FACTSHEET - F18

Community Care Charging

Introduction
This factsheet looks at local authority charging policies for community care (home care) services in:

•England
•Northern Ireland
•Scotland
•Wales

Charging in England
The power of local authorities to make reasonable charges for community care is contained within section 17 of the Health and Social Services and Social Security Adjudications Act 1983. Chargeable services include day (eg day centres) and domiciliary (ie services provided at home) services for disabled, elderly, mothers and young children. If you are a carer you may be charged for services you receive direct.

There is no definition of reasonable and in the past local authority charging policies varied considerably. There is now guidance aimed at standardising these policies. These are:

•Fairer Charging Policies for Home Care and other non-residential Social Services - Guidance for Councils with Social Services Responsibilities (September 2003)
•Fairer contributions guidance 2010: calculating an individual's contribution to their personal budget - This document provides guidance for councils in England to use when determining what contribution, if any, a person receiving a personal budget should make towards it.

The Fairer Charging guidance is detailed and needs to be read carefully. Basically the intention is to ensure that local authorities do not overcharge for services and leave the service user with at least the equivalent of their income support assessment plus 25%. However if you are in receipt of income support any severe disability premium, paid as part of this may be taken into account as part of your income.

If the services are for you any assessment should only take account of your income, not that of your partner if you have one. Jointly held income or savings may be an exception.

If you are in receipt of disability living allowance mobility component this cannot, by law, be taken into account for charges. Disability living allowance care component can be taken into account but a local authority is not allowed to count an award for night needs where they are only providing day time care (and vice versa).

Your earnings should be ignored in any assessment.

You cannot be charged for services provided by the NHS, such as those provided by a district nurse. Community equipment is also free, and minor adaptations which you or your carer are assessed as needing will be provided free by social services, as long as the cost is less than £1,000.

Charging in Northern Ireland
In Northern Ireland if you are 75 or over you are not charged for your home help service. The charges for people under 75 are explained in circular HSS (SS) 1/80, which has been regularly amended. This circular lays down a charging procedure based on allocated times for various tasks.

Charging in Scotland for people aged 65 or over
If you live in Scotland and are age 65 or over you will not be charged for personal care. Personal care is defined in section 2(28) of the Regulation of Care (Scotland) Act 2001 as...

"care which relates to the day to day physical tasks and needs of the person cared for (as for example, but without prejudice to that generality, to eating and washing) and to mental processes related to those tasks and needs (as for example, but without prejudice to that generality, to remembering to eat and wash); and "personal support" means counselling, or other help, provided as part of a planned programme of care."

The amount of free care you will receive is determined by a local authority assessment and there is no set limit to the amount they can provide. This care can be provided by the local authority or alternatively you can ask for a direct payment.

Your benefits, including attendance allowance or disability living allowance will not be affected.

Examples of free personal care are outlined in the Community Care and Health (Scotland) Act 2002 and includes help with:

•personal assistance – eg help with dressing, getting up and going to bed, help with moving about indoors, using a hoist, help with surgical appliances and manual aids;
•personal hygiene – eg bathing, showering, washing hair, shaving, nail care, oral hygiene;
•continence management – eg toileting, catheter/stoma care, skin care, bed changing, incontinence laundry;
•dealing with problems arising from immobility;
•simple treatments – eg assistance with medication, simple dressings, eye drops, oxygen therapy and the application of creams and lotions;
•counselling and psychological support including behaviour management and the provision of reminding and safety devices;
•food and diet – eg assisting with the preparation of food, assisting in the fulfilment of special dietary needs.

The definition of free personal care covers physical assistance with care and help with the mental processes related to that care – eg helping someone to remember to wash.

You may still be charged for non-personal care such as day care, lunch clubs, meals on wheels, community alarms and help with shopping and housework.

Guidance on community care available in Scotland is at www.scotland.gov.uk/Topics/Health/care.

Charging in Scotland for people under age 65
The level of charge is determined by your local authority. Guidance is contained within Charging Guidance for Non-residential Social Care Services.

The guidance recommends that local authorities should adopt a common threshold at which charges would begin to apply. These thresholds are:

  • Single person under 60 year - £107
  • Single person over 60 years - £152
  • Couples under 60 years - £164
  • Couples over 60 years - £232

Charging in Wales
Similar fairer charging guidance has been issued for Wales as for England except the fairer charging assessment should leave the service user with the equivalent of their income support assessment plus 35% (and a further 10% flat-rate disability-related expenditure disregard). In addition, there is weekly maximum charge of £50 for the services a person receives.

Where Can I Get Help?
You should seek further advice if you want to challenge a decision about your benefit. You can get help with your appeal at a local advice centre, such as a citizen's advice bureau. You can get more information about this from our factsheet F16, Finding a local advice centre, which is available at www.cara-online.org

Central Africa’s Rights & AIDS (CARA) Society has also published Benefit appeals - A guide to benefit appeals for advisers and disabled people. This guide helps you prepare for an appeal tribunal and will increase your chances of success at the hearing. It takes you through all the stages of the benefit decision-making process from the moment you receive an unsatisfactory decision through to the tribunal hearing.

It is available to have a look at it on our website at www.cara-online.org or by contacting CARA on Tel: +44 (0) 844 478 0015 - Mob: +44 (0) 795 695 2645 - Fax: +44 (0) 872 115 8436 - E-mail: info@cara-online.org

Updated 8 April 2011