Care at Home Charging Policy

RENFREWSHIRE COUNCIL

SOCIAL WORK

CARE AT HOME CHARGING POLICY

Introduction

Clients may be charged for certain elements of Renfrewshire Council’s Care at Home Services. These apply whether the service is provided by the in house service or is purchased from an external provider. The charging policy operated by the Council complies with Scottish Government guidance and the COSLA framework.

To assess a client’s ability to pay for the services they receive, financial assessments are completed for all clients, other than those highlighted below. Financial assessments take into account the type of service(s) which clients receive as some services are not chargeable. This financial assessment includes a review of income and savings to ensure all benefits due are in payment. If clients have problems relating to debt or are not receiving their maximum benefits they are advised to contact the Advice Works team. If the client agrees, contact will be made on their behalf.

Services for which charges do not apply

Charges are not made for:

 Criminal justice social work services,

 People with mental health problems who are subject to community care or supervision orders or who are subject to a criminal court order (note; if a client under section 18 mental health detention is on leave of absence and benefits are being accessed a financial assessment should be carried out. Where clients are unable to access funds due to issues of capacity the client is still liable to pay a charge which will be recovered, including any backdated amounts, when the client is able to access their funds).

 Children in need, including: children subject to statutory and voluntary supervision arrangements, and, children in families who are involved with social work under section 12 or 22.

Charges are not made for advice or guidance on community care services, for assessment of needs, or for care management.

Services which are provided free of charge

1. Home Care services on discharge from hospital

In response to the recommendations from the Royal Commission on Long Term Care for the Elderly, the Scottish Government introduced free home care for people aged 65 and over who have been discharged from hospital for a period up to 4 weeks. This applies to clients admitted for treatment, who have had a minimum 24 hour stay and who have been assessed as requiring support upon discharge.

Provision of free home care applies to admission to and discharges from hospitals and hospices but does not apply to any stay for respite care. The free 4 weeks applies each time a person is discharged from hospital. Relief from charging should not apply to discharges following admission on a frequent or regular basis as part of ongoing care arrangements, respite and ongoing episodic treatment.

1. Free Personal and Nursing Care

The Community Care and Health (Scotland) Act 2002 introduced free nursing and personal care for people in Scotland aged 65 and over. Services which do not fall into the category of “personal care” continue to be chargeable.

Information on the services classified as personal care is detailed at Appendix 1. This appendix also includes Renfrewshire Council’s definition of tasks classified as domestic and housing support.

Please note:

 Eligibility for Attendance Allowance or Disability Living Allowance is not affected by Free Personal Care provided in clients own home.

 Free Personal Care does not depend on income or savings

 All Nursing Care provided by the NHS in clients own homes is free of charge.

1. Housing Support Services

Renfrewshire Council’s Care at Home Charging policy relates to all housing support services.

Prior to 10 April 2006 clients in receipt of housing benefit did not make a contribution towards the cost of services classified as housing support. For these clients charging for housing support services was phased in from April 2006. From 1 April 2008 all elements of housing support services have been included as chargeable services for all clients. This change was implemented in accordance with COSLA guidelines and to ensure that a single charging framework applied for all care at home services.

Charging for housing support services is not applied in certain circumstances. These are mainly in relation to clients receiving designated short term services e.g. Women's Aid, Blue Triangle, and Paisley Threads. The majority of services which fall into this category are managed centrally.

Charging for housing support services within sheltered housing commenced in January 2008. The charging policy was fully implemented with effect from 1 April 2008

1. Independent Living Fund (ILF)

As part of a client’s application for ILF a financial assessment should be carried out. The Council's Care at Home Charging policy should be applied and a charge raised if applicable. Any charge the Council raises should be entered on the client's ILF application form.

Where a client is pursuing an application for ILF assistance, it is essential to ensure that the net cost of the social work services after the Council charge has been applied exceeds £320. Net costs less than £320 would mean a client would be ineligible for ILF assistance. If the application of the Council’s charge marginally impacts on the ability to pursue ILF, client charging should be in line with ILF’s charging policy.

A charge applied by Renfrewshire Council after an application has been made to ILF would mean that Renfrewshire Council would be in breach of the trust deed.

1. Independent Living Service (ILS)

Where clients are in receipt of ILS, a financial assessment should be carried out and an appropriate charge levied.

1. Charge for Direct Payments

Where clients receive direct payments a financial assessment should be carried out to determine whether a charge will apply. As clients receive Direct Payments gross, accounts should be issued for any charge due.

1. Care at Home Services

Clients whose net income, after housing costs, is below a set level or “threshold” are not charged for any services they receive.

Separate threshold levels are in place for clients under and over 60. Thresholds are linked to pension credits for those over 60. For those under 60 their income support personal allowance, plus any disability premium is included. In both cases a “buffer” of 16.5% is added. Inclusion of the buffer of 16.5% means that a savings credit disregard is not applied in care at home financial assessments.

The current income thresholds are detailed at Appendix 2.

To allow an accurate charge to be established, it is essential that a client’s assessment of need clearly identifies the three components of care and support provided: Personal Care, Domestic Service or Housing Support.

Services to clients may be arranged through in house and purchased services. Where clients receive services from multiple providers, the information is collated and a single financial assessment completed.

The charge for any 4 week period should be adjusted to take account of any breaks in service e.g. hospital admission, clients on holiday.

To ensure that correct charges are applied charges for care at home services should be reviewed following any service change.

1. Meals

The introduction of the community meals service means that the meal service will be removed from the core home care package and separate charges applied. These charges are the same as those applied within day care. Where the community meals service has not yet been implemented, the cost of meals provided at home as part of a home care package will continue to be included in the home care weekly charge. Meals delivered at home will be charged 4 weekly in arrears. The current cost of meals is detailed in Appendix 2.

1. Community Alarms Charge

The service is chargeable from the time of installation to permanent withdrawal. There are no reductions to charges for clients on holiday, in hospital, in respite or temporary accommodation. Community alarm bills are issued 13 weekly in arrears.

For tenants in sheltered housing accommodation the community alarm charge is included as part of their housing support charge.

The current charge for the Community Alarm service is detailed in Appendix 2.

If clients regularly receive overnight support from the Community Alarm responder service, the client will be classified as being in receipt of an overnight service.

1. Respite Care

Respite in a Care Home:

Clients who receive less than 8 weeks respite care do not need to be financially assessed. Charges for respite care for older people and adults are aligned with the DWP benefits received by clients. Current charges are detailed in Appendix 2.

Respite at Home:

If respite is provided at home the Care at Home charging policy applies.

Summary of Appendices

Appendix 1: Analysis of tasks within each of the categories of care; personal, domestic and housing support

Appendix 2: Charging rates for care at home services.

Appendix 3: Care at Home Charging leaflet

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APPENDIX 1

ANALYSIS OF SERVICE PROVISION – “3 WAY SPLIT”

Workers MUST contact Janice Toner in the Independent Living Team prior to making ILF applications or requesting ILF reviews, to ensure the three way split meets the ILF criteria.

• Bathing
• Showering
• Hair Care
• Shaving
• Oral Hygiene
• Nail Care

• Toileting
• Catheter / Colostomy / Stoma Care
• Skin Care
• Incontinence Laundry
• Associated bed changing
• Emptying commode

• Eating
• Managing and preparing special diets eg pureed food

• Preparation of food in the home
• Advance preparation of snacks and drinks

• Dealing with the consequences of not being able to move
• Moving and handling

• Behaviour management
• Psychological support
• Reminding and safety devices

• Medication
• Eye drops
• Creams and lotions
• Simple dressings
• Oxygen therapy

• Dressing
• Surgical appliances
• Prosthesis
• Mechanical and manual aids
• Getting into and out of bed
• Transfers and hoist use

• Carrying out personal laundry (excluding incontinence laundry)

• Carrying out Ironing

• Carrying out clothing repairs

• Management of food stores / fridges etc
• Menu planning
• Providing meals and refreshments as appropriate
• Dealing with dietary needs including having regard to health related needs eg diabetes or religious requirements
• Supervision at mealtimes

• Coping with domestic pets including day to day care and feeding

• Kitchen / food hygiene
• Kitchen routines eg cleaning, washing up, bin emptying
• Personal laundry routines, ironing
• Cleaning (hovering, dusting, window cleaning, floor cleaning, kitchen and bathroom cleaning)
• Arranging services eg gas, electricity, water
• Appropriate personal routines
• Appropriate clothing / footwear
• Appropriate personal hygiene
• Prompting re the above
• Prompting re medication routines
• How to keep garden, close, stairs, bin areas etc in appropriate condition

• Arrange and attend doctors / hospital etc (inc. escort)
• Attend day care (including escort)
• Attend groups, social activities and reviews (inc. escort)
• Maintain contact with friends and family (inc. escort)

• Assist service user to make referral to OT dept or make referral for service user
• Arrange appointments and attend appointments with or for the service user in relation to adaptations
• Arrange to be present when adaptations are being carried out in the service user’s home
• Remind the service user of the safe use of adaptations

• Collect benefits with or for the service user
• Advise and assist service user to budget income
• Advise and assist service user to pay bills
• Enable service user to access debt counselling services
• Enable service user to access advocacy services
• Enable service user to access legal services
• Advise and assist service user to set up and maintain bank account appropriately, including direct debits, standing orders etc
• Advise and assist service user to plan / save for future expenditure eg furniture purchase, holidays etc

• Advise and assist service user to sustain appropriate relationships with neighbours, friends and family
• Advocate and negotiate appropriately with or on behalf of the service user in disputes.

• Visit the benefits agency
• Read and understand correspondence
• Complete forms
• Provide evidence of income / savings
• Liaise / advocate for the service user with utility companies DWP etc
• Liaise / advocate for the service user with housing benefit and council tax benefit
• Liaise / advocate for the service user with the landlord
• Access welfare rights services

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APPENDIX 2

CHARGING RATES FOR NON RESIDENTIAL SERVICES 2012/13

APPENDIX 3

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Renfrewshire Council Social Work

calculating YOUR CARE AT HOME charge 2012/13

We use your “available weekly income” to calculate what you are liable to pay

Firstly, from the information you have given us we will calculate what your available weekly income is.

Available weekly income is the income you receive every week, such as: welfare benefits; pension etc., less certain housing payments that you make. We then apply a set charge (this is currently 85p) for every £1 of available weekly income above the threshold level.

What we include as weekly income

When calculating available weekly income, we include:

 state retirement pension

 any works pension in payment

 some welfare benefits in payment (some benefits are not included - see below)

 an amount related to savings above £10,000

If you have savings between £10,000 and £24,750, we will add £1 to your available weekly income for each block of £500 between these amounts. For example, if you have savings of £12,000, then £4 of income per week will be added to your available weekly income.

What we leave out of weekly available income

When calculating available weekly income we leave out:

 Any rent, or mortgage interest, being paid

 DLA Mobility Component

 War Pensioner’s Mobility Supplement

 Carers Allowance

 Christmas Bonus

 Council Tax and Housing Benefits (water and sewerage charges are not excluded)

 Gallantry Awards (GC, VC, similar from abroad)

 Social Fund payments

 Winter Fuel Payments from DSS

 Independent Living Fund Payments

 War Widows’ Special Payments

 any payment from a range of charitable and special funds

 income from a mortgage protection policy

 income from a “home income plan” annuity

 income in kind, not cash

 trainees’ training premium and travelling expenses

 child benefit

 £20 earning disregard

 Attendance Allowance / Disability Living Allowance (Care Component)

Unless a client receives overnight services we disregard the difference between the higher and lower / middle rate attendance allowance or disability allowance (care component). In all other circumstances the full value of the Allowances is taken into consideration.

We also disregard the first £10 of the following:

 payments to victims of Nazi persecution paid under German or Austrian law

 Civilian war injury pension

 War Disablement Pension

 War Widow’s Pension (but not War Widows’ Special Payments)

Free service below “charge thresholds”