Policy and Resources Committee
Agenda Item 126
Subject: Adult Social Care Charging Policy
Date of meeting: 09 February 2023
Report of: Executive Director, Health & Adult Social Care
Contact Officer: Name: Angie Emerson
Tel: 01273 295666
Email: angie.emerson@brighton-hove.gov.uk
Ward(s) affected: All
1.1 To consider the proposal that charges for the Council’s carelink service should increase by 10% with effect from April 2023.
2.1 That Committee approves an increase of 10% to the current carelink charges with effect from April 2023. (See table below)
3.1 A report was taken to the Adult Social Care and Public Health Sub-Committee on 10th January which contained a number of recommendations to increase various charges for in-house council services. All charges were recommended to increase by 10% (rounded) with the exception of Carelink Charges. The recommendation for Carelink increases was 6%. The reason for the lower increase for this particular service was based upon mitigation to the risk that some people might cancel their existing service or decline to take up the service in future and this could lead to an increased need for other resources.
3.2 Committee members approved the 10% increase for all other service charges but did not agree to the recommendation of a 6% increase for Carelink charges. Instead, the ASCPH Sub-Committee received and agreed to an amendment to the report recommending an increase of 10% (rounded) in line with all other increases to in-house social care services. The report did not quantify the potential number of cancellations nor the cost that might be incurred so the revised recommendation of a 10% increase required a further report to Policy and Resources Committee.
3.3 Current and proposed increases to Carelink Charges:
|
2022-23 |
2023-2024 +6% |
2023-24 + 10% |
|
|
Standard Carelink Plus |
£20.30 per month |
£21.50 |
£22.30 per month |
|
Enhanced Carelink Service |
£24.30 per month |
£25.80 |
£26.70 per month |
|
Exclusive Mobile Phone |
£26.30 per month |
£27.90 |
£28.90 per month |
4.1 The alternative option could be to increase carelink by 6% as originally proposed.
4.2 The council’s Carelink Service is considered an excellent preventive service which often reduces the need for more expensive service options such as agency home care and residential care as well as the potential need for ambulances and hospital care.
4.3 This information is provided on the BHCC website:
CareLink Plus alarm and telecare service (brighton-hove.gov.uk)
CareLink Plus is Brighton & Hove City Council’s telecare alarm service. Telecare describes a range of services and equipment that allow you to call for help in an emergency. This could be in and outside the home. Telecare can increase your independence and help you feel safe. You can apply for an alarm that’s worn round your neck or wrist. If you fall, feel unwell or need help in an emergency, you can call for help by pressing a button on the alarm. Telecare can help:
Most telecare devices connect you to a CareLink staff member. They are available 24 hours a day, 7 days a week.
4.4 The Carelink service is provided and part-funded by the council and the net cost to the council after income from charges is proposed to increase from £430k in 2022/23 to £536k in 2023/24 (an increase of 25%). The increase mainly relates to additional staff costs and include the pay award.
4.5 Approximately 2,120 people are charged for the carelink service in accordance with the fees listed above. Others have a free service due to low income or financial hardship.
4.6 The projected income from client charges is currently £540k per annum.
At current activity levels, if fees are increased by 6% the additional income will be £32k per annum and if increased by 10% the additional income would be £54k per annum. The difference in income is therefore £22k per annum based on the differential percentage rates.
4.7 In light of the challenging financial position the council is facing, it is recommended that the council applies and increase aligned to the current inflation rate to Carelink.
4.8 Carelink keep a log of cancellations and around 12% of those relate to financial reasons (approximately 250 people). Some people are deterred from accepting this service due to affordability but this data is not available. There is a risk that if people resort to calling on other services due to their vulnerability, illness or falls, the cost to the council and/or the NHS could be significantly higher than the additional income we expect to receive by increasing fees by 10%. However, it is not possible to provide an accurate estimate, either for the additional number of people who may cancel the service (expected to be a further 3% - approximately 65 people) or the effect of an increase of 6% or 10% on the potential number of cancellations. It is not possible to estimate the potential escalation of future costs as a possible result due to carelink cancellations. HASC will monitor the rate of cancellation on a monthly basis to determine whether there is a significant increase above the current position and should this arise will report back to Adult Social Care and Public Health Sub Committee for consideration.
4.9 There are other mitigations. Carelink can offer advice and guidance around finances and benefit claims to maximise income and can also offer a hardship assessment which may lead to a nil charge for Carelink and prevent cancellations.
5.1 The Carelink Service sends out an annual survey regarding service user satisfaction. Returns from a recent survey showed that approximately 86% of those who replied felt this service was good value for money
6.1 The ASCPH sub-committee agreed to a Labour amendment to the earlier report and recommended an increase in fees of 10% for the council’s carelink service. Whilst there is a legitimate concern regarding the risk that customers will cancel their service or decline future services when advised of the cost, which may have the effect of calling on other more costly services instead, it is not possible to quantify this risk. There will be mitigating actions to limit the impact of the 10% increase and on balance it is recommended that the increase of 10% to Carelink charges is agreed.
7.1 Charges for Adult Social Care services within this report have been reviewed in line with the Corporate Fees & Charges Policy and budget guidance. This is to ensure that fees and charges are appropriately benchmarked to comparative services and recover the full cost of service wherever possible.
Based on current activity levels, a 6% uplift will deliver the level of income assumed in the 2023/24 budget strategy. An uplift of 10% is projected to generate an additional £0.022m per annum. However, the level of income is variable based on demand and client contributions are determined on a means tested basis.
7.2 Any net reduction in clients contributing to the service will impact on overall income received. There are also possible additional long-term costs to the Council from clients who may choose to cease using the Carelink service.
Name of finance officer consulted: Sophie Warburton Date consulted: 17/01/2023
8.1 As described in the body of this report this decision was agreed by Adult Social Care and Health Committee following an amendment to increase the charges for Carelink from 6-10%, subject to approval by Policy and Resources Committee due to the potential impact on resources and budgetary considerations.
8.2 Paragraph 4.2 of the report refers to “preventative services”. Section 2 of the Care Act 2014 imposes a duty on the local authority to provide or arrange for the provision of services, facilities or, or take other steps, which it considers will contribute towards preventing or delaying the development of, or reduce the need for, care and support for adults in its area.
Name of lawyer consulted: Sandra O’Brien Date consulted 17/01/23
9.1 There are no equality issues as this service is universally available to those who want or need it.
10.1 There are no sustainability issues.
11.1 There are no other implications
Crime & disorder implications:
11.2 No Implications
Public health implications:
11.3 There are no other implications than those included above
Supporting Documentation