Care and Support Charging and Financial Assessment Framework

Contents

• 1. Summary
• 2. Legal context
• 3. Principles of this framework
• 4. Care and support services provided free of charge
• 5. Chargeable care and support services
• 6. Care and support financial assessment policy
  • 6.1 Capital
  • 6.2 How is a financial assessment carried out?
  • 6.3 Deprivation of assets
  • 6.4 Delays to the financial assessment process
  • 6.5 Financial assessment reviews
  • 6.6 Change in circumstance and use of financial information
  • 6.7 Debt recovery
  • 6.8 Debt Management and Relief
  • 6.9 Financial assessment and charging for care home accommodation
  • 6.10 Financial assessment and charging for non-residential care and support
  • 6.11 Annual Review
  • 6.12 How to pay your charges for care and support
• 7. Section 117 and social care packages of care
• 8. Mental capacity to manage finances
• 9. Residence when moving to accommodation outside Bath and North East Somerset Council
• 10. Deferred Payment Agreements (DPAs)
• 11. Interim funding policy
• 12. Choice of accommodation and top up payments
• 13. Funding agreement
• 14. Direct Payments
• 15. Equality Impact Assessment
• 16. Reviewing the Charging and Financial Assessment Framework
• 17. Appeals
• 18. Annex A
• 19. Annex B
• 20. Annex C
• 21. Annex D
• 22. Annex E
• 23. Glossary of terms

6.9 Financial assessment and charging for care home accommodation

If you have care and support needs identified that can only be met in a care home, you will need to pay a charge towards your accommodation fees in the care home.

• If your capital assets (such as savings and investments) are above the upper capital limit, you will need to pay the full costs of your care home fees, usually, directly to the care home.
• If your capital assets are below the upper capital limit, the Council will carry out a financial assessment with you to work how much your charge towards the costs of the weekly care home fees will be35.
• If you own a property, or part of a property, or have a beneficial interest in a property, there are rules around whether this is counted within your capital assets or disregarded. (See 'if you own a property' below.)
• If you qualify for funded nursing care part of your weekly care charge will be paid through the NHS37.

There are exceptions to being charged for care and support:

• If your care home placement is an ‘After-care’ support service provided under section 117 of the Mental health Act 1983, you will not need to have a financial assessment as you will be exempt from charge.
• If your care home placement is fully paid by the NHS through Continuing Healthcare you will not need to have a financial assessment as the care and support is provided free by the NHS38.
• If you are placed in a Step Down bed.
• If you are receiving services from the integrated reablement service for a short period of intensive therapies and support from health and social care professionals to promote regaining independence. (Please note that once the reablement service confirms that your short term reablement goals have been met, you may become charged for any additional services if the reablement service continues to meet your ongoing care needs while an long term care provider is found.)

If you are responsible for the full charge of your care home because your savings and investments are above the upper capital limit the Social Worker can arrange advice and support to help you choose a suitable care home that will meet your needs. You should consider:

• Finding out from the care home what happens if your savings/investments fall below the upper capital limit. For example, would the home accept local authority payment rates or would they require you to nominate someone to pay a third party top-up? If you do not have anyone who could pay a third party top up you should ensure you chose a home that will accept local authority payment rates.
• That you are responsible for paying the care charges directly to the care home.
• That if your savings/investments reduce and approach the lower capital limit, you should contact the Council and request help with the care home costs. The Council will also review your care and support needs at the same time to make sure that the care home still meets your identified needs.

If you ask the Council to arrange your care home placement, you will be charged an arrangement fee of £250.00 plus VAT.

If your capital assets are below the upper capital limit, and you do not own any property, the Council will carry out a financial assessment of your income and capital assets to work out your ‘calculated weekly care charge’. The Council use national rules to do this called the ‘Care and Support (Assessment of resources) Regulations 2014’ which are issued under section 17 of the Care Act 2014.

If you have chosen to move to a care home that is more expensive than the care homes that the Council have identified to meet your needs, you will need to identify a person who is willing and able to make top up payments – to pay the shortfall, this is called a third party top-up. (See 'third party top-ups'.)

Your financial assessment will always make sure you are left with an amount for you to use for your day-to-day personal expenses in the care home. There is a standard amount for this personal expense allowance set out in the Care and Support (Charging and Assessment Resources) Regulations 2014 which is reviewed each year by the Government. The current rate is shown in Annex A.

If you were previously living in rented accommodation before you moved into the care home during the first 4 weeks that you are resident in the care home the following costs will be allowed in the financial assessment:

• Utility standing charge only (subject to evidence being provided of the amount being paid)
• Home buildings and contents insurance (subject to evidence being provided of the amount being paid)
• Rent (subject to evidence being provided of the amount being paid)
• Essential service charge and ground rent net of funding through benefits (subject to evidence being provided of the amount being paid)

If you own a property

If you own a property, or have a beneficial interest in a property, the Care Finance Officer will check whether the property capital is disregarded.

The Care and Support (Charging and Assessment of Resources) Regulations 2014 and the Care and Support Statutory Guidance set out the circumstances in which property capital is always disregarded. For example:

• If your spouse or partner still lives in the property your property capital would be disregarded in the financial assessment for as long as they continue to live at the property.
• If you have a relative aged over 60, or a disabled relative who resides at the property the property would be disregarded for as long as they remain residing at the property.

The regulations state who counts as a ‘relative’ and the Statutory Guidance gives more information41.

Your property capital is disregarded for the first 12 weeks of moving permanently to a care home42.

The purpose of the 12 week property disregard is to provide time to allow a long term decision about the property to be made.

The 12 week property disregard applies if:

• You move into a care home for the first time, and, as a result of the ownership of your home, you are responsible for the full charge of the care home fee.
• You are already living in a care home, and your property was previously disregarded in your financial assessment under a statutory disregard or a discretionary disregard, but, due to a change of circumstance those disregards are no longer relevant and the value of the property means you would be responsible for the full charge of the care home fees. A change of circumstance could, for example, be where a partner or relative living in the property goes into a care home themselves, moves house, or passes away.

The 12 week property disregard only applies to your sole or main residence prior to moving into a care home. It does not apply to any other property or land you own.

If you have savings and capital above the upper capital limit at the start of your placement in a care home, and you own a property, you have the opportunity to make decisions about what to do with your property during the period you are able to self-fund – unless this is less than 12 weeks. In this event you will be entitled to the remaining period of the 12 week property disregard from the start of your placement. For example, if you can self-fund for a period of 6 weeks from the start of the care home placement you would be entitled to a further 6 weeks property disregard period.

Your financial charge during the property disregard period will be based on a financial assessment of your income. The Care Finance Officer will carry out the financial assessment based on your financial circumstances excluding the value of your main property. The financial assessment will take account of your income and any savings or assets above the lower capital limit and leave you with your personal expense allowance.

In addition to your personal expense allowance during the 12 week property disregard period you will be allowed the costs of44:

• Rent/mortgage
• Home buildings and contents insurance44 (subject to evidence being provided of the amount being paid)
• Utility standing charge
• Basic property maintenance
• Ground rent/service charge (if applicable)

The Council will pay your assessed weekly care charge directly to the care home on your behalf. You will be sent an invoice for the assessed weekly charge which will be due for payment at the time we raise the invoice. See how to pay your charges for care and support

If you receive Attendance Allowance, Disability Living Allowance (Care Component) or Personal Independence Payment (Daily Living Component) these benefits will continue to be paid to you by the Department of Work and Pensions for the first four weeks that you are in the care home or hospital. After the first four weeks these benefits are not payable to you whilst the Council provides funding towards your care home costs.

At the end of the 12 week property disregard period, if you have not entered into a deferred payment agreement, you will become responsible for the full cost of your care home placement.

If you ask the Council to arrange your Care Home placement you will be charged an arrangement fee of £250.00 plus VAT.

Discretionary disregard of property

The Care Act 2014 sets out a number of situations where the property you live in and have a beneficial interest in, must be disregarded46.

However, there may be circumstances where the Council considers it appropriate to disregard your interest in the property, even though we are not required to by the national Regulations, this is a discretionary disregard47.

The Council must balance the use of this discretion with the need to ensure that public funds are not used inappropriately.

If you ask us to consider disregarding your property on a discretionary basis, in making this decision we will consider our financial resources, and the following factors:

• The reason for the occupation of the property by any third party.
• The timing of the move to the property by any third party.
• How long has the third party resided at the property.
• What is your relationship with the third party.
• Has the third party cared for you and if so for how long and what was the main reason for the move to your property.
• Where did the third party reside before moving to the property.
• When did you first have identified care needs.
• When was care home accommodation first considered as an option for you.
• Has the third party made any financial contribution to the property and if so, how much and why.
• How is the property owned.

The weight placed against each factor in considering the request will depend on the individual circumstances and actions taken. The decision will be made by a Senior Manager or the Councils Panel.

You can ask your Care Finance Officer if you would like the Council to consider a discretionary property disregard.

The Council will require you to provide all the information relevant to your request, and once this information has been gathered the request will be considered by the Team Manager for a decision.

In difficult cases advice may be sought from the Council’s legal advisers.

If your request is turned down, you will be informed of the reasons in writing and the Council will inform you how you can make a complaint if you disagree with the decision.

If your property is disregarded and the person residing there wants to move to a new house, the Council will continue to disregard your equitable share, which on sale would be realised, subject to yours or your financial representative, and the person residing in the property agreeing to the following:

• The Council is kept up to date with progress of the sale.
• The new property is placed in the same names and equitable share as the property being sold.
• The Council is informed within two working days of completion and a copy of the completion statement is provided.
• The Council is provided with a copy of the Land Registry Office Copies within two working days of receipt.
• If monies from the sale are not used for the purchase of the new property, you will be financially re-assessed and may be made self-funding.

If your new property is not registered in accordance with point 2, or any of the points above are not complied with, the Council will treat your share of the full sale price as notional income and you will be self-funding.

If you do not have capacity, any acting Lasting Power of Attorney or Deputy must comply with the above conditions on your behalf, and ensure compliance with the Court of Protection criteria in respect of acting in your best interest.

• 35See Annex B
• 37See Annex B
• 38You will need to request an assessment and meet the criteria.
• 41Annex B Clause 35 of the Care and Support Statutory Guidance.
• 42The Care and Support (Charging and Assessment of Resources) Regulations 2014 Schedule 2 Paragraph 2.
• 44a44bSee Annex C Clause 49 of the care and Support Statutory guidance.
• 46See Clause 34-41 Annex B of The Care and Support Statutory Guidance.
• 47See Clause 42-44 Annex B of The Care and Support Statutory Guidance.