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Paying for services
at home |
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DISC Tel: 0845 120 4048 email: info@disc.org.uk |
This fact
sheet will cover what services the person you care for can and cannot be
charged for. It explains what guidance
local authorities must follow when charges are being assessed. You may also find the following
fact sheets helpful:
·
What is dementia? ·
Assessment and diagnosis ·
Making your home dementia friendly ·
Treatment and therapy for people
with dementia ·
Finding what help someone needs and
who can provide it ·
Looking at your needs as a carer -
having a carer’s assessment ·
Making the decision about future
plans for care Services not charged for NHS services and services delivered through your
Primary Care Trust or GP are free at the point of delivery. This may include respite
care in a hospital. If you are getting
additional help from social services for a temporary period (6 weeks) as part
of intermediate care then these services should not be charged for (outlined
in the Delayed Discharge Act 2003). If
the cared-for person has been receiving after
care services under section 117 of the Mental Health Act 1983 then these
services should not be charged for. Finance - If services are offered how much will they cost? Charges for community care services. Your local authority can charge for services that
they arrange to provide to the cared-for
person in their own home. This may
include laundry services, home care, meals on wheels and day centres. The Local Authority cannot make a profit on
what they charge you. Guidance is issued to Local Authority Social
Services, under Fairer Charging Polices
for Home Care and other non-residential Social Services. If
they are unable to pay or refuse to pay, the service cannot be withdrawn if
there has been an assessment of need. |
How are the charges worked out?
Each person
has an individual financial assessment (means test) to see what they should pay
towards a service. There is government
guidance on how and what local authorities can charge for services but each local
authority sets its own charges. If the
cared-for person’s income is calculated at being
below a certain amount then they should not be charged for the service.
”Regard
should be had to the effect of any charge on a user’s net income; net income
should not be reduced below defined basic levels of Income Support or the
Guarantee Credit of pension, plus 25%.
Charging polices which reduce users’ net income below this defined basic
level are not acceptable.” (Fairer Charging Polices for Home Care and other
non-residential Social Services)
Certain
disability benefits may be taken into account as part of the cared for person’s
income when calculating how much they will be charged for services. Where
disability benefits are taken into account as income in assessing someone’s
ability to pay, the person’s disability expenditure should also be taken into
account in an individual assessment.
The local authority should ensure comprehensive
benefit advice has been given so that the person is receiving their maximum
income entitlement.
Once the person you care for has had a single
assessment they should be given clear information about what the charges for
services will be, and how the local authority will calculate the amount.
If you disagree with the charges you should contact
your local Age Concern, Citizens Advice Bureaux, Alzheimer’s Society or Carers
Centre who may be able to help you.
What cannot be
taken into account:
The mobility component of Disability Living Allowance
is excluded by law from being taken into account for charges.
Benefits that can
be taken into consideration are:
1) Disability
Living Allowance (care component).
2) Attendance
Allowance (and constant AA).
3) Exceptionally
Severe Disablement Allowance.
However where these benefits
form part of the cared for person’s income, that income may not be reduced below basic levels of income support plus 25%. It must not result in the cared-for person being left without the means to pay any
other necessary care or support or for other costs arising from their
disability.
When assessing disability related expenditure, councils should include
the following:
·
Payment for any community alarm
system
·
Costs of any privately arranged care
services required, including respite care
·
Costs of any speciality items caused
by disability eg specialist washing powders or laundry
·
Additional costs for special dietary
needs due to illness or disability
·
Special clothing or footwear, for
example where this needs to be specially made, or additional wear or tear to
clothing caused by a disability
·
Additional costs of bedding, for
example because of incontinence
·
Any heating costs or metered costs of
water, above average levels for the area and housing type, required by age,
medical condition or disability
·
Reasonable costs of basic garden
maintenance, cleaning or domestic help if necessitated by the individual’s
disability and not met by social services
·
Purchase, maintenance and repair of
disability-related equipment
·
Personal assistance costs, including
any household or other necessary costs arising for the cared-for person
·
Other transport costs necessitated by
illness or disability, including costs of transport to day centres, over and
above the mobility component of DLA
Costs of infrequently
purchased equipment can also be taken into account.
Charges to respite
care
If the local authority arrange for someone to go into
respite care the charge is usually based on a means test that has the same formula
as if someone were going into a care home, except that the value of the
person’s home is ignored. If your local
authority does not do this they will set a “standard charge” that they think is
reasonable for you to pay. Charges may
vary from a proportion of the weekly cost to the whole cost.
If the person you care for is in residential care for
over eight consecutive weeks then they will be assessed as a temporary
resident.
What do I do if I
am not happy with the assessment?
If you are not satisfied with anything about your
carer's assessment, the care provided or the amount charged for the services,
there are a number of ways in which you can complain. Each local authority has its own complaints
procedure.
Advice centres like the Citizens Advice Bureau or a
disability organisation can help you make a complaint or give you details of
lawyers able to advise on community care law.
Under the Data Protection Act 1998, you can ask social
services for a copy of the cared-for person’s
assessment and the care plan. If you are
legally able to act on behalf of the person you are caring for, you can also
ask for their file. You should receive
this information within 40 days, but the local authority can charge for
accessing a client’s file.
Carer’s Assessment
If you are providing “regular and substantial” care
for a family member, friend or relative then you will have a right to an
assessment of your own needs as a carer.
This should look at your ability to continue caring
and take into account other commitments you may have eg other family
commitments. Local authority Social
Service can provide services, for instance breaks from caring. The local authority has a power to charge –
but many authorities do not actually charge for services to carers.
It is often helpful to carers if this assessment can
take place away from the person with care needs. You are entitled to an assessment of your
needs even if the person you are caring for does not wish to have their needs
assessed. See Fact sheet: ‘Carer’s
Assessment’.
Then the local authority decides what to provide. They have to take into account the results of
both your own carer's assessment and the community care assessment of the
person you care for. The completed
assessment should be the basis on which services are offered. The local authority social services
department will then provide certain services.
This fact sheet can
be made available in large print.
We are constantly
looking to improve our information. It helps
if you let us know whether the information in this fact sheet was/was not
useful and if there are other fact sheets that you would have found helpful
that we have not yet provided.
While the information contained in
this fact sheet is believed to be correct, DISC does not accept liability for
any error/s it may contain.