North Yorkshire Council
EXECUTIVE
6 MAY 2025
ADULT SOCIAL CARE CHARGING POLICIES
Report of the Corporate Director- Health and Adult Services
1.0 PURPOSE OF REPORT
1.1 To approve refreshed and updated Charging Policies for Adult Social Care and to agree to delegate any future minor amendments or changes required by legislation to these policies to the Corporate Director – Health and Adult Services (consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources), noting that no changes are proposed which have any impact on what or how people are charged.
2.0 SUMMARY
2.1 The Council’s Adult Social Care Charging Policies set out, at a high level, why and how the Council charges people for adult social care, where this is applicable. Detailed arrangements of what this means in practice for people can be found on our website: Helping you prepare for the cost of social care | North Yorkshire Council
2.2 Generally, the Policies are derived from national regulation and guidance and have not changed fundamentally for a number of years. No such changes are proposed at this stage, but it is felt that the Policies need to be updated to take account of technical changes since their last review. The Council has been awaiting significant change proposed by the previous government on how people pay for their care, but these proposals have now been put on hold indefinitely.
2.3 Therefore it is felt that a refresh of the Policies would now be appropriate.
2.4 Although the proposed changes here are minor, the Constitution sets out that they should still be approved by full Executive. However, following advice from Legal Services, it is proposed that the Executive delegates any future minor or directed changes (not having any impact on what or how people are charged, or where such changes are required by legislation) to the Corporate Director – Health and Adult Services, in consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources.
3.0 BACKGROUND
3.1 North Yorkshire Council provides and commissions a range of adult social care services. Charges are made for some of these services while others are free of charge. Generally, where a charge is made, the amount is based on the supported person’s ability to pay. The charge is calculated by a means tested financial assessment of their income and capital.
3.2 Charging for services is permissible under Section 17 of the Care Act 2014, and in accordance with the Care and Support Statutory Guidance chapters 8 and 9 and available online here: Care Act 2014: supporting implementation - GOV.UK
3.3 North Yorkshire approach to charging is largely derived from national regulation and guidance and is set out in two policies:
(i) Charging Policy for Community-Based Services
(ii) Charging Policy for Residential Care
4.0 PROPOSALS
4.1 As the Policies have not been updated for some time – in part while awaiting nationally-directed changes which have now been halted – it was felt that the time was right to review these.
4.2 Following that officer-led review, only minor changes are proposed as set out in below. These do not necessitate any changes in practice or procedure, but reflect:
· updates to terminology and legal references, including North Yorkshire Council in place of North Yorkshire County Council
· more consistency of language between the two documents, including ensuring that both policies include the Complaints and Appeals Procedure
· areas where clarification is felt to be useful to the reader (but with no change in that practice)
· any impact of government definitions, such as Universal Credit
· inclusion of references to online financial assessments tools
4.3 In addition, Executive is asked to agree that decision-making for any future minor amendments (not having any impact on what or how people are charged), such as those proposed here today, is delegated to the Corporate Director – Health and Adult Services, in consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources. Any amendments which reflect an actual change in policy will still come to Executive for approval.
4.5 A summary of the amendments is set out below.
4.6 There are a number of places where there have been changes to terminology or language and/or have been made to encompass updated legal references. These include:
Charging Policy for Community-Based Services
|
Section 2 |
“Non-residential” now “Community-based” services |
|
Section 4 |
Added the word ‘equipment’ as well as aids to daily living |
|
Section 8 |
Included link to the Online Financial Assessments tool |
|
Section 8 |
Added ‘means tested’ to ‘financial assessments’ to make it clearer |
|
Section 8 |
Statement added to advise on actions taken if failure to pay |
|
Section 9 |
Added ‘Universal Credit’ to the sources of income taken into account, to update and reflect on the current welfare benefits being paid |
|
Section 9 |
Added ‘daily living component’ to make it clearer |
|
Section 10 |
Added ‘and capital’, after income to make it clearer |
|
Section 10 |
Added in a clear statement about ‘deprivation’ and what it means |
|
Section 11 |
Removed ‘disabled persons tax credits’ as these no longer exist |
|
Section 11 |
Removed ‘families’ from tax credit so it now reads ‘tax credit’ as ‘working families tax credits’ no longer exist |
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Section 12 |
Removed the statement regarding ‘an additional amount equal to 25% of the above’ because it is already included in minimum income guarantee which is set by central government so should not be listed separately. . |
|
Section 13, 15,16 |
Changed the term ‘service user’ to ‘person or people using our service(s)’, this being the change in language used when referring to the person |
|
Section 14, 15,16 |
Added to the statement re capital limits to advise that it is set by central government each year |
|
Section 17 |
Added in the ‘Appeals and complaints’ procedure |
Charging Policy for Residential Services
|
|
Changed to reflect the same format as that for community-based services |
|
Section 2 |
As per section 8 of the above |
|
Section 2 |
Added more detailed explanation about respite when a person has a direct payment. |
|
Section 4 |
Changed service user to ‘supported person’ |
|
Section 4 |
Added the word ‘equipment’ as well as aids to daily living |
|
Section 6 |
Added ‘means tested’ to ‘financial assessments’ to make it clearer |
|
Section 7 |
Changed so that it now mirrors section 8 of the policy for community-based services, including link to the Online Financial Assessment tool |
|
Section 10, 14,15, 17, 19 |
Replaced ‘resident’ with the word ‘person’ |
|
Section 12 |
Added the word ‘capital’ and ensured that the statement mirrors that of the community-based services policy |
|
Section 13 |
Changed so that it mirrors section 14 of the community-based services policy |
|
Section 15 |
Removed statement about top up payments as these are recorded in a separate document |
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Section 16 |
Changed ‘Finance Assessment team’ to ‘Benefits, Assessments and Charging team’ |
|
Section 18 |
Added a statement regarding the local authority expectations that charges are paid whilst a CHC award is being considered. |
5.0 CONSULTATION UNDERTAKEN AND RESPONSES
5.1 Consultation has taken place with the Engagement Service and they will work with people with lived experience to produce an Easy Read version of these documents. The Independent Care Group was also asked for comments.
6.0 FINANCIAL IMPLICATIONS
6.1 There are no financial implications arising from these proposals as they do not give rise to any changes in the policies.
7.0 LEGAL IMPLICATIONS
7.1 Charging for services is permissible under section 17 of the Care Act 2014, and in accordance with the Care and Support Statutory Guidance chapters 8 and 9 and available online here: Care Act 2014: supporting implementation - GOV.UK. Legal. There are no specific legal implications arising from the refresh of these policies as they do not give rise to any substantive changes.
7.2 Legal advice has been sought regarding the need to bring any future minor changes (such as those defined by government for which the Council has no discretion) and this has led to the proposal to delegate those to the Corporate Director – Health and Adult Services, in consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources. Any amendments which reflect an actual change in policy will still come to Executive for approval
8.0 EQUALITIES IMPLICATIONS
8.1 There are no equalities implications arising from these proposals as they do not give rise to any changes in the Policies. An Initial equality impact assessment screening form has been attached as Appendix C below.
9.0 CLIMATE CHANGE IMPLICATIONS
9.1 There are no climate change implications arising from these proposals. An Initial Climate Change Impact Assessment form has been attached as Appendix D below.
10.0 REASONS FOR RECOMMENDATIONS
10.1 The recommendations seek to refresh the current Policies, while not making any changes in how people are charged for services and to allow the Corporate Director – Health and Adult Services (in consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources) to make any future minor changes which have no impact on how and what people are charged for care.
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11.0 |
RECOMMENDATION
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|
|
i) That Executive approves the refreshed Charging Policies for Adult Residential and Community-Based Care while noting that no changes have been proposed which change how or what people are charged.
ii) Executive agrees that approval of any future minor changes to these Policies (not having any impact on what or how people are charged), or changes otherwise required by legislation, is delegated to the Corporate Director – Health and Adult Services, in consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources.
|
APPENDICES:
Appendix A – Refreshed Policy for Community-Based Services
Appendix B – Refreshed Charging Policy for Residential Services
Appendix C – Initial equality impact assessment screening form
Appendix D – Initial Climate Change Impact Assessment
Richard Webb
Corporate Director – Health and Adult Services
County Hall
Northallerton
May 2025
Report Author – Anton Hodge, Assistant Director - Resources
Presenter of Report – Anton Hodge, Assistant Director - Resources
Note: Members are invited to contact the author in advance of the meeting with any detailed queries or questions.
 |
|
Document Type:
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Policy |
|
Author:
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Mark Foster, Interim Head of Financial Assessments, Benefits & Court of Protection |
|
Approved By:
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Executive |
|
Reviewing Officer:
|
Mark Foster, Interim Head of Financial Assessments, Benefits & Court of Protection |
|
Approval Date |
6 May 2025 |
|
Review Date |
April 2026 |
Contents
1. Introduction
2. Services that are chargeable under this policy
3. The principles underlying this policy
4. Services that are not chargeable under this policy
5. Services charged at a flat rate
6. Charges to other local authorities using services in this county
7. People who will not be charged
8. How charges will be assessed and eligibility for benefit checks
9. Assessable income
10. Notional income and Capital
11. Types of income that are not taken into account as assessable income
12. Expenditure and allowances
13. Partners income and savings
14. Capital that is taken into account
15. Property
16. Paying charges
17. Appeals and complaints against charges
1. Introduction
Why North Yorkshire Council charges for some of its services
North Yorkshire Council provides and commissions a range of services. Charges are made for some of these services; others are free of charge. Generally, where a charge is made, the amount is based on the supported person’s ability to pay. The charge is calculated by a means tested financial assessment of their income and capital. Charging for services is permissible under the Care Act 2014, and in accordance with chapters 8 and 9. Care Act 2014: supporting implementation - GOV.UK
Some services are charged at a flat rate, i.e. every person who uses that service will pay the same, regardless of income. The services to which this applies are identified in this policy.
Some people will not be charged for any service. See paragraph 7.
This policy aims to make charging as reasonable and fair as possible.
2. Services that are chargeable under this policy
All types of day care
§ Whether provided in centres managed by Health and Adult Services or purchased from the voluntary or private sectors.
§ Charges will be made either for a half day’s or a full day’s attendance.
§ A person will not be charged for day care attendance if they go out of the centre on activities which they pay for themselves, including day trips.
Personal home care (domiciliary care) provided in the day or at night
§ If provided or purchased by Health and Adult Services, this will be charged for at an hourly rate based on the actual cost of providing this service
Direct payments
§ If a person is given a direct payment to purchase their own care the amount will be the actual unit cost (e.g. hourly rate) or the unit cost of an equivalent service if the service were provided by Health and Adult Services.
Domestic help
§ If provided or purchased by Health and Adult Services.
Non-residential services out of the county
§ Services purchased from other local authorities for people who use our services
Housing Support and Telecare Services
§ The supported persons’ charges will be set at the same rate that the Council has to pay the service provider.
3 .The principles underlying this charging policy
§ The supported person is at the centre of the policy and processes.
§ A financial assessment offers the supported person the opportunity to increase their income and to contribute towards the cost of their services.
§ Welfare Benefits advice is a key part of North Yorkshire Council’s commitment to social and financial inclusion.
§ Income maximisation improves people’s quality of life and promotes their independence.
§ Disability related expenses are recognised.
§ Getting the financial assessment right avoids confusion and alienation and reduces the likelihood of loss of income to the Council
§ Integrating all charges will ensure a supported person’s income is not brought below the levels set by central government.
4. Services that are not chargeable under this policy
§ Permanent residential care services whether in or outside the county. Charges for these services are covered by a separate policy.
§ Respite residential care services
Whilst people are in permanent or respite residential care they will not be charged for any other services that they use. The charge for an overnight or weekend stay in respite residential care will cover all of the day they enter and all of the day they leave.
§ Education based activities
§ Supported employment
Services that are free to people using our services
§ assessment of needs;
§ advice services;
§ some aids to daily living;
§ small household adaptations;
§ intermediate care (rehabilitation services) up to 6 weeks. In exceptional circumstances this period can be extended after a full re-assessment
§ community based services which are wholly funded by the health service.
5. Services charged at a flat rate
§ Meals at home or in a day care centre
§ Transport
6. Charges to other local authorities using services in this county
Any other local authority purchasing services from North Yorkshire Council will be charged the full cost of the service.
7. People who cannot or will not be charged
§ people suffering from Creuzfeldt Jacob Disease;
§ people receiving after-care under section 117 of the Mental Health Act 1983;
§ people who are terminally ill and require intensive care from Palliative Health and Health and Adult Services staff, either for rehabilitation during or following treatment and those who wish to remain in their own homes to die will not be charged. This service is normally limited to 6 weeks. During this period the care plan will be reviewed to determine whether this service needs to be extended.
8. How charges will be assessed and eligibility for benefits checked
§ A ‘supported person’s ‘ability to pay’ relates to their income and capital.
§ Each supported person will be charged for the full cost of their social care and support unless a financial assessment determines that the Council will pay some or all of this. This financial assessment can be done by, or on behalf of, the person receiving (or about to receive) care by an Online Financial Assessment See For Yourself - Contribution Calculator. If the person is unable to undertake this online assessment or arrange for someone else to undertake this online assessment, they can agree to it being carried out by the Council.
§ The assessment will look at the persons’, income, expenditure and capital. If a person declines a financial assessment, they will be charged the full cost for providing care.
§ If a person declines a financial assessment, they will be charged the full cost of the services provided to them.
§ Each supported person will have a welfare benefits check at the same time as their financial assessment and will be assisted to claim all welfare benefits to which they are entitled.
§ Only the individual supported person’s means will be assessed for charges, except when they can reasonably be considered to have access to someone else’s savings or income. (See paragraph 10 on the treatment of partners’ income and savings.)
§ In accordance with legislation and statutory guidance certain disability related expenses will be offset against charges for all supported people, irrespective of whether or not they receive disability benefits such as Attendance Allowance or Disability Living Allowance Care Component.
§ The supported person’s reasonable expenditure will be set against their individual chargeable income to determine the maximum amount they might have to pay. This is called a supported person’s “maximum disposable income”. (See paragraph 18). The amount a person will actually pay is the lower of their maximum disposable income and the full cost of the services they receive.
§ If a person feels that they cannot pay their charges they can use the Council’s Appeals and Complaints procedure.
§ Charges will rise annually, usually in April, subject to the person’s ability to pay and in line with the decisions taken to review charges for the service provision.
§ Failure to pay a charge by the due date will lead to reminder letters and, if necessary, a visit to determine the reason(s) the person has not paid their charges. If a person refuses to pay their charges legal proceedings may be taken in the courts to enforce payment.
9. Assessable Income
The following sources of income will be taken into account as assessable income:
§ Income Support/Employment and Support Allowance/Pension Credit (Guarantee Credit)
§ Attendance Allowance
§ Disability Living Allowance Care Component
§ Personal Independence Payment
§ Constant Attendance Allowance
§ Exceptionally Severe Disablement Allowance
§ Retirement Pensions
§ Occupational and private pensions
§ Other benefits for example, Incapacity Benefit, Severe Disablement Allowance, Carers Allowance, Industrial Injuries benefit etc.
§ Income from tenants and boarders and other such income will be treated in the same manner as it is for residential care
10. Notional Income and Capital/Asset that has been disposed of
If a person fails to claim a benefit to which they are entitled or does not take up a source of income available to them (e.g. Housing Benefit) the Council may count that benefit or income as part of the person’s assessable income unless it is satisfied there are good reasons for the person not to claim the benefit or take up the income. This is called ‘notional income’
If a person seeking or receiving local authority funding for their care has disposed of capital (money, savings, any form of investment, property or any other item of value) and the council believes they have done so to avoid paying for care or to reduce the amount they should pay towards their care, the council has a legal duty to, and will investigate the disposal of the capital.
If satisfied the disposal was made with that intention, the council has a legal duty to, and will, treat the person as still owning the item(s) in question and take its value into account when assessing their capital.
11. Types of income that are not taken into account as assessable income
§ Earnings
§ Any partner’s earnings
§ Any benefits paid for children i.e. Child Benefit, Child Tax Credit, Child Support and Child Maintenance
§ Pension Credit (Savings Credit)
§ Working Families Tax Credit
§ War Pensions (Payments made to Veterans)
§ Disabled Person’s Tax Credits
§ Disability Living Allowance/Personal Independence Payment (Mobility Component)
12. Amounts that will be deducted from the assessable income
§ An amount for day-to-day living expenses which is set by the government each year according to a person’s age and condition. It is known as the Minimum Income Guarantee.
§ Some housing costs.
§ Disability Related Expenses.
13. Partner’s income and savings
§ Only the finances of the person in receipt of services are used to calculate the charge they have to pay.
§ If the person shares income or capital with a partner (married or not) the partner may be asked to disclose particulars of the asset in order to determine the person’s share of that asset
§ Where benefits are paid to a couple, the council will not automatically treat the person as receiving half of the joint benefit; the council will assess the contribution in two ways, looking at the financial position of the individual and of the household. The actual charge will be the lower of the two, i.e. the one that leaves the person in receipt of services “better off”.
§ Jointly held savings will be treated as divided equally between the account holders unless the person satisfies the council that there is a different arrangement.
14. Capital that is taken into account
§ The capital limits specified in the Care Act, regulations and statutory guidance will be applied within this policy.
§ Capital includes all forms of cash, savings and investments, for example:
o Money in the bank/building society current and deposit accounts.
o Post Office/National Savings and Premium Bonds.
o PEPs, TESSAs, and ISAs.
o Stocks, Shares and Unit Trusts.
o Any other cash savings, including bonds without life assurance.
§ The value of all Trust Funds will be treated in accordance with the guidelines
§ The surrender value of any life insurance, private pension or annuity will be disregarded.
15. Property
§ The capital value of a property which is occupied by a person using our service as their sole or main dwelling will be disregarded.
§ Any income from a property (e.g. rent) will be taken into account.
§ The value of any other property wholly or partly owned by the people using our services may be taken into account unless income from that property is taken into account.
16. Chargeable income
The assessable income less the above deductions represents the maximum disposable income of a person using our service, i.e. the highest amount that they will be charged for all the non-residential (community based) services received.
16. Paying charges
NYC will invoice the person in receipt of services on a regular basis 4 weeks in arrears. Payment should be made within 28 days of the date of the invoice.
Failure to pay a charge by the due date will lead to reminder letters and if necessary, a visit to determine the reason(s) the person has not paid their charges. If a person refuses to pay their charges, then the continuation of their care will be at risk and legal proceedings may be taken in the courts to enforce payment.
17. Appeals and complaints against charges
If a person indicates they cannot afford to pay their assessed charge following a financial assessment they may ask for a review of their charge.
On receipt of such a request, a different officer will review the original financial assessment. This person will check that the assessment has been carried out fully in line with this policy and the practice advice on what can and cannot be treated as disability related expenses.
If the person still
feels they cannot pay their charge, they may use the Financial
Assessment appeals procedure. (See Appendix 2)
Appendix 1
DISABILITY RELATED EXPENDITURE THAT MAY BE SET AGAINST CHARGES
|
ITEM |
AMOUNT |
EVIDENCE
|
|
1.Privately arranged care |
This means care purchased outside the care identified on the care plan. This will be discussed further with the social care assessor/coordinator. |
Signed receipts for at least four weeks using a receipt book where possible. |
|
2. Private domestic help |
This means domestic cleaning / shopping / window cleaning as a direct result of the person’s illness/disability. The actual cost claimed should be reasonable and appropriate for the size of property. |
Signed receipts for at least four weeks using a receipt book where possible.
|
|
3. Prescription charges |
Where the person does not receive free prescriptions the amount allowed should be capped at the annual season ticket charge. |
For those not eligible for free prescriptions. |
|
4. Fuel |
We will follow national guidelines agreed with central government each year. Each year the council will set allowances for each of the following categories: Single person in flat or terraced property; Couple in flat or terraced property Single person in semi-detached property; Couple in semi-detached property; Single person in detached property; Couple in detached property. |
Last four bills for all types of fuel or evidence via monthly direct debit. |
|
5. Water |
This only applies to metered water. |
Water bills or direct debit evidence. |
|
6. Clothing |
Additional clothing costs may arise for many reasons such as continence issues, frequent spillages, being housebound or confined to a bed / chair. |
Discretionary. |
|
7. Laundry |
Government guidelines advise a specific weekly amount where a specific health condition has been identified on the care plan and more than four loads are identified per week for the person using our service. |
Discretionary. |
|
8. Dietary |
Additional costs will be dependent on specific health conditions. This does not include additional costs which should be met by the national health service. |
Details of special purchases must be provided. |
|
9. Gardening |
Only the cost of a basic service should be allowed and this cost should be related directly to a person’s disability, not a lifestyle choice. |
Discretionary. |
|
10. Transport |
The need for transport should be taken into account where the person can show that due to disability they incur additional costs. A person who is in receipt of DLA mobility will be required to evidence amounts above the amount they receive for it to be allowable as this has already been disregarded from their income.
|
Identified as a need, not a lifestyle choice. |
|
11. Community Alarm System |
Community Alarm systems are in most cases covered by Supporting People. |
Bills from provider. |
|
12. Wheelchair |
Identify the cost of the wheelchair / scooter. |
Evidence of purchase if available. |
|
13. Powered Bed |
Identify the associated costs |
Evidence of purchase if available. |
|
14. Turning Bed |
Identify the associated costs |
Evidence of purchase if available. |
|
15. Powered Reclining Chair |
Identify the associated costs |
Evidence of purchase if available. |
|
16. Stair-lift |
Identify the associated costs |
Evidence of purchase if available. |
|
17. Hoist |
Identify the associated costs |
Evidence of purchase if available. |
|
18. Other |
The need for this additional cost must be demonstrated and identified in conjunction with the social care assessor / coordinator. |
Evidence of purchases if available. |
Appendix 2
Financial Assessments – appeals process
Customers are expected to contribute towards the cost of the services they receive, unless they are supported under Section 117 of the Mental Health Act. The amount that a person is expected to contribute is calculated by completing a financial assessment, which takes account of income and outgoings.
The financial assessment will be completed by the Benefits, Assessments and Charging (BAC) team. As part of the assessment the BAC team will explain the financial assessment process, discuss the outcome and make sure that the customer receives the correct benefits.
If a customer is unhappy about the outcome of the financial assessment, they can contact the local BAC team. The process outlined below will then be followed.
Appeals process
If a customer is not satisfied with the outcome of the financial assessment, the following steps will be taken.
Stage one
The financial assessment will be checked by the local area BAC team manager. If a new assessment is necessary, it could be carried out by a different member of staff. The BAC team manager will inform the customer what actions are being taken.
Stage two
If the customer is not satisfied with the second assessment, the case should then be referred to the BAC Manager to review the case in discussion with the local social care assessor/coordinator.
Complaints process
If the customer remains dissatisfied, the case will be referred to the Complaints Manager to deal with through the statutory complaints process. This will involve further discussion with the BAC Manager and the local Care Services Manager in the first instance. The General Manager will make the final determination of the appropriate course of action.
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Document Type:
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Policy |
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Author:
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Mark Foster, Interim Head of Financial Assessments, Benefits & Court of Protection |
|
Approved By:
|
Executive |
|
Reviewing Officer:
|
Mark Foster, Interim Head of Financial Assessments, Benefits & Court of Protection |
|
Approval Date |
6 May 2025 |
|
Review Date |
April 2026 |
Contents
1. Introduction
2. Why the council charges for residential care
3. Charges to other local authorities that use NYCC services
4. Services that are free of charge to the person using our service
5. People who will not be charged for services
6. The principles underlying this charging policy
7. How charges are assessed
8. Further information about assessments
9. The maximum charge
10. Personal expense allowance
11. Disregards
12. Notional income and Capital
13. Capital taken into account
14. Absences from the care home
15. Paying charges
16. Choosing more expensive accommodation
17. Deferred payment agreements
18. Nursing care
19. Fully funded continuing health care
20. People unable to make their own arrangements or manage their money
21. Complaints and appeals
1. Introduction
The North Yorkshire Council (NYC) Health and Adult Services arranges and provides residential accommodation and commissions a range of services appropriate to meet people’s assessed care needs.
This policy aims to make charging as reasonable and fair as possible and has been developed in accordance with the requirements of the Care Act 2014, regulations made under the Act and statutory guidance issued under the Act by the Department of Health. The charge is calculated by a means tested financial assessment of their income and capital. Charging for services is permissible under section 17 of the Care Act 2014, and in accordance with the Care and Support Statutory Guidance chapters 8 and 9. Care Act 2014: supporting implementation - GOV.UK
Scope of this policy
This policy applies to the Benefits, Assessments and Charging (BAC) Service countywide.
Legislation and Guidance
Care Act 2014, regulations made under the Act and the Care and Support Statutory Guidance issued by the Department of Health.
Equality and Diversity
Our policies and procedures support the commissioning and delivery of services that
meet the needs of individuals and communities. Ensuring equity of access and outcomes is central to this. In developing and applying our policies, we will take account of:
§ Equality and diversity
§ Anti-discriminatory practice
§ Dignity and respect
§ Human Rights
Review:
NYCC will review this policy annually.
2. Why North Yorkshire Council charges for residential care
NYC Health and Adult Services provides and commissions a range of residential services. Charges are made for these services. Generally, the amount the supported person pays is based on their ability to pay, through a means-tested financial assessment of their income and capital.
Whilst people are in permanent or respite residential care, they will not be charged for any other services they use. The only exception to this is for those people who receive a Direct Payment for community-based services as they are required to pay their weekly contribution for 52 weeks per year. People who stay overnight or for a weekend in respite residential care will be charged for this care; the charge will cover all of the day they enter and all of the day they leave.
3. Charges to other local authorities using services in this county
Any other local authority that purchases services from NYC will be charged the full cost of the service, and that other local authority may charge the person in accordance with its own charging policy.
4. Services that are free to the supported person
§ assessments of community care needs
§ advice services
§ some equipment/aids to daily living
5. People who cannot or will not be charged
§ people suffering from Creuzfeldt Jacob Disease;
§ people who receive after-care under section 117 of the Mental Health Act 1983
6. The principles underlying this policy
§ The supported person is at the centre of the policy and processes
§ A means-tested financial assessment offers the supported person the opportunity to increase their income and determines their contribution towards the cost of their care
§ Welfare Benefits advice is a key part of NYC’s commitment to social and financial inclusion
§ Getting the means-tested financial assessment right avoids confusion and alienation and reduces the likelihood of loss of income to the Council
7. How charges will be assessed and eligibility for benefits checked
- Each supported person will be charged for the full cost of their social care and support unless a financial assessment determines that the Council will pay some or all of this. This financial assessment can be done by, or on behalf of, the person receiving (or about to receive) care by an Online Financial Assessment See For Yourself - Contribution Calculator. If the person is unable to undertake this online assessment or arrange for someone else to undertake this online assessment, they can agree to it being carried out by the Council.
- The assessment will look at the persons’, income, expenditure and capital. If a person declines a financial assessment, they will be charged the full cost for providing care.
- Each supported person will have a welfare benefits check at the same time as their financial assessment and will be assisted to claim all welfare benefits to which they are entitled.
- If a person feels that they cannot pay their assessed charges they can use the Council’s Appeals and Complaints procedure.
- Charges will increase annually, usually in April, subject to the person’s ability to pay and any changes to charges for the service provision.
- Failure to pay a charge by the due date will lead to reminder letters and, if necessary, a visit to determine the reason(s) the person has not paid their charges. If a person refuses to pay their charges legal proceedings may be taken in the courts to enforce payment.
8. Further information about the financial assessment
We calculate the weekly amount that a person can afford to pay towards the care they receive by carrying out a means-tested financial assessment. In this assessment, we take account of income, certain outgoings and capital.
9. Maximum charge
The most that a person will be expected to pay for their residential care services is their ‘assessed maximum disposable income’, which is calculated as follows.
10. Personal Expense Allowance
A person in residential care funded by the local authority is entitled to an allowance for personal expenses. The allowance is set each year by the Department of Health; currently it is £30.15 per week (2024/2025). The first £30.15 of a person’s income is therefore disregarded (see below) by the local authority when it assesses how much a resident must pay towards their care.
11. Disregards
The legislation and guidance requires some sources of income and/or some capital (savings, property etc.) to be partly or wholly disregarded, i.e. not taken into account in determining the amount a resident must pay. The disregard might be for a limited period or for the entire length of a person’s stay in residential accommodation.
12. Notional Income and Capital/Asset that has been disposed of
If a person fails to claim a benefit to which they are entitled or does not take up a source of income available to them (e.g. Housing Benefit) the Council may count that benefit or income as part of the person’s assessable income unless it is satisfied there are good reasons for the person not to claim the benefit or take up the income. This is called ‘notional capital’ or ‘notional income’.
If a person seeking or receiving local authority funding for their care has disposed of capital (money, savings, any form of investment, property or any other item of value) and the council believes they have done so to avoid paying for care or to reduce the amount they should pay towards their care, the council has a legal duty to, and will, look into the disposal of the capital.
If satisfied the disposal was made with that intention, the council has a legal duty to, and will, treat the person as still owning the item(s) in question and take its value into account when assessing their capital and therefore how much they may have to pay towards the cost of their care
13. Capital taken into account
Capital includes all forms of cash, savings, investments, property and other items of value, including for example (this list is not exhaustive)
§ Post Office/National Savings and Premium Bonds.
§ PEPs, TESSAs, and ISAs.
§ Stocks, Shares and Unit Trusts.
§ Any other cash savings, including bonds without life assurance.
The value of trust funds will be treated in accordance with the guidelines contained within The Care Act 2014.
14. Absences from the care home
If a person goes into hospital, it may affect their benefits. It is the person’s responsibility to inform the Benefits Agency and/or DWP.
If a person goes on holiday they will continue to be charged as normal (and the local authority will continue to pay its share of the cost as normal.)
14. Paying charges
For residents living at a NYC Elderly Person’s Homes, NYC will invoice every 4 weeks, two weeks in advance, two weeks in arrears.
Residents in independent sector care homes will be expected to pay their assessed contribution in line with the Provider’s preferred default payment method
Failure to pay a charge by the due date will lead to reminder letters and, if necessary, a visit to determine the reason(s) the person has not paid their charges. If a person refuses to pay their charges, then the continuation of their care will be at risk and legal proceedings may be taken in the courts to enforce payment.
Choosing more expensive accommodation
A person requiring residential care and who is eligible to receive financial assistance from the local authority may have the right to choose a more expensive home, or more expensive room, than the local authority offers.
A person who does so must make arrangements for the extra cost to be paid, either by them or another person, a “third party”. The extra payment is known as a “top-up”.
Before choosing more expensive accommodation, consideration must be given as to whether the extra payment can be sustained over what might be many years. If it cannot, there is a risk that the person may have to be moved to an alternative residential care setting. The Council reserves the right to find other suitable care provision if the cost should pass on to it. Such care will always meet required standards but the Council will not automatically pass on the same cost to taxpayers if the individual is no longer able to pay for themselves.
Top-up payments are made directly to the care home by the payer, i.e. the resident for a “self-top-up” or the third party. Therefore, formal agreement should be made between the payer and the care home, but the local authority will need details of the top-up. Further information can be provided on request.
The Care Act 2014 Annex A: Choice of accommodation, requires that where a person’s needs are best met in a care home, or other type of accommodation, that the person must have the right to choose between different providers of that type of accommodation provided that;
- the accommodation is suitable in relation to the person’s assessed needs;
- to do so would not cost the local authority more than the amount specified in the adult’s personal budget for accommodation of that type;
- the accommodation is available; and
- the provider of the accommodation is willing to enter into a contract with the local authority to provide the care at the rate identified in the person’s personal budget on Health and Adult Services terms and conditions.
15. Deferred payment arrangements
If a person who is receiving, or is likely to receive, financial assistance from the local authority to pay for their residential care cannot afford to pay their charges, they may be able to make a “deferred payment agreement” with the local authority.
It may be that the person’s assessed charge, i.e. the amount they have to pay towards their care, is high because they have a large amount of capital they cannot immediately turn into cash, for example a house that has been taken into account because it does not attract a disregard. Alternatively, they may have chosen a more expensive care home than the council offered, and therefore they, or someone else (a “third party”), must pay the extra: a “top-up”.
The local authority may be able to pay some or all of the amount the resident or third party cannot pay immediately, provided the local authority can obtain sufficient security to ensure it can recover the money it pays for the resident (or third party), plus any administrative charges and interest. The loan or debt is usually secured by a legal charge, which works like a mortgage, being placed on a property owned by the person who is unable to pay the charge or top-up immediately.
It must be understood that the council, in enabling a person to defer their payments, is using public money to pay for them and therefore is obliged to recover the total amount in full. This is achieved by the person (resident or third party, depending on the circumstances) entering into a binding legal agreement with the local authority. It is known as a deferred payment agreement. More information about deferred payment agreements can be obtained from the Area Finance Administration team or from the Benefits and Assessments Officer completing the financial assessment itself.
16. Nursing care
If a person requires residential nursing care by a registered nurse, they may be eligible for a contribution from the NHS, known as a Registered Nursing Care Contribution (“RNCC”), sometimes called Free Nursing Care. The NHS pays the RNCC because this type of nursing is provided free by the NHS. As nursing care homes employ their own registered nurses, it would be unfair to pass on the costs to residents and therefore the NHS pays the care home the RNCC, which is a fixed amount, for each person who is eligible for it.
This contribution by the NHS will therefore affect the total charges made by the care home, but it will not affect the assessed contribution payable to the local authority by the resident.
17. Fully funded Continuing Health Care (CHC)
Some people need a very high level of nursing care. If their “primary need” is a health need they may qualify for Continuing Health Care, which is fully funded by the NHS: neither the local authority nor the resident pays anything towards the care the person needs.
Eligibility for CHC is determined by an assessment of the person’s needs; this is carried out jointly by the NHS and the local authority. Further information can be provided on request.
Any charges due to the local authority for residential care provided outside CHC will have to be paid.
18. People unable to make their own arrangements or manage their money
If a person who needs or is in residential care is unable to make their own arrangements for care, or to manage their money, someone else will have to do so for them.
The person may have given a relative or friend Power of Attorney. (Power of Attorney is given by the person wanting someone else to act for them, not taken by the person wanting to be their attorney. Thus only people who have mental capacity can give someone else power of attorney.)
If the person has not given someone else power of attorney and now loses (or has never had) capacity, another person, perhaps a relative or friend, can apply to the Court of Protection to be appointed the person’s Deputy.
Attorneys and Deputies can manage the person’s money and financial affairs (depending on the precise powers they have been given). Amongst other things, an Attorney or Deputy can enter into a deferred payment agreement on the resident’s behalf. Anyone claiming to hold power of attorney or be a Deputy will be requested to provide a copy of the document(s) appointing them.
19. Appeals and complaints against charges
If a person indicates they cannot afford to pay their assessed charge following a financial assessment they may ask for a review of their charge.
On receipt of such a request, a different officer will review the original financial assessment. This person will check that the assessment has been carried out fully in line with this policy and the practice advice on what can and cannot be treated as disability related expenses.
If the person still
feels they cannot pay their charge, they may use the Financial
Assessment appeals procedure, which is set out in Appendix
1.
Appendix 1
Financial Assessments: appeals process
Customers are expected to contribute towards the cost of the services they receive, unless they are supported under Section 117 of the Mental Health Act. The amount that a person is expected to contribute is calculated by completing a financial assessment, which takes account of income and outgoings.
The financial assessment will be completed by the Benefits, Assessments and Charging (BAC) team. As part of the assessment the BAC team will explain the financial assessment process, discuss the outcome and make sure that the customer receives the correct benefits.
If a customer is unhappy about the outcome of the financial assessment, they can contact the local BAC team or the local team direct. The process outlined below will then be followed.
Appeals process
If a customer is not satisfied with the outcome of the financial assessment, the following steps should be taken.
Stage one
The financial assessment will be checked by the local area BAC team manager. If a new assessment is necessary, this could then be completed by an alternative member of staff. The BAC team manager will respond direct to the customer to let them know what actions are being taken.
Stage two
If the customer is not satisfied with the second assessment, the case should then be referred to the BAC Manager to review the case in discussion with the local social care assessor/coordinator.
Complaints process
If the customer remains dissatisfied, the case will be referred to the Complaints Manager to deal with through the statutory complaints process. This will involve further discussion with the BAC Manager and the local Care Services Manager in the first instance. The Locality Head Care and Support will make the final determination on the appropriate course of action.
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APPENDIX C - Initial equality impact assessment screening form
This form records an equality screening process to determine the relevance of equality to a proposal, and a decision whether or not a full EIA would be appropriate or proportionate.
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Directorate |
Health and Adult Services |
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Service area |
Resources |
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Proposal being screened |
Adult Social Care Charging Policies |
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Officer(s) carrying out screening |
Anton Hodge |
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What are you proposing to do? |
To approve refreshed and updated Charging Policies for Adult Social Care and to agree to delegate any future minor amendments or changes required by legislation to these policies to the Corporate Director – Health and Adult Services (consultation with the Executive Member for Health and Adult Services and the Corporate Director – Resources), noting that no changes are proposed which have any impact on what or how people are charged. |
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Why are you proposing this? What are the desired outcomes? |
This will make the policies more contemporary while making no significant changes, including updating terminology and it will enable any future minor changes to be agreed more quickly. |
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Does the proposal involve a significant commitment or removal of resources? Please give details. |
No |
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Impact on people with any of the following protected characteristics as defined by the Equality Act 2010, or NYC’s additional agreed characteristics As part of this assessment, please consider the following questions: · To what extent is this service used by particular groups of people with protected characteristics? · Does the proposal relate to functions that previous consultation has identified as important? · Do different groups have different needs or experiences in the area the proposal relates to?
If for any characteristic it is considered that there is likely to be an adverse impact or you have ticked ‘Don’t know/no info available’, then a full EIA should be carried out where this is proportionate. You are advised to speak to your directorate representative for advice if you are in any doubt.
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Protected characteristic |
Potential for adverse impact |
Don’t know/No info available |
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Yes |
No |
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Age |
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X |
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Disability |
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X |
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Sex |
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X |
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Race |
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X |
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Sexual orientation |
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X |
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Gender reassignment |
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X |
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Religion or belief |
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X |
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Pregnancy or maternity |
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X |
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Marriage or civil partnership |
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X |
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People in rural areas |
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X |
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People on a low income |
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X |
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Carer (unpaid family or friend) |
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X |
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Are from the Armed Forces Community |
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X |
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Does the proposal relate to an area where there are known inequalities/probable impacts (for example, disabled people’s access to public transport)? Please give details. |
There is no impact on individuals of these proposals |
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Will the proposal have a significant effect on how other organisations operate? (for example, partners, funding criteria, etc.). Do any of these organisations support people with protected characteristics? Please explain why you have reached this conclusion. |
There is no impact on other organisations of these proposals |
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Decision (Please tick one option) |
EIA not relevant or proportionate: |
ü?
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Continue to full EIA: |
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Reason for decision |
No adverse impacts identified. |
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Signed (Assistant Director or equivalent) |
Anton Hodge |
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Date |
14.04.25 |
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