Hillingdon Council Cabinet Member and Officer Decisions
OUTCOME OF CHARGING FOR SOCIAL CARE AND SUPPORT POLICY CONSULTATION
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Democratic Services Location: Phase II Ext: 7655 DDI: 01895 277655 CMD No: 1405 To: COUNCILLOR JANE PALMER CABINET MEMBER FOR HEALTH & SOCIAL CARE c.c. All Members of th e Health & Social Care Select Committee c.c. Sandra Taylor, Corporate Director of Adult Social Care & Health c.c. Sarah Baker, Programme Manager Date: 17 April 2025 Non-Key Decision request Form D OUTCOME OF CHARGING FOR SOCIAL CARE AND SUPPORT POLICY CONSULTATION Dear Cabinet Members, Attached is a report requesting that a decision be made by you as an individual Cabinet Member. Democratic Services confirm that this is not a key decision, as such, the Local Authorities (Executive Arrangements) (Meetings and Access to Information) (England) Regulations 2012 notice period does not apply. You should take a decision on or after Tuesday 29 April 2025 in order to meet Constitutional requirements about publication of decisions that are to be made. You may wish to discuss the report with the Corporate Director before it is made. Please indicate your decision on the duplicate memo supplied and return it to me when yo u have made your decision. I will then arrange for the formal notice of decision to be published. Anisha Teji Democratic Services Title of Report: Outcome Of Charging For Social Care And Support Policy Consultation Decision made: Reasons for your decision: (e.g. as stated in report) Alternatives considered and rejected: (e.g. as stated in report) Signed ……………………………………………………… Date…………………….. Cabinet Member for Health & Social Care Cabinet Member Report – 17 April 2025 Part I – Public OUTCOME OF CHARGING FOR SOCIAL CARE AND SUPPORT POLICY CONSULTATION Cabinet Member & Portfolio Councillor Jane Palmer, Cabinet Member for Health & Social Care Responsible Officer Sandra Taylor, Corporate Director of Adult Social Care & Health Report Author & Directorate Sarah Baker, Programme Manager Papers with report Appendix 1, Appendix 2 and Appendix 3 HEADLINES Summary The purpose of this report is to present to the Cabinet Member the outcome of the Adult Social Care Charging Policy consultation, which ran from 3rd February 2025 to 17th March 2025. In January 2025 Cabinet approved a consultation of an updated Adult Social Care Charging for Social Care and Support Policy for Hillingdon for 2025/26 for charging adults receiving care and support services in the Borough. The consultation focussed on the introduction of a fee for arranging care to any resident receiving care in the community (not in a care home or nursing home) who has sufficient funds to pay for their own care Cabinet delegated authority to the Cabinet Member for Health & Social Care, in consultation with the Corporate Director of Adult Social Care and Health and Corporate Director of Finance , to consider the outcome of the public consultation and to then determine the final policy and fees for 2025/26. Putting our Residents First Delivering on the Council Strategy 2022-2026 This report supports our ambition for residents / the Council of: Stay living independently for as long as they are able This report supports our ambition for residents / the Council of: An efficient, well-run, digital-enabled council working with partners to deliver services to improve the lives of all our residents This report supports our commitments to residents of: Safe and Strong Communities Cabinet Member Report – 17 April 2025 Part I – Public This report supports the visions outlined in the Joint Health & Wellbeing Strategy and Adult Social Care and Health Plan. Financial Cost Having a robust and up to date charging policy enables the council to successfully collect assessed contributions for care services . The updated policy proposes applying a care arrangement fee to residents funding their own care in the community (not in a care home or nursing home). This charge will take two forms: an annual set up fee and then a yearly admin cost after that to cover the cost of arranging, reviewing and monitoring care and will generate a c£65k new income stream. Select Committee Health & Social Care Select Committee Ward(s) N/A RECOMMENDATIONS That the Cabinet Member for Health & Social Care: 1. Considers the outcome of the consultation and the equalities impact assessment as set out in the report. 2. Upon the advice of Corporate Director of Adult Social Care and Health agrees the 25/26 Adult Social Care Charging for Social Care and Support Policy. 3. Notes that for 26/27 onwards, this policy and fees will be reviewed annually as part of the Council’s wider review of fees and charges to provide a transparent and consistent approach going forward. Reasons for recommendation(s) The revised Policy will meet the principles for charging set out in the Care and Support Statutory Guidance. It is a robust, up-to-date and comprehensive policy that will ensure that the Council is able to charge and collect contributions towards the cost of care and support services. The fees charged by the council for adult social care services are crucial, they are however, proportionate and take into consideration the ability to pay. Without the revenue from these charges, the service would not be viable in the future The feedback from the consultation exercise reflected the challenges in providing a technically detailed policy that is also easy to follow but there were no issues raised that have required any Cabinet Member Report – 17 April 2025 Part I – Public changes to the revised Policy. Further work will be undertaken to provide supporting information via the councils’ factsheets to aid understanding. It is essential that there is a policy to provide a framework for charging, and that this is reviewed and updated annually in line with the Councils fees and charges review at annual budget setting. Alternative options considered / risk management The Cabinet Member can choose not to agree to the revised charging policy. This is not recommended due to: • Feedback from the consultation does result in the need to review or rewrite the charging policy. • T he current policy is out of date and therefore is not providing the necessary clarity and transparency regarding paying for care which may result in a loss of income • The benefits highlighted in the points above will not be achieved Democratic compliance / previous authority Cabinet in January 2025 delegated authority to the Cabinet Member to determine fees and charges and the policy following consultation. Select Committee comments None at this stage. SUPPORTING INFORMATION Residents of Hillingdon who require adult social care support have both their care needs and income assessed by the council to determine their financial contribution. Some residents do not need to contribute towards their care, some pay a contribution, and some pay for all their care (these people are known as self-funders). If a resident has more than £23,250 in savings and other capital (not including the value of their main or only home) they must pay the full cost of their care and support. Self-funders can choose to arrange their care themselves or ask the council to do it on their behalf. Self-funders are still entitled to have an assessment of care needs and can ask the council to arrange their care on their behalf or arrange it for themselves. They may ask the council to arrange care on their behalf due to reasons such as the person finding the system too difficult to navigate or wishing to take advantage of the council’s knowledge of the local market for care and support services. When a person asks the council to meet their eligible needs in the community, then the council may choose to meet their needs but charge a fee for the service. The fee should include the cost of negotiating and managing the contract with the provider and cover administration costs. Cabinet Member Report – 17 April 2025 Part I – Public The Charging for Care and Support Policy for Hillingdon has been updated to include the application of a fee for arranging care to any resident who is receiving support in their own home and has sufficient funds to pay for their own care. Financial Implications Following the consultation, this report recommends that, as part of the revised charging policy, a charge for self-funders receiving care in the community is introduced. This charge will take two forms: an annual set up fee of £470 and then a yearly admin charge of £255 thereafter to cover the cost of arranging care. The financial implications are unchanged from the January 2025 Cabinet report. The forecast number of self-funders receiving care in their own home by the end of the financial year is 270. It is estimated that the new charging policy will produce a n income stream of c£72k per annum. This assumes 13 new self-funders each year based on historic trends but also assumes attrition of 13 self-funders due to deterrent impact of the charge. There is a risk that the deterrent impact is greater than anticipated which will reduce the income target and this will be monitored closely as part of the budget monitoring process. RESIDENT BENEFIT & CONSULTATION The benefit or impact upon Hillingdon residents, service users and communities A robust Adult Social Care C harging policy is essential for creating a sustainable, fair, and effective social care system that meets the needs of all residents. It is important that the Adult Social Care Charging policy is reviewed and updated annually in line with the Councils annual fees and charges review. The proposed changes will have an impact on all residents who are funding their own care but ask for it to be arranged by the council Self Funder Modelling 25/26 £'000 Set Up Modelling New Self Funders Clients 13 New Self Funder Income 6 A nnual Review Modelling Existing Self Funders Clients 257 Annual Review Income 66 Total Self Funders Clients 270 Total Self Funder Income 72 *Modelling assumes 13 new starters each year but anticipated attrition of 13 due to deterrent impact of charge Cabinet Member Report – 17 April 2025 Part I – Public Consultation Details and response As agreed by Cabinet in January 2025, the council has now run a public consultation on the proposed changes to the Adult Social Care charging policy The consultation ran from 3rd February to 17th March 2025 and was focussed on the main change to the policy, specifically the application of a fee for arranging care to any resident who has sufficient funds to pay for their own care in the community and would like the council to negotiate, arrange and manage care and support services with care providers on their behalf. A letter was sent to 209 adults who are currently self -funding their care in their own homes to inform them of the consultation. The letter advised them how they could give their feedback on the proposal to apply an arrangement fee for the service. Feedback on the changes could be sent in writing or through the completion of an online survey on the Hillingdon Council website. Details of the consultation was published in the Hillingdon People magazine a nd the weekly Voluntary services Partnership Circular . Social care providers and staff were briefed and asked to support people in taking part in the consultation. Officers also directly contacted the Hillingdon Carers Trust, Age UK Hillingdon, Citizen Advice Hillingdon, Bellfarm, DASH and Hillingdon Mind to inform them of the consultation, and to offer to meet with their members to discuss the consultation proposals. The letters contained a telephone number and email address to contact with any queries relating to the consultation or if the person was unable to access the information online and needed any support to take part. 6 residents raised questions via the telephone or through the website, these were all answered via a call from an officer in Adult Social Care. 46 responses to the consultation were received (22% of the number of self funders directly affected) and unsurprisingly with a consultation of this nature where people may have to pay more for services, responses on the proposal were mixed. Most responses focussed on the principle that they or their family member already pay for their care and do not believe they should pay more into the social care system, very few said that they couldn’t afford it. Our intention is to ensure the most vulnerable residents who have care act eligible needs are supported. The residents directly affected by the proposal do not need to ask the council to arrange care on their behalf, they or their family can arrange it and this would be free. The Care Act is clear those that can afford to pay do so and that if they choose to ask the council to arrange their care, an arrangement fee can be charged. If the application of an arrangement fee is agreed, a further letter will be sent t o the residents directly affected advising them of the decision and informing them when they will receive an invoice for the fee. Cabinet Member Report – 17 April 2025 Part I – Public A breakdown of the responses is detailed in Appendix 2 An Equality Impact Assessment is detailed below in Appendix 3. CORPORATE CONSIDERATIONS Corporate Finance Corporate Finance have reviewed this report and concurs with the Financial Implications set out above, noting that the Cabinet Member for Health and Social Care considers the outcome of the consultation and the equalities impact assessment and agrees to the 2025/26 Adult Social Care Charging for Social Care and Support Policy. Furthermore, it is noted that the Adult Social Care Charging for Social Care and Support Policy will create an additional income stream through charging self -funding residents. The current estimate for this income stream is £72k, based on the forecast number of 270 self -funding residents receiving care in their own homes by the end of the financial year 2025/26, however, this could reduce if the new charge acts as a deterrent and reduces the number of self -funding residents. The impact of the additional income stream will be monitored as part of the regular monthly budget monitoring process and as part of the wider MTFS. Legal There are no legal impediments to the recommendations set out within the report. BACKGROUND PAPERS NIL TITLE OF ANY APPENDICES Appendix 1 – Hillingdon Charging for Care and Support Policy Appendix 2 – Details of consultation responses Appendix 3 – Equality Impact Assessme Cabinet Member Report – 17 April 2025 Part I – Public Appendix 2 Adult Social Care Charging Policy Consultation Summary 2025 1. Circumstances of those completing the form: I get help from family and paid carers, but no help from the Council 1 I am a resident 3 I am the carer or representative of someone who gets help with care and support from the council (Adult Social Care) 13 I am the carer or representative of someone who gets help with care and support from the council (Adult Social Care) and I get help with care and support from Hillingdon Council (Adult Social Care) 1 I belong to an organisation that works with vulnerable adults in Hillingdon 1 I get help with care and support from Hillingdon Council (Adult Social Care) 18 I get help with care and support from Hillingdon Council (Adult Social Care) and I am the carer or representative of someone who gets help with care and support from the council (Adult Social Care) 2 I pay for the Adult Social Care Social 1 I pay in full for all services 1 My son looks after my mum 1 Other (not specified) 4 Grand Total 46 2. Do you support the Council's proposal to introduce an annual set up fee and a yearly admin charge for arranging care for residents receiving care in their own home who have sufficient funds to pay for their own care? Cabinet Member Report – 17 April 2025 Part I – Public 5. Postcode of respondents 6. Gender of respondents Female 25 Male 17 Prefer not to say 4 Grand Total 46 7. Age range of respondents 35-44 2 45-54 3 55-64 4 65+ 32 Prefer not to say 5 Cabinet Member Report – 17 April 2025 Part I – Public Grand Total 46 8. Ethnicity of respondents Asian or Asian British ethnic group or background (Indian, Pakistani, Bangladeshi, Chinese or any other Asian background 3 Other ethnic group or background (Arab, any other ethnic group) 1 Prefer not to say 11 White group or background (English, Welsh, Scottish, Northern Irish or British Irish, Gypsy, Irish Traveller, Roma, any other Traveller background, any other White background) 31 Grand Total 46 9. Sexual orientation of respondents Straight/heterosexual 30 Prefer not to say 16 Grand Total 46 10. Religion or belief of respondents Christian (Catholic, Church of England, Protestant, and all other Christian denominations) 23 Hindu 2 Muslim 2 Sikh 1 No religion 6 Prefer not to say 12 Grand Total 46 11. Whether respondents have a disability (A physical or mental illness or condition that has a substantial and long-term effect on your ability to carry out normal day to day activities). Yes 26 No 10 Prefer not to say 10 Cabinet Member Report – 17 April 2025 Part I – Public Grand Total 46 12. How survey was completed. By post 20 Online 24 Over the phone 2 Grand Total 46 Cabinet Member Report – 17 April 2025 Part I – Public Appendix 3 Equality and Human Rights Impact Assessment NOTE: all text in red and blue is for information and guidance only. Delete this once the assessment is completed. Please refer to guidance published on the intranet here: Equality impact assessment tools (sharepoint.com) STEP A) Description of what is to be assessed and its relevance to equality What is being assessed? Please tick Review of a service Staff restructure Decommissioning a service Changing a policy Tendering for a new service A strategy or plan Update of Adult Social Care Charging Policy including that addition of an arrangement fee, Who is accountable? E.g. Head of Service or Corporate Director Sandra Taylor Date assessment completed and approved by accountable person 8th April 2024 Names and job titles of people carrying out the assessment Sarah Baker Adult Social Care Programme Manager Cabinet Member Report – 17 April 2025 Part I – Public A.1) What are the main aims and intended benefits of what you are assessing? Residents of Hillingdon who require adult social care support have both their care needs and income assessed by the council to determine their financial contribution. Some residents do not need to contribute towards their care, some pay a contribution, and some pay for all their care (these people are known as self-funders). If a resident has more than £23,250 in savings and other capital (not including the value of their main or only home) they must pay the full cost of their care and support. Self - funders can choose to arrange their care themselves or ask the council to do i t on their behalf. Self-funders are still entitled to have an assessment of care needs and can ask the council to arrange their care on their behalf or arrange it for themselves. They may ask the council to arrange care on their behalf due to reasons such as the person findi ng the system too difficult to navigate or wishing to take advantage of the council’s knowledge of the local market for care and support services. When a person asks the council to meet their eligible needs and the care is in their own home, then the council may choose to meet their needs but charge a fee for the service. The fee should include the cost of negotiating and managing the contract with the provider and cover administration costs. The Charging for Care and Support Policy for Hillingdon has been updated to include the application of a fee for arranging care to any resident receiving care in their own home who has sufficient funds to pay for their own care. A.2) Who are the service users or staff affected by what you are assessing? What is their equality profile? A letter was sent to 209 adults who are currently self-funding their care in their own homes to inform them of the consultation. The letter advised them how they could give their feedback on the proposal to apply an arrangement fee for the service. 46 responses were received with the following equality profile 69% Older People 67% White group or background 56% People with disabilities 54% Women A.3) Who are the stakeholders in this assessment and what is their interest in it? Stakeholders Interest Cabinet Member Report – 17 April 2025 Part I – Public Leader and Cabinet Members A well-defined charging policy ensures that residents receiving care in their own home pay what they can afford towards their care and support and that councils can effectively collect contributions towards the cost of care and support services. This helps maintain the financial health of the council and ensures that resources are available to support those in need Regularly reviewing and updating the policy allows councils to respond to changing needs and circumstances, ensuring that the policy remains fit for purpose and sustainable Residents paying towards their care and support including those being asked to pay an arrangement fee A clear and transparent charging policy helps residents understand how charges are calculated and what they are paying for. This transparency builds trust and allows residents to plan their finances better By ensuring that the council can sustainably fund social care services, a robust charging policy helps maintain high standards of care. This means residents can access the support they need to live independently and with dignity Cabinet Member Report – 17 April 2025 Part I – Public A.4) Which protected characteristics or community issues are relevant to the assessment? in the box. Age Sex Disability Sexual Orientation Gender reassignment Socio-economic status Marriage or civil partnership Carers Pregnancy or maternity Community Cohesion Race/Ethnicity Community Safety Religion or belief Human Rights STEP B) Consideration of information; data, research, consultation, engagement B.1) Consideration of information and data - what have you got and what is it telling you? At the time of the consultation 209 residents were funding their own care in the community and were sent a letter advising them of the proposal to apply an arrangement fee. The proposal will have a negative impact on some residents, since they will need to pay more for the services. • Gender, more residents are female, however, males would also be impacted by the fee • It is noted that there is clear evidence to show that older people and people from white groups or background have proportionately higher levels of income and would therefore be impacted due to having the ability to pay for services. • The majority of those affected did not state that they were unable to afford the fee, they generally felt that they already paid enough. Noone would be asked to pay more than they can afford. Cabinet Member Report – 17 April 2025 Part I – Public Consultation B.2) Did you carry out any consultation or engagement as part of this assessment? Please tick NO YES Details of the consultation was published in the Hillingdon People magazine and the weekly Voluntary services Partnership Circular. Social care providers and staff were briefed and asked to support people in taking part in the consultation. Officers also directly contacted the Hillingdon Carers Trust, Age UK Hillingdon, Citizen Advice Hillingdon, Bellfarm, DASH and Hillingdon Mind to inform them of the consultation, and to offer to meet with their members to discuss the consultation proposals. No face-to-face meetings were requested B.3) Provide any other information to consider as part of the assessment Legal context The council has a public duty to pay due regard to the need to eliminate discrimination, advance equality of opportunity and foster good relations (Equality Act 2010) Financial context - standard text Since 2010, the Business Improvement Delivery (BID) Programme has driven transformation across the Council, reducing costs and improving efficiency to ensure that in an environment of increased expenditure from population growth and inflationary uplifts we continue to deliver high quality services that put residents first. Hillingdon's approach to maintaining sound financial management ensures that our finances are in a robust position, and therefore the Council is well placed to respond to Government funding not increasing at the same pace as the combined impact of a growing demand for services and increased market forces. Our latest projections indicate that further savings of £35m will be required by 2026/27 to bridge the resulting budget gap. What are your local savings targets? The savings attached to this review is £270k Cabinet Member Report – 17 April 2025 Part I – Public National policy context The Care Act 2014 requires the Council to set up and deliver an Information, Advice and Guidance service for all people in their area regarding a range of topics including, maximising independence, accessing care and support, preventing and managing homelessness and tackling poverty. C) Assessment What did you find in B1? Who is affected? Is there, or likely to be, an impact on certain groups? C.1) Describe any NEGATIVE impacts (actual or potential): Equality Group Impact on this group and actions you need to take Older People As there is a high percentage of older people who are paying the full cost for their care in their own home, the revised policy may have a potentially negative impact on this group. Residents will be advised that they or their family can arrange their own care and this would be free. The council can support with finding a provider by signposting to the care directory which details a range of care providers for them to consider From a white group or background As there is a high percentage of people from a white group or background who are paying the full cost for their care, in their own home the revised policy may have a potentially negative impact on this group. Residents will be advised that they or their family can arrange their own care and this would be free. Cabinet Member Report – 17 April 2025 Part I – Public The council can support with finding a provider by signposting to the care directory which details a range of care providers for them to consider People with disabilities As there is a fairly high percentage of people with disabilities who are paying the full cost for their care in their own home , the revised policy may have a potentially negative impact on this group. Residents will be advised that they or their family can arrange their own care and this would be free. The council can support with finding a provider by signposting to the care directory which details a range of care providers for them to consider Women As there is a fairly high percentage of women who are paying the full cost for their care in their own home, the revised policy may have a potentially negative impact on this group. Residents will be advised that they or their family can arrange their own care and this would be free. The council can support with finding a provider by signposting to the care directory which details a range of care providers for them to consider C.2) Describe any POSITIVE impacts Equality Group Impact on this group and actions you need to take Older People Residents including older residents will be made aware that the fee can ensure that self-funders have access to the council's expertise in negotiating and managing care services. This can lead to better quality and more reliable care arrangements From a white group or background Residents including those for a white group or background will be made aware that the fee can ensure that self- funders have access to the council's expertise in negotiating and managing care services. This can lead to better quality and more reliable care arrangements Cabinet Member Report – 17 April 2025 Part I – Public People with disabilities Residents including those with disabilities will be made aware that the fee can ensure that self-funders have access to the council's expertise in negotiating and managing care services. This can lead to better quality and more reliable care arrangements Women All Residents will be made aware that the fee can ensure that self-funders have access to the council's expertise in negotiating and managing care services. This can lead to better quality and more reliable care arrangements D) Conclusions The application of an arrangement fee for adult social care self-funders paying for care in their own home has been assessed for its potential equality impacts. The assessment indicates that while the introduction of this fee may impose an additional financial burden on self-funders, it is designed to ensure fairness and sustainability in the provision of care services. The fee is structured to ensure that those who can afford to pay for their care contribute to the administrative costs, promoting a fair distribution of resources. There will be clear communication about the fee and its purpose enhances transparency, helping residents understand the costs involved. The revenue generated from the fee supports the sustainability and quality of adult social care services, benefiting all users. The fee structure will be regularly reviewed to ensure it remains fair and equitable and we will ensure that the fee does not create barriers to accessing necessary care services. Overall, the arrangement fee is a necessary step towards maintaining a robust and sustainable adult social care system, with careful consideration given to minimising any negative impacts on residents. Signed and dated: Sarah Baker...8th April 2024 Name and position: Sarah Baker Adult Social Care Programme Manager 1 Adult Social Care Charging Policy 2 Contents Section Title Page number 1 Introduction 3 2 Purpose of this policy 3 3 Legal Framework 5 4 Principles 5 5 Chargeable Services 6 6 When charges do not apply 6 7 The Financial Assessment 6 8 Examples of how the council work out a contribution 7 9 Mental Capacity 9 10 Capital Limits 9 11 Deprivation of Capital 10 12 Changes in an individual’s financial circumstances 11 13 Living Expenses - Residential Care 11 14 Treatment of Property - Residential 11 15 Deferred Payment Agreement 12 16 Top Up Payments 14 17 Charging for Non-Residential Care and Support 14 18 Living Expenses - Non-Residential 15 19 Housing Costs 15 20 Disability Related Expenses 15 21 Operation of the Councils Charging Policy 16 22 Transport Costs 16 23 Charging for Telecare 17 24 Charging for the arrangement of care 17 25 Safeguarding 18 26 Debt Recovery and Fraud 18 27 Appeals 19 28 Complaints 19 29 Reviewing the Policy 19 3 1. Introduction Adult social care provides personal and practical support to people with care and support needs, including older people or people with a disability or a physical or mental illness. People with informal caring responsibilities can also benefit from social care support. In the London Borough of Hillingdon, the core purpose of adult care and support is to help you to achieve the outcomes that matter to you in your life and to promote your wellbeing. A key aim is to support you to live as independently as possible, for as long as possible. The Council provide free information and advice, relating to care and support for adults and support for carers, to enable you to make informed choices and take control of your care and support. This includes information about social care on our website at www.hillingdon.gov.uk/socialcare Adult Social Care vision Hillingdon Council is committed to its provision of Adult Social Care Services (ASC) and its vision that “Care and support will be personalised and will prevent, reduce and delay needs. Residents will be enabled to live independent and fulfilled lives, supported within and by their local networks wherever possible.” The ASC vision is underpinned by the Council Strategy 2022-2026, and the Council’s five commitments to residents which can be found here: www.hillingdon.gov.uk/council-strategy 2. Purpose of this policy In England, adult social care is currently means-tested and, unlike the NHS, is not free for everyone, with costs dependent on a person’s level of need and their financial situation. This means that most care and support will be subject to a charge, but you will only be asked to pay what you can afford, this will be done by a fair and transparent financial assessment process. This Charging for Care and Support Policy outlines how Hillingdon Council calculates any charges it may make to you or a third party following an assessment of your care and support needs. There are rules around whether a financial contribution needs to be made by you towards care and support provided to you whilst living in your own home, which is also known as non -residential care. There are also rules around the contribution you may need to make if you are living in a residential home or nursing home. These rules follow central government policy designed to make sure that people over the age of 18 are charged in a fair and reasonable way. The policy does not apply to people under the age of 18 years. 4 Residential Residential care means care and support is provided to someone in a care home setting. It is for people who need substantial help with their personal care. There are 2 main types of care home: • residential - offers personal care, such as help with washing, dressing, going to the toilet and taking medication. • nursing - provides personal care and always have qualified nurses on duty. They can be suitable for people who require frequent medical attention. Non-Residential Non-residential services refer to a range of care and support that is provided in your home or in the community to meet your needs and to help you achieve your identified outcomes. These include: • Day opportunities and support in the community; • Transport to and from day care and respite care; • Assistive Technology • Care at home services that provide support with personal care and daily living in your home; • Other services that you may purchase directly, e.g., a personal assistant; • Shared Lives services; • Extra Care services • Supported living services 5 3. The Legal Framework A key aim of the policy is to ensure that when you are charged for care and support, that you are charged in accordance with the Care Act 2014 and the associated statutory guidance. Section 14 of the Care Act 2014 provides the Council with the power to ask you to make a contribution for the cost of your care and support. Section 17 of the Care Act 2014 allows the Council to carry out a financial assessment to determine the amount you can afford to contribute towards your care and support. The Council must undertake an assessment as stipulated under the Care Act 2014 for any adult that appears to need care and support. This is regardless of whether the Council thinks you have eligible needs or of your financial circumstances. Where the Council decides to charge it must follow the Care and Support Charging and Assessment of Resources Regulations 2014 and have regard to the Care and Support Statutory Guidance. The legal framework provided by the Care Act is aimed at making charging fairer and clearly understood by everyone. 4. Principles The policy adopts the following principles when making decisions on charging. • You will not be charged more than it is reasonably practicable for you to pay in accordance with the Care Act 2014 legislation. • Be clear and transparent so you know how much you will be charged. A written record of the financial assessment will be given to you to explain how the assessment has been carried out, what it will be, how often it will be made and the reason for any fluctuations. • Ensure that the Council charging arrangements reflect the true cost of the services, unless flat rate charges apply. • Be sustainable for the Council in the long-term. • Be comprehensive to reduce variation in the way you are assessed and charged. • Advice on how to claim welfare benefit entitlements will be made available to you and anyone that is a carer. • Promote wellbeing, social inclusion, and support the vision of personalisation, independence, choice and control. • Be person-focused, reflecting the variety of care and caring journeys and the variety of options available to meet your needs. • Support you, if you are a carer, to look after your own health and wellbeing and to care effectively and safely. • Have an effective formal appeals and review process, in addition to the complaints process. 6 5. Chargeable Services All services, whether residential or non-residential will be chargeable except where the Council is required to arrange care and support free of charge – see section 6. The detail of how to charge is different depending on whether you are receiving care in a care home or your own home or another setting. 6. When charges do not apply There are some circumstances and services which the Council will not charge for. These include: • Provision of community equipment (including minor adaptations to property up to £1,000). • Intermediate care and reablement support services must be provided free of charge for up to a maximum of six weeks. The period of reablement you receive is determined by your needs. • Any services which are provided as part of your aftercare under section 117 of the Mental Health Act 1983. • If you are suffering from variant Creutzfeldt -Jacob disease for meeting your needs. • Any services which a local authority is under a duty to provide through other legislation may not be charged for under the Care Act 2014. • Assessment of needs, financial assessments and the preparation of the care and support plan. • In the same way as chargeable services, all provision should reflect best value and be clearly linked to specified outcomes. 7. The Financial Assessment If the Council assist with arranging any care services that you need, there will always be a financial assessment to see if you can afford to pay towards the cost of these services. The financial assessment will look at your: • Income • Savings and investments • Benefits • Any property that you own or part own - where applicable • Any other regular income that you receive. You will be assessed on your own finances which will determine how much you will be expected to contribute towards the cost of the care you receive. It is your responsibility to provide all the information required to complete the financial assessment. The Financial Assessment Team within the Council will aim to complete the financial assessment within 28 days of all required information being received. The completion date is dependent on the Council receiving the information requested. 7 If you do not want to undergo a financial assessment or refuse to cooperate with the assessment process and you have not contacted the Council regarding any delays, the Council will assume that you have over the £23,250 threshold. You will be charged for the full cost of your care and the Council will consider that you do not require any financial contribution from Hillingdon council until the assessment is completed. The financial assessment for both residential and non-residential care and support can be undertaken online and can be found here: www.hillingdon.gov.uk/financial-assessment/completing 8. Examples of how the council work out a contribution In your own home A resident who receives care and support outside a care home will need to pay for their general living costs, such as: food, utilities, daily activities and clothing. To ensure that a resident can meet their general living costs, when a financial assessment is carried out, they must be left with a weekly minimum income guarantee (MIG) amount, as set out in The Care and Support (Charging and Assessment of Resources) Regulations 2014. The MIG amount is reviewed each year by the Secretary of State for Health and Social Care. Examples of the weekly MIG for a single person, in different age groups, are set out below: Aged 18-24: £160.30 Aged 25 up to pension age: £183.25 Pension age and over: £228.70 The examples are based on the pension credit age group or over receiving the Standard Minimum Income Guarantee (Pension Credit) and the remaining age groups receiving an Income Support Personal Allowance, a Disability Premium and an Enhanced Disability Premium. Example 1 A 27-year-old resident lives at home with their family. They receive Employment and Support Allowance (Support Group) and Personal Independence Payment (PIP) Mobility and has £63.51 per week disability related spending. They have been assessed and agreed that a personal budget of £200.00 a week will enable them to purchase their care and support. Income each week Employment Support Allowance (Support Group) £149.05 PIP Mobility £ 75.75 Total income £224.80 8 Less PIP Mobility - £ 75.75 Less disability-related spending - £ 63.51 Less MIG - £183.25 Total amount ignored £322.51 The total income less the total amount ignored gives the assessed contribution - £97.71 They will not be required to make a contribution to their care costs. They will receive their personal budget allocation of £200.00 a week to purchase their care and support. Example 2 A 76-year-old resident living on their own has a State Pension, a private pension and receives Attendance Allowance. They have been assessed to have £36.08 disability related expenses each week and £11.15 housing expenses ignored each week. Their care needs have been assessed and a care manager has agreed that a personal budget of £108.00 a week will enable them to purchase their care and support. Income each week State Pension £128.95 Private pension £110.10 Attendance Allowance £108.55 Total income £347.60 Less the night element of Attendance Allowance - £ 35.90 Less disability-related spending - £ 36.08 Less housing costs - £ 11.15 Less MIG - £228.70 Total amount ignored £311.83 The total income less the total amount ignored gives the assessed contribution £35.77 Weekly personal budget £108.00. Their contribution is £35.77 per week. They will receive £72.23 per week from the council, so they have a total of £108.00 to purchase their care. In a residential/nursing home If you are in a care home, the Council deduct a personal expenses allowance of £30.15 a week from your total income, along with a deduction of up to £6.95, if you receive the savings part of Pension Credit. For the first four weeks of a permanent placement, the Council may consider making an allowance for any additional expenses that you have to pay during this period 9 Example of a financial assessment A resident has been offered a place in a care home whose weekly fees are £650.00 and Adult Social Care agree to fund the care. The resident receives a retirement pension of £185.00 each week and rental income of £300.00 each week. Income each week State Pension £185.00 Rental income £300.00 Total income £485.00 Less the personal allowance - £ 30.15 Total amount ignored £30.15 The total income less the total amount ignored gives the assessed contribution £454.85 The council will pay the care home the weekly fee of £650.00 per week. The resident’s contribution is £454.85. This means that the council will contribute £195.15 per week towards the resident’s care home fees. 9. Mental Capacity If you lack mental capacity, the Council will still financially assess you to establish if you can contribute towards the cost of your care and support. The Council will work with the person who has the legal authority to make financial decisions on your behalf. For example: • Enduring Power of Attorney • Lasting Power of Attorney for Property and Affairs • Lasting Power of Attorney for Health and Welfare • Property and Affairs Deputyship under the Court of Protection; or • Any other person responsible for dealing with that person’s affairs (e.g. a person who has been given appointeeship by the Department for Work and Pensions for the purpose of benefit payments. Where reasonable efforts to identify the person or persons with legal authority to make financial decisions on your behalf have been unsuccessful. The Council will make the necessary arrangements to assume this role for the purposes of financial assessment. 10. Capital Limits The capital limits refer to the levels of capital and/or savings to qualify for Council funded care and support services. If you have capital above the capital limit, you would not qualify for Council -funded care services. The following list gives examples of capital. This list is intended as a guide and is not exhaustive. • In bank or building society accounts, no allowance is made for deferred expenditure 10 • In National Savings bank accounts • In PEP or ISA accounts • In save-as-you-earn (SAYE) schemes • In cash • As Bonds or National Savings Certificates • As stocks, shares, trust funds and investments; invested in property, building and land (rental income will be included); and which someone else is holding on your behalf. When determining the classification and/or treatment of an asset in the financial assessment, the Council will consider each individual asset that you own on its merits, guided by relevant legislation, regulations and statutory guidance where appropriate. The value and treatment of capital will be based on the guidelines set by the Department of Health and Social Care. For 2024 to 2025, the upper limit is currently £23,250 and the lower limit is £14,250. The Council will ignore: • The mobility part of Disability Living Allowance or Personal Independence Payment • War Pension or War Widow’s Pension • Payments to veterans, under the War Pension Scheme, are fully disregarded, with the exception of payments of Constan t Attendance Allowance, which will be taken into account • Payments you may receive under the War Pension Scheme who is not a veteran (e.g. surviving family members) only the first £10 per week is disregarded • War Widow’s special payment • Child Benefit and Child Tax Credit • The part of Attendance Allowance, Disability Living Allowance (care part) or Personal Independence Payment (daily living part) that covers your care at night • Working Tax Credit • Disabled Person’s Tax Credit • Maternity Allowance • Payments you receive from a charity • The savings part of Pension Credit • Earned income from paid employment The Council will require evidence of your income and capital and cannot accept redacted or amended documents. 11. Deprivation of Capital The term “Deprivation of Assets” refers to cases where you may have deliberately tried to avoid paying for your care and support costs through depriving yourself of assets - either capital or income. Where it is deemed that you have deliberately deprived yourself of a capital asset the Council may treat you as possessing the asset , and it 11 will be included in any financial assessment. The Council will, in instances where they believe deprivation has occurred, follow the Care Act 2014 statutory guidance. 12. Changes in an individual’s financial circumstances The amount you need to financially contribute towards your care will usually increase every April, in line with the annual increase in state benefits and pensions. The Council will review the amount you have to contribute every April and will notify you in writing of any change to your contribution. However, if you experience any changes in your circumstances before April, for example your income or capital increases or decreases, you must tell the Council about the change im
View Decision / Minutes Text
Executive Decision Notice – 30 April 2025
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
OFFICIAL EXECUTIVE DECISION NOTICE
PUBLISHED BY DEMOCRATIC SERVICES
Notice is hereby given that the following decision(s) have been made today by
Cabinet Members at the London Borough of Hillingdon:
Title of decision OUTCOME OF CHARGING FOR SOCIAL CARE AND
SUPPORT POLICY CONSULTATION
Reference No. 1405
Date of decision Wednesday 30 April 2025
Call-in expiry date Thursday 8 May 2025
Relevant Select
Committee
Health & Social Care Select Committee
Relevant Wards N/A
Decision made
Cabinet Members
making the decision
Councillor Jane Palmer, Cabinet Member for Health & Social
Care
Decision Approved
The Cabinet Member for Health & Social Care:
1. Considered the outcome of the consultation and the
equalities impact assessment as set out in the report.
2. Upon the advice of Corporate Director of Adult Social
Care and Health agreed the 25/26 Adult Social Care
Charging for Social Care and Support Policy.
3. Noted that for 26/27 onwards, this policy and fees will
be reviewed annually as part of the Council’s wider
review of fees and charges to provide a transparent
and consistent approach going forward.
Reason for decision The revised Policy will meet the principles for charging set out
in the Care and Support Statutory Guidance. It is a robust, up-
to-date and comprehensive policy that will ensure that the
Council is able to charge and collect contributions towards the
cost of care and support services.
The fees charged by the council for adult social care services
are crucial, they are however, proportionate and take into
consideration the ability to pay. Without the revenue from these
charges, the service would not be viable in the future
Executive Decision Notice – 30 April 2025
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
The feedback from the consultation exercise reflected the
challenges in providing a technically detailed policy that is also
easy to follow but there were no issues raised that have required
any changes to the revised Policy. Further work will be
undertaken to provide supporting information via the councils’
factsheets to aid understanding.
It is essential that there is a policy to provide a framework for
charging, and that this is reviewed and updated annually in line
with the Councils fees and charges review at annual budget
setting.
Alternative options
considered and
rejected
The Cabinet Member can choose not to agree to the revised
charging policy. This is not recommended due to:
• Feedback from the consultation does result in the
need to review or rewrite the charging policy.
• T he current policy is out of date and therefore is not
providing the necessary clarity and transparency
regarding paying for care which may result in a loss of
income
• The benefits highlighted in the points above will not
be achieved
Classification Part 1- Public
Link to associated
report
The link to the report can be found here
Relevant Officer
contact & Directorate
Sarah Baker, Programme Manager
Any interest declared
by the Cabinet
Member(s) /
dispensation granted
N/A
Implementation of decision & scrutiny call-in
[Internal Use only]
When can this
decision be
implemented by
officers?
Officers can implement Cabinet Member decision in this notice only
from the expiry of the scrutiny call-in period which is:
5pm on Thursday 8 May 2025
However, this is subject to the decision not being called in by
Councillors on the relevant Select Committee. Upon receipt of a
Executive Decision Notice – 30 April 2025
This notice is a public document also available to view on the Council's website www.hillingdon.gov.uk
valid call-in request, Democratic Services will immediately advise
the relevant officer(s) and the decision must then be put on hold.
Councillor scrutiny
call-in of this
decision
Councillors on the relevant Select Committee shown in this notice
may request to call-in this decision. The request must be before the
expiry of the scrutiny call-in period above.
Councillors should use the Scrutiny Call-in App (link below) on their
devices to initiate any call-in request. Further advice can be sought
from Democratic Services if required:
Scrutiny Call-In - Power Apps (secure)
Further information These decisions, where applicable, have been taken under The
Local Authorities (Executive Arrangements) (Meetings and Access
to Information) (England) Regulations 2012.
This is the formal notice by the Council of the above executive
decision, including links to the reports where applicable.
If you would like more information on this decision, please contact
Democratic Services on 01895 250636 or email:
democratic@hillingdon.gov.uk.
Circulation of this decision notice is to a variety of people including
Members of the Council, Corporate Directors, Officers, Group
Secretariats and the Public. Copies are also placed on the
Council’s website.
Democratic Services
London Borough of Hillingdon
Civic Centre
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