To receive a report on the Adult Social Care Fairer Charging Policy.

The Committee received a paper on the outcome of the consultation on charging for Adult Social Care Services and the recommendations for changes to the Fairer Charging Policy.

The Cabinet Member (Health & Wellbeing) reported that Cabinet had adopted a general policy of full cost recovery across all services.  The implications of this policy for adult social care services had been consulted upon to update the Fairer Charing Policy.  People in receipt of a “chargeable” service were entitled to a financial assessment and only those assessed as being able to pay will pay. It should be noted that 51% of people in Herefordshire who are in receipt of services did not pay following financial assessment. The introduction of a more equitable and transparent approach to charging would also have the benefit of promoting choice and market development and providing greater access to services for users.

The Interim Programme Director: Adult Social Care reported that this had been a widespread consultation, with 2000 questionnaires issued to service users, from which there had been a 564 replies. Face to face discussions had been held with 344 people, and there had been 16 public meetings.

In the ensuing discussion, the following points were made;

·         That there would be no change to Extra Care, supported/shared living and adult placement, as these were already charged at full cost. 

·         Currently there was inequality between how charges are applied depending on whether service users decided to receive care through managed services or a direct payment. In the consultation, 59 % of replies agreed that equity of charging was needed.

·         In the consultation, 51% of replies agreed that equity of charging was needed, whilst 69% agreed that adult placement should be charged equally.  That whilst there was a proposed increase in cost for meals, some daycentre users were already paying more than the present rate.  The Interim Programme Director added that the Council would go out to tender for all contracts.  As an example, costs for short breaks for carers had been reduced from £20 to £16.

·         The Interim Programme Director added that the Council was keen to ensure that value for money and tendering exercises had taken place which had reduced the costs of services.

·         That as part of the charging process, if services received by an individual were chargeable, then the Benefits Team would visit them to undertake a financial assessment to ensure that they paid only as much as they could afford to pay.

In reply to a concern, the Director for Peoples Services said that whilst it was not possible to prevent a judicial review of the process being sought, the Council had mitigated as much as possible against such an outcome.  The process that had been undertaken had been informed by those undertaken by other local authorities, and the Council had done everything reasonable and possible to ensure all service users were consulted on the proposals.

·         That a cost benchmarking exercise of near neighbour local authorities as well as the Council’s family of similar authorities had been undertaken in November 2011 by PricewaterhouseCoopers. 

·         That there had been much discussion around charges for transport, and following an assessment process, users would only be expected to pay the maximum that they could afford.  The majority of users would not pay the full cost for the service.

·         That the financial assessment process would be the subject of an adult social care seminar for all Members in November, which would look at how people were assessed, and the benefits of the process.

·         That there was, at present, no proposal to phase the changes to the charges.

·         That there would be a full financial assessment for all those involved in supported employment, and charges would not penalise those who were working, as earnings would be disregarded as part of this process.

·         That reviews would be undertaken for those service users who were just out with the limit for financial support.  If users did withdraw from services they would be referred back to the Wye Valley NHS Trust Assessment Team.

·         That the financial assessment process was made as simple as possible, and that it was made clear to the user that the assessment team were looking after their wellbeing, and were ensuring that they were only paying the maximum that they could afford.

RESOLVED:

That

a)    the Committee noted the outcome of the consultation on charging and the contents of the Equality Analysis;

b)    the Committee was satisfied with the report; and;

c)    An updated report on the outcomes of the policy be brought to the Health and Social Care Overview and Scrutiny Committee within 12 months of implementation.