NORTH AYRSHIRE COUNCIL SOCIAL SERVICES APRIL 2011

Transcription

1 NORTH AYRSHIRE COUNCIL SOCIAL SERVICES APRIL 2011 Non-residential and residential care services

2 CONTENTS Introduction...4 Principles on which the charging policy is based:...4 CHARGING FOR NON-RESIDENTIAL SERVICES...5 What the charging policy aims to do Services for which we charge Services that are Free Charges for services How we will assess ability to pay Completion of financial assessment form Weekly Income Section Treatment of income and capital Income not taken into account when calculating charges Capital taken into account when calculating charges Capital not taken into account when calculating charges Notional income and capital Treatment of Board paid by service users to families Where the Service User has a commercial boarder living in the house Disregards when calculating charges Weekly Charge Service users who are exempt from charges Write off/waiving of charges Non payment of charges Incorrect financial assessment Discharge after hospitalisation Disputes /04/11 2

3 CHARGING FOR RESIDENTIAL SERVICES...13 Introduction Financial Assessment: treatment of income and capital Hospital Absence Planned absences Self-funding Property jointly owned Emergency admissions into a care home Temporary admission to a care home Admission to a care home...14 Glossary...15 Appendix A...Error! Bookmark not defined. Definition of chargeable services Appendix B...Error! Bookmark not defined. Definition of services that are free Appendix C...Error! Bookmark not defined. Thresholds for Charging 2010/2011 Appendices D1(a) & D1(b)...Error! Bookmark not defined. Financial Assessment / Claims Notification Form IMAX1 (18 to 60) Financial Assessment / Claims Notification Form IMAX1 (60+ ) Appendix D2...Error! Bookmark not defined. Financial Assessment / Claims Notification Form LAC1D (Birth to17 years) Appendix E1...Error! Bookmark not defined. Tariff Income from Capital over 6,000 Non-residential Charging for claimants under 60 Appendix E2...Error! Bookmark not defined. Tariff Income from Capital over 10,000Non-residential Charging for claimants aged 60 and over Appendix F...26 North Ayrshire Council - Social Services Chargeable Services 06/04/11 3

4 Introduction This Charging Policy explains how the Council works out how much people should pay towards the cost of the services they receive from Social Services. The policy covers residential, non-residential Social Work Services and Housing Support Services. The Policy is intended to help staff working for the Council, service providers, service users, carers and other interested groups understand how we will calculate charges. The policy is available in hardcopy, Braille, audiotape, community languages or on the Council s web site The Social Work (Scotland) Act 1968 and the Mental Health (Care and Treatment) (Scotland ) Act 2003 allows us to charge for certain Social Care and Housing Support Services. Charges made for services are an important part of the Council s income, and income generated is used to promote the well being of people living in the community. We do not charge for personal care services for service users 65 and over, as defined by the Community Care and Health (Scotland) Act Further information on what constitutes personal care is included in Appendix B. We aim to have a charging policy which is easy to understand and which ensures that affordable charges are made for services, and that these are applied fairly and collected efficiently. Principles on which the charging policy is based: National guidance the charging policy takes account of COSLA s Guidance on Charging Policies for Non Residential Services and the Charging for Residential Accommodation Guide (CRAG) for residential care Transparency service users should be advised how and why they are being charged for a particular service. A public information leaflet will be available. Consistency the framework for charging should ensure consistency of decision-making by managers and staff. Equity all service users will be treated equally. Assessed Need services will be provided following an assessment of need. Charges should not influence service users choice or type of service. Ability to pay service users will contribute towards the cost of services they use, on the basis of their available income and capital. Maximisation of Income provision of a benefits check and information and/or assistance to maximise income from state benefits is an integral part of the charging policy. 06/04/11 4

5 Maximum Charge There is a maximum charge for non-residential care. The maximum charge may apply if services users elect not to undergo a financial assessment. We will not charge more than the cost of providing the service. Cost effectiveness we will not collect a charge for the service if the real cost for doing so is greater than the amount of money recovered. Exceptional Circumstances the policy takes account of individuals with exceptional circumstances. Further details are contained in section 17 about waivers and write-offs. Continuous Improvement and Best Value we will monitor and review the charging policy to ensure it is achieving the Council s aims. Charging for non-residential services What the charging policy aims to do The Policy explains: Services for which we charge. Level of charges for services. How we assess ability to pay. 1. Services for which we charge The Charging Policy applies to the following services:- Children and Families Services:- Residential Care Fostering Services Respite for Young adults 16 and over Community Care Services:- Housing Support Care at Home Day Care Aids and Equipment Adaptations Community Alarm Scheme Meals on Wheels Intermediate Care North Ayrshire Council Sheltered Housing Unit guest accommodation Services provided via direct payments. Blue Badges 06/04/11 5

6 Other services Civil Court Procedures Inter Country Adoptions Lawyers reports Care Management Assessment & Reviews Other Local Authorities Hire of Disability Equipment Cleaning Machine For details of these services please see Appendix A. 2. Services that are Free Befriending Services for children. Community Alarm for tenants of North Ayrshire Council Sheltered Housing Personal care for people aged 65 and over which includes:- Personal Hygiene Continence Management Food and Diet Simple Treatments Personal Assistance Counselling and Support For details of these services see Appendix B. 3. Charges for services Charges have been set after consideration of: - Best Value framework Unit costs Other local authority charges Private Sector charges Income generation Charges are reviewed and increased annually in line with inflation. 4. How we will assess ability to pay Each year a weekly income threshold will be set for single service users and couples according to age. Service users with income below the threshold will not be charged for services. The threshold incomes are based on minimum income guaranteed by the Department for Work and Pensions. For all service users there is an additional buffer of 16.5%. COSLA guidance recommends a 16.5% buffer above income levels to prevent financial hardship for service users. Details of thresholds/incomes are at Appendix C. 06/04/11 6

7 We will take into account applicable income, savings and capital when working out how much a service user can pay towards the cost of the services they receive. This determination is called the financial assessment. Appendix D1 and D2 5. Completion of financial assessment form The Assessor will meet the service user to discuss service provision and collect financial information. A financial assessment is then completed. This financial assessment will take account of income, savings and other capital to work out how much a service user can afford to pay towards the cost of the services they receive. Assessors will collect personal details and provide information and advice on unclaimed benefits. This enables a benefits check to be completed to ensure that the service user is in receipt of all the benefits to which they are entitled. Certain benefits such as Attendance Allowance, DLA Care Component and Severe Disability Premium are paid to people in need of care and attention. These allowances are intended to meet the cost of care and will be taken into account when assessing ability to pay. A mandate signed by the service user, authorised signatory or person acting on a service user s behalf is required for the financial assessment. If benefits are paid jointly for a couple, the service user s partner may need to sign a mandate. The person completing the financial assessment will verify up-to date copies of recent documentation and bank statements. A service user in receipt of Housing Benefit or Council Tax benefit may authorise Social Services to access information from North Ayrshire Council s Financial Services. In this situation no financial details need be discussed with the assessor. The charge for non-residential services will be calculated from the financial information available. This will be increased each year in line with inflation on the basis of information collected for benefit purposes. The following notes relate to the various sections of the financial assessment form: - Personal Details Section: - Details of the service user, their personal details, household tenure and the household composition. Outgoings for rents, mortgages and Council Tax. A couple (defined as a married or non married partnership) will receive a joint financial assessment. For other household arrangements i.e. mother and daughter, brother and sister etc people will require to be assessed separately. It is essential that service user s and partner s National Insurance Number be entered. This enables clear identification when liaising with the DWP. 6. Weekly Income Section Weekly income requires to be detailed for the service user and partner. When completing a financial assessment the following information will be checked; 06/04/11 7

8 Income (e.g. benefits award notices for Retirement Pension, Income Support, Pension Credit, DLA, Attendance Allowance, bank statements and wage slips). Capital (e.g. bank statements, savings passbooks, ISA or share certificates). Notes: (1) Earnings are assessed after Income Tax, National Insurance and other deductions. (2) Occupational Pension should be net of tax. 7. Treatment of income and capital Income taken into account when calculating charges; Attendance Allowance Benefits DLA (Care Component only) Wages/salaries Pensions Rental Income Income from capital Other income 8. Income not taken into account when calculating charges DLA Mobility Component and war pensioners mobility supplement All War Pensions Council Tax and Housing Benefit Independent Living Fund Payments Partner s earned income where the service user is under 65 years Payments in respect of children Charitable Payments Income from Insurance Protection Policies. Income from a home income plan annuity. Winter Fuel Payments Social Fund Payments Christmas bonus Gallantry Awards (GC, VC, similar from abroad) Payment to victims of Nazi persecution paid under German or Austrian law. Trainees training premium and travelling expenses. Income in kind, not cash 9. Capital taken into account when calculating charges Examples of other capital are: Savings Stocks & Shares, PEPs, ISAs, National Savings Certificates, 06/04/11 8

9 Savings Bonds, Unit Trusts, Surrender value of annuity, Surrender value of insurance or Premium Bonds, Other Property/Land The first 6,000 for under 60 years of age and the first 10,000 for over 60 years of age of total capital is disregarded in full. Income derived from capital over 6000/ 10,000 will be calculated at 1 per every 500 for people 60 and over. 1 per every 250 people under 60. For details of calculation of income from capital see Appendix E. 10. Capital not taken into account when calculating charges Value of the family home Personal property, such as household goods, family car etc. 11. Notional income and capital Where people dispose of capital in an effort to avoid charges this will be deliberate deprivation and notional capital calculated will apply. Unclaimed income e.g. Pension Credit, Attendance Allowance will not be adopted as notional income in non-residential financial assessments. It is sufficient that ongoing benefit checks will encourage the service user to claim available benefits and maximise income. 12. Treatment of Board paid by service users to families If a service user lives with family and pays board, the maximum allowance for the rent element of board will be calculated at the shared rate for a single person under the Local Housing Allowance Scheme (issued annually). For further information benefits@north-ayrshire.gov.uk or write to North Ayrshire Council Housing Services, Cunningham House, Irvine. 13. Where the Service User has a commercial boarder living in the house The service user s benefits will be affected. We will take part of the income from the boarder into consideration in the financial assessment, in line with the DWP rules, i.e. disregard first 20 and then disregard 50% of the balance. Example: Boarder contributes Less Disregard Balance Net income taken into consideration (i.e. 50% of the Balance) Disregards when calculating charges The following disregards will apply after calculating total income and capital: - 06/04/11 9

10 Night time rate of Attendance Allowance/DLA Care, unless overnight care is commissioned by the Local Authority Housing costs net of rebates or allowances. Water or waste water rates Carers premium 15. Weekly Charge The appropriate weekly charge for each service user will be calculated taking into account; Total weekly income. Appropriate disregards. Excess income, income above the threshold. Example: Total Income Less: total disregard Less: Threshold Excess Income The amount of excess income used to determine the charge is; Service users 60 years or over will pay 50% of their excess income. Service users under 60 years will pay 40% of their excess income. Anomalies may arise for people who reach 60 (due to pension transition). In such cases an individual assessment will be undertaken to ensure the individual is not financially disadvantaged. The service user will pay the maximum weekly rate for all services or the indicative hourly rate whichever is lower (see Appendix F). Individual services, i.e. meals and small aids will be charged separately. Completed forms including the mandate should be signed by service user/representative and assessor/care manager, then forwarded to relevant office who will advise the service user in writing of the following details: - How the charges are calculated printout of financial assessment provided. When charging will commence and billing frequency. The service user s right to request a reassessment. Advice on our annual charge to be levied. 16. Service users who are exempt from charges Service users whose chargeable income falls below the weekly threshold for charging will not be required to pay. Children up to age of /04/11 10

11 Service users who are terminally ill (DS1500) - A Request to waive charges for care services form should be completed and authorised by an Operational Manager. People with a mental illness who are subject to a Compulsory Treatment Order or Compulsion Order (Community or Suspended Hospital Order). Criminal Justice Service, excluding housing support. Housing Support offered in the following circumstances on a short-term basis: Domestic violence Young vulnerable people Single homeless Ex-offenders Drugs/alcohol rehabilitation Refugees A short-term service is defined by the Scottish Government as a service lasting 2 years or less. If one of the services listed above is continuous for 2 years, a financial assessment may be undertaken and a charge may apply from the date of the financial assessment. 17. Write off/waiving of charges Write off Only the Corporate Director Social Services & Health can authorise debt for write-off. All normal Council debt recovery procedures will be followed before considering write-off. Write off of debt for non-residential services will be considered only in the following circumstances: Social grounds: to pursue the debt would be to the detriment of the service user s well being. Financial reasons: the service user has died and has left no estate or, the service user has absconded. Waiving Charges All or part of the weekly charge can be waived for a maximum of 6 months by the Operational Manager. An extension of waiver/reduction can be agreed only by a Head of Service. This means that before a service starts, a decision is made not to charge provided that - There is a complete record of income and expenditure. There is evidence that the service user has made application for all benefits to which he/she may be entitled. Charges cannot be waived retrospectively. In advance Operational Managers can use this discretion only in the following circumstances: The service user s circumstances are unusual. A waiver of charges application form must be completed. See appendix G. The application of charges would cause hardship. 06/04/11 11

12 18. Non payment of charges Where a service user has been assessed as requiring a service and refuses to pay the service should not be withheld where it is clear that the service is essential to the service user s well being. Where a service user is in receipt of a service and they refuse to pay the service should not be withdrawn where it is clear that the service is essential to the person s well being. North Ayrshire Council will pursue such debtors and the Council s normal debt recovery process will apply. 19. Incorrect financial assessment If we discover that an incorrect financial assessment has led to a service user being charged too much or too little, we will carry out a new financial assessment and will apply the correct charge from the date of the new assessment. Where we have been given the correct financial information by the service user, or his/her representative, and have calculated the charge wrongly, the full amount of any over-charge will be reimbursed and we will not seek to recover any under charged amount. If any under charge results from the service user, or their representatives, providing us with incorrect financial information, we may seek to recover the amount by which they have been undercharged. If a service user, or their representative, provides us with incorrect financial information and this results in them being over-charged, we may refund the amount by which they have been overcharged. 20. Discharge after hospitalisation If a person was receiving services before a temporary admission to a hospital or care home, we will not charge for any services while they are away from home. Following discharge from hospital, clients 65 years of age will receive 4 weeks additional care services free following an assessment of need (see appendix B) otherwise the charge prior to admission will be reinstated. Other assessed services may have charges applied subject to a financial assessment When a couple are receiving services jointly and one goes into hospital both will be entitled to 4 week s free additional home care on discharge from hospital. 21. Disputes Service users who are not satisfied with the calculation or outcome of their financial assessment will be encouraged to discuss their concern with the member of staff working with them or his/her manager in the first instance. Service users who remain dissatisfied will be entitled to pursue their complaint through the Council s Customer Comments Scheme. 06/04/11 12

13 Charging for residential services Introduction The legal basis for charging for residential services is governed by the National Assistance Act 1948 and the National Assistance (Assessment of Resources) Regulations Our charging policy is based on the Scottish Government s guidance on the above legislation and the Department of Health s Charging for Residential Accommodation Guide (CRAG). 1. Financial Assessment: treatment of income and capital We will carry out all financial assessments in terms of the above legislation, regulations and guidance. Service users will be charged on available income net of disregards over the personal allowance rate set by the DWP on an annual basis. 2. Hospital Absence When a person living in a care home is admitted to hospital the Council will continue to pay 100% of the contracted contribution for up to 6 weeks, thereafter it will be paid at 80% of the contracted contribution up to 52 weeks as long as it appears likely that the person will be returning to the care home. The service user will continue to pay their assessed contribution to the care home whilst in hospital, National Assistance (Assessment of Resources) Regulations 1992 Regulation 2 (1). We will review these situations every 4 weeks. However, where the Council is funding only free personal care and/or free nursing care, entitlement ceases after 14 days of absence from the care home. Consequently payments to the provider will cease from the 15 th day of absence. The service user is required to pay the full cost of care if they wish to retain the bed after the 15 th day of absence. 3. Planned absences Where a person living in a care home is absent temporarily, on holiday or similar circumstances we will continue to pay 100% of our contracted contribution for up to 6 weeks. Where a planned absence is more than 14 days, we will cease to make Free Personal Care and/or Free Nursing Care payments to the provider from the 15 th day of planned absence. 4. Self-funding Service users who have capital over 23,500 will not be eligible for funding. However, an application can be made for the Council to pay free personal and/or nursing care. This would require a community care assessment to be undertaken to ensure that this level of care is required. Self-funding service users, whose capital subsequently falls below the selffunding threshold, will become eligible for funding by the Service from the date of notification that the threshold has been reached providing that the need for this level of care is confirmed by a community care assessment. Notification must be no earlier than the date the threshold has been reached, and a financial assessment must be done. 06/04/11 13

14 The self funding threshold is the amount of assessable capital, defined by legislation i.e. 23,500 that a service user has, above which they are required to meet the full cost of their care and accommodation, excluding free personal and free nursing care. Where a service user s capital is between 14,500 and 23,500 a tariff income will be calculated at a charge of 1 for every Property jointly owned We will disregard the property whilst it is shared by the spouse or a son/daughter who has been assessed as having a disability and is in receipt of benefit. 6. Emergency admissions into a care home No financial assessment will be undertaken and the service user will be charged the respite rate. However, a full financial assessment will carried out within 8 weeks and the assessed charge will be applied thereafter. 7. Temporary admission to a care home A temporary stay can be up to 56 weeks and in exceptional circumstances slightly longer, as allowed by the Department of Health s Charging for Residential Accommodation Guide (CRAG). 8. Admission to a care home Where a person is admitted to a care home and when assessing their contribution towards the cost of their care, we will only take into account their own financial resources, including their share of any resources they jointly hold with their partner or spouse. 06/04/11 14

15 Glossary Absconded Assessor Applicable income Best Value Framework Buffer Deprivation Disregards DWP Equipment Income threshold Indicative hourly rate Mandate Notional capital Tariff Income Definition Leave without paying and no contact information. The lead worker who has responsibility for coordinating the assessment (both care and financial). The assessor may be a social worker, community nurse, occupational therapist, care at home manager etc. See Appendix C The principle of Best Value is one which establishes a duty to deliver services to clear standards covering both cost and quality by a balance of the most effective, efficient and economic means available, taking full account of equalities and sustainability factors. It is a requirement, which needs to be demonstrated by all Councils, and in due course, by all public bodies. Additional level of protection over and above the income threshold. Where it is deemed that a service user has disposed of capital or property in an effort to avoid paying charges for services. The income not taken into account when calculating charges. Department of Works & Pensions Provision of aids and adaptations that support people to live with independence and dignity in their own home. Set level of income below which the council will not charge for services. The hourly rate set by the council. An instruction from the service user authorising the council to access financial information. The assumed level of capital that has been disposed of by service users to avoid paying charges. The amount of weekly income calculated from a person s capital taken into account in a financial assessment. 06/04/11 15