at Home

service in respect of service users who access this service following assessment.

19. The services a person receives will always be based on assessed needs and the contribution

will be based on ability to pay.

Financial Assessments

20. The Convention of Scottish Local Authorities (CoSLA) provides annual advice on the level of

weekly income below which a person cannot be asked to pay charges. These are known as

Minimum Income Thresholds and are updated each financial year in line with the Department

for Work and Pensions (DWP) benefit up-rates. For contribution purposes the weekly

thresholds are converted to annual thresholds.

21. If the assessable annual income is less than the annual income threshold figure, there will be

no contribution for services other than the flat rate charges.

22. If the assessable annual income is more than the annual income threshold figure, the income

based contribution will be a % (agreed annually) of the difference between the threshold

income figure and a person’s assessed income. Please refer to Appendix 2 which provides

an illustration of assessable income.

23. East Ayrshire Council will not charge more than 80% of the personal budget or the cost to

deliver the service. The contribution will be the lowest between the percentage of the

disposable income, 80% of the budget or the maximum yearly charge.

24. East Ayrshire Council sets a maximum charge, above which service users cannot be charged,

irrespective of the income based charge or the indicative cost of the service/s provided.

Income Disregarded in the Financial Assessment

25. The following income sources are disregarded when calculating charges:

The Mobility Component of Disability Living Allowance (replaced for new claimants

by Personal Independence Payment (PIP) from June 2013)

War Disablement Pension and compensation payments made through the Armed

Forces Compensation Scheme should be disregarded from the financial

assessment for non-residential social care services.

War Widows Supplementary Pension

Income derived from benefits paid for or on behalf of children

Up to £25.00 of any earned income

26. If a service user has the higher rate of Attendance Allowance, DLA (Disability Living

Allowance)(Care Component) or the enhanced rate of PIP, this higher rate is only taken into

account in the financial assessment, if services are provided during the night as well as during

the day.

27. Where services are not provided during the night, only the lower rate of Attendance

Allowance, the middle rate of DLA (Care Component) or the standard rate of PIP will be

treated as assessable income.

Treatment of Capital

28. Capital such as savings, bonds, stocks and shares, ISAs etc. will be taken into account in

determining charges for non-residential social care services.

29. Capital and/ or savings up to a set disregard threshold will be disregarded (this amount is

reviewed annually) as will be any property owned and lived in by the service user.

30. For service users with capital in excess of the DWP disregard threshold, a tariff income is

applied. For people over pension age, this is currently £1 for each band of £500 over the

disregard threshold and for people under pension age, the tariff is £1.00 for each band of

£250 over the disregard threshold. These amounts are added to the assessed income.

Temporary or Emergency Admission to Hospital or Care Home/Absence from their Home

31. If a service user is absent from home on a temporary basis, there will be no charge for building

based Day Care during the absence period. The flat rate charge for Smart Supports will

continue to be payable during any temporary absence from the home. In respect of personal

budgets and home care the contributions will continue short term and following reconciliation,

credits if appropriate, will be applied to the service users contribution.

Non-Disclosure or Incorrect Information Provided in Respect of Financial Assessment

32. If a service user does not wish to divulge financial information for the financial assessment,

East Ayrshire Council will charge 80% of the personal budget or 80% of the cost to provide

the home care service, up to the maximum contribution..

33. If incorrect financial information has been provided by a service user or representative, the

Council will seek to recover any amount due by the service user or reimburse any amount

overpaid. A new financial assessment will be undertaken and the correct contribution applied.

Waiver of Charges and Write off of Debt

34. East Ayrshire Council expects people who use services, assessed as being able to pay for

essential support services, to contribute towards the costs of these services. The Council will

pursue all contributions not paid by people assessed as being able to pay, through the

Corporate Council Debt Recovery process. However the Council acknowledges that there

are some exceptional circumstances which may result in financial hardship.

35. Waiving of contributions means that before a service commences, a decision by the Director

H&SCP/Head of Service is made not to apply a contribution for the service. Contributions

cannot be waived retrospectively. Director H&SCP/Head of Service can use discretion to

waive contributions in the following circumstances:

For abnormal expenditure caused by serious or long term illness or disability.

Where there are exceptional domestic circumstances, or

Where there is an exceptional need not recognised in the normal financial

assessment procedure.

36. All or part of the contribution can be waived for up to 6 months.

37. In respect of write off, only the Depute Chief Executive, Economy and Skills can recommend

debt for write off. All normal debt recovery procedures will be followed before considering

write off. Write-off of debt for non-residential social care services can only be considered on

the following grounds:

Social grounds – to pursue the debt would be at the detriment of the service user’s

wellbeing.

Financial reasons – the service user has died and has left no estate or has

absconded.

SECTION 3: CHARGING FOR RESIDENTIAL SERVICES FOR ADULTS

What are Residential Services?

38. Residential services for adults refer to 24 hour care and support provided in a care home

setting. The care home must be a registered service with the Care Inspectorate and meet the

assessed needs of service users on either a residential or nursing care basis or both.

39. Care provision can be on a permanent, temporary or respite basis and is usually planned in

advance. However on occasions, emergency admissions to care homes can occur.

40. The legal basis for charging residential services is the National Assistance Act 1948, as

amended by the National Assistance (Assessment of Resources) Amendment (Scotland)

Regulations 2010 and the National Assistance (Sons for Personal Requirements) (Scotland)

Regulations 2010.

41. East Ayrshire Council’s charging for residential services is based on this legislation and on

the Charging for Residential Accommodation Guide (CRAG). Residential care includes care

provided directly by the Council or by the voluntary and private sectors.

How are Charges for Residential Services Calculated? Permanent Residential Services

42. Charges for permanent or temporary residential services are based on a financial assessment

and are usually referred to as the “Service User Contribution”.

43. The financial assessment identifies the level of income, savings and capital assets belonging

to the person moving to a care home which allows the service user’s contribution towards the

cost of care to be calculated. Capital assets include any property owned by the service user,

either solely or jointly with others.

Treatment of Income

44. In general, all income received by the service user with the exception of Mobility Allowance/

PIP (Mobility), if in payment, requires to be paid towards the service user’s contribution to

their care costs.

45. If an Occupational Pension is in payment, the service user can give 50% of the amount paid

to a spouse/ partner. This must be declared on the financial assessment form.

46. The service user is also entitled to a Weekly Personal Allowance from Income and some

outgoings such as life insurance can be disregarded in the financial assessment.

Funding Thresholds

47. There is both an upper and lower funding threshold in respect of charges for residential

services. The upper threshold is the amount of assessable capital, defined by legislation, that

a service user has, above which they are required to meet the full cost of their care (Self-

Funding service users).

48. For service users aged 65 years and over who have capital in excess of the upper funding

threshold, there is an entitlement to a Free Personal Care payment if residing in a residential

unit and a Free Personal and Nursing Care payment if residing in a nursing home.

49. Self-Funding service users under 65 years are also eligible for the Free Nursing Care

Entitlement.

50. The Free Personal and/or Nursing Care entitlement is a fixed weekly amount, paid direct to

the care home by the Council, the amounts payable being set nationally.

51. The lower threshold is the amount of assessable capital, defined by legislation, that a service

user has, below which they are not required to contribute towards the cost of their care from

their capital.

52. Service users whose capital falls between the upper and lower threshold levels will have a

tariff income applied. This is currently £1 for each band of £250 above the lower threshold

level.

53. The threshold levels are reviewed nationally on an annual basis.

Treatment of Property

54. The treatment of property requires to be based on the individual circumstances surrounding

the property and its ownership. East Ayrshire Council, in line with national guidance will

disregard the value of a service user’s property where;

The service user’s partner is continuing to reside in the property.

A relative of the service user who is over 60 years is continuing to reside in the

property.

A relative aged under 16 years and is liable to be maintained by the service user

is continuing to reside in the property.

A relative who resides in the property is incapacitated.

In certain circumstances discretion may be applied if a carer has given up their

own home in order to care for the resident.

55. Other discretionary disregards in respect of property may also apply.

56. For service user’s who do not have savings in excess of the upper funding threshold, but who

do own a property, the value of which is to be taken into account in the financial assessment,

the value of the property is disregarded for the first 12 weeks following admission to a care

home.

57. This is called a 12 Week Property Disregard and allows service user’s this time period to

decide if they wish to remain in a care home setting, and to allow them to make arrangements

for the sale of the property, if appropriate.

58. After the 12 week disregard period, the value of the property will be taken into account in the

financial assessment. If the service user or legal representative makes the decision to sell

the property and the property is not sold within the 12 week period, the Council can assist

with interim funding, either by placing a Charging Order on the property or arranging a

Deferred Payment.

59. More detailed information regarding the use of Charging Orders or Deferred Payments can

be provided by the worker assisting with the completion of the financial assessment.

Deprivation of Capital

60. Where East Ayrshire Council is of the opinion that a service user or representative has

deprived the service user of a capital asset in order to avoid liability for care home costs, the

service user will be treated as still possessing the asset and the value of this asset will be

included in the financial assessment.

Hospital Admissions/Planned Absences

61. Where a non Self-Funding service user is admitted to hospital or has a planned absence for

any other reason, East Ayrshire Council, in line with national guidance, will continue to pay

the Council’s normal contribution to the care home for a maximum of 6 weeks. After 6 weeks,

the Council reduces this payment to 80% of the Council’s contribution. The service user

requires to continue to pay the service user contribution during any absence, unless the

placement is terminated.

62. Where a Self-Funding service user is admitted to hospital or has a planned absence for any

other reason, East Ayrshire Council, in line with national guidance, will continue to pay the

Free Personal and/or Nursing Care entitlement for 14 days. This payment will then cease and

be reinstated on the date of the service user’s return to the care home. The service user

requires to continue to pay the service user contribution during any absence, unless the

placement is terminated.

Annual Financial Re-Assessments

63. All service users residing in care homes on a permanent basis are subject to an annual

financial re-assessment in line with DWP up-rating of benefits and the annual review of

national guidance.

64. Self funding service users or their representative must advise the Council at least 2 months

in advance of capital falling below the self funding threshold. This is in order for a new financial

assessment to be completed in respect of additional funding being required from the Council.

Failure to comply with this timescale for notification may result in additional cost to the service

user.

Respite Care

65. The charge for adult respite provision within a care home setting is a standard charge based

on the minimum income guarantee minus a weekly personal allowance. This is also the

interim charge for adult service users who require an emergency admission to a care home,

until such times as a financial assessment is completed to determine the actual service user

contribution. The financially assessed service user contribution is backdated to the date of

admission.

66. The charge for respite provision for young people within residential units is based upon the

level of Disability Living Allowance (DLA)/PIP Care Component which the service user is in

receipt of.

SECTION 4: CHARGES TO OTHER LOCAL AUTHORITIES

67. East Ayrshire Council set annual charges in respect of providing services on behalf of other

Local Authorities. These charges are designed to achieve full cost recovery for the service.

PUBLIC INFORMATION

68. East Ayrshire Council’s Social Care Charging Framework is available on the Council’s

Website. A charging information leaflet is also available in Social Work offices and on the

Website.

APPENDICES

Appendix 1 - Self Directed Support charging illustration (CoSLA)

Appendix 2 – Maximum charge illustration (CoSLA)

APPENDIX 1

FROM COSLA GUIDANCE – SELF DIRECTED SUPPORT

Individual with potential support needs becomes

known

Initial Financial

Assessment Outcomes-based Assessment of Needs

Eligibility for support established

Calculation of personal budget

through RAS

No

Yes

Information and

Advice

Required to

Contribute?

Calculate likely personal contribution

to personal budget

No

Total transparent picture of

resources

Yes

Support

Planning

Final Financial elements agreed and support package signed off

Retrospective attribution of service hours for Free

Personal Care

APPENDIX 2