Proposed decision
To introduce a one-off Self-Funding Arrangement Fee for new self-funders.
Reason for the decision
Kent County Council (KCC) is proposing to introduce a one-off Self-Funding Arrangement Set up Fee for new self-funders. This fee would be in addition to the existing annual Arrangement Fee.
Background
KCC provides adult social care services to approximately 16,394 residents aged over 18 years old (data taken January 2024). Approximately 15,806 of these people receive chargeable social care services, this includes providing services like residential care and support and care in a person’s own home or in the community.
When people living in Kent need adult social care, as well as assessing their care needs, we also assess their income to decide how much they pay towards their care. This is known as means testing. Some people do not need to contribute towards their care, some pay a contribution, and there are people that pay for all of their care (these people are known as full payers).
If the person has more than £23,250 in savings and other capital (not including the value of their main or only home) they must pay the full cost of their care and support. Self-funders can choose to arrange their care themselves or ask the council to do it on their behalf.
Where KCC makes arrangements for self-funders’ care the Care Act 2014 enables us to charge an “Arrangement Fee” to cover the cost to the council for doing this work. This only applies to non-residential care and support and only for certain categories of people who would pay the full cost of their care and support. KCC currently charges self-funders an annual Arrangement Fee (paid weekly).
Options (other options considered but not taken forward)
Before deciding on the preferred proposal presented in the consultation, a number of options were considered:
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Alternative/additional option considered |
Why the option has not been taken forward to consultation |
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Increase the weekly Arrangement Fee only (no new initial set-up fee) |
The majority of the work is the initial set up of care and support arrangements by KCC, which is reflected in the proposed one-off set-up fee. Despite current self-funders not having had to pay a set-up fee it was felt that it would be unreasonable to increase the cost of the weekly fee to cover work that had taken place in the past and unfair to include a one-off cost in an annual fee. |
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Introduce a fee for changing provider |
The review of other councils showed some had introduced a fee for changing provider. Changing a provider adds additional work and costs in making changes to care and support arrangements. This option was considered as part of the review, but due to the complexities in applying this fee, it was agreed not to progress this further. |
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Do nothing |
Due to the significant financial challenge being faced by KCC, we need to ensure we make the best use of our resources. By introducing the proposed initial set-up fee, we will cover the costs associated with supporting new self-funders. If we continue to not fully cover these costs, then other options will need to be considered. |
How the proposed decision supports Framing Kent's Future - our council strategy for 2022 to 2026
The proposed decision aligns with the ambitions set out in Framing Kent’s Future to place Kent on a sustainable footing for the medium and long term and also aligns with Objective 2 of Securing Kent’s Future to identify opportunities to set a sustainable budget and MTFP.
Financial Implications
The latest budget monitoring presented to Cabinet on 21 March 2024 shows £30m budget gap for 2023-24, of which £31.3m relates to the ASCH directorate before management action and one-off use of reserves are considered. Members have agreed the immediate actions needed to reduce spending in the short term and have set the course for getting the council back to financial sustainability, securing the services that residents in Kent need the most.
Spending growth in KCC 2024-25 is £209.6m as stated in the 2024-25 budget. The net change to the budget is £113.9m (matched by funding increases through government grants, council tax, etc), leaving £95.7m savings which need to be found.
Of the above, the spending growth in Adult’s 2024-25 is £115.8m as stated in the 2024-25 budget. The net change to the budget is £61.7m (matched by funding increases through government grants, council tax, etc), leaving £54.1m in savings/additional income which needs to be found, of which this proposal is included within.
The proposed one-off arrangement fee would be for all new self-funders only. In 2023 there were 400 new self-funders. Based on this figure, it has been estimated that the proposed change could raise approximately £140,800 a year. We would use this money to help increase income so that we can continue to provide council services to those who need them.
Equalities implications
An initial Equality Impact Assessment (EqIA) has been completed to help us to understand how this proposal could impact on people due to their protected characteristics (age, disability, gender reassignment, race, religion or belief, sex and sexual orientation) and those with carer’s responsibilities. The full EqIA can be found on the consultation webpage: www.kent.gov.uk/adultsocialcarecharging or upon request. This is a live document and will continue to be reviewed and updated following the consultation.
Whilst the proposed policy change does not actively promote equal opportunities, KCC uses the financial contributions that people make to ensure we are able to continue to help as many people as possible with the limited resources that are available. This proposed change would contribute to our objective of protecting front line services and continuing to provide the level of care and support needed by people in Kent.
Age, disability, sex, race and carer’s responsibilities have been identified as having potential for negative impact if we were to implement the proposed change.
The EqIA has identified that the highest proportion of self-funders currently paying the Arrangement Fee are older people aged 61 to 101 and females.
There are specific health and economic inequalities that need to be considered in terms of the impact of raising charges for social care. People from ethnic minorities are more likely to suffer from underlying health conditions. Therefore, new self-funders from ethnic minorities could be more negatively impacted by this proposal.
Some people may not want to pay the proposed Self-Funding Assessment Set up Fee and may choose to put their own arrangements in place. This may not be of the same quality of care organised by the council. Alternatively, those impacted may decide not to access the right levels of care and support or may decide to not access care and support at all. As a result, any carer may be required to provide more unpaid care, thereby affecting their economic, social and emotional wellbeing. This might also result in an increased need for support from other KCC services and an increase in safeguarding concerns due to carer breakdown.
Decision type: Key
Decision status: Recommendations Approved
Notice of proposed decision first published: 07/05/2024
Decision due: Not before 5th Jun 2024 by Cabinet Member for Adult Social Care and Public Health
Reason: To allow 28 day notice period required under Exeuctive Decision regulations
Lead member: Cabinet Member for Adult Social Care and Public Health
Lead director: Richard Smith
Department: Social Care, Health & Wellbeing
Contact: Cathi Sacco, Interim Director of Commissioning and Provision Email: sarah.denson@kent.gov.uk Email: cathi.sacco@kent.gov.uk Tel: 01622 694899/4905.
Consultees
The proposed decision was considered and endorsed by the Adult Social Care Cabinet Committee meeting on 15 May 2024.
Financial implications: Please see details above
Legal implications: Where KCC makes arrangements for self-funders’ care, the Care Act 2014 enables us to charge an “Arrangement Fee”. This only applies to non-residential care and support and only for certain categories of people who would pay the full cost of their care and support. KCC currently charges self-funders an annual Arrangement Fee (paid weekly). The Department of Health and Social Care (DHSC) gives all councils statutory guidance on how to work out the amount people may have to pay towards their social care services and how much they should be left with for living expenses. This is called the Care and Support Statutory Guidance which was issued with the Care Act. All councils must also comply with the primary legislation (Care and Support (Charging Assessment Resource) Regulations 2014). How much people pay towards their care is determined through a means tested financial assessment.
Equalities implications: Equalities Implications: Please see detail above Data Protection implications: A full DPIA was carried out and signed off by the Information Governance Lead and the Corporate Director of ASCH.