Doncaster Council – Changes to Adult Social Care Charges

Introduction

On Monday 14th October 2019, Doncaster Council will start consulting about proposals to change the way it charges for some adult social care services.

This consultation provides an opportunity for people to let the Council know how they feel about the changes proposed and how they think it could affect them either now or in the future.

This page explains why the council is considering changes, the details of each of the proposals and what will happen next.

Background

The amount of funding that the Council receives from the government has reduced by around 50% in the last 10 years. At the same time the number of people needing adult social care in Doncaster is growing.  This makes it harder to keep vital services running and make sure they are fit for the future. In order to protect and invest in services the Council has to consider how it can make the best use of the budget available whilst still supporting people to live independent, happy and healthy lives.

The way that services are charged for in Doncaster has remained unchanged for many years and it feels the right time to look at this. Charging needs to be clearer, more consistent and fairer. People with social care needs, including Doncaster’s most vulnerable people, will continue to be protected. Charges will be limited to levels that the government judge people can afford in relation to their income and assets. People will be assisted to claim the full range of benefits available to them.

The consultation contains nine proposals. The Council is seeking people’s views on individual proposals and also views on them collectively. People may have general views about the proposals and may also have views about how they could individually be affected.  The response to the consultation will inform Council Cabinet when it considers the proposals in February 2020. Cabinet will take account of the views of the public and decide which of the proposals will be taken forward, over what timescale and decide any actions needed to minimise the impact on individuals. Consequently, the consultation will influence which proposals are put into practise, over what period of time and who is affected by them.

Any changes agreed by Cabinet are proposed to start from April 2020, however some of the proposed financial assessment changes may be introduced over a number of years.

If all nine proposals are applied, then annual income would increase by approximately £2.5 million. This income would be re-invested in services to support increased demand for social care, mainly due to an estimated additional 400 people needing support.

The individual proposals, including the current arrangements, the future proposals and the potential impacts of these are detailed below:

Proposal 1: Home Alarm Service

Background

The Home Alarm Service provides 24 hour monitoring and response for 6,000 people across Doncaster, costing £1.5million a year to run. The service offers a pendant or wristwatch that is connected to a telephone line and is available to adults over 18 years of age, whatever their level of need or disability. The standard package gives access to an emergency responder and full maintenance of the equipment.

Extra items of assistive technology such as motion and falls sensors are available through the service to those people who are eligible for additional social care support.

Current Arrangement

The Service is currently charged at a standard weekly rate of £3.30 which has not changed significantly for a number of years. There are the following exceptions where people do not have to pay the charge:

  • People aged 65 and over who get housing benefit or Council Tax Support
  • People who are provided with assistive technology equipment as part of their assessed social care needs.
  • People who have reablement services (short term help to get their independence back for up to 6 weeks).

Issues with current arrangement

The Council’s current approach to charging generates £0.5 million in income. This is just one third of the current cost of the service. The Council also has to continually invest to improve the service. An extra £350,000 of investment is committed this year to further improve call monitoring and response. Over time, especially with more demand from people with social care needs, this will become unaffordable.

In light of this, it is hard to justify the charge remaining frozen. The cost of the service has increased over a number of years while the charge has not.

Having a one-size-fits all charge also feels too restrictive. Everybody using the service will benefit from the 24 hour monitoring, but people may want a choice about how any response is organised. This can be reflected in charges so that people who do not need a response from the Council (for example because their family are willing and able to respond if alerted) pay less than those who do.

It also does not seem fair to exempt some people aged 65 and over from charges, when people aged under 65 are not exempted in the same way.

New Proposal 

The proposal is to replace the current £3.30 per week charge with new charges that will cover more of the current costs and help towards improving the service; all people who can afford to would pay these charges. Two separate charges are proposed, one for the pendant alarm (which would be standard) and one for the response (which would be additional for those who wanted this).

New proposed Home Alarm Service rates based on choice and need
 

Pendant alarm service             £3.64 per week

Response Service                   £1.50  per week

 

 

The two separate charges give people a choice about which service would be best for them. For example, a person may just want the pendant alarm monitoring service with no response, costing £3.64 per week. Adding the response service to this would cost a total of £5.14 per week (£3.64+£1.50).

The proposed charges would be paid by everyone apart from people who:

  1. Qualify for care and support as part of their assessed social care needs, where assistive technology is used to meet a person’s social care need.
  2. Have reablement services to help to get their independence back, for up to a maximum of 6 weeks.

Impact

The Council’s approach to charging in this area would become fairer and more consistent for the reasons already described.

People would have more choice of what level of service they receive and pay for.

This proposal would not cause a change in charging for approximately 1,000 people who are eligible for adult social care. Therefore people with eligible social care needs would be protected.

There are approximately 700 people who do not have eligible social care needs who do not currently pay a charge but who would be expected to if this proposal was agreed.

A further 3,500 people who do not have eligible social care needs and who currently pay a charge would see this charge increase.

This proposal would increase annual income by £433,000 which would support the continued sustainability of the service and its ability to improve support year-on-year for Doncaster people.

Proposal 2: Care at home 

Background

The Council uses the national Care Act guidance to assess how much individuals should be charged for care they receive in their own homes. However there is current inconsistency in the approach that the Council takes to this assessment. For some people the Council does not include all the costs of care when working out what they should pay.

Current Arrangement

Some people need two or more care workers to help them at the same time. However only the cost of one care worker is currently included in financial assessments, when care has been arranged by the Council. However, when people opt to take a Direct Payment and arrange their care themselves they are charged against all care workers.

Issues with current arrangement

Costs are the same however services are accessed, so the charges that people have to pay should be the same. People who have taken the decision to receive a Direct Payment so they have more freedom to purchase their own care could be financially disadvantaged if they have high care needs that require more than one care worker to visit at one time. Because of this, people may be less likely to choose to have Direct Payments, meaning they do not have access to the choice and control this option otherwise brings.

New Proposal

The proposal is to include the costs of all care workers attending and providing a service to a person in their financial assessment.

Impact

Everyone’s financial assessment will be treated in the same way which will be much fairer.

People will only have to pay more if their financial assessment says they have enough money to pay for it. At the moment there are only about 10 people in Doncaster who would be likely to have to pay more.

Advances in new types of community equipment and assistive technology mean an increasing number of people can safely be supported without more than one care worker needing to visit at once. The Council is talking to people who currently have more than one care worker visiting at once to better understand their circumstances and increase their privacy and dignity whilst reducing their costs.

Proposal 3: Day Opportunities

Background

The Day services that the Council provides have changed significantly over the last few years, the new name for Doncaster Council day services is ‘SMILE’. Many of the services are now in community buildings that are nearer to where people live, so that the 280 people who use them have the opportunity to be involved within communities, enjoying different activities and improving their wellbeing and independence. People who attend day services have a financial assessment to ensure that they only pay what they can afford. The Council also provides transport for some people to attend day services for which there is also a charge.

Current Arrangement

People are only charged for their day care if they can afford it after financial assessment. The current chargeable cost of day care is £31 per person per day. This is the maximum that the Council charge people who have been assessed as able to afford it. However it actually costs the Council £46 for moderate support and £76 for high level support to provide the service.

People are charged a flat rate for their transport to day care regardless of their assets. This is in line with national rules. The current charge for transport to day care is £3 per journey. The Council has worked hard to reduce transport costs, but it still costs an average of £10 per journey to provide the service.

Issue with current arrangement

The costs of providing day services rise every year and the Council needs to look at appropriate options to increase income and continue to provide high quality support.

New Proposal

To ensure longer term sustainability, SMILE day services will continue to modernise and look at alternative transport delivery options.  While this is taking place, new charges for day care and for transport are proposed:-

Day Service:

The proposal is to increase the day care charge to reflect the actual cost of providing the services. This will mean that the maximum current charge per day, will increase from £31 to £46 for moderate support and from £31 to £76 for high level support. This will remain subject to financial assessment so people will only pay what they can afford.

Transport:

The proposal is to increase the charge for each journey from £3 to £4 from April 2020 and to further increase the cost by £1 a year after that, until the cost charged equals the actual cost of providing the transport. There are currently 150 people who still use Council transport. The relocation of day services to a range of community buildings across the borough has made it easier for the remaining 130 people to access them independently, avoiding the charge.

Impact

The new charge for day care is proposed to be introduced for new customers from April 2020. People who attend day services will continue to have a financial assessment to ensure that they only pay what they can afford. The council will work with existing service users who currently pay for their day care as their needs change over time.

About 150 people use transport services and would pay more, which would increase income by £25,000 a year.

 Proposal 4: Safeguarding personal assets

Background

The Council’s Safeguarding Adults Personal Assets Team (SAPAT) looks after financial, property and personal matters for some people who cannot do this for themselves or do not have family help. This is defined as either Deputyship, which is appointed by the Court of Protection, or Appointeeship, which is appointed by the Department of Work and Pensions.

Approximately 500 people are registered for this service.

Current Arrangements

The Council currently charges for Deputyship but it does not charge for Appointeeship.

The Council also does not charge for other aspects of the SAPAT service although it is allowed to by law. For example, protection of property and travel costs for Appointeeships and Deputyships.

Issues with current arrangement

The Council is not required to directly provide this service. If this service was not available from the Council then people would have to pay someone else to help them. The Council wishes to continue to provide this service for vulnerable people but it is difficult to do this sustainably without charging where it is lawful and reasonable to do this.

New Proposal

The proposal is to introduce new charges that the Council has not taken up before although it is allowed:

  1. Appointeeship charge – It is proposed to bring in a new charge to make sure that people using the council to look after their money and property all pay the same, whether it is an Appointeeship or Deputyship. The monthly charge will be between £2.03 and £48 depending on the persons assets/money and residential situation (see table).
Total savings Monthly  charge to community based clients Monthly tariff charge to residential care clients
£0 – £1,999 £2.03 £2.03
£2,000 – £2,999 £9.00 £6.00
£3,000 – £3,999 £12.00 £8.00
£4,000 – £4,999 £15.00 £10.00
£5,000 – £5,999 £18.00 £12.00
£6,000 – £6,999 £21.00 £14.00
£7,000 – £7,999 £24.00 £16.00
£8,000 – £8,999 £27.00 £18.00
£9,000 – £9,999 £30.00 £20.00
£10,000 – £10,999 £33.00 £22.00
£11,000 – £11,999 £36.00 £24.00
£12,000 – £12,999 £39.00 £26.00
£13,000 – £13,999 £42.00 £28.00
£14,000 – £14,999 £45.00 £30.00
£15,000 – £15,999* £48.00 £32.00

*Above £15,999 will become Deputyship

  1. Protection of property fee – It is proposed to reclaim any money it costs the council for protecting the property of adults being cared for away from home. Charges will be for property searches (£70 per visit); weekly property checks (£10 per visit); storage of property (actual cost), and; boarding of animals (actual cost).
  • Travel charge for client visits – The council proposes to charge a fixed rate of £40.00 per hour for travel costs when staff visit clients, which is what the Court of Protection allows.

Impact

269 people are supported by Appointeeship and would pay the new charges.

The charges for protection of property and travel costs will apply to all people referred to the service.

This proposal would increase annual income by £165,000 which would make sure that the service can continue to support the vulnerable people who are not able to look after their own affairs.

 

Proposal 5: Arrangements for people who pay for their own care in full

Background

People who have over £23,250 (including investments/bonds but excluding the value of their home), are currently seen by the government as being able to pay for their own care and support. This amount is updated each year by the government.

Current arrangements

At the moment the council helps around 450 people in this group to arrange their care without charging them. The majority of people in this group make their own care arrangements using free information and advice that is available.

Issue with current arrangements

Arranging care means the Council has to incur administrative costs for a group of people who are regarded by national rules as having the means to fund their own care.

New Proposal

It is proposed that an annual charge is introduced to contribute to the costs of providing the services described above and to encourage people to arrange their own care where appropriate, using information and advice that the Council is already required to provide.

Proposed new administration fee for people who pay for their own care
Yearly administration charge of £300

The council is not allowed to charge for giving information and advice, or assessment of needs and so these costs are not included in the proposed administration fee.  The cost covers the organisation, set up and paperwork costs.

Impact

There are 450 people who pay for their own care currently supported by the council who use both residential and home care services. This number is expected to reduce as more people are helped to arrange their own care.

This proposal would increase annual income by £135,000 which would contribute to the cost of providing the service, helping to keep it running and making sure money is available to continue to support the most vulnerable people.

Financial Assessment Procedure Changes

Background

After people’s care needs have been assessed and an agreed care and support plan is in place, there is a financial assessment. This is where the Council asks about finances and income, to work out how much a person will contribute to their care in line with national guidance.

For some people the way Doncaster Council does a financial assessment is based on old rules and circumstances. So how Doncaster Council does financial assessments needs to be brought up to date, made more fair, more clear and easier to understand and use.

The changes to financial procedure rules are estimated to increase income collectively by approximately £1.7m. This money will contribute to making sure that the additional demand for social care can be supported.

The council is proposing four changes to the financial assessment as follows:

Proposal 6: Maximum weekly charge for non-residential services

Current Arrangement

No matter how much a home care and support package costs, the council will only charge those who are deemed able to afford to pay a maximum of £429.20 per week. For some people it costs more than this for their care and support package, but the council does not ask for more than the maximum amount.

Issue with current arrangement

The maximum charge does not have a clear justification.

New Proposal

The proposal is to take away the maximum amount and instead charge the full cost of the service provided to those people who can afford to pay.

Impact

The proposed change would only apply to people who exceed the current maximum in the future. This is to avoid a sudden large increase for people who are exceeding the current maximum now.

Financial assessment will determine the maximum amount people are able to pay. It is expected that fewer than 10 people at any one time will have to pay more than the current £429.20 per week limit.

Proposal 7: Enhanced daily living component of Personal Independence Payment (PIP)

Current Arrangement

When people are financially assessed their savings, income and money they need to pay out are all taken into account.  The Department for Work and Pensions benefits paid to people with a long-term illness or disability are seen as part of a person’s income.  These benefits include Attendance Allowance (AA), Disability Living Allowance (DLA) and the enhanced daily living component of Personal Independence Payments (PIP).

However the enhanced rate of PIP is not currently taken into account. This is £28.95 a week more than the standard rate.

Issue with current arrangement

Many other Local Authorities take both components of PIP into account. There is no clear reason why it should be exempt as compared to other benefits paid to people with a long-term illness or disability.

New Proposal

The proposal is to move towards including all of the enhanced rate of PIP in financial assessments from April 2020. If a person receiving PIP can show that they pay for additional care at night, their night care costs will be looked at as part of the assessment.

Impact

This is likely to have an effect on around 261 people and would increase annual income by £290,000 when fully implemented. The people who would pay more are people without night care costs.

 

Proposal 8: Financial assessments for residential respite and short stay care

Current Arrangement

When people receive residential respite or short-term residential care (ie they receive their care away from home for a short period most often to give family carers a break), this arrangement is also subject to charging after a financial assessment. The Care Act allows options to carry out this financial assessment under residential or non-residential rules. Up to now, the Council has chosen non-residential rules.

Issue with current arrangement

It does not seem logical to charge a residential arrangement against non-residential rules.

New Proposal

Where the respite and short stay care is residential based, the proposal is that in future the financial assessment for this service would be carried out under the residential care rules.

Impact

This proposal will affect anyone that is entitled to respite or short stay accommodation. 395 people had residential respite care in 2018/19. It would increase annual income by £378,000 a year.

The residential care assessment includes options to take into account the extra household costs that a person might have to pay for their normal home whilst spending time in respite care. This household allowance is there to cover expenses such as rent, service charges, water rates or insurance premiums.  People will still pay more, but the extra household allowance will protect more of a person’s money.

 

Proposal 9: The Minimum Income Guarantee (MIG)

Current arrangement

When doing a financial assessment to work out how much a person can afford to pay  towards the cost of their care, councils are given advice by the government on how much of a person’s total weekly income should not be used towards care charges. The protected money is known as the Minimum Income Guarantee (MIG). This is to make sure that people living in their own homes, who need social care, have enough money left to pay their everyday living costs once they have paid for their care.

Every year the government announces the amount of MIG that it recommends councils should use in financial assessments. At present the Council does not use these recommended amounts but uses its own MIG amounts, which are more generous than the government recommends. As an example, the government recommends using a MIG of £189 per week for a single person over pension age but the council uses a MIG rate of £209.06.

The government publishes different MIG rates to reflect people’s different circumstances. These are updated every year.

Age Government MIG Doncaster MIG Weekly MIG difference
18-24 £132.45 £136.31 £3.86
25-64 £151.45 £155.31 £3.86
65 years or older £189.00 £209.06 £20.06

 

Issue with current arrangement

Many other Local Authorities use the government recommended Minimum Income Guarantee.  The current Doncaster Minimum Income Guarantee rates limit the income that is available to support services for everybody who needs them.

New Proposal

From April 2020, the council is proposing to move towards the government set MIG rates and use these in financial assessments instead of working out its own rate.

Impact

Using the government set MIG rates will affect 1,658 people who currently receive services and would increase annual income by £1 million when fully implemented.

The change would be brought in over a period of time, which would mean that the council Minimum Income Guarantee rates would not change by more than 3% per annum. It is expected that the Minimum Income Guarantee Government rate will be increasing each year and that will be taken into account.

On the basis of current information, the proposal would mean that people in the above group would pay an increasing contribution until they are paying the following amounts more than they do today:

  • 48% would pay no more than £3.86 extra per week
  • 3% would pay between £3.87 and £10 extra per week
  • 44% would pay between £10 and £20.06 extra per week
  • 5% would pay between £20.07 and £40 extra per week

In extremely rare cases (1 person currently known) there would be a requirement to pay more than £40 extra.

The biggest impact of the Council adopting the national government rules would be on couples. The government advises councils not to assess couples on their joint money and instead to only take into account the money of the person receiving care.

There are currently 104 people affected and the council will work with them to ensure that both their and the cared-for person’s financial wellbeing is appropriately taken into account.

 

Next steps

Following the end of the consultation period all views, comments and survey responses will be collated into a report, which will then be passed to the decision makers.  This report will be available to you via the Doncaster Council website.  Council Cabinet will be meeting in February 2020, when it will consider each of the proposals, taking into account the views of the public, and will decide upon which of the proposals will be taken forward, over what time scale and whether there are any extra actions needed to lessen the impact upon individuals.  The outcome will be published on the Council’s website.  If the proposals are agreed we will be writing to those people affected detailing how the changes will individually affect them.

Note: Further information and answers to frequently asked questions are available on the consultation website or on request. You can access to consultation website here

Please help us to spread the word and encourage as many people as possible to feedback their views on these proposals. If you can not do this using the on-line consultation website, you can attend a meeting and make your views known in person. Details of these meetings are as follows:

Drop-in Events

There are drop-in events taking place across the Borough, during the consultation period, which are open to all. You do not have to pre-book and you can attend any time during the event:

  • Bentley Library, Chapel Street – 24/10/2019 10:00am – 12:00pm
  • Mexborough Library, John Street – 28/10/2019 10:00am – 12:00pm
  • Edington Martin Wells Centre, Thompson Avenue – 29/10/2019, 10:00am – 14:00pm
  • Denaby Community Library, Old Road – 01/11/2019 10:00am – 14:00pm
  • Thorne Vermuyden Centre, Field Side – 05/11/2019 10:00am – 15:00pm
  • Bawtry Library, Doncaster Road – 08/11/2019 10:00am – 11:30am
  • Rossington Holmescarr Centre, Grange Lane – 12/11/2019 09:30am – 12:00pm
  • Carcroft Redmond Centre, High Street – 13/11/2019 10:00am – 12:00pm
  • Armthorpe Library, Church Street – 13/11/2019 10:00am – 11:30am
  • Stainforth for All (Old Library), Church Road – 14/11/2019 10:00am – 11:30am
  • Cantley Neighbourhood Centre, St Wilfrid’s Road – 21/11/2019 10:00am – 12:00pm
  • Intake Library, Montrose Avenue – 26/11/2019 10:00am – 12:00pm
  • Moorends Medical Centre, Marshland Road – 27/11/2019 10:00am – 11:30am
  • Askern Library, Station Road – 28/11/2019 10:00am – 12:00pm
  • Doncaster Council Civic Office, One Stop Shop, Waterdale – 04/11/2019 14:00pm – 16:00pm
  • Balby Library, High Road – 11/12/2019 13:00pm – 15:00pm

Please note that the consultation is open for your feedback for 10 weeks, closing on 22/12/2019

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