Charging and financial assessment Care Act 2014 Outline of content Introduction Conducting the financial assessment What charges can be made? Choice of accommodation and top-up fees Charging to support carers Recovery of debts Summary 2 Introduction Local authorities may charge a person needing care or a carer, but certain types of care and support must be arranged free of charge If a local authority has chosen to charge a person for a service it is arranging it must undertake a financial assessment of one level or another The detail of how to charge is different depending on whether someone is receiving care in a care home, their own home, or another setting The rules for charging are split into those for: A care home; and All other settings Local authorities should develop and maintain a policy on charging in settings other than care homes 3 Charging and financial assessment principles from the statutory guidance 1. Ensure that people are not charged more than it is reasonably practicable for them to pay 2. Reduce variation in the way people are assessed and charged 3. Be clear and transparent 4. Promote wellbeing, social inclusion, and support the vision of personalisation, independence, choice and control 5. Support carers 6. Be person-focused 7. Apply the charging rules consistently 8. Encourage and enable those who wish to stay in or take up employment, education or training 9. Be sustainable for local authorities in the long-term 4 Where Care Act charges must not be made Intermediate care including reablement (for up to six weeks) Aids, and minor adaptations of less than £1,000 Care and support provided to people with CJD After care/support provided under Mental Health Act 1983 s117 NHS services Any services which an authority is under a duty to provide through other legislation 5 Financial assessment In a financial assessment, both capital and income must be assessed, which will be either disregarded, partially disregarded or included Some capital and income must be disregarded and local authorities have discretion to disregard assets in some other circumstances The value of a person’s main or only home must be disregarded where they are receiving care in a setting that is not a care home or where a qualifying relative occupies the property as their main or only home To help encourage people to remain in or take up employment earnings from current employment must be disregarded Notional capital and income can be taken into account 6 ‘Light-touch’ financial assessments A local authority may choose a ‘light touch financial assessment’ for instance where: a) The person has significant financial resources, and does not wish to undergo a full financial assessment for personal reasons b) There is a small or nominal charge for a particular service, and carrying out a financial assessment would be disproportionate c) An individual is in receipt of certain benefits e.g. Jobseekers Allowance The authority must be sure the person is able to pay any charges due A person must be informed that they have the right to request a full financial assessment should they so wish, and so, in effect, agree to a light touch assessment 7 Information and advice Accessible information and advice, including: Independent financial information and advice Operation of top-ups Deferred payment agreements (DPA) Complaints The person must be given a written record of the financial assessment which includes: Explanation of how it has been carried out What the charge will be How often it will be made The reason for any fluctuation in charges 8 If the person lacks capacity At the time of the assessment of care and support needs, the local authority must establish whether the person has capacity If the person lacks capacity, the local authority must find out if the person has someone with legal powers to act on their behalf, as the appropriate person will need to be involved If there is no such person, then an approach to the Court of Protection is required 9 Capital limits A person with more in capital than the upper capital limit is responsible for arranging and funding their own care and support Upper capital limit Lower capital limit Below the upper capital limit, a person is entitled to access means-tested local authority support Where a person’s resources are below the lower capital limit they will not need to contribute to the cost of their care and support from their capital 10 Deprivation of assets Deprivation of assets refers to where a person has intentionally deprived themselves of or decreased their overall assets in order to reduce the amount they are charged towards their care If a person deliberately tries to avoid care and support costs through deprivation of assets, the local authority may charge the person as if they still possessed the asset Deliberate deprivation may occur when someone knows they have a care and support need and that they would be charged and reduces their assets in order to avoid those charges 11 What charges can be made? The rules for charging are split into those for a care home and all other settings Charges should be reasonable and not leave people with less than a specified amount of income Where a person has capital between the upper and lower limit, they may be charged a ‘tariff income’ of £1 per week for every £250 in capital between the two amounts A local authority must not charge more than the cost that it incurs in meeting the assessed needs of the person A local authority cannot charge an administration fee for arranging care and support 12 Choice of accommodation and top-up fees The local authority must provide for the person’s preferred choice of accommodation, subject to certain conditions This choice applies between providers of the same type The local authority must offer at least one option that is affordable within a person’s personal budget, and should offer more than one A person can choose a more expensive setting, through a ‘top-up’ from a third party (or the resident in some circumstances) The local authority must ensure that the person paying the ‘top-up’ is willing and able to meet the additional cost, and enters into a written agreement with the local authority, agreeing to meet that cost 13 Charging to support carers Carers play a vital role in the care and support system Local authorities are not required to charge a carer for support, but they may do so If the local authority chooses to charge for it, replacement care should be charged to the adult needing care and not the carer seeking a respite break Local authorities should ensure that any charges do not negatively impact on a carer’s ability to look after their own health and wellbeing and to care effectively and safely Charging of carers must be in accordance with the non-residential charging rules A local authority should carry out a financial assessment to ensure that charges are affordable, but it is likely that a light-touch financial assessment will be appropriate 14 Recovery of debts The existing powers under S22 of HASSASSA 1983 will no longer apply from 1 April 2015 From then on local authorities must use the provisions under S69 of the Care Act: Must offer a DPA whenever possible Ultimately an authority has powers to recover money through the county court Principles of the approach to debt recovery: Court action should be the last resort The local authority should act reasonably Affordable repayments Debts and repayments discussed with the person 15 Summary The local authority may charge people for care and support services, and for arranging them, but some services must be free of charge The local authority must carry out a financial assessment of both capital and income if it is going to charge for services A ‘light touch’ financial assessment may be appropriate There should be choice of accommodation for individuals whose needs are best met outside their own home Top-up fees can be charged if a person chooses a more expensive residential care option Debts may continue to be recovered under the new legal framework, but from 1 April 2015 HASSASSA 1983 will no longer apply 16