Paying for a permanent care home placement in Wales

Transcription

1 Factsheet 10w April 2015 Paying for a permanent care home placement in Wales About this factsheet This factsheet provides information on the financial help that may be available from the local authority for older people needing care in a care home in Wales. It should be read in conjunction with Age Cymru s other factsheets on care home funding, social care service provision and NHS continuing healthcare, including: 38w Treatment of property in the means test for permanent care home provision in Wales 39w Paying for care in a care home in Wales if you have a partner 29w Finding care home accommodation in Wales 60w Care homes in Wales: choice of accommodation when the local authority is assisting with funding 40w Deprivation of assets in the means test for care home provision in Wales 20w NHS continuing healthcare and NHS-funded nursing care in Wales 41w Local authority assessment for community care services in Wales This factsheet describes the situation in Wales. There are differences in the rules for funding care in a care home in England, Northern Ireland and Scotland. Contact Age UK, Age NI and Age Scotland respectively for further information see section 25 for details. This section also has details of how to order other factsheets or information materials. Factsheet 10w April of 62

2 Inside this factsheet 1 New developments 4 2 Introduction Definitions and terminology 8 3 How to obtain help from your local authority Assessment and eligibility will you qualify for help from the local authority? People who have to fully self fund care is any sort of assistance still available? 10 4 The financial means test for receiving help with care home fees overview 11 5 Your savings and capital in relation to the financial means test The capital limit Capital held in the value of your home Disregarded capital Jointly held capital Notional capital Valuation of capital 17 6 Your income in relation to the financial means test Disregarded income Income that is partly disregarded Notional income 20 7 Business assets and the financial means test 20 8 Deprivation of assets and the financial means test for care home charging 21 9 Social security and disability benefits in the context of paying for care in a care home Pension Credit Disability-related benefits Choice of care home accommodation and top-ups /third party contributions The Personal Expenses Allowance for care home residents The means test calculation your assessed contribution towards your care Paying for extras in care homes 40 Factsheet 10w April of 62

3 14 Arrangements for paying the care home fee NHS and other social care services in care homes Non means-tested help with care home costs Fully funded NHS continuing healthcare Care provided by registered nurses in nursing homes Rehabilitation intermediate care and re-ablement Mental health after-care services Continence services Specialist assessment and bespoke equipment Assistance for war veterans Deciding to appoint someone to deal with your financial affairs and/or welfare decisions Acting on behalf of an older person who lives in a care home As an attorney appointed via a Lasting Power of Attorney As a deputy appointed by the Court of Protection Appointeeships for benefits Advocacy Mental capacity issues and care home residents protection of rights Arranging and paying for your care yourself Care home contracts Complaints about care When the local authority arranges or provides the care Self-funders When the health authority makes the arrangement Equality, human rights and safeguarding Safeguarding older people Useful organisations Further information about Age Cymru Contact details 61 Factsheet 10w April of 62

4 1 New developments This section contains some recent, or forthcoming, developments relevant to the subject matter covered in this factsheet. For the main body of information which this factsheet covers, see section 2 onwards. In April 2015 the weekly NHS funded nursing care contribution increased to see section 16.2 for further details. New legislation for Wales, the Social Services and Well-being (Wales) Act 2014, received Royal Assent (became law) in May The bulk of the provisions in the Act will not be implemented until April 2016, however. The Act brings together in one place many provisions that were previously covered in a number of pieces of legislation. In some cases that means there will be little change to current practices. In other areas, however, new duties will be placed upon local authorities. According to the Welsh Government the Act will transform the way social services are delivered, promoting people s independence to give them [a] stronger voice and control [and] provide greater consistency and clarity to...people who use social services; their carers [and] local authority staff. The Act will also encourage a renewed focus on prevention and early intervention 1. At the time of writing (April 2015) the guidance and regulations that will underpin the Act are in the process of being developed. Detailed information on the Act can be found on National Assembly for Wales website at: Note: Reference to various legislation will be made in this factsheet, where relevant for example, the legislation which underpins people s rights to an assessment of their care needs by a local authority, or that underpins how eligibility for help with care home fees is determined. As the Social Services and Well-being (Wales) Act guidance and regulations are still being drawn up and thus the majority of provisions not due to be implemented until April 2016, the factsheet will make reference to older, existing, community care legislation which will remain in force in Wales until April 2016 (in England, the situation may well be different where the Care Act 2014 has already superseded a raft of older legislation). 1 Social Services and Well-being (Wales) Act, Welsh Government website (page last updated 3 February 2015) (last accessed 2 April 2015) Factsheet 10w April of 62

5 A significant change, brought about by the Social Services and Well-being (Wales) Act 2014 and already implemented concerns the right of people who fully self fund their social care services to escalate a complaint about those services to the Public Services Ombudsman for Wales. This change came into force from 1 November Prior to this the Ombudsman had only been able to investigate complaints relating to care provided or commissioned by a local authority social services department and/or a Local Health Board (the change brings Wales into line with England, where self funders have been able to access an equivalent Ombudsman service for a number of years). The Care Act 2014 came into force on 1 April The majority of this act affects England only some of the exceptions are measures regarding cross border placements (where someone s care needs might be best met in a different part of the UK); duties on local authorities to meet care and support needs where registered providers of care services suffer business failure and regulations governing disputes between local authorities in relation to cross-border placements or business failure. In general, reforms and changes to the social care system in Wales are being enacted through the Social Services and Well-being (Wales) Act 2014 (see above), rather than the Care Act. Some measures in the Care Act which have received particular publicity are changes coming into force in England from April These relate to the introduction of new rules on paying for care based on the Dilnot care funding recommendations made in These include: a lifetime care cost cap ( 72,000) above which the State meets the cost of eligible social care needs (excluding a new daily living cost charge of 230 per week); a significantly increased capital limit for the financial means test for residential care charging ( 118,000); and the introduction of care accounts which will track personal expenditure towards meeting eligible care needs (i.e. in relation to the lifetime care cost cap). However, as social care is a devolved issue, it is up to the Welsh Government to decide whether they will introduce any equivalent or comparable measures in Wales. At the time of writing (April 2015), the Welsh Government have not announced what their exact intentions are. 2 These are recommendations for adult social care funding reform put forward by an independent Commission on the future funding of care and support in England, chaired by the economist, Andrew Dilnot. The recommendations were published in July Factsheet 10w April of 62

6 A further legislative development in Wales concerns the Regulation and Inspection of Social Care (Wales) Bill. This was introduced into the National Assembly for Wales in February If passed, the Bill will provide a reformed and simplified regulatory regime for care and support services in Wales. Regulation will move beyond compliance with minimum standards, and focus more on the quality of services and the impact which they have on people receiving them and there will be greater rules of accountability 3. In October 2013, the Older People s Commissioner for Wales launched a review into care homes in Wales, examining the quality of life and care provided to older people. The Review was carried out using the Commissioner s legal powers to [examine] the way in which the interests of older people are safeguarded and promoted when public bodies discharge their functions 4. A final report as a result of the review was published in November 2014 A Place to Call Home? A Review into the Quality of Life and Care of Older People living in Care Homes in Wales. The report is split into four key topic areas: Day-to-Day Life (including social participation; personal hygiene and cleanliness and comfort); Health and Wellbeing (including prevention of health conditions; control of existing ones and access to GPs); People and Leadership (including staff capacity, training and care home managers); and Commissioning, Regulation and Inspection (including analysis of the existing National Minimum Standards for care homes in Wales and issues for self-funders). At the end of the report the Commissioner outlined seven Key conclusions. Within each of these are a number of Requirements for Action and the organisations who should carry these out (for example, the Welsh Government, Local Health Boards, local authorities or Care and Social Services Inspectorate Wales). The relevant organisations were required to provide an account of how they had complied (or were proposing to comply) with the Commissioner s Requirements for Action by February The Regulation and Inspection of Social Care (Wales) Bill, Welsh Government website (page last updated 23 February 2015) (last accessed 8 April 2015) 4 Special Bulletin: Residential Care Review (Issue 1), Older People s Commissioner for Wales, October 2013 Factsheet 10w April of 62

7 At the time of writing (April 2015), the Commissioner s website contained the following update: All of the statutory bodies subject to the Review and the Commissioner s Requirements for Action have provided a response; these responses are currently being analysed and assessed by the Commissioner, and a register of responses will soon be published on the Commissioner s website. Should any response be deemed unsatisfactory, a formal written notice will be issued, requiring an improved response within one month 5. Note: A copy of the report can be accessed via the following web link, or contact the Older People s Commissioner for Wales by using the details in section 24 of this factsheet: 2 Introduction Most people needing residential care will be expected to pay something towards the costs of their accommodation and personal care from their income and/or capital. This will be via a means test if the local authority is involved with arranging the placement. The means test is based on nationally set guidelines. Some people are expected to pay all of the costs themselves, if they have savings or capital assets over a certain amount. The means testing procedures and other relevant information related to paying for residential care are explained in the sections which follow. Note: There are, however, some exceptions to the means test requirement in certain situations, or for particular elements of residential care. For instance, one example you may have heard of is NHS continuing healthcare. This, and other possible exceptions, are outlined towards the end of the factsheet in section Next Steps, Older People s Commissioner for Wales website - (last accessed 9 April 2015) Factsheet 10w April of 62

8 2.1 Definitions and terminology Local authority social services departments In this factsheet references to the local authority or council will refer to the adult social services department of the local authority. The relevant social services department may be referred to as the following, or similar variations: social care department adult social services older persons department older persons team We will use the term local authority in this factsheet to describe this type of service. However, generally, the term local authority can also describe Wales 22 unitary authorities (i.e. county and county borough councils) which deliver a wide range of other services locally (for example, environmental health or housing). If you have internet access, a list of all the local authorities in Wales, together with links to their individual contact details, can be found on the Welsh Government s website at: Contact details for your local authority should also be available in your local telephone directory; from your town hall, local council offices; or a local Age Cymru or Citizens Advice Bureau should also be able to provide them. Care homes The term care home is used to mean any home that is registered with the Care and Social Services Inspectorate Wales (CSSIW) to provide accommodation together with personal care and, in some cases, also nursing care (sometimes the terms residential care home and nursing care home might be used to differentiate between the two types of care home). This includes local authority homes and independent homes, which are run by private or voluntary sector providers. These are all inspected and monitored by the CSSIW, using national minimum standards for care homes (these are available on their website) see section 24 for their contact details. Factsheet 10w April of 62

9 3 How to obtain help from your local authority 3.1 Assessment and eligibility will you qualify for help from the local authority? Whether your stay in a home is temporary or permanent, your local authority must carry out an assessment of your needs to establish that you require this type of social care provision before it can assist you with the cost of the placement. Note: If you have already been assessed as needing a place in a care home, you may wish to move on to sections 4 and 5 which explain how your contribution towards the cost of care will be calculated. Under section 47 of the NHS and Community Care Act 1990 the local authority social services department has a duty to carry out an assessment of your care needs if it appears that you may require community care services that the authority may provide or arrange (either directly, or by entering into a contract with another provider). This duty to carry out a care needs assessment exists, regardless of someone s financial situation. Your needs assessment will usually be carried out by a social worker also often called a care manager and should result in an agreed care and support plan. You should be given a written copy of this document. Each local authority sets its eligibility criteria for services, based on national guidelines issued by the Welsh Government. 6 If you are assessed and found to have eligible needs within the criteria then the local authority has a legal duty to meet these needs. This could include a recommendation for a permanent care home placement, though this decision is usually made after all other options to assist you to remain in your own home have been explored. If you are assessed as needing to live in a care home that provides nursing care an NHS nurse may be involved in assessing and confirming your eligibility. 6 Integrated Assessment, Planning and Review Arrangements for Older People: Guidance for Professionals in supporting the Health, Care and Well-being of Older People, Welsh Government, December 2013 (or for people aged under 65, Health and Social Care for Adults: Creating a Unified and Fair System for Assessing and Managing Care Guidance for Local Authorities and Health Services, Welsh Government, April 2002). Factsheet 10w April of 62

10 In situations where the local authority is going to make the arrangements for your care home place, there should be no undue delay in them doing so. If there is a delay, the local authority should ensure that there are suitable arrangements in place while you wait. Note: If you have savings or assets which are worth less than 24,000, you should be able to get help towards your care home fees from your local authority (you may therefore wish to move on to section 4). If you have savings or assets worth 24,000 or more you will expected to meet the full cost of your residential care i.e. you will be a selffunder (see section 3.2 below). 3.2 People who have to fully self fund care is any sort of assistance still available? As mentioned above, it is important to be aware that regardless of your financial circumstances you still have a right to an assessment of your care needs by the local authority. Generally, if you are in a position to self fund, you will be expected to make your own arrangements in terms of finding a care home to move into; however, following your care assessment, you should still be advised by the local authority of the type of services that will meet these needs. This will allow you to be in a more informed position when it comes to finding a care home which will be suitable for you. Note: It may well still be useful for you to read other sections in this factsheet if you believe that you are going to be a self-funder. For example, you may wish to check sections 5 and 6 which deal with what counts as capital and income for the purposes of the financial means test (some things are fully or temporarily disregarded), to make sure that you will definitely be over the capital limit. Additionally, section 20 has information on arranging and paying for care yourself (including what will happen if your capital is likely to reduce to 24,000) and section 22 has information on what to do if you need to make a complaint. Age Cymru s Factsheet 38w Treatment of property in the means test for permanent care home provision in Wales and Factsheet 29w Finding care home accommodation in Wales may also be useful. Factsheet 10w April of 62

11 What if you are not able to make your own arrangements? Sometimes due to health reasons, such as lacking mental capacity a person who can self fund may not be in a position to make their own arrangements to find a care home place. Therefore, even though you may have over 24,000, a local authority must satisfy itself that you are able to make your own arrangements, or that you have others who are willing and able to do so on your behalf. If the care you have been assessed as needing is not otherwise available (you are unable to make the arrangements yourself and there is no family member, friend or other contact who is willing and able to assist), the local authority has a legal duty to make suitable arrangements 7. An advantage of this is that the care should be arranged at the local authority s usual cost (the cost it would usually expect to pay for that type of accommodation), which may be lower than the cost for individuals who arrange their own care 8. If the local authority is going to make the arrangements because you are unable to do so yourself, there should be no undue delay. If there is a delay, the local authority should ensure that there are suitable interim arrangements in place. 4 The financial means test for receiving help with care home fees overview The charging procedure sometimes called the means test or financial assessment is the system of calculating how much you should contribute towards the costs of your placement in a care home, when that placement is being arranged by your local authority. 7 National Assistance Act 1948, Part 3, section The authoritative Community Care and the Law (5th edition) by Clements, L and Thompson, P, published by Legal Action Group, makes reference to this issue. It states that the emphasis on any representative being willing and able [to assist] is important. It enables, for example, such a person to decline to contract with a care home directly and so benefit from the local authority s superior negotiating position in relation to care fees (which in some cases are considerably lower than the home would charge for the same services for a person making their own arrangements). In such a situation, since the care and attention is not otherwise available the duty reverts to the local authority to provide or to secure the provision of the accommodation. Factsheet 10w April of 62

12 Both your income and capital are taken into account in the means test (though there may be some exceptions with particular types of income or capital, or in certain situations see sections 5 and 6 below). Point of law: National rules governing financial eligibility for assistance with care home costs are contained in the National Assistance Act (Assessment of resources) Regulations These explain how local authorities should assess an individual s ability to pay for residential accommodation arranged under Part 3 of the National Assistance Act To supplement this legislation, the Welsh Government has produced statutory guidance for local authorities, presenting the rules in a more accessible format. This guidance is known as the Charging for residential accommodation guide (CRAG) and is amended each April (this year s edition will be dated 2015/2016). A copy should be available from the Welsh Government website: This factsheet is largely based on CRAG. You do not have to make any contribution towards care home fees from your capital below 24,000. However, you will still be expected to contribute from your day to day income for example, your State Pension, or occupational/private pension (though not any earnings from employment). All care home residents who are receiving help towards their care home fees from the local authority are entitled to a Personal Expenses Allowance (PEA). This is the amount of money that residents are entitled to keep after their contribution to the costs of their care have been paid see section 11 for further information on the PEA. Financial resources of couples Local authorities cannot generally assess the joint resources of couples they can only look at your own income and capital. This will include income and savings that are in your sole name and any jointly held savings, which will be divided equally (other than property where it is the resident s actual share or beneficial interest that is taken into account) see section 5.4 below for further information. Factsheet 10w April of 62

13 Nursing homes If you move into a nursing home (as opposed to a residential care home), the NHS is responsible for meeting the cost of care provided by a registered nurse on site. This is made via a weekly NHS funded nursing contribution further information on this can be found in section 16.2 below. Therefore, in these cases, it will be the rest of the care home fee minus the amount that is covered by the weekly NHS funded nursing care contribution which you will be means tested on. You may need to ask for clarification regarding the NHS funded nursing care contribution if it isn t clearly separated from the main fee in the information provided to you about the fee and how it has been worked out. Temporary care home provision Temporary care home residents are treated differently in regard to certain aspects of the financial means test see Age Cymru s Factsheet 58w Paying for a temporary stay in a care home in Wales for further information. 5 Your savings and capital in relation to the financial means test Most forms of capital and savings will be included in the means test, including bank or building society accounts, National Savings accounts, Premium Bonds, stocks and shares, and property (buildings or land). Note: In regard to property, the value of the home that you own and have been living in (up until the need arose to go into a care home) may be taken into account in the means test. Whether or not it will be, can depend on who if anyone will remain living there once you have moved into a care home. Deferred payment agreements may be available for residents who do not wish to sell their former home immediately, or who are unable to sell it quickly enough to pay for their care. Under such agreements, the local authority agrees to provide funding as a loan, to be repaid when the property is sold at a later date. See Age Cymru s Factsheet 38w Treatment of property in the means test for permanent care home provision in Wales for further information about these issues. Factsheet 10w April of 62

14 5.1 The capital limit In Wales the capital limit is 24,000. Capital and savings above 24,000 As previously mentioned in section 3, you will be expected to pay the full fee until your capital is reduced to this level. However, if your capital is held in the value of the property you were living in as your home and you have less than 24,000 in liquid capital, see section 5.2 below. Capital and savings below 24,000 Capital of this amount or less is fully disregarded in the local authority means test for care home provision. Also, no income can be assumed from capital below 24,000 in the local authority s calculation (however, the social security office will calculate tariff income on savings over 10,000 for Pension Credit purposes at a rate of 1 per week for every 500, or part of 500, that you have over 10,000). Note: The capital limit system differs in other parts of the UK. Also, from April 2016, there may be significant changes to the capital limit system in Wales. Further information can be found above in section 1, New Developments. Prior to April 2016, the capital limit stated above will remain in place. 5.2 Capital held in the value of your home Where you have capital above 24,000 and are expected to pay the full care home fee, this may be a problem if your capital is held in the value of the property you were living in as your home, prior to needing to go into a care home. Therefore, if you have less than 24,000 in readily available capital, you will be able following a 12 week property disregard to ask the local authority to consider entering into a deferred payment agreement with you. Factsheet 10w April of 62

15 In these circumstances the local authority will contract with the care home and pay the difference between your assessed contribution (see section 12) and the full cost until you are able to repay the shortfall. The local authority will usually place a charge on your property for the purpose of securing repayment when the property is eventually sold. Notes: The 12 week property disregard This is a disregard which the local authority must apply to the value of a care home resident s former home for the first 12 weeks of a permanent stay in a care home (where the care is provided by the local authority under section 21 of the National Assistance Act 1948). If the local authority knows that you own your own home it should tell you about this disregard. Deferred payment agreements If someone s property is taken into account in the means test and the local authority has determined that the person has insufficient income and capital, excluding their property, to meet their care home fees [a] deferred payments [agreement] may be offered 9. Under such an agreement, the local authority agrees to provide funding as a loan, to be repaid when the property is sold at a later date. This enables residents who do not wish to sell their former home immediately, or who are unable to sell it quickly enough to pay for their care, to get help with their fees. Further information on the 12 week property disregard and deferred payment agreements can be found in Age Cymru s Factsheet 38w Treatment of property in the means test for permanent care home provision in Wales. 5.3 Disregarded capital Some capital is disregarded or ignored. Capital that is disregarded indefinitely includes: in particular circumstances, the value of your home (see Factsheet 38w) personal possessions such as paintings or antiques (as long as they were not bought with the intention of avoiding the charge see section 8) 9 Charging for residential accommodation guide (CRAG), Welsh Government Factsheet 10w April of 62

16 the surrender value of life insurance policies or annuities the value of funds held in trust or administered by a court, which derive from a payment for personal injury (including compensation for vaccine damage and criminal injuries) the value of certain types of investment bond with a life assurance element. If you hold an investment bond but are unsure whether it has a life assurance element, ask the company that issued the bond or your financial adviser (Age Cymru and Age UK cannot advise on particular financial products) compensation paid to Far East Prisoners of War on or after 1 February 2001 payments made to those who caught hepatitis C as a result of contaminated NHS blood products. Note: The treatment of money held in trust depends on what rights you have to demand that the trust money be paid to you. The rules about trusts are complicated so seek advice from the trust provider if you have an interest in a trust. Trust ownership principles are also discussed in Age Cymru s Factsheet 38w, in section 6, on the valuation of jointly owned property. A number of other disregards are also listed in the Welsh Government s Charging for residential accommodation guide (CRAG). 5.4 Jointly held capital As indicated above in section 4, local authorities cannot generally assess the joint resources of couples, but they can look at your share of jointly held savings if you hold capital with your spouse, partner, or another person/multiple people. You and the other joint owners are generally treated as having equal interests in that capital at the time of the means test. For example, if you have a joint bank or building society account with your spouse, you will be assessed as having half of the balance of the account. Dividing accounts so that capital is held separately? In the above circumstances it is worth considering whether to divide any joint accounts so that each person holds their capital separately. Factsheet 10w April of 62

17 This is because where one account holder uses part of their share of the account to meet care fees, dividing the remainder equally will not accurately reflect the parties true interests in it. This is explained further in Age Cymru s Factsheet 39w Paying for care in a care home in Wales if you have a partner. Important: Be aware of the information in section 8 of this factsheet, Deprivation of assets, if you are considering transferring any of your resources or giving away any money to your spouse/partner or another person. Property There is an exception to the general rules on jointly held capital when it comes to jointly owned property. This is calculated on the basis of the resident s actual share or present sale value of their beneficial interest in the property see Age Cymru s Factsheet 38w Treatment of property in the means test for permanent care home provision in Wales for further information on this topic. 5.5 Notional capital This is capital that may be included in the means test even though you do not have it. For example, it could be capital that would be available to you on application, such as an unclaimed Premium Bond win, or capital that you have disposed of to avoid using it to pay for care see section Valuation of capital Capital will either have a market value that is, the amount a willing buyer would pay (e.g. for stocks and shares), or a surrender value (e.g. Premium Bonds). Any outstanding debt secured against the asset, such as a mortgage, is deducted from the value. If, in order to realise an asset, you would incur expenses through selling it, then 10% will be deducted from the capital value for the purposes of the means test. If your capital is valued at more than 24,000 then no precise valuation is needed because you are expected to pay the full fee yourself (the cost of your accommodation and care). Factsheet 10w April of 62

18 As mentioned previously in this section, if you require information about the valuation of capital held in the form of property, including your former home, see Age Cymru s companion factsheet to this one Factsheet 38w Treatment of property in the means test for permanent care home provision in Wales. 6 Your income in relation to the financial means test In the local authority means test, income will be either: disregarded (ignored); partly disregarded; or included in full. Generally, unless your income is specifically identified in CRAG as being fully or partly disregarded it will be taken into account in full. Your income will also be taken into account straight away (so this will include during an initial 12-week disregard period that is applied for property and during any subsequent deferred payment arrangements in regard to the property). If you are the person assessed as needing care in a home, then income in your name will be looked at for the purposes of the means test. The local authority will usually make its calculations on the basis that any income that is available from benefits such as Pension Credit (PC) is being claimed, so it is important to ensure that you have applied for any possible benefit see section 9 for further information. 6.1 Disregarded income The most common disregards include: Disability Living Allowance (DLA) mobility component or Personal Independence Payment (PIP) mobility component see section 9.2 for further information on these benefits. Earnings from employment (including self employment). War Widows special payments the special payment of introduced in April 1990 for pre-1973 War Widows (in addition to a 10 partial disregard for War Widows see section 6.2 below). Factsheet 10w April of 62

19 Christmas bonus (paid to people receiving certain benefits). Income from savings if you have interest paid on your savings, this is added to the balance of your savings and counts as part of your capital, not as income. Charitable and voluntary payments (which could be made by a relative) intended to pay for a specific item not covered by the home s fees for instance your own television set or telephone, or for a regular outing not covered by the contract with the local authority. Any payments of Child Tax Credit or Guardian s Allowance Any payment made because of any personal injury to a claimant or his or her partner, except where the payment is specifically intended to cover the costs of care, for up to 52 weeks from the day of receipt of the first payment (if the money is placed in a disregard location such as a personal injury trust or administered by a court the relevant disregards will apply). Also, awards of certain damages, not only where those awards are held by the court, but where they are held subject to the order of direction of the court. Discretionary payments that started being made in October 2011 to those who have been infected with hepatitis C by contaminated blood products. 6.2 Income that is partly disregarded Some kinds of income must be partly disregarded, such as: 10 per week of a War Widow s, War Widower s or War Disablement Pension. 50% of a private or occupational pension must be ignored by the local authority where the pension is received by a married person or a civil partner in a care home, provided this amount is actually paid to his or her spouse or civil partner to help with their living costs (the disregard will apply wherever the spouse or civil partner lives, except if they are in the same residential or nursing home as their partner who is passing them the pension) The disregard of 50% of a private/occupational pension in these circumstances applies to care home charging only. For example, the Department for Work & Pensions (DWP) will take the full amount of the private/occupational pension into account when calculating Pension Credit eligibility. Factsheet 10w April of 62

20 A small amount of income up to a maximum of 5.75 per week (or 8.60 per week for a couple) where the person has made additional retirement provision on top of their State Pension (i.e. occupational pension/s or similar savings). This particular disregard the savings disregard is related to the Pension Credit Savings Credit system. For an explanation of how this disregard works and who it will apply to, see section Notional income Similar to notional capital, this is income in the means test that you may be treated as having even though you don t actually receive it. For instance, it could be: income paid by someone else (perhaps a relative) to the local authority or to the home as a third party contribution ; income that would be available to you if you applied for it, such as unclaimed social security benefits or unclaimed occupational pension; or income that you have disposed of see section 8 below for further information on this particular issue. 7 Business assets and the financial means test As discussed above, the presumption in CRAG is that all of your eligible capital and income can be considered by the local authority for the residential care means test. However, CRAG also allows a 26 week or longer disregard of the assets of any business owned (or part-owned) by a new care home resident who has had to stop self-employed work due to illness or disablement. However, this is in the short-term where the intention is to take up work again in the future when the person is able. With regard to permanent residents, CRAG gives the local authority discretion to disregard the capital value of eligible business assets for a reasonable period of time, providing steps are being taken to realise the capital value. If no immediate intention to realise the capital value in the business assets is demonstrated, CRAG advises local authorities to take their value into account in the means test. Factsheet 10w April of 62

21 CRAG advises the local authority to obtain information about: The nature of the business asset. The resident s estimate of the length of time necessary to realise the asset. The resident s share of assets. A statement of what, if any, steps have been taken to realise the assets, what these steps were and what is intended in the near future. Any other relevant evidence (for example the person s health, receivership, liquidation or an estate agent s confirmation of placing any property on the market. 8 Deprivation of assets and the financial means test for care home charging If you give away assets or otherwise dispose of them in order to put yourself into a more favourable position to get local authority assistance with your care home fees, the local authority may be able to assess you as if you still have the assets. Welsh Government guidance to local authorities suggests that the timing and motive behind the transfer should be taken into account for example, there could be other motives for transferring an asset and in order for it to amount to deliberate deprivation, the intention to avoid accommodation charges must be a significant part of the reason for taking this action. In relation to this, the timing is likely to be a big factor in establishing a motive because for example could the resident foresee that it was likely they were going to need to enter a care home at the time that the transfer/disposal of an asset took place. The local social security office can also consider whether assets were disposed of deliberately to qualify for means-tested benefits such as Pension Credit. Factsheet 10w April of 62

22 Note: Deprivation of assets can occur in regard to income, as well as where capital or an asset, such as your home, is transferred to someone else (or otherwise disposed of). For example, deprivation of income may occur if you fail to apply for income you are entitled to receive (say, from an occupational pension), or, in CRAG the following example is suggested: A resident is assessed as having to pay the full charge based on his income from retirement pension and occupational pension. When reviewing the charge the local authority find that he has sold his right to receive the occupational pension thereby reducing the charge he is assessed as having to pay. The local authority decides that this was done for the purpose of reducing the charge and the occupational pension was taken into account 11 Further information about intentional deprivation and the impact which this could have on you, or the person(s) to whom you have given assets, is contained in Age Cymru s Factsheet 40w Deprivation of assets in the means test for care home provision in Wales. 9 Social security and disability benefits in the context of paying for care in a care home Whether you are single or one of a couple, the local authority will expect you to claim all the social security benefits to which you are entitled when you move to live permanently in a care home. If you are already claiming a social security benefit, the local authority may ask to see details. It may also ask you for permission to request information from your local social security office. Social security benefits include the State Pension, Attendance Allowance, Disability Living Allowance, Personal Independence Payment and Pension Credit. 11 Charging for residential accommodation guide (CRAG), Welsh Government Factsheet 10w April of 62

23 9.1 Pension Credit Pension Credit has two parts: Guarantee Credit; and Savings Credit. The general rules governing eligibility for Pension Credit (PC) are explained in Age UK s Factsheet 48 Pension Credit. PC is means tested. Eligibility is based on your income and capital and your age 12. Up to 10,000 of capital is disregarded (this applies whether someone lives permanently in a care home, in their own home, or temporarily in a care home). If a single person or a couple have capital above 10,000, for the purposes of the PC means test, they are treated as having a tariff income of 1 per week for every 500 (or part of 500) above the 10,000 capital limit. Note: There are PC figures given below for both couples and single people. The figures for couples refer to those who are permanently living together. It should be noted that where one partner moves permanently into residential accommodation Pension Credit will be paid as if he or she is a single person. However, if one of a couple enters a care home on a temporary basis (perhaps for respite or a trial period) then they will still be treated as a couple for Pension Credit purposes and resources belonging to both members of the couple are taken into account (unless a specific disregard applies). For more details see Age Cymru s Factsheet 39w Paying for care in a care home in Wales if you have a partner. 12 The Government is increasing the qualifying age for those social security benefits where provision is aligned with the age at which women become eligible for state pension. It will increase from 60 to 65 between 6 April 2010 and 5 November State Pension age for both men and women will then increase to 66 by October These changes affect Pension Credit and a number of other benefits. For example, in April 2015 the qualifying age was 62.5 years. Factsheet 10w April of 62

24 Guarantee Credit Guarantee Credit tops income up to a set level for individuals whose income would otherwise be below that level. The level of income the claimant is said to need is known as the appropriate amount. The appropriate amount is made up of a standard minimum guarantee per week for a single person and for a couple and, in some circumstances, other additional amounts, such as a severe disability additional amount for a claimant who receives any of the following benefits and lives alone (or is classed as living alone for the purposes of the PC means test): Attendance Allowance (AA) the middle or higher rate care component of Disability Living Allowance (DLA) the daily living component (either rate) of the Personal Independence Payment (PIP). The amount of Guarantee Credit paid will usually be the difference between the claimant s existing income and the appropriate amount (the existing income figure will be the claimant s total income, minus any disregarded amounts that are specified in the PC rules see Age UK s Factsheet 48 Pension Credit for information on types of income that may be disregarded). Note: Pension Credit can be paid if you are receiving interim funding from the local authority (usually as a deferred payment agreement) providing that your property is up for sale. If Attendance Allowance or Disability Living Allowance (care component) or Personal Independence Payment (daily living component) is being paid at the same time then the appropriate amount for Guarantee Credit should be calculated to include the additional amount for severe disability, currently per week, as you will be treated as living on your own as a permanent resident in a care home. This income may help reduce the amount that ultimately has to be repaid to the local authority from your capital. See section 9.2 below for further information on Attendance Allowance, Disability Living Allowance and Personal Independence Payment. Factsheet 10w April of 62

25 Savings Credit The Savings Credit is only available to claimants aged 65 or over. It is designed to reward those who have made provision for their old age through an occupational pension (or similar savings). If you have qualifying income above a certain threshold you may be able to claim the Savings Credit. Those thresholds are currently per week for a single person (and for a couple). If your qualifying income is more than the figures above, but less than your appropriate amount for Guarantee Credit (i.e per week/ for a couple or more if you qualify for one of the extra amounts), Savings Credit is calculated at a rate of 60p for every 1 of income above the threshold, up to a maximum of per week for a single person ( for a couple). For incomes greater than the appropriate amount, Savings Credit is reduced from its maximum level by 40p for every 1 of income above these levels. As a result, a single person with qualifying income above per week, or a couple with qualifying income above , would not qualify for Savings Credit (except if their appropriate amount included any of the additional amounts). Factsheet 10w April of 62

26 Explanation: The savings disregard As mentioned in section 6.2 above, there is a savings disregard included in the Welsh Government s CRAG, the rules of which are related to the Savings Credit part of Pension Credit (PC). The disregard was introduced for people aged 65 and over in 2003 and applies to income and savings that count, within the Pension Credit rules, towards the Savings Credit. A resident who actually receives Savings Credit as part of a Pension Credit award will get a savings disregard in the care home means test of an equal amount to the Savings Credit they receive, or a maximum amount of 5.75 per week for a single person ( 8.60 for a couple) whichever is less. So, for example, if a single resident receives only 4.45 of actual Savings Credit, it would be this figure that is disregarded; whereas, if he or she happens to receive Savings Credit above 5.75, they would still only have 5.75 of this figure disregarded. Individuals whose income is such that it takes them above the level for receiving a Pension Credit Savings Credit award are still entitled to have a flat rate of 5.75 of their income disregarded ( 8.60 for a couple) in the means test. As mentioned above, the levels of qualifying income that would take you above the Pension Credit Savings Credit level are per week for a single person and for couples. There does not need to be a claim for (or an award of) Pension Credit Savings Credit in the above situation. The level of income above the threshold does not affect the entitlement to a savings disregard in the financial means assessment for care home charging, though it must be qualifying income as defined in the Pension Credit Savings Credit rules 13. Pension Credit and property While you are trying to sell a property that is not disregarded for another reason, Pension Credit can be paid for 26 weeks (or longer if reasonable ). The office handling your claim will need to be satisfied that you are taking reasonable steps to sell the property for this to apply, however. 13 Unlike Pension Credit Guarantee Credit, there are some types of income that do not count as qualifying income for Pension Credit Savings Credit. Age UK s Factsheet 48 Pension Credit has further information on this. Factsheet 10w April of 62