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 2019 Lead Officer: Eddie Fraser

Page 2 of 13

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

Page 3 of 13

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.

Page 4 of 13

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?

Page 5 of 13

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

Page 6 of 13

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

Page 7 of 13

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.

Page 8 of 13

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

Page 9 of 13

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.

Page 10 of 13

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.

Page 11 of 13

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)

Page 12 of 13

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

Page 13 of 13

APPENDIX 2