Proposal to charge for non-residential care

We had a limited amount of time to engage with people in October/November 2024, and although we did receive a high level of comments from carers, we recognise we were not able to engage with everyone as fully as we would have wanted.

To remedy this, and to support our policy development should the proposal be approved, we have created an easy to understand information pack and feedback form, as well as guidance that carers, families, providers and support staff can use to provide feedback. 

Providers have been asked to support people to participate and to provide this feedback to us. We would welcome families/carers sharing this with a Personal Assistant if they/their loved one doesn't have a support provider, or you can complete it together as their parent/guardian or POA, and return it to HSCPPA@eastrenfrewshire.gov.uk. 

We will look to complete as many as possible by the Cabinet meeting on 6 February 2025 where the proposal will be reconsidered. If the proposal is approved this engagement will continue, as the findings will also support the development of the Health and Social Care Partnership charging policy.

You can view and download the easy to read charging policy with visuals here as well as a document with background infomation to support this activity

 Non-residential care includes services like social supports, charges for meals, day opportunities, building and community based services. Personal care at home is categorised as non-residential care but this cannot be charged for and will remain free. Legislation sets out what is categorised as personal care and this information can be found at     https://www.legislation.gov.uk/asp/2002/5/schedule/1 

 

For many years, we have worked hard to avoid the need to introduce charges for non-residential care, and up until now we are the only Health and Social Care Partnership (HSCP) in Greater Glasgow and Clyde that does not charge for these services.

Regrettably, our financial position, the demand for services and the increasing complexity of need, means we need to consider introducing charging for these services. If approved, charges would be linked to the ability to pay and this would be established through a financial assessment.

This is a proposal at this stage and a paper will go to the Council Cabinet committee on 5 December for consideration. The Council retains the authority to set charges.

Modelling indicated that around £1.5m per year could potentially be raised from charging, and this is broadly comparable with other similar HSCPs.

This proposal is being made with a very heavy heart and we do not want to have to bring this forward, but we have a statutory duty to set a balanced budget.

For 2024/25 we've had a £12 million gap in our budget. We've had to make a lot of difficult decisions to find this amount of money - staff redundancies, holding posts, moving our social care criteria to substantial and critical needs only. We have had to focus on supporting those with the greatest needs and meeting statutory duties. We have exhausted savings from staffing, from buildings and from all other areas of costs. We have increased income from the areas where we currently charge for including Bonnyton House and Community Alarms (Telecare), it has been extremely difficult for the people we support and our staff.

When we look to 2025/26 we know things aren't going to get any easier. The cost pressures for 2025/26 range from £3.5 to £7 million depending on a range of scenarios and we expect the trend of flat cash settlements from Council and the Health Board to continue. We need to find further savings to offset these potential costs, and that is why we are proposing introducing charging for non-residential care, as it's really the last stone left unturned.

Personal care will remain free, and this is set out by legislation. The details of what is considered personal care can be found at https://www.legislation.gov.uk/asp/2002/5/schedule/1

The policy would not look at who provides the care, but who funds it. The aim of the policy is not to reduce care, but to charge for the applicable elements of care.

This will be different for everyone, but very generally, income is wages or pensions/benefits and expenditure is household related things, like mortgage/rent and council tax. Most other expenditure such a food, living expenses and utilities would be covered by the minimum income guarantee set by the DWP to ensure everyone could secure a minimum acceptable standard of living.

We will also work with partners including the Council Money Advice and Rights Team (MART) and Citizens Advice Bureau to ensure residents have access to everything they are entitled to..

If approved, this would be established through a financial assessment and we will work in partnership with the person and their carers/family.

We will also work with partners including the Council Money Advice and Rights Team (MART) and Citizens Advice Bureau to ensure residents have access to everything they are entitled to.

How much is paid will be different for each person, as it will be based on a financial assessment.

If approved, a charging policy to support this process will be drafted to include:

• A taper % that determines how much disposable income we can access (we are proposing 60%, the highest we have seen is 75%)
• Where a waiver for a charge would apply
• Where and when it is not appropriate to charge

We are still working on the level of charges that we will propose to Cabinet, but it is likely to be around £20 per hour, which is less than the lowest cost we can purchase care for.

The policy will agree the time between financial assessment and invoices being issued, and it will also reflect a reasonable amount of time for a financial assessment to be completed.

No, the financial assessment will be based solely on the individual's circumstances. There may be occasions where we do assess people together because it makes more sense for them i.e. couples who share care.

The policy and detail of this is not yet set in stone, so we will be able to discuss this with you if the proposal is approved and the policy is written.

The policy will have no impact on your income but it will consider, based on your income and expenditure, whether you can contribute towards paying for relevant services.

If the financial assessment establishes you do not have the means to contribute to your care, you will not pay anything.

Absolutely not.

Capital is considered separately from income, but depending on the levels of capital, there may be a capital tariff, which acknowledges that higher levels of capital can yield income in their own right. This will be detailed in full in any policy.

Absolutely not. The primary property of the person being assessed is also disregarded.

Our system would be adjusted manually to take into account increases in DWP benefits and pensions. People would receive a financial reassessment annually to take into account changes in other sources of income, e.g. occupational pensions. In order to avoid more than one assessment per year for someone, we would take figures as they stand at the start of each financial year, unless they are likely to materially change during the year.

We would ask that if someone experiences material changes in their income during the year, they should contact us for a reassessment.

The mobility element of disability allowance will be disregarded for financial assessment purposes.

Financial assessments can be completed in a variety of ways, including electronic or paper copies, or having an officer from the HSCP visit a person to assist with completion if preferable.

No, this is classified as personal care.

People receiving a direct payment would receive this net of any assessed contribution. People whose care is paid for directly by the HSCP would receive a bill from the HSCP for their portion, likely on a 4 week basis.

What each person pays towards their care will be based on individual circumstances, and no one will pay more than the cost of their care.

Any support provided to carers themselves is exempt from any charge.

The financial assessment will be on the individual receiving care and their disposable income.  

The financial assessment of the person receiving support may have an effect on the households overall disposable income and you may wish to ensure that you are receiving all the financial support that you are entitled to.

East Renfrewshire Carers' Centre can assist with this. www.eastrenfrewshirecarers.co.uk as can the Council Money Advice and Rights Team (MART) https://www.eastrenfrewshire.gov.uk/mart

Elected members have been kept fully informed throughout this process. The proposal came from an Income Generation Short Life Working Group that was formed in April 2023, and the membership includes three elected members (Cllr O'Donnell, Cllr Pragnell and Cllr Edlin) as well as senior HSCP officers.

Members who sit on our Integration Joint Board (IJB), which governs the HSCP, have heard a number of papers over the last year around the HSCPs financial position and the work of the short life working group. We held a seminar for IJB members on 28 October to discuss the views raised at the information sessions.

Officers have also presented at the Council Budget Strategy Group to outline the implications a flat cash settlement will have on the people we support.

Since our information sessions, all elected members have been sent an overview of the points raised and information to help them support constituents.

There is no indication that this will be taken forward and our financial situation is so challenging that we need to progress with this proposal.

A number of people have told us that the short notice of the recent public events we held to discuss the charging proposal has meant they were unable to attend. In response, we are have arranged two further events for the 25 November. You can also share your views by email - HSCPPA@eastrenfrewshire.gov.uk

DATE	TIME	IN PERSON OR ONLINE	LOCATION/LINK
Monday 25 November	2pm - 4pm	In person   If you would like to attend, please email HSCPPA@eastrenfrewshire.gov.uk with '25 November' in the subject line, and let us know how many spaces you would like to request. Places will be secured on a first come, first served basis and we will respond to confirm if you have a space(s)	The Foundry, Main St, Barrhead, G78 1SW
Monday 25 November	6pm - 8pm	Online	Microsoft Teams Need help?   Join the meeting now   Meeting ID: 344 544 785 471 Passcode: jWeAye

We are taking a number of steps to include people's views and to listen to people to identify the issues that may arise from the proposal becoming a policy, and the impact this may have on their lives:

• Feedback from events - held by the HSCP and its partners
• Sharing comments made by email with colleagues working on the EFRIA
• Hosting community engagement sessions - email Mark.Mulhern3@eastrenfrewshire.gov.uk if you would like to participate
• Sharing this survey for people to complete 

24 November:HSCP information sessions:

·       2pm - 4pm, Barrhead Foundry

·       6pm - 8pm, Microsoft Teams

5 December: Paper considered by Cabinet

If approved:

January 2025 - April 2025: Follow up sessions with people impacted

1 April 2025: Charges introduced