Agenda item - Charges and Fees in Adult Social Care Services

Presentation by Anne Hagan,  Head of Commissioning & Partnerships; Jane MacDonald, Commissioning Manager; and Angie Emerson, Head of Financial Assessment.

95.1         Anne Hagan, Jane McDonald and Angie Emerson presented proposals for fees and charges for ASC services.

95.2         They advised members that most Adult Social Care services are chargeable to service users but, in the main, these charges are subject to a means test.

95.3         All councils are required to set a charging  policy which is compliant with the requirements of this Act and the Department of Health’s “Fairer Charging” Guidance

95.4         Non-residential care services

·        A package of non-residential care can include home care, day care, community support, adaptations and direct payments in lieu of services.

·        One financial assessment covers all services and the amount a person must pay will depend upon their income, savings and expenditure, (except for the fixed charges for meals, transport and carelink).

·        The value of a person’s home is not counted.

95.5         There are around 1850 service users with non-residential care services and this includes older people and adults with physical disabilities, learning disabilities and mental health difficulties. 

95.6         Around 47% of service users have minimal savings and limited income from state benefits which results in no charge, other than the fixed rate charges for meals, transport or carelink.

95.7         About 45% of service users are assessed to contribute an average of £20 to £60 per week, usually based on their entitlement to extra disability benefits.

95.8         A financial assessment is carried out to determine whether a service user can pay the maximum charge for their care services.

·        People with savings and assets over the threshold (currently £23,250 or £45,500 for couples) pay the maximum charge.

·        Also, some people who have higher private incomes, or a low cost care package may pay the maximum charge, eg. £50.00 per week for 2 days per week at a day centre.

95.9         Around 8% of service users (140 people) pay the maximum charge.

95.10    The council also provides:

·        meals in the community

·        meals at Day Centres

·        Transport to Day Centres and other venues

95.11    Recommended Changes

·        maximum charge for in-house home care should be reduced from £21.50 per hour to £20.00 per hour.

·        This takes into account the disparity between other councils where maximum charges are generally set at a lower rate. 

·        It is recommended that the maximum charge for day care should be increased from £23.50 to £25 per day. 

·        The rates charged by other councils vary significantly but are often much higher.

·        Increase the Fixed Rate Transport charge from £2.15 per return journey to £2.50 per return to take account of higher fuel costs and public transport costs.   

·        Increase the meals charge at Day Centres from £3.10 per meal to £3.50 per meal in line with community delivered meals. 

·        (note that Committee have already approved an increase in community meals to £3.50).

·        No increase to Carelink charges.

95.12    Fee Level For Adult Social Care Services 2013-14

95.13    Fees paid to independent and voluntary sector providers that supply care services on behalf of Brighton and Hove City Council Adult Social Care. Recommendations:

95.14  Members thanked the officers for the presentation. There was general agreement that the approach seemed a reasonable one.