7. Types of care and support that cannot be charged for
The local authority may charge people for some care and support services, but some types of care and support must be free of charge. These include but are not restricted to:
- intermediate care, including reablement (care that can help to restore a person’s independence by providing support or helping them relearn daily living skills) for up to six weeks
- after-care/support provided under the Mental Health Act 1983 section 117
- transport to a day service where the transport is provided as part of meeting a person’s needs
- independent professional advocacy where a local authority has arranged it
- any services that an authority has a duty to provide based on other legislation.
Care and support for someone in their own home
Most local authorities will charge for care provided in someone’s own home. How much the person pays will depend on the financial assessment.
The Social Services and Wellbeing (Wales) Act 2014 states that any charges for care and support at home must be ‘reasonable’, and that people receiving care at home should not be expected to live on an income lower than a ‘basic level’. This basic level is calculated as the income received on Income support or the guarantee credit element of Pension credit, plus an extra 35 per cent of this figure.
Anybody whose income is at or below the basic level should not be charged for homecare. However, in Wales there is a maximum weekly charge that any local authority can impose for services at home. For up-to-date figures go to alzheimers.org.uk/benefitrates
Individual local authorities can decide whether or not to count Severe disability premium, Disability living allowance, Personal independence payment or Attendance allowance as income. If a person’s care needs mean that they require a service during the day, the local authority should not count any benefit entitlement linked to care needed at night. For example, if a person receives the higher level of Attendance allowance, and is eligible for this higher level because of the supervision they need during the night, the additional higher amount should not be counted in a financial assessment for the care that the person needs during the day.
Depending on the financial assessment, a local authority may ask a person to contribute a certain amount towards the cost of care, with the local authority paying the rest. Most local authorities will charge for care that is provided in the person’s own home. How much the recipient of care pays will depend on the financial assessment, and also where the person lives. Each local authority can decide its own charges, up to a maximum national limit for care at home.
A copy of the local authority’s charging policy should be available online or can be requested. It may contain a savings and income threshold. Anyone with savings or income above this threshold is expected to pay for their own care. If their savings or income is below the threshold, the local authority should fund their care. These thresholds apply to financial assessments for care at home and care received in a care home (see ‘Care home fees’ below). For up-to-date threshold figures go to alzheimers.org.uk/benefitrates
If someone is a self-funder, their savings may fall as they pay for their care. Once someone’s savings or income have dropped below the threshold, depending upon the person’s income, the local authority may start paying for or contributing to their care services.
A local authority should regularly review a person’s savings so that they are aware of when they must take over paying some or all of the care costs. If you feel that someone’s savings have dropped below the limit, or are about to, you can contact the local authority to ask for a review.
Importantly, when receiving care at home, the value of the person’s home is not considered when assessing their contribution towards the cost of domiciliary care.
If a person refuses to pay for homecare, the local authority cannot withdraw the service if they are deemed not to have the mental capacity to make this decision. They have a legal duty to meet people’s eligible care needs. They would therefore be expected to continue to meet the person’s needs while attempting to resolve any dispute. However, if the person has the mental capacity to make this decision and understand the consequences the local authority is not required to continue to meet their needs.
If someone feels they have been excessively charged for care, they (or their carer) have a right to complain (see ‘Complaints’ below).