Chapter 3 - Local authorities: charging and assessing financial resources

Question 1

Needs assessments

Key points

• The Care Act 2014 governs most aspects of residential and non-residential care in England. It provides a statutory approach to many aspects, which ensures a consistent national approach to providing care.
• Local authorities are obliged to undertake a needs assessment to establish an individual’s care needs. They only have a duty to meet eligible care needs, which are determined using set criteria.
• If someone meets the eligibility criteria, the individual receives a care and support plan which documents what care and support is deemed necessary to meet the individual’s needs and what this will cost.
• Where someone is eligible for care and has assets that exceed the means-test threshold, the local authority is still responsible for meeting their needs if the eligible individual lacks the mental capacity to arrange care and does not have anyone under the Mental Capacity Act 2005 who is able to do so on their behalf.

Question 2

Determining eligibility – residential care

Answer 2

• The Care and Support (Charging and Assessment of Resources) Regulations 2014 state how local authorities in England must determine their ability to contribute financially to the costs of the care and support for individuals with eligible care needs.
• The capital limits in England are £14,250–£23,250. Individuals with capital above this limit will not receive financial assistance, while those with capital below this limit may get financial assistance depending on their other income.
• Capital is specifically defined in the Regulations as something that is not held for a limited period or intended to form part of a series of payments. It will normally be valued at the market value less any costs of selling it.
• Some capital is disregarded – most notably the main residence (where conditions are met), personal possessions and the proceeds of life policies.
• Deliberate asset deprivation is where capital is deliberately disposed of. The capital disposed is likely to be regarded as notional capital or income and, therefore, taken into account when assessing the individual’s contribution towards the cost of their care.
• The Regulations refer to how pensions under the pension freedoms should be treated. A pension fund will not be regarded as capital before the individual has a right to access it but it may be if a pension can be accessed, but isn’t.
• Tariff income describes how the capital between the limits is converted into ‘notional’ income.
• Income, with a few exceptions, is fully assessed.
• Those in local authority funded care are allowed to retain some income known as the personal expenses allowance.
• The main residence is disregarded for the first twelve weeks and, under the deferred payments scheme, care costs can be offset against the disposal value of the property. Interest may be charged on the amount deferred.

Question 3

Determining eligibility – domiciliary care or social care

Answer 3

• How needs are assessed and the determination of financial eligibility under the Care Act 2014 are now largely the same as with residential care.
• Most local authorities will charge for domiciliary services. They cannot make a profit and, as a result, the person requiring care must not be left with an income below the Minimum Income Guarantee (MIG).
• The individual’s personal care and support plan must include a personal budget if the individual is to receive financial support towards their care from a local authority.

Question 4

National variations

Answer 4

• In Scotland, nursing care is free for those who are 65 or over and assessed as needing care in a care home.
• In Scotland, gifts that are regarded as deliberate asset deprivation and made within six months of requiring care may be reclaimed from the recipient. If the timescale is over six months, local authorities are able to regard these as notional capital.
• While the process of obtaining local authority assistance towards care in Scotland is similar to that in England, there are four key differences. These relate to the single assessment process, charging for personal care, timescales and the cost of providing non-personal care.
• In Northern Ireland, registered nursing care provided in an individual’s home is provided free by the NHS. Personal care is charged for unless the individual is over age 75 or in receipt of income support.
• Wales is the only national region to have a separate capital limit for domiciliary care. This is £24,000 and the maximum amount an individual may be asked to pay is £90 a week for non-residential social services.
• In Wales, after paying the costs of care, the individual must be allowed to keep an MIA which is the level of Pension Credit Guarantee Credit that an individual receives, plus a buffer of 45%.