Paying for care

The financial assessment process

For the Council to assess and invoice you for any financial contribution towards the cost of support we first need you to provide us with details of your financial circumstances. This work is undertaken by the Council’s Revenue and Assessment, LGSS Transactions team.

You will be required to complete a financial assessment form (FS6) which discloses your full financial circumstances. This form will be given to you, however if you require assistance completing the FS6 form you may wish for a Revenue and Assessment team member to visit you at home. If you require us to visit you, you can have a relative, friend or advocate present at this time, or they can act for you if you have given them permission to do so. Please contact the Revenue and Assessment Team on 01604 366895 if you wish for a financial team member to visit you at home.

We will ensure that you receive a Welfare Benefits check and Welfare Rights advice so that you know what state benefits you may be able to claim.

Charging rules and regulations
When the Council arranges or provides residential or nursing care services for people aged 16+ years that person is required to pay towards the full cost of the services provided. This is because for care – long or short term – the law states that if the person cannot pay the full cost of the care the Council will undertake, the Council is to work out how much the person should pay by a financial assessment process.

If your overall savings and investments (capital) are more than £23,250 you will need to pay the full cost of your care. This rule applies whether or not the Council arranges or provides the care for you. Once your capital falls below the £23,250 limit you may apply to the Council for help towards paying the cost of your care.

Charging Exemptions
Under Section 117 of the Mental Health Act 1983 people who are recovering from mental ill health and/or have previously been detained in hospital under sections 3, 37, 47 or 48 of the Act and remain classified under these sections, services are provided free of charge. However, a ‘third party’ charge can be made if a person makes a choice to go in to a care home that costs above the Council’s Expected to Pay Rate (EPR) (see section on Council funding towards care on page 40-41). In general, this charge has to be paid by a third party.

‘Intermediate care service’ will not be charged for any care provided, for a period of up to six weeks. But if within the six weeks you agree with your social care practitioner that you need ongoing care support, then the service will be chargeable from that date and we will work out how much you have to pay towards the cost of your care. For more information on benefits please see the website: www.gov.uk.

Contributions towards residential care and support
If you require care the Revenue and Assessment team will review the following information to calculate how much you may be asked to pay towards the cost of the service:

• all of your income, savings and capital;
• information on any land and property you may own or have a legal interest in;
• any savings certificates and annuities;
• details of any Trusts, Bonds or investments held (please see further details on page 41);
• State pension / benefit payments;
• occupational or personal pension details;
• share certificates;
• earnings (last three payslips); and
• household expenditure e.g. Council tax bills, mortgage or rent payments.

If you have capital between £14,250 and £23,250 there is a tariff of £1.00 for every £250.00 (or part of £250.00). This is known as ‘Tariff Income’ and is included in the financial contribution. These figures may change after April 2014, please check with Adult Social Care  after this date.

Short term care
If you are going into a care home for a temporary period, Attendance Allowance (AA)/Disability Living Allowance (DLA) (care component) now called a Personal Independence Payment (PIP), ceases after four weeks (see the website: www.gov.uk). Both of these allowances are ignored when calculating your charge for short-term care. However you must notify the Department for Work and Pensions when you are due to have your short term care and when you return to your own home, if this is more than four weeks.

If your social care practitioner has agreed either a number of weeks within a year or a one-off stay in a residential or nursing home (i.e. respite, short term or intermediate care), you will be asked to pay towards the cost of the care (not for intermediate care – unless six weeks has been exceeded). However, allowances will be considered for costs incurred for your rent, mortgage and Council tax payments.

If you have both short term care and a care package at home, your assessed charge for your short term care will be different to the charge for your care package at home.

Permanent care
If you are going into a care home on a permanent basis the Attendance Allowance (AA)/Disability Living Allowance (DLA) (care component) now called a Personal Independence Payment, will continue to be paid for the first four weeks after you enter the care home and is included in calculating your weekly contribution.

However you must notify the Department for Work and Pensions when you enter the care home for the AA/DLA/PIP to cease.

Both the AA/DLA will continue to be paid if you are paying the full weekly charge in a private home or local authority owned home. The AA/DLA/PIP will cease after 4 weeks when the Council is contributing towards the cost of your care. However if you own your own property and the Council have included this in your assessment you can re-apply for the AA/DLA/PIP to be reinstated from the thirteenth week of your stay.

If you are admitted to hospital for four weeks or more, these allowances will cease to be paid, when you notify the Department for Work and Pensions. However, the mobility element of the Disability Living Allowance will continue to be paid but this will not be included in calculating your weekly charge for short term care or permanent care.

Council funding towards care
Each year the Council agrees a maximum amount that will normally be paid for a place in a care home. This is known as the ‘Expected to Pay Rate’ (EPR). Your social care practitioner will advise you of the figure that the Council is prepared to pay for your care in the home, your contribution forms part of this EPR.

If you wish to choose an approved home that is more expensive than the Council is prepared to pay then a relative or interested party will need to pay the difference. This is known as a third party agreement and will be invoiced to the person meeting the third party cost.

Life Bonds/Annuities
If you invest in life bonds or annuities you will need to ensure that access remains available to pay for your care as these will form part of your overall capital or income and will affect your charge. Under some circumstances bonds can be disregarded however our finance team will seek advice from the Council’s legal team to determine this. You may wish to seek independent financial advice.

Asset deprivation
If the Council feels that you have deliberately deprived yourself of a capital asset in order to reduce the amount you pay for care, they may treat you as if you still possess the asset for the purpose of charging. For example, if you give money or assets away to a family member in  order to reduce your capital or assets. You may, therefore, not be able to pay the charge assessed using the notional capital the Council have considered you still own. In that case they will transfer the liability for this debt to the person to whom you have passed the capital or asset.

Assessing the value of your home
The Council will take in the value of your home as a capital asset. However in the circumstances below, the value of your property will not be included when calculating your charges, even if your stay in a residential or nursing home is permanent.

The value of your property is ignored if, for example:

• Your spouse/partner continues to live in the property.

• A close relative or a member of the family for whom you are responsible is living in the property and they are:

– aged 60 years or over, or
– aged 16 years or under, and is a child you are liable to maintain.

• If a person remaining in your property has a disability and has proof of benefit entitlement or medical evidence due to their incapacity.

The Council has some discretion to ignore the value of property for other reasons, and each case is assessed individually.

Assessing the value of your home
The Council will take in the value of your home as a capital asset. However in the circumstances below, the value of your property will not be included when calculating your charges, even if your stay in a residential or nursing home is
permanent. The value of your property is ignored if, for example:

• Your spouse/partner continues to live in the property.
• A close relative or a member of the family for whom you
are responsible is living in the property and they are:
– aged 60 years or over, or
– aged 16 years or under, and is a child you are liable to
maintain.
• If a person remaining in your property has a disability and
has proof of benefit entitlement or medical evidence due
to their incapacity.
The Council has some discretion to ignore the value of
property for other reasons, and each case is assessed individually

Self-funding your care
If you own a property and do not wish to sell it, and you want to reside in a care home without the financial support of the local authority, the following information may be useful to you.

You may still access funding for up to the first twelve weeks of your permanent care if you meet our eligibility criteria and your capital is below the £23,250 capital limit, this is known as  the twelve week property disregard. If your property is sold within the twelve weeks, the disregard ceases from the date the property is sold and you will fund your care home placement entirely.

If the Council helps fund the cost of your placement you will still have to pay your financially assessed contribution, and in addition if the home cost is above the EPR then a third party top-up payment is required. However, by maximising your income (for example, renting out your property) you may be able to meet the cost of your care home directly.

If you do not meet the eligibility criteria and have over the capital threshold you will have to fund all of your care and support.

For 2013/14 the capital threshold is £23,250 although this figure may change after April 2014. Please contact the Customer Service Centre (please see page 4 for contact details) for assistance one to two months before your capital reaches the threshold or if you are  self-funding and are no longer able to meet the cost of your care and your capital has fallen below £23,250.

For further information and help, call this Directory’s independent helpline: 0800 389 2077.

Deferred Payment Agreements (DPAs)
When the value of your property is taken in as part of the financial assessment, Section 55 of the Health and Social Care Act 2001 and the accompanying National Assistance (Residential Accommodation) (Relevant Contributions) (England) Regulations 2001, allows Councils to agree and operate Deferred Payment Agreements. This is where the Council places a legal charge on your property to protect its interests in loaning you the difference between the amount you are asked to pay (your assessed contribution) and the full cost of the home, until your house is sold.

This provision is intended to ensure that if you do not wish to sell your former home, or cannot sell it quickly enough to pay for your care, you will still be able to get help with payment of your fees.

Although until your home is sold, you will still continue to pay your assessed contribution towards the care home fees and the Council will defer the loaned difference against your property. So you will have to pay this amount back when your house is sold. You will also be  entitled to receive Attendance Allowance/Disability Living Allowance (care component)/Personal Independence Payment from week 13.

There are a number of factors to consider when deciding whether to sell your property now or in the future.

Things to consider include:

• the state of the local property market and how much your property is expected to sell for in the current economic climate;

• how you might invest any proceeds from the sale to your best advantage whilst still being able to access monies to pay the care fees;

• insurance/general maintenance or heating of the property if it is empty; and

• the pros and cons of renting out the property, and the effect this will have on your state benefit entitlements.

Deferred Payments Scheme (DPS)
A DPS is a contractual arrangement which is similar to a Deferred Payment Agreement in that a legal charge will be placed on your property to protect the interests of the Council, however, with a DPS the loaned amount can include, from week 13, the element that is the third party amount where a home charges more than the EPR.

A DPS contract can only be considered upon certain criteria being met and Councils have discretion to decide who they will offer the DPS to. All applications will be considered on their individual merits and you will have to sign a contract with us agreeing to the loan conditions. However, it is important to note that you should always seek independent financial or legal advice if you wish to enter a DPS.

If you are accepted into a DPS, you will receive the agreement in writing and the Council may charge for the cost of land registry searches and other legal expenses. The agreement will last until you terminate it (perhaps because you have sold your property) or until 56 days after  your death.

During the time of either a DPA or DPS agreement, no interest can be charged but, if your property remains unsold for longer than 56 days after your death, the Council will charge interest on the debt.

Please be aware that interest will accrue from 56 days after death, in accordance with Section 24 of the Health and Social Security and Social Services Adjudications Act (HASSASSAA). Interest is calculated at 4% plus the current Bank of England base rate.

Contributions towards non-residential care and support

The Council is currently reviewing the way they assess how much you have to pay towards your care to ensure that its approach is fair and takes into account your personal circumstances. You can find more details about the consultation the Council has been undertaking and the feedback from the public on the website www.northamptonshire.gov.uk. Your assessment takes into account your capital, income, benefits and occupational pension(s), as detailed below.

If you receive care in the community, you will be financially assessed in the same way as for residential care (see the above sections). The Council will follow Government guidance when deciding which sources of income they will take into account, and also when calculating any allowances due to your disability. If you are in receipt of a disability benefit, you will have an allowance made for expenses above average and linked to your ill health or disability. These will  be assessed and discussed with you on an individual basis.

Only once these allowances have been deducted from your available income will the Council calculate what you are required to contribute towards the cost of care. They will always ensure that you are left with enough income to maintain your quality of life, based on Government guidance: minimum protected income or minimum pension guarantee plus 25%.

Benefits
When you complete the financial assessment form, the Council will undertake a Welfare Benefit Check. They will notify you in writing of how to make a claim for the benefits they believe you may be entitled to. Customers with savings over £23,250 will be charged the full cost for any services provided. Figures mentioned here and the way the Council seeks contributions towards charging may change during the life of this Directory.

Intermediate care
Anyone receiving intermediate care services such as START (Short Term Assessment and Rehabilitation Team who provide support in your home, such as personal care) or rehabilitation at a Specialist Care Centre will not be charged for the care provided for a maximum period of up to six weeks. This excludes any transport and Meals on Wheels service provision.

However, if within the six week period a social care practitioner discusses and agrees with you that you need ongoing care support, the intermediate care service you are receiving will be chargeable from that date. If an intermediate care service extends beyond six weeks, it will become chargeable. The Council will then work out how much you have to contribute towards the cost of your care.

When would you NOT be asked to contribute towards the cost of your community care services?

The Council will not charge for:

• advice, information and assessments regarding social care needs, available services, charging, welfare benefits and income collection for people receiving services;

• services provided to people who are only on the basic level of income support, Job Seekers Allowance or guarantee credit and are not in receipt of Attendance Allowance or Disability Living Allowance/PIP;

• services provided to those people who have Cruetzfeldt Jacob Disease (CJD);

• services provided to those people who have a terminal illness and are in receipt of either Attendance Allowance or Disability Living Allowance/PIP claimed under ‘special rules’ on the DS1500 claim form;

• services provided for after care under section 117 of the Mental Health Act 1983;

• services provided for a maximum of six weeks as part of an Intermediate Care Package; or

• minor adaptations where the cost is less than £1,000.