Adult social care charging policy

9.1

The Council will charge for care and support delivered in a Care Home on a permanent basis. 

9.2

Adults requiring permanent care and support in a Care Home must initially satisfy an eligibility assessment for care and support. Only where an adult has an eligible care and support need will a financial assessment be required.

9.3

All adults requiring permanent care and support in a Care Home must have a Financial Assessment. The adult’s individual financial circumstances will determine whether they are eligible for support towards permanent care costs from the Council.

9.4

Adults will be made aware at the outset of the maximum amount of funding the Council makes available towards care and support provided by independent / voluntary sector Care Homes. This is known as ‘The Local Authority Rate’. This rate is inclusive of any assessed customer contribution, and in the case of Nursing Care, includes the free Funded Nursing Care element (FNC) paid by the NHS.

9.5

Third party top ups may be applicable when an adult chooses more expensive accommodation than the Local Authority Rate. The top-up is to be paid by a third party, the third party must confirm they are able to meet the costs of the top-up for the duration of the agreement, including any price changes that may occur. Both they and the adult will be made aware of the cost and to whom payment is to be made, together with the frequency, as well as provision for review, the consequences of failing to maintain payment and the effect changes in any parties’ financial circumstances will have on the agreement. It is recommended that the top up is paid directly to the care home by the third party, this is the simplest option. The second option is for North Tyneside Council to pay the top up to the care home and then invoice the third party for the four-weekly amount. Non-payment of the top up; if the top up is not paid the service user may be moved to a room or other home that does not require a top up. Any unpaid top up costs that are paid by North Tyneside Council will be passed on to the third party as debt to be recovered. If the Local Authority were not involved in the placement of the person, any third party top up would be a private arrangement.

9.6

Where an adult is eligible to receive Local Authority funding for support in a care home setting, but decides to reside in another Local Authority area, North Tyneside Council will pay the Local Authority rate for the area where the customer decides to live. Where an adult chooses more expensive accommodation than the Local Authority Rate of their chosen area and the top-up is to be paid by a third party, the third party must confirm they are able to meet the costs of the top-up for the duration of the agreement, including any price changes that may occur. Both they and the adult will be made aware of the cost and to whom payment is to be made, together with the frequency, as well as provision for review, the consequences of failing to maintain payment and the effect changes in any parties’ financial circumstances will have on the agreement. It is recommended that the top up is paid directly to the care home by the third party, this is the simplest option. The second option is for North Tyneside Council to pay the top up to the care home and then invoice the third party for the four-weekly amount. Non-payment of the top up; if the top up is not paid the service user may be moved to a room or other home that does not require a top up. Any unpaid top up costs that are paid by North Tyneside Council will be passed on to the third party as debt to be recovered. If the Local Authority were not involved in the placement of the person, any third party top up would be a private arrangement.

9.7

Adults who own a property, over which security can be taken, may be eligible to defer care costs against the value of the property. This is known as a Deferred Payment Agreement. On an individual basis, North Tyneside Council will consider other assets than a property as eligibility for the Deferred Payment Scheme. North Tyneside Council will make Deferred Payment Agreements available under the national ‘Universal Deferred Payment Agreement Scheme’ and ‘North Tyneside Council Deferred Payment Agreement Scheme’ providing the eligibility criteria has been met. Details of Deferred Payment Agreements can be found within the Council’s Deferred Payment Agreement Policy located at www.northtyneside.gov.uk 

9.8

The Council will undertake a financial and benefits check for adults entering Residential Care on a permanent basis to ensure that their income is maximised. Contributions are payable from the date care commences.

9.9

The Financial Assessment will consider income, capital and the value of any assets. The charging methodology will take into consideration any mandatory disregards of income, capital and property as defined in the Care and Support (Charging and Assessment of Resources) Regulations 2014.

9.10

The Financial Assessment will take into account statutory amounts required to be retained by the customer from their income. These are known as ‘Personal Expenditure Allowance’ (PEA) and ‘Disposable Income Allowance’ (DIA). These amounts are dependent upon the adult’s individual financial circumstances and are reviewed annually by the Department of Health and Social Care. The rates applicable for the relevant financial year (April – March) are set out on the Councils website www.northtyneside.gov.uk Where a customer has no income the Local Authority must ensure that they receive a personal expenditure allowance at the prevailing rate.

9.11

Financial assessments will be regularly re-assessed to ensure that the person is able to meet the cost of any charges. An assessment will take place if there is a change in circumstances or if the person requests an assessment.