Social Services Charging Policy

Charging for services

Information and Advice
Financial Assessments
Those who will not be charged
Services that will not be chargeable
Fees and Charges
Flat rate charges for statutory services
Chargeable Services
Choice of Accommodation and Additional Cost Contribution
Deferred Payments and Deferred Payments Interest Charges
Charging Carers
Appealing Assessed Charges
Recovery of Debt and Deprivation of Assets

Information and Advice

Information, advice and assistance services are in place to provide access to information on maximising income, the financial assessment and the charging policy. This will be provided in a format consistent with a person’s communication needs. Advocacy services are also available for those who require it.

Financial Assessments

The local authority has a duty to carry out financial assessments in certain circumstances. Financial assessments will be offered to everyone who is in receipt of a chargeable service that is not charged at a flat rate; to determine how much they can afford to pay. Assessed charges will be determined in accordance with the Financial Assessments regulations and as approved by the Council, council tax and mortgage or rent liability will be taken into account.

A person who lacks capacity will be charged for care and support; where applicable, as determined through application of the financial assessment process. A person who has been assessed as lacking capacity will be provided with information, advice and assistance, appropriate to their assessed needs.  This will include consultation with family members where applicable and/or the appointment of an advocate or application to the Court of Protection, if required.

A person will only be assessed as part of a couple where it is financially more advantageous to the person being assessed. The partner of the person in receipt of assessed services can decline to provide their own financial information.

If a person needs a suitable person to make financial decisions on their behalf, because they lack capacity, but there is no such person; then an application to the Court of Protection may be required, if the person lacks capacity. 

Service users will be given a form to complete which will provide the information needed for the financial assessment. This form together with the relevant supporting documentary evidence will be used to calculate the assessed charge. Anyone choosing not to complete the form or provide the necessary supporting documentation within the timescales given; will be charged full cost in accordance with regulations. See Appendix 3 Financial Assessments.

Those who will not be charged

The SSWBA and/or regulations require that the following people are not charged:

• A child; for care and support they receive; as a service user or a carer.
• A parent or guardian of a child or a child who is a carer in receipt of care and support.  The SSWBA allows for charges but current regulations preclude it.
• A person who has Creutzfeldt-Jacob Disease.
• A carer will not be charged for services provided to or arranged for the person they are caring for.

The above list also applies to seeking contributions or reimbursement towards direct payments.

Other local authorities who use PCC facilities and services to meet the needs of children will be charged the appropriate rate. Parent of children who choose service options over and above what is required to meet the assessed needs of those children will be charged in line with the Additional Cost Contribution regulations.

Services that will not be chargeable

• Transport to access day opportunities where the transport is identified as a need and the person is not in receipt of a mobility component as part of any relevant benefit payments.
• Reablement and equipment provided as part of reablement will not be charged for up to a maximum of 6 weeks.
• Intermediate Care could be provided at no charge, where there is an assessed need, for up to 6 weeks.
• A person who is provided with an assessment bed as part of an integrated assessment to determine needs, will not be charged.  Charging will commence once the assessment bed service ends and the appropriate assessed service begins.
• Employment Programmes.
• After-care services/support provided under section 117 of the Mental Health Act 1983.
• Provision of information and advice; assessment of needs; care planning; care plans and undertaking a review of a determination of a charge or independent professional advocacy.
• Services provided or arranged to meet the assessed needs of a child are disallowed in regulations for 2016/17.  [The Care and Support (Charging) (Wales) Regulations 2015]

The above list also applies to seeking contributions or reimbursement towards direct payments.

Fees and Charges

Fees and Charges are governed in part by legislation and local financial policies. These will be set at a level that will allow for the recovery of the full cost to the local authority. These will be reviewed as part of the budget process each year. Charges for services will not exceed the cost of providing or arranging the care and support or what can be sourced through direct payments. 

Charges will apply:

• from the date the service started; or
• if the service has changed the new charge will apply from the date the service changed.

The charge to the service user will be determined using the agreed rate and charged at the amount that is determined as part of the financial assessment. The charge will apply from the date the service started but will only be collected after the person has had an opportunity to complete a financial assessment and has been provided with a statement for the charges. For a list of service charges and rates please see Social Services fees and charges.

For non-residential services the Welsh Government sets a weekly maximum that a person may be charged. However, flat rated charges are allowed for some services such as meals on wheels, community alarms, and meals provided in residential settings, day centres, social activity centres; whether provided or commissioned by the Local Authority. This list is not exhaustive.   

Flat rate charges for statutory services

Flat rate charges will be set for statutory low level, low cost care and support, such as community alarms, meals on wheels and assistive technology solutions. These flat rate charges will also apply when people opt for direct payments option for these services. 

Flat rate charges will not exceed the cost incurred to arrange or provide the related care and support. For flat rate charges, financial assessments will only be offered and undertaken where it is considered that; either separately or together with other care and support charges; the flat rate charges will have an adverse impact on a person’s income.

Chargeable Services

Additional Costs for Non-Residential services - There may be additional costs relating to activities that take place during the provision of some of the services listed below. These could include costs such as entrance fees, meals out etc. These costs will be paid by the service user or another person, such as the service user’s personal assistant; at the time of purchase and will not be included in statements. Direct payments will not be provided to cover these types of costs as they do not relate to a service user’s assessed needs.

Additional Cost (Third Party) Contributions - In some instances a service user may choose a more expensive option that is over and above what is required to meet assessed needs. In such cases, it may be possible for a service user or third party to pay the difference between what PCC will pay and the cost of the service. The service user/third party will need to be willing to pay the additional cost for the term that the service is required. A Statement of Means will have to be completed so an assessment can be done on the affordability and long term sustainability of this payment.

Direct Payments are provided to meet a range of needs. However, most are used to employ personal assistants or to procure day opportunities. Some direct payments will be determined on individual circumstances. See the rates and fees appendix for details. 

Adult Placement - Adult Placement services include, long term accommodation placements which are charged per week and will be offset by housing benefit, care and support which is charged per night and is subject to the weekly maximum and day opportunities charged per hour which is also subject to the weekly maximum.

Reablement - Reablement will not be charged for up to a maximum of 6 weeks, after this initial period reablement will be charged at the same rate as home and community support, per hour on a weekly basis; subject to the weekly maximum.

Home and Community Support is provided at home, which includes supported living settings. This support includes but is not limited to personal care, general support, shared hours for general support for those in supported living tenancies and replacement care which is provided to someone who usually receives care from an unpaid carer, in their own home. This is charged per hour on a weekly basis. This will be subject to the weekly non-residential maximum charge.

Short Term Residential Care [Often referred to as respite] is a stay in a registered residential setting that does not exceed 8 consecutive weeks. A nightly rate will be applied based on the weekly rates of individual care homes. A person will be charged per night for the length of the stay, regardless of whether the stay falls across two weeks. This will be subject to the weekly non-residential maximum charge. The night care rate of any benefits the person is receiving will be used in the financial assessment to determine a charge for short term residential stays. 

Temporary Residential Stay – If a person enters a registered residential placement on a temporary contract (where the stay is expected to last longer than 8 consecutive weeks, up to 12 months) and the stay ends within 8 weeks, then this will be charged as non-residential up to the national weekly maximum. If it exceeds 8 weeks then the person will be charged under residential charging regulations. The service user will be liable for charge from the day the placement started.

Respite Services at PCC Care Homes [Havenhurst, Milford House and Hillside]

1. A person who is not ordinarily resident in Pembrokeshire will be charged full cost.
2. A Pembrokeshire resident who has been provided with a direct payment (DP) for respite services will be charged the full cost. This means that the person will need to pay any shortfall between the full cost and their DP amount.
3. A Pembrokeshire resident who is not known or has not been assessed, by social services for respite services will need to refer through the first contact team to establish eligibility for respite. If this assessment identifies a need for respite then non-residential charging will apply up to the national weekly maximum charge. 
4. A Pembrokeshire resident who does not wish to be assessed by social services for respite services and wants to purchase this service privately will be charged the full cost.

Day Opportunities can include a range of services.

• Day opportunities provided in one of the Council’s day/social activity centres will be charged at a daily rate. This will be subject to the weekly non-residential maximum charge.
• Day opportunities provided in other settings will be charged based on individual circumstances and will be subject to the weekly non-residential maximum charge.
• Training opportunities provided to meet assessed needs will be charged according to the programme being accessed; and will be subject to the weekly non-residential maximum charge.

Short Breaks is the continued provision of care and support in settings other than registered care homes; including but not limited to hotels. These services may be provided for those in receipt of care and support in the community who require a short break. These will not exceed one week in length. These are provided to meet assessed needs of service users and/or unpaid carers. These will be charged based on individual circumstances in accordance with non-residential charging regulations. For full details please refer to the Short Breaks Policy.

Meals provided in residential settings, in Day Centres and PCC Social Activity Centres are charged at a flat rate, per meal. This will not be subject to the weekly non-residential maximum charge.

Permanent Residential Care - A person who has been assessed as requiring a care home placement; will be financially assessed to determine whether they should fund the care home placement. Someone with capital at or below the capital limit will contribute to the costs as determined in the financial assessment.  However, the person will be left with at least the minimum weekly income amount set out in regulations. Permanent residential care will be charged at the weekly rate agreed with the care home. Additional costs for options that the service user chooses; which are over and above what is required to meet assessed needs; will have to be paid by the service user, in certain circumstances, or a third party in addition to the assessed charge.

Please see Appendix 3 Financial Assessment Charges assessment)

Please see Ordinary Residence, Self Funding and Choice of Accommodation.

Permanent Residential Nursing Care - The nursing care portion of a residential placement will be paid by the local Health Board at the current agreed rate. Depending on the level of health and nursing related needs, some people may be eligible for Continuing Health Care (CHC) funding or a jointly funded package of care.  People may still need to contribute towards the Local Authority cost of a jointly funded package of care. However, CHC is funded 100% by the local Health Board and is provide free of charge.

Intermediate Care Beds - Just like reablement this care could be provided where there is an assessed need, for up to 6 weeks free of charge. A person may be eligible for an extension which will be based on a review of assessed needs on a case by case basis. After the initial agreed period, non-residential charging will apply up to the national weekly maximum charge. If the person is subsequently assessed as requiring a residential bed then residential charging rules will apply.

Interim Support Beds - A person who is medically fit for discharge but for whom domiciliary care cannot immediately be sourced, will be offered a bed in an appropriate care home. The charge applied for the first 8 weeks will based on the assessed number of domiciliary care hours the person would need.  After the first 8 weeks the case will be reviewed and the person may be charged according to the residential charging rules.

Changing Needs That Impact Charges - If a person’s needs change part way through a planned period of service and a different service starts, then charges for the new service will apply from the date the new service starts.  An example of this is where a person is receiving respite but within the agreed period the placement is changed to permanent because the person’s needs have changed. The person will be charged under non-residential rules for the respite received and under residential rules from the date the permanent placement began.

Choice of Accommodation and Additional Cost Contribution

A person’s assessment of needs will determine which accommodation will be most suitable. The choice of accommodation may impact on the charge to be levied. A person must be provided with two or more choices of residential setting at the local authority’s standard rate; that meets the assessed needs of the person. If the person then chooses a more expensive option, they, in certain circumstances, or a third party will need to pay the additional cost. The additional cost will be paid over and above the assessed charge. The local authority may seek to recover any outstanding debt relating to the additional cost contribution, from the person responsible for paying it. The person applying to pay an additional cost contribution will need to provide a statement of means, so that it can be determined that the person can meet the additional cost over a sustained length of time.

Deferred Payments and Deferred Payments Interest Charges

It may be necessary for a person to sell their home to pay for their care costs in a care home. A deferred payment agreement will be offered to someone who wants to delay the sale of their home until a time that is more suitable, if they meet the criteria set out in the Deferred Payments regulations. The full Deferred Payments policy is available on request. Regulations allow discretion to charge admin fees and interest up to 0.5% in excess of the Market Gilt Rate as reported by the Office of Budget Responsibility in their Economic and Fiscal Outlook report.  The Fees and Charges appendix will include details of deferred payment admin and interest charges that may be applied.

Charging Carers

An adult carer [Other than a parent or guardian of a child or a child who is a carer in receipt of care and support.] who has assessed needs in their own right and is in receipt of services or a direct payment, may be charged in accordance with this charging policy.

Appealing Assessed Charges

Service users who think an error has been made with the calculation of their assessed charge; or think they have additional needs related expenditure that was not taken into account in the financial assessment, can request a review of their assessed charge. Full details are included in the Appendix 4 Appealing Assessed Charges.

Recovery of Debt and Deprivation of Assets

Recovery of debt will be considered where it is clear that it is as a result of a person’s deliberate non-payment. All other reasonable options will be considered before using debt recovery powers under section 70 (Recovery of charges, interest, etc.) of the Act, including but not limited to: engagement/consultation, negotiation, mediation and court action if this is considered appropriate. Social services case workers and managers will not undertake debt recovery to ensure no conflict of interest and so that social services maintain focus on meeting assessed needs.  However, social services staff will be involved in the first stage of the debt recovery process to engage with the service user; to determine the circumstances for non-payment and possible early resolution. Social services staff will also be consulted with during the process where necessary.  Each case will be considered on its merits so that specific circumstances such as health and well-being and any communication needs are given due consideration. 

Deprivation of Assets applies to a person who has deliberately deprived themselves of assets to avoid or reduce charges. Assets mean capital and/or income. Only assets that would normally be considered as part of a financial assessment will be examined for deprivation. If deprivation of assets is suspected, further enquiries will be made to determine if it was deliberate and the reason for doing so. These enquiries will be led by PCC legal division. 

Where it is clear deprivation has occurred and a decision is made to collect the debt which results from this, all other reasonable options to collect this will be considered prior to initiating the deprivation of assets process. The full policy on Recovery of Debt and Deprivation of Assets is available on request.