From 1^st April 2015 statutory guidance on charging for care and support under the Care Act is provided in The Care and Support (Charging and Assessment of Resources) Regulations 2014. The new law for adult care and support sets out a clearer approach to charging and financial assessments with one of the drivers of the Care Act 2014 being the portability of care and financial assessments; this would be better achieved if Bradford was to adopt the standard alternative.

Prior to any changes being made to the Policy, the Council is required to carry out a formal consultation on the proposed change.  The Interim Strategic Director of Adult and Community Services will submit Document “H” which details the outcome of that consultation.

The report also suggests that consideration should be given to including charges for the Shared Lives Scheme in the Contributions Policy. It also suggests introducing charges for other services not currently charged for under the Policy.

Recommended –

That the Committee considers the feedback received to date as part of the consultation on changes to the Contributions Policy and that this Committee requests that the views and comments raised by Members be included in the final report to Executive on 20 September 2016.

(Bev Tyson – 01274 431241)

The Interim Strategic Director, Adult and Community Services introduced Document “H” which detailed the outcome of the consultation on the proposed changes to the Council’s Contributions Policy for non-residential services.  He explained that all Local Authorities had the ability to make charges to recover social care costs and that Bradford’s current system was unique in that it favoured those with the most available income.  It had been agreed that a consultation be undertaken on the Contributions Policy with the aim that the more money that could be recovered, the more services that could still be provided.  The funds raised through charges would be spent on people with support needs, however, if the proposals did not go ahead then there would be cuts to social care services.  The Interim Strategic Director, Adult and Community Services stated that a wide consultation had taken place and it had been identified early on in the process that the information was not easy to understand.  He confirmed that the Council had worked with Healthwatch and other organisations and had extended the consultation process.  The Council was looking at a full cost recovery and needed to identify the real costs of a person’s care.  It was proposed that charges for the Shared Lives Scheme be included in the Contribution Policy in line with all other services.  In relation to the Supported Living service, it was noted that if a person was only in receipt of this service the proposals would result in them being assessed to make a contribution.  The Strategic Director, Adult and Community Services reported that the responses to specific questions asked on the questionnaire were detailed in the report.  He indicated that the proposals had not been well received.  Each individual would have a financial assessment that would consist of two elements, a benefit check and a review of the support plan and any changes or effect on the service user’s contribution would be identified on their completion.  The Strategic Director, Adult and Community Services informed Members that if approved the planned roll out would be over six months and there would be a review or appeal process.

Members then made the following points:

·        If the standard alternative was accepted by the Executive, would all services users be assessed?  Was the charging formula used nationally or just by Bradford Council.

·        Was the Council going up to the full 10% that it could charge on top?

·        There would always be winners and losers when changes were implemented, but 40% of service users would be affected which was a significant amount.  Could individual reviews be undertaken if necessary, as the most vulnerable people in society would be affected?

·        Would the old charge be retained until a review had been undertaken?  How long would the review process take?  Would the charges be backdated if the review was not successful?

·        The issues on both sides were understood and everything would be undertaken to ensure that there was equity.  

·        Service users had not understood the consultation process, so the Strategic Disability Partnership had been proactive and helped.  What would have happened if they had not?

·        The number of questionnaires received was concerning.  What had been done for those people for whom English was a second language?

·        The questionnaire return rate was poor, so it could be assumed that people had not understood it.  How was this followed up?

·        Responses to the questionnaire should have been chased up.

·        The issue regarding questionnaires had been raised many times previously and it was hoped that additional efforts had been made.

·        What was the cost  to the organisation?  Healthwatch was trusted and they were concerned.  The Council appeared to be ‘robbing Peter to pay Paul’ and would end up paying out more money.

·        The report was daunting and complicated.  There was a need to ensure that no-one was unnecessarily affected.  Would there be assessments for everyone?  What exactly was the Council charging for?

·        It was good that the Council was to take up ‘double ups’.

·        Was it appropriate to set the maximum charge?  Was the Council adding 10%?

·        In relation to the consultation, accessible standards had been introduced this year, but 80% of service users had been excluded from the process.

·        If the policy was agreed what safety net would be put in place for service users and their families?  There could not be a 12 month wait for a report on the implementation of the policy.

·        It had been a difficult consultation and the Council had been reliant on the assistance of others.

·        Why not keep the current policy? 

·        The Committee’s role was not to make decisions, but to protect vulnerable people.

·        Could the new policy cost the Council more money?

·        Would service users be means tested?

·        Would socialising be included as part of their needs?

·        When would the proposal be submitted to the Executive?

·        It was welcomed that the Council accepted that the consultation process had been flawed, but lessons had not been learnt as this had happened before.  Was the report being submitted to the Executive on its own merits?

·        Would the people undertaking the assessments have the correct skills set?  It would be beneficial if a knowledgeable person carried out the assessments.

·        Was it anticipated that many challenges or appeals would be submitted?

·        There had to be give and take.  A 100% increase was not acceptable.   The consultation process  could have been handled better and more results obtained. 

·        Would the Executive consider the report and not just accept it?

·        If the policy was implemented, it should be phased in, which would take longer but would alleviate hardships.

·        Could the increases be phased in?

·        Would there be a rolling program of implementation?

In response, Members were informed that:

·        The contributions policy applied to everyone.  The Council had the authority to charge and most Local Authorities did so.  The proposals put forward a policy that would be similar to other Authorities in West Yorkshire.

·        The Council would be adding an extra 25% on top.

·        The Executive would decide whether there would be individual assessments.  Any increase in charges would be stressful for service users and any appeals would be undertaken as soon as possible within short timescales.  The percentage figures were guesstimates and the reassessment of care plans could not be taken into account.  60% of service users would gain from the changes to the policy and there would be equity across the system.  The Council could not have a two tier system.

·        It was accepted that the consultation process was flawed in the beginning and the Council was grateful of the roles that the Strategic Disability Partnership and Healthwatch played in the consultation process.

·        The response rate to the initial questionnaire was 21% (723) and 18% to the revised questionnaire.  Approximately 3500 questionnaires had been sent out and the results were detailed in the officer’s report.

·        The response to the postal questionnaire was very good.  The Council did not have the resources to visit all 3500 people and relied upon organisations to respond on behalf of individuals.  Those people that had not replied had not been contacted.

·        Consultation had been undertaken with groups and individuals and part of the role of organisations was to present the information.  Not all organisations were contacted and it was expected that those who had been would circulate the information to others.

·        The implementation of the proposed policy would have a one off additional cost which had been factored into the budget process.  The intention would be to recover the cost of care from those that could afford it.  It was about maintaining services and not making cuts.

·        The Government had set a minimum amount that people were expected to live on and vulnerable people were allowed disability benefits.  The proposal meant that only any money over the minimum income guarantee plus any benefits and the additional 25% on top, would be looked at by the Council to recover for the cost of care. 

·        There were currently 417 service users that used ‘double up’ care and 280 did not pay the full costs for one person. 

·        The Executive could amend the maximum charge to be set.

·        As part of the consultation process, letters had initially been circulated and the Council had relied upon carers to provide information.  The process had not been perfect but the Council had tried to disseminate the information.  Until it was explained by an individual, most people would have difficulties in understanding the proposal.  The best way forward would have been to have one to one sessions, however, this could not be undertaken with 3500 people.

At this point a representative of Healthwatch stated that the organisation had assisted the Council in order to improve the consultation process.  Healthwatch had agreed with the Strategic Disability Partnership’s view and requested that the consultation process be extended, which it had been, however, other recommendations had been made but they had not been put in place.  He stated that it was believed that the consultation process had not been carried out properly and stressed that Healthwatch had not been part of the process.  The main concern for everyone involved was the impact of the proposals.

Members were further informed that:

·        Consultation had been undertaken with People First Keighley and Craven and it was believed that a plain English version of the questionnaire had now been produced.  The Council could also provide information in braille or by British Sign Language if requested.  It was acknowledged that the consultation had not been perfect, but it was believed to have been wide reaching.

·        Discussions would need to be undertaken with the Adult Safeguarding Board in relation to the implementation and a number of lessons must be learnt from the consultation process.

·        The proposed policy had not been designed to make people’s situation worse and there was no intention to cause harm.  Assessments of individuals would be undertaken and their disposable income looked at.  It was not expected that people’s needs would increase due to the policy and their contribution would be based upon their ability to pay. 

·        The Government had set the amount a person required o be able to live and the policy would only take account of 75% of disability benefits received.

·        The proposal would be submitted to the Executive on 20 September 2016.

·        The consultation process had been agreed as part of last year’s budget proposals.  The budget could be reviewed, but accounts had to be balanced and the funds would have to be replaced.  The Department already had an overspend and was accountable for this, as it had legal responsibilities and it was in a position where it would have to do things that it did not want to do.

·        Confidentiality issues could arise if people not connected to the Council assisted with the assessments.

·        It was expected that there would be appeals.

·        There were different elements to the report to be submitted to the Executive.

·        Not all the increases would be by 100%.  There would be a basic contribution.

·        The financial assessments undertaken would be based upon the needs of the individual and a social worker would undertake a review of a service user’s support needs.

Resolved –

(1)       That consideration be given by the Executive to a more incremental approach to the introduction of the Standard Assessment process.

(2)       That, on the assumption that the changes to the Contributions Policy be approved by the Executive, an update report be submitted to the Committee in six months and to include consideration of ways to improve consultation with vulnerable groups. 

Action: Interim Strategic Director, Adult and Community Services