Most vulnerable in Cambridgeshire hit with rise in social care charges
Some of the least well off and vulnerable could see their adult social care charges to Cambridgeshire County Council increase as the authority looks to reduce its forecast budget gap by £3.4 million.
Cambridgeshire County Council has lowered its minimum income guarantee for social care for those over state pension age. The guarantee is the minimum amount of money someone in receipt of care must be left with to live off after paying the council’s care charges.
The council said the changes are necessary to meet “significant financial pressures” and protect frontline services, and that everyone affected will have a new financial assessment where personal circumstances will be considered, meaning any potential changes will be “affordable”.
The change agreed on Thursday by the council’s adult committee has lowered that threshold by £5.50 a week, to the government’s lowest permitted level, currently a protected minimum income of £189 a week. The council estimates 2,100 people could be affected – more than first thought before the consultation.
Consultation results show 58.76 per cent of the 485 responses opposed this change, and the council summarised a key concern raised in consultee comments as: “The proposed change would impact disproportionately on the most vulnerable members of society, people who can least afford to pay more.”
The council said the changes followed an “extensive and wide-ranging consultation” and were made in reference to the Care Act charging legislation and guidance and through “close and detailed comparison with other councils”.
The move is anticipated to generate an additional income for the council of £1.7 million in 2020/21 and a further £1.7 million in 2021/22.
The savings are anticipated from a range of charge increases which will also affect thousands of service users, including those who pay the full cost of their care.
Up to 600 people could be impacted by both changes to disability benefit charge increases and a reduction in the minimum income protection, the council said. How much exactly each individual’s costs will change depends on the benefits they receive and the result of a financial assessment, with the council not able to provide figures for exactly how many of those 600 will be charged the maximum potential increase of £26.45 a week, or £1,375.40 a year, if any.
But an example used in the council papers, based on a fictional but indicative example of how it could affect someone, showed in that instance the person’s costs would increase by 34 per cent, from £77.30 a week to £103.75. But the council stresses each individual’s situation will need to be assessed before a determination can be made on the impact of the changes, and in some cases there may even be no change at all, and that the example of 34 per cent used cannot be seen as a wider representation of the impact the policy will have on those 600 people.
Other changes affect appointee service charges and care arrangement fees.
Addressing the changes as they were implemented at the county council’s adult committee, chair Conservative Anna Bailey said: “It’s not a decision we wanted to make. We did examine this two years ago. We are in a very different financial situation then we were in two years ago. And as a reminder, after the hundreds of millions that this authority has already saved over the last few years, we have got a budget gap even just this coming financial year of nearly £21.5 million, of which we have identified a lot of those savings, but still over £4 million to identify and the same next year.
“This is not easy at all. But we will not stop banging the drum for fairer funding for this authority.”
Addressing the change in the minimum income guarantee to the minimum level permitted by the Department for Health and Social Care, Cllr Bailey said: “It’s right that as a policy decision we set our policy at the (Department for Health and Social Care’s) minimum income guarantee, but absolutely I think we need to recognise and hear what people have said to us that it is not at an acceptable level any more.”
And she said she would write to the government on the issue: “I will do lobbying on this and I will try and get the change, and I believe it needs to be recognised that it needs increasing, it needs reviewing, and it certainly needs to go up each year as a minimum with inflation. And it needs to recognise it hasn’t been increased for five years.”
The council pulled a proposed increase in the charges for respite care. Up to 250 people could have been charged an additional £140 a week under proposed changes to the financial assessment process. The council said it scrapped the proposal “because concerns were raised during the consultation that individuals, families and carers may be more reluctant to use respite services which could adversely impact on their health and wellbeing”.
A resident spoke at the meeting, Alan Pitts, on behalf of someone with a severely disabled son in need of 24 hour care. Had the council not pulled plans to increase charges for respite care, the man said the care costs could have increased by £2,500 a year. Even so, “there is still quite a big impact from the other changes, which maybe were about £500 or £600 a year,” he said, adding it would “impact (the disabled man’s) life”. And he said it was not the first reduction in support.
Mr Pitts hit out at reductions in funding from the government for the council, saying it was “impacting the most vulnerable”.
Council officers assured Mr Pitts they would meet and go through the personal circumstances in that case.
The council’s head of service for adult social care financial operations, Mark Gedney, also said the council would “review and improve” the financial assessment service, providing “more personal contact”. This follows concerns raised during the consultation, “in some surprise to officers,” about the way the service is delivered.
The council said it will invest more in the financial assessment to ensure it takes account on individual and financial circumstances, but it has not yet proposed the new level of investment.
The council said “everyone will receive a new personalised financial assessment, by home visit if requested, to ensure that their income after charges have been paid meets or exceeds statutory protected income levels”.
The changes will apply to all new service users from April 2020, and for existing service users on a phased, rolling basis from April 2020.
Minimum income guarantee
The council has lowered the minimum income guarantee it uses in its financial assessment calculations for those over state pension age.
The minimum income guarantee is the minimum amount of money someone in receipt of care must be left with after paying the council’s care charges. This change has lowered that threshold by £5.50 a week, to the level permitted by the Department for Health and Social Care – currently a protected minimum income of £189 a week in 2019/20. The council estimates 2,100 people could be affected – more than first thought before the consultation.
Disability benefit charge increase
The government provides disability benefits to help people with the extra costs associated with their care and support needs. This change will mean those receiving higher rates of disability benefit will have to contribute additional care costs, whereas before the council’s financial assessment excluded the higher disability payment brackets. The disability payments affected are attendance allowance, the care component of Disability Living Allowance, and the daily living part of Personal Independence Payment. The council says up to 2,100 are expected to be affected, and the result will be a net charge increase of up to £20.95 a week.
Affected by both disability charge increases and the lowering of the minimum income guarantee
The council estimates around 600 people could be affected by both the disability benefit charge increases and the lowering of the minimum income guarantee. How much exactly each individual’s costs will change depends on the benefits they receive and the result of a financial assessment, but the maximum increase for those 600 people as a result of the changes is £26.45 a week.
Not to adopt the original proposal to charge for respite care using residential care charging rules
The council pulled plans for an increase in the charges for respite care. Up to 250 people could have been charged an additional £140 a week under proposed changes to the financial assessment process.
The council said it scrapped the proposal “because concerns were raised during the consultation that individuals, families and carers may be more reluctant to use respite services which could adversely impact on their health and wellbeing”.
Appointee service charge
The council will introduce a flat-rate charge for its appointee service. It will charge £10 for residential clients and £12.50 for non-residential clients. This charge will rise annually with inflation and will not apply to those with capital below £1,000. This charge will affect 40 people.
Care arrangement fee increase
The fee for those who fund their own social care but choose to have it arranged by the county council is set to increase and become an annual recurring fee.
The current one-off £75 charge is going to increase to a maximum of £400 a year. The council said around 200 people have been charged the one-off arrangement fee so far “but there is potential to apply the proposed annual charge to around 800 people”.