Meeting documents

1 THE ISSUE

1.1 There are two new pieces of legislation that are required to be implemented by April 2003. These are Fair Access to Care and Fairer Charging. The purpose of this report is to report the results of the public consultation and to seek agreement to the recommendations for implementation.

2 RECOMMENDATION

2.1 To agree the setting of the threshold for the eligibility criteria within the Fair Access to Care framework (see appendix E).

2.2 To agree the implementation of Fairer charging and changes to charges as detailed in paragraphs 9.2 and 9.3.

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3 FINANCIAL IMPLICATIONS

3.1 The Government has allocated no additional funding for Fairer Charging or Fair Access to Care. The implementation of Fairer Charging will mean a loss of income from charges of approximately £130,000 and so the recommendations include proposals to increase charges and recover this lost income.

4 BACKGROUND

4.1 Fair Access to Care is about ensuring Council's use a consistent approach in determining eligibility for Social Services. Fairer Charging is about ensuring Council's use a fair approach in determining charges for non-residential services e.g. home care charges.

4.2 The areas requiring review for Fairer Charging were detailed in a report agreed by the executive member on 13^th September 2002. A summary of the issues relating to Fairer Charging and Fair Access to Care were further detailed in a report to the Housing, Social Services and Community Safety Overview and Scrutiny Panel of 19^th November 2002. This report gave information on the consultation process and draft consultation documents.

4.3 These two policies have many overlaps as both have related financial implications. The consultation on both policies was therefore conducted together.

4.4 There have been two working groups established that have been working on the detail of the Fairer Charging Guidance. Officers have also met with representatives of WECODP to discuss the issues raised and process for consultation.

4.5 Discussions with a Focus Group convened by the Disability Equality Forum and with the Advocacy Project have taken place to assist with the writing of consultation material for FACS.

4.6 Approximately 1000 Consultation documents ( including 200 in easy English) were widely circulated in December and a consultation meeting was held with users and other stakeholders on Jan. 14^th (for a full report of the outcomes of the consultation see Appendices A, B &C)

5 FAIRER CHARGING

5.1 Fairer Charging requires Council's to review their charging policies for `non-residential' services. This mainly relates to charges for domiciliary care.

Progress in implementing Fairer Charging

5.2 Since October 2002, all service users being charged for domiciliary care have had revised financial assessments to ensure that they have a higher disregard of their income in accordance with Fairer Charging. This meant that 40% of service users had a reduction in their weekly charges or became exempt from charging.

5.3 A joint visiting team is in the process of being set up with the Department of Work and Pensions (DWP). There will be 3 council visiting officers and 8 DWP visiting officers working as a single team to visit people in their own home, help them complete council and income support forms. A primary target for the team is to increase the take up of Attendance Allowance and Disability Living Allowance. Approximately 40% of the people receiving a home care service were not in receipt of Attendance Allowance or Disability Living Allowance. The team will also be able to assist people in claiming other benefits. It is anticipated that the team will be in place from April 2003.

Outcome of Consultation

5.4 The consultation document for fairer charging dealt with two main areas. The first set of questions dealt with the implementation of the fairer charging guidance. The second part dealt with proposals for increasing charges.

5.5 There were 106 responses received, 47 of which were the easy English version. A summary of the responses to each question and comments made are detailed in Appendix A. A summary of the responses for the first section of the guidance is as follows:

· Proposal to have the same threshold for maximum charges as residential and nursing care 57% agree (32% disagree)

· Proposal to include attendance allowance and disability living allowance in financial assessments 61% agree (28% disagree)

· Proposed costs to be included in disability related financial assessments 79% agree (15% disagree)

· Proposal not to include gardening or transport as a disability related cost

50% disagree (44% agree)

· Proposal to charge carers 60% disagree (28% agree)

5.6 This would suggest that the first three questions were broadly agreed with.

5.7 There was dissatisfaction that gardening and transport should be disallowed as a disability related expense. Gardening is not a need that would be eligible for a service under Fair Access to Care (FACS). It was felt it would be unfair to allow some service users who could afford to buy this service, to claim for it whilst other service users would have no access to this help. Transport needs are common to many service users, the Council subsidises half price bus tickets and taxi tokens and many service users receive mobility allowance. It was therefore felt that these expenses should not be included.

5.8 There was general disagreement that charges for carers should be introduced. Carers may receive services in their own right following an assessment. This may, for example, include domestic help where the carer is providing substantial amounts of personal care to the service user. Discussions with practitioners indicate that where people have more than £19,000 they have been treating our current policy of not charging as a loophole for receiving services. Due to the dissatisfaction with the proposal to charge carers and the low level of income likely to be received it is proposed that carers with less than the charging threshold limits are not charged. Outcome of Consultation regarding increasing charges

5.9 There were a range of comments received about the proposals for increasing charges. There was approximately 46% of responses agreeing with the increased charges and 54% disagreeing. It should be noted that 20% of responses were from staff and 50% were from service users. Generally comments were received as follows:

· Increases were large

· Increases for day care were too large

· The maximum charge of £248 was too high and did not allow for household expenses.

5.10 Within the easy English responses there were 37 specifically related to increases in day care charges with 46% agreeing with the increase and 54% disagreeing. It should be noted that the day care charges have not been increased since they were introduced in 1996.

5.11 Some comments suggested protecting people that would face large increases. It should be noted that protection of existing service users from increases in charges would mean a loss of income of approximately £80,000. This would mean that the costs of fairer charging would not be met from increased charges.

Summary of charges by other Councils

5.12 Appendix D details the charges being made and proposed by other local authorities. It should be noted that the current charges for home care are significantly lower than near authorities and a charge of £7.20 per hour would bring charges more in line.

6 FAIR ACCESS TO CARE

6.1 The requirement for authorities to develop new eligibility criteria was introduced in `fair access to care services', (referred to as `FACS'). FACS was a part of the 1998 government white paper "modernising social services".

6.2 The key elements of FACS are as follows:

6.1 The progress so far is as follows:

7 IMPACT OF DRAWING THE THRESHOLD IN THE MODERATE BAND

The working group on FACS looked at a small sample of service users receiving either one domiciliary care service or meals only. They estimate that two thirds of these service users would continue to be eligible for a service.

8 CONSULTATION

8.1 Respondents (see appendix C) felt that on the whole the threshold in Fair Access to Care Services was fair and the framework was set out in a relatively clear way. There was concern that some people with needs in the lower bands would lose out and this would affect their quality of life and in some cases may lead to deterioration in their health and well being.

9 CONCLUSIONS

9.1 Drawing the threshold for Fair Access to Care in the middle of the moderate band would ensure that most current service users would continue to receive a service and the Council would be demonstrating a commitment to a preventative strategy. There would be some small savings over time where service users were no longer eligible for a service.

9.2 The proposals for implementing Fairer Charging should be implemented in accordance with the consultation document apart from Charges for Carers. Only carers with savings of more than the maximum thresholds (currently £19,000) should be charged.

9.3 The proposed increases in charges should be as follows :

· Increase charges for home care to £7.20 per hour

· Increase maximum charges for people with less than £19,000 to £56.25 per week

· Increase maximum charge for people with more than £19,000 to £200 (This allows for heating/lighting costs and is a reduction from the consultation document)

· Increase community meals charges to £2 per meal.

· Increase day care charges to £2.00 per day

· Include severe disability premium in financial assessments.

9.4 It should be noted that Fairer Charging and Fair Access to Care are linked. A reduction in charges will result in loss of income. In order to reduce costs it may mean that the thresholds for eligibility need to be tightened.

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