Changing Charges

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Purpose	Lancashire County Council has to make significant savings over the next few years. As a result, we have to recognise that we no longer have the resources to subsidise social care as we have done in the past. In fact we need to raise more money to help meet the growing demand for services. A new policy has been proposed for how Lancashire County Council charges people for the full cost of home and day care and other social care services - subject of course to their ability to pay. This will cater for the introduction of personal budgets and will bring in additional income to support the budget and help deal with the financial pressures faced by the county council. This will mean that some people will be asked to pay more towards the cost of their services. However, we plan to have a transitional period during which people who already receive support would not pay more than an extra £50 per week. People will be offered a financial assessment to make sure they are able to meet any increase in the charges. Currently, 42% of people who receive home care do not pay anything towards the cost of their services. If you are one of these people you will continue to pay nothing under the changes. We want to make sure that any changes are based on feedback from the people who receive support at home, together with their carers and other interested parties. It is important to have this consultation and hear your views before we take the next steps.
Subject	Priorities for social care services
Commissioned by	Adult Social Care

Geographic area	All of Lancashire
Method	Questionnaire - online Questionnaire - postal
Consultation with	General public
Date	01/02/2011 - 04/03/2011
Undertaken by	Corporate Research & Intelligence Unit

Results

Key findings	Over two thirds of respondents think that charges for home care should be kept at the current level (68%). A quarter of respondents agree that people should be charged for each carer that attends to support them (26%) while over half disagree (56%). Over half of respondents think that charges for day care should be kept at the current level (55%) while a quarter think that they should be increased but not up to the full cost paid by the council (27%). A third of respondents agree that people should be charged for transport to and from day centres (33%) while around half disagree (53%). Three fifths of respondents agree that people should be charged if they don't give notice to cancel a service (58%) while only a third disagree (32%). Around three quarters of respondents think that the percentage of net disposable income contribution should remain at 60% (73%). Three fifths of respondents agree that people should be given a weekly allowance for disability related expenses (60%) while only a fifth disagree (18%). Over half of respondents think the weekly cap should be kept at £60 (54%) but a fifth of respondents think we should increase, but not remove, the weekly cap (19%). The most common response regarding protection options is to limit the weekly increase to £25. Opinion is split between the length of time this protection should last for. The majority of respondents agree that they understand why the county council is proposing to change its charging policy (70%).
Outcomes	Following the consultations, we have had to make some key decisions on how we are going to deliver social care across Lancashire in the future. As a result, one of the main changes is that we have raised the threshold for access to social care and will now support those in the 'critical' and 'substantial' categories but will no longer include those in the 'moderate' category. All those currently in the 'moderate' category will be reviewed and it is likely that some will move into the 'substantial' category as a result. The second main change is that people who can afford to pay will be asked to contribute more to their care. However, 42% of our customers do not pay anything towards the cost of their care services and will continue to pay nothing under the changes. We have listened carefully to the views of those we have consulted and have made some changes, but the reality is we cannot afford to deliver the services in the same way and to the same level as we have in the past. We have made some alterations to our original proposals after hearing your views: - Service users facing higher charges will have increases limited to a maximum of £30 per week in the first year and a further £30 in the second year, rather than being capped at £50 each year as was originally proposed - We will put greater emphasis on identifying problems before they escalate and will invest £6 million in this area - prevention as opposed to cure - Fees paid to providers of care homes will be frozen for existing residents at current levels rather than being reduced by 4%. Fees will be reduced only for new residential placements by 4% and new nursing care patients by 3% from April 2011

Key findings

Over two thirds of respondents think that charges for home care should be kept at the current level (68%).

A quarter of respondents agree that people should be charged for each carer that attends to support them (26%) while over half disagree (56%).

Over half of respondents think that charges for day care should be kept at the current level (55%) while a quarter think that they should be increased but not up to the full cost paid by the council (27%).

A third of respondents agree that people should be charged for transport to and from day centres (33%) while around half disagree (53%).

Three fifths of respondents agree that people should be charged if they don't give notice to cancel a service (58%) while only a third disagree (32%).

Around three quarters of respondents think that the percentage of net disposable income contribution should remain at 60% (73%).

Three fifths of respondents agree that people should be given a weekly allowance for disability related expenses (60%) while only a fifth disagree (18%).

Over half of respondents think the weekly cap should be kept at £60 (54%) but a fifth of respondents think we should increase, but not remove, the weekly cap (19%).

The most common response regarding protection options is to limit the weekly increase to £25. Opinion is split between the length of time this protection should last for.

The majority of respondents agree that they understand why the county council is proposing to change its charging policy (70%).

Outcomes

Following the consultations, we have had to make some key decisions on how we are going to deliver social care across Lancashire in the future. As a result, one of the main changes is that we have raised the threshold for access to social care and will now support those in the 'critical' and 'substantial' categories but will no longer include those in the 'moderate' category.

All those currently in the 'moderate' category will be reviewed and it is likely that some will move into the 'substantial' category as a result. The second main change is that people who can afford to pay will be asked to contribute more to their care. However, 42% of our customers do not pay anything towards the cost of their care services and will continue to pay nothing under the changes.

We have listened carefully to the views of those we have consulted and have made some changes, but the reality is we cannot afford to deliver the services in the same way and to the same level as we have in the past. We have made some alterations to our original proposals after hearing your views:

- Service users facing higher charges will have increases limited to a maximum of £30 per week in the first year and a further £30 in the second year, rather than being capped at £50 each year as was originally proposed
- We will put greater emphasis on identifying problems before they escalate and will invest £6 million in this area - prevention as opposed to cure
- Fees paid to providers of care homes will be frozen for existing residents at current levels rather than being reduced by 4%. Fees will be reduced only for new residential placements by 4% and new nursing care patients by 3% from April 2011

Project document(s)

Report(s)

Changing Charges report

Contact information

For more information about this research contact:

Financial Assessment Team
01772 530188
Email: fin.assessment@lancashire.gov.uk

Related information

You can find out more about the changes to adult social care here:
http://www3.lancashire.gov.uk/corporate/atoz/a_to_z/service.asp?u_id=3429&tab=1