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Practical support

Homecare costs

After a community care assessment has been carried out and it has been decided that the person you're looking after needs support, they will be given a means-tested financial assessment. This is to assess whether they have to contribute towards the cost of the services.

Support services needed at the home of the person you're looking after may be provided free of charge by the local authority. A local authority can choose whether or not to make charges for a service. However, there are certain services local authorities are never allowed to charge for.

If it does make charges, the local authority has to follow the Department of Health’s fairer charging guidance (PDF, 161kb).

The local authority has discretion when it comes to charging for non-residential services. The person you're looking after can ask the local authority to use its discretion if there is a dispute about charges.

Local authorities will consult with those using their services before they make any changes in their policy about charging. This is particularly important if an increase in charges is proposed. Consultations must give service users adequate information about the change in charges.

Service provided directly or by direct payments

Charges can be made whether the services at home are provided directly by social services or the person you're looking after receives direct payments and organises their own services.

Savings

There are rules that local authorities follow when they're carrying out a financial assessment. Both income and capital are taken into account, but some items are disregarded.

If the person you're looking after receives disability-related benefits, such as Disability Living Allowance, Attendance Allowance or a severe disability premium in means-tested benefits, disability-related expenditure can be disregarded. There is guidance explaining the type of disability-related expenditure that can be deducted. For more information see Disability-related expenditure, below.

Local authorities must ensure that advice about entitlement to welfare benefits is available to the person who may be charged for services.

Information about charges

Once the financial assessment has taken place, the person you're looking after will receive written information about the charges they'll have to pay and how they've been calculated. This will be done as quickly as possible and normally before the first bill is sent.

Non-payment

If the person you're looking after doesn't pay the assessed charges for their services it doesn't mean the services will automatically stop. If they're assessed as needing the services, they will continue to be provided even if social services takes legal steps to recover the debt.

Free support from local authorities

The local authority can choose whether or not to charge for support services provided at home. If it does make charges, there is guidance that explains how it should carry out financial assessments. For more information see External links.

However, there are some items that social services will never make a charge for. These include services provided as part of intermediate care or services provided under the Mental Health Act as aftercare. They are not allowed to charge for community equipment (see below) and minor adaptations.

Community equipment

Community equipment is equipment that is specifically designed to make daily life easier for the person you're looking after. For example:

  • equipment to help with zips or buttons,
  • telephones with large buttons or flashing lights,
  • communication aids, and
  • telecare equipment.

The person you're looking after will first need to have a community care assessment. This will provide information about their needs and the equipment they need to aid them in daily life.

Disputes about community equipment

A local authority sometimes makes a distinction between community equipment and ordinary equipment that could be used by anyone. For example, an electric tin opener might be helpful for the person you're looking after, but your local authority may regard it as ordinary equipment that they will not fund.

You and the person you're looking after could argue that it would be reasonable and sensible to provide equipment that will help with assessed needs.

A local authority may have fixed criteria about the type of equipment it will consider supplying or the level of costs it will meet. If this is the case, you could argue that they shouldn't have blanket policies about the equipment they will provide and should make decisions depending on individual circumstances.

If the person you're looking after disagrees with a decision about community equipment, they can use the complaints procedure. For more information see NHS Choices links.

The government is considering introducing a scheme that would give people who need community equipment a prescription to take to an accredited retail shop in order to get the equipment needed.

Some types of equipment are healthcare related and are provided free of charge by the NHS. You and the person you're looking after may also want to buy equipment from private companies.

Minor adaptations

Minor adaptations costing less than £1,000 are provided by local authorities at no charge. Minor adaptations include:

  • grab rails to make it safer to get in and out of a bath,
  • blocks to make beds higher, and
  • raised toilet seats and bath seats.

You will get adaptations through a community care assessment which will assess needs and how those needs can be met.

Disputes about minor adaptations

The person you're looking after may be refused help with a minor adaptation. In some cases they may be asked to pay associated costs, such as maintenance charges. If they disagree with the decision about a minor adaptation they can use the complaints procedure.

If the adaptation will cost more than £1,000, you or the person you're looking after may be eligible for a disabled facilities grant. For more information about disabled facilities grants see External links.

Income and capital

Local authorities should only consider the income and capital of the person receiving care at home when assessing their ability to pay.

If the person receiving care is a member of a couple, the council may take into account income or savings to which the person receiving care has a legal entitlement, such as a share in a bank account. This can apply even if the income or savings are not in their own name.

This may mean that the local authority will ask for information about the finances of the partner of the person you're looking after. If the person receiving care at home wants to dispute their partner’s income or savings being taken into account they can use the complaints procedure.

Capital

If a local authority makes a charge for care at home it will use the same upper capital limit set for residential care purposes. However, it can use more generous limits if it wants to do so. For more information about charging for residential care see NHS Choices links.

If it uses the same limits as the residential charging guidelines, the upper limit for capital is £23,250. If capital is above the upper limit the person you're looking after may have to pay the full cost of their services. There is also a lower limit of £14,250. If their capital is between £14,250 and £23,250, £1 a week for every £250 is taken into account as income.

The value of the property in which the person receiving care lives should not be taken into account.

In general, the guidance suggests that the same rules that apply to charging for residential care should apply to care provided at home.

However, it is not always clear how the residential care charging rules apply if the care is provided at home. If the person you're looking after has any concerns about the way in which the rules are being applied they can ask the local authority to use its discretionary powers. Alternatively, they can make a complaint.

Income

Certain types of income should not be taken into account. This includes:

The care component of Disability Living Allowance (DLA) and Attendance Allowance (AA) can be taken into account, but the mobility component of DLA should be disregarded. In some cases, the care component of DLA or AA can also be disregarded.

Example

Sam receives the high rate of AA because he needs help with personal care during the day and night.

He is assessed by social services for care at home during the daytime. As services are only to be provided during the day, the part of AA that is paid for help with personal care during the night is not taken into account when Sam’s income is assessed.

Disability-related expenditure

If the local authority takes into account any disability-related benefits, such as DLA, AA or the severe disability premium in means-tested benefits, they also have to take into account disability-related expenditure.

When social services has considered all the income (less any that is disregarded), they then need to do a further calculation to ensure that income is not reduced below a certain level. That level is the equivalent of Income Support or the guarantee credit of Pension Credit plus 25%.

Example

Sam has £200 of income a week, which the local authority could, in theory, take into account.

His income should not be reduced below the weekly guarantee credit of Pension Credit, which is £132.60 for a single person, plus 25% (£33.15). This makes £165.75 in total.

This means that the local authority can only take £34.25 of Sam’s income into account (£200 minus £165.75) when assessing the charges they could make for care at home.

Disability-related expenditure

Guidance issued to local authorities states that if they take into account disability-related benefits, such as Disability Living Allowance (DLA), Attendance Allowance (AA) or the severe disability premium in means-tested benefits, they must also take into account disability-related expenditure.

This guidance includes examples of possible disability-related expenditure, but it is not a comprehensive list. Other items can be included as long as they're needed so that the person you're looking after can live at home. Examples of disability-related expenditure listed in the guidance include:

  • laundry and specialist washing powders,
  • special diets,
  • special clothing or footwear,
  • extra bedding needed, for example, because of incontinence,
  • extra fuel costs,
  • garden maintenance, private cleaning or domestic help, if needed because of disability and not provided by social services,
  • privately arranged care services, including respite care,
  • the purchase, maintenance and repair of disability-related equipment,
  • transport costs needed because of disability, over and above the mobility component of Disability Living Allowance (DLA), and
  • complementary therapies.

Some local authorities have lists of the disability-related expenditure they will consider. There is no reason why the person you're looking after cannot ask for other expenditure to be considered if it's disability related.

Setting standard costs

Some local authorities allow set or standard amounts for items such as laundry. The local authority will have to justify those set costs. If the actual costs of the person you're looking after are higher, they should ask the local authority to review how much it will take into account.

Proving expenditure

The local authority is entitled to ask for proof of disability-related expenditure, particularly if it is for unusual or expensive items. However, it should be flexible when asking for receipts.

Disputes

If the person you're looking after is not satisfied that their disability-related expenditure has been taken into account, they can ask the local authority to look at its decision again. If this doesn't resolve the matter, they can use the complaints procedure.

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Page last reviewed: 20/12/2012

Next review due: 20/12/2014

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