Agenda item

Purpose: To assess the intent and scope of the Fairer Contributions policy.

Councillor Gwen Mason introduced a report detailing the Fairer Contributions Policy and thanked the Commission for postponing the item in order that a representative from the Disability External Scrutiny (DES) Board could contribute towards the discussion.

Councillor Mason explained that feedback provided via the DES Board suggested that overall the Fairer Contributions Policy was difficult to understand and therefore required simplification. However, the suggested topic for scrutiny sought to review the Disability Related Expenditure of the Fairer Contributions Policy in particular.

Jo England introduced the report to the Commission. The current Fairer Contribution Policy had been in place since April 2012, the Policy’s purpose was to provide a mechanism to establish how much an individual receiving an adult social care service would be required to contribute towards the cost of their care.

On 21 July 2003 the Council introduced the Fairer Contribution Policy which was broadly in line with the Department of Health’s (DH) 2001 guidance. As the previous policy had only charged individuals 50% of any Attendance Allowance or care component of Disability Living Allowance in payment, the new policy dramatically increased the amount that individuals had to pay.

To alleviate the financial impact additional elements of expenditure were also included in the 2003 policy that was over and above the DH guidance.  These included the inclusion of water rates, an element for building maintenance for owner occupiers and not charging for a second carer.  A decision to charge an individual 90% of their chargeable income was also made to alleviate the financial impact.

The Policy was reviewed on an annual basis to take account of new DH capital thresholds and benefit rates.  The next major change to the Policy was on 7 April 2008 when the Policy was amended to charge individuals 100% of their chargeable income in line with the DH guidance.

In response to budget reduction proposals for 2012/13 the Policy was reviewed and following wide consultation a decision was made to remove the concessions included in the 2003 Policy.  This included charging for second carers and removing expenditure items from the policy that should be covered by general living expenses i.e. water rates and building maintenance. 

 

Jo England stated that Disability Related Expenditure, allowable as part of the financial assessment, was also reviewed to bring it in line with the DH guidance and neighbouring authorities.

 

The Chairman welcomed Alan Fleming from the DES Board to comment on the report and explain why they requested the item for scrutiny.

 

Alan Fleming thanked the Commission for inviting him to the meeting and stated that he was the Deputy Chairman of the DES Board. He proceeded to explain that the DES Board were concerned that the current DRE policy was inadequate and resulted in a negative financial challenge for  those in need.

 

The Commission heard that on occasion service users had to prioritise living related expenditure in order to meet care costs. Alan Fleming provided examples of the types of additional support residents required around the home and garden and the dilemmas faced when trying to fund them. Alan Fleming referred to the increased number of DRE appeals since the change was made to the policy and suggested that this was evidence that residents were unhappy with the guidance.

 

Alan Fleming stressed that the challenges impacted on his extended family who would deliver the support he was otherwise unable to afford. Alan Fleming stated that this was a common issue amongst service users.

 

Councillor Brain Bedwell asked Officer’s to explain how they dealt with the issues outlined by Alan Fleming. Jo England explained that the guidance was provided by Central Government and restricted levels of discretion. The DH guidance was designed to ensure that a service user hadsufficient money to meet their basic housing costs and disability related expenditure andretain their basic ‘Protected Income’.

 

The assessment calculation was summarised as the following;

The financial assessment will make sure that all service users retain a basic living cost allowance plus 25%. This was a level of ‘protected income’ that would not be considered in the financial assessment. Each service user would have at least this level of income to pay for their housing, living and disability related expenses, before they are asked to pay an assessed charge for Adult Social Care Services.

The financial assessment calculation was represented as:

- Assessable income

- Level of ‘protected income’

- Housing expenses

- Allowable expenses

- Disability related expenses

= Net disposable weekly income

For adult social care services that have an assessed charge, the Financial Assessments and Benefits Team will undertake a financial assessment to work out how much service users will be charged.

The financial assessment considered service users’:

·                     Income and savings

·                     Allowable expenditure (such as housing costs) and

·                     Extra expenses they may have due to a disability or condition.

 

Councillor Roger Hunneman asked how the Council helped service users to manage basic needs expenditure. Jo England stated that government grants were in place to help support residents; these were outside the charging policy. The Commission heard that residents would be entitled to their basic income plus 25% before the assessment considered charges for Care.

 

June Graves explained that of the various grants available there were flexible payback options to consider. The Adult Social Care Service endeavoured to support service users so they could remain in their home by way of making necessary modifications, the grants were designed to assist with such work.

 

Councillor David Goff asked whether the challenges highlighted by Alan Fleming could have been met under the previous policy and requested clarification from Officer’s in terms of the changes made in 2012.

 

Jo England explained that the previous policy funded health care which should have been funded by health services, contribution towards water rates and building maintenance. The policy was amended and subsequently brought in line with Central Government guidance and policies within neighbouring Local Authorities.

 

Officers were asked to clarify the cost to the Council associated with the Policy. Jo England stated that each case was assessed in isolation; there was no upper limit in terms of allowances as such restrictions would contradict the purpose of the policy.

 

Councillor Jeff Brooks referred to point 5.5 of the cover report and suggested that it would have been helpful if Officers provided details regarding the savings made by the change.  Furthermore, Councillor Brooks suggested that the Commission required sight of the consultation results in order to assess the effectiveness of the policy. In his view the Commission required more detailed information in order to consider the item appropriately. Councillor Brooks stated that there was no doubt the policy required simplification; he stated that the quality of information contained within the report was questionable.

 

Councillor Mason explained that a concern from the DES Board related to inconsistency of assessments and the difficulty services users had in understanding the outcome of an assessment. Jo England advised that the team comprised of three experienced advisors and an appeal process ensured service users could request a review of a decision.

 

Councillor Paul Bryant acknowledged that Members had concerns about the cost associated with the policy, he suggested that the report required information about how many clients the Council had, how the budget was allocated and the upper limit within the budget. It was agreed that the information would be helpful and would enable the Commission to fully consider the parameters of the policy.

 

Councillor Emma Webster made reference to item 6.6 of the policy which listed the exclusions of the DRE and asked whether they were exclusions as guided by Central Government or as agreed by the Council. Jo England explained that many of them were taken from the DH guidance. Councillor Webster suggested that crucial basic care needs included within the list placed people in a more vulnerable state. Councillor Webster echoed concerns raised by Members that the policy was confusing and required simplification.

 

Councillor Webster requested a review of the list to consider elements which could be altered if within the power of the Council to do so and within the constraints of the budget, and to understand elements which were outside the power of the Council to change but could be influenced to change in the longer term.

 

Jo England explained that elements of the policy were changed by Central Government. It was stated that the Fairer Contributions Policy would be reviewed as a part of the Care Act review in 2015/2016.

 

Councillor Hunneman queried why broadband and telephone charges were included within the DRE exclusion list. It appeared appropriate to assume that a large majority of service users would require such services in order to access the Fairer Contribution Policy. Jo England explained that DRE expenditure aimed to address unmet care needs, the decision was made that such services were paid for by the general public and a similar approach would be taken in the context of policy. Councillor Hunneman challenged the decision on the basis that services users had to prioritise expenditure based on a very limited source of funds.

 

Councillor Hunneman queried how many grant applications were successful. Jo England stated that the grant success rate was 86%, the proportion that was unsuccessful generally related to incomplete applications or a request for further information/ evidence.

 

The Commission heard that the assessment timescale varied dependant on a number of factors such as the involvement from other services, at which point the process was reliant on progress of the Department for Works and Pensions. The aim of the service was to complete an initial assessment within 21 days of receiving the referral.

 

Nick Carter suggested that the policy answered some of the questions raised by the Commission. He asked whether Members felt the issue related to the boundaries of the DRE and to what extent the Council could exercise its discretion and create an opportunity to widen the scope of the policy. Nick Carter suggested that such information could be bought back to the Commission for further consideration.

 

David Lowe explained that in response to an action captured within the previous meeting, Councillor Mason was asked to clarify the scope of the item. The Commission heard that the DES Board wanted to highlight the issue relating to the operation of the DRE specifically. David Lowe suggested that the issue concentrated on the content of the DRE exclusion list and therefore, by providing Members with information about the flexibility of the list within Local Authorities, the item could be revisited.

 

Councillor Brooks challenged the proposed scope of the discussion; he felt the Commission required evidence to illustrate the efficiency of the policy by way of understanding the reasons for appeals, the output from the consultation and nature of complaints received. It was suggested that in order to appropriately consider the topic, a better understanding of the service user experience would be required. Councillor Brooks suggested that the item be deferred until such time when the information was available.

 

Councillor Webb asked whether the Government guidance was statutory. Jo England stated that it was not.

 

June Graves reminded the Commission that the policy was reviewed and subsequently amended following the 2012 consultation. The consultation invited all service users to comment on the proposed changes to their individual situation. The Commission heard that the previous policy delivered services above and beyond Government guidance which was proving difficult to maintain. The revised policy bought the Council in line with other local authorities .

 

June Graves stated that the assessment considered input from the support team around the individual at that time, she stressed that the policy enabled a degree of flexibility in order to deliver the best arrangement of the individual. The service took a person centred approach, in conjunction with a view to the benefits awarded to that individual. June Graves explained that the income generated from charges to care was used to deliver the wider Adult Social Care service and was therefore part of the financial dynamic of the service delivery.

 

June Graves stated that the number of appeals correlated with the change to the policy. Previous assessments were more generous and it was therefore less likely that someone would appeal the decision.

 

The Chairman suggested that an OSMC task group formed part of the wider review of the policy. June Graves welcomed the inclusion of an OSMC task group.

 

Councillor Mason asked whether Members were part of the appeal process, Jo England stated that they were not. Councillor Mason suggested that this was changed. It was agreed that a member of the DES Board would also form part of the OSMC task group.

 

Resolved that

·         A Task Group would be established in order that the Commission could contribute towards the DRE policy review.

·         Officers would provide information regarding the constraints of the Government guidance around the DRE exclusion list.