Agenda item

The Director for Adult Social Care and Commissioning submits a report setting out the background on a proposal to implement an optional care arrangement fee.

The report also outlines the measures that will be introduced to support self-funders in their decision making, should this arrangement be introduced.

The Director for Social Care and Commissioning submitted a report and gave a presentation on the powers within the Care Act 2014 which allowed the council to implement the proposed charging approach. Research had been carried out to understand practice across the country. A targeted 6 week consultation took place between 11^th  August and 26^th September. As a result of the feedback the proposal was revised to introduce a single one off fee payable to the local authority, with all other associated care costs covered by the council. It was noted that:

The proposed charge was £165.47 per arrangement. This was considered favourable compared to the 24 local authorities examined. The fee reflected the administrative cost incurred and the council emphasised that it was not a profit making organisation.

Implementation was planned in a way that minimised the impact on residents and responded to consultation feedback. A total of 45% of respondents felt the revised proposal was manageable. Scheduled payment options, and support to help people make an informed choice would be offered .

In discussion with Members, the following was noted:

• Clarification was sought on what performance indicators would be used to track the impact of the scheme and ensure quality. Officers referred to the quality information already included in the report and explained that relevant data on the service and fee would be collected.
• Concerns were raised that 32% of people were already known to be affected and that no clear indicators had been set to measure the impact. Officers stated that uptake of the arrangement was optional and could be declined if residents believed it would negatively affect them.
• The discussion reflected wider concerns about the shift in responsibility towards residents managing their own care. Members highlighted the potential risks to individuals and the need to understand the real world impact of this change on people’s lives and financial stability.
• Questions were raised about the financial implications for those with savings above the £23k threshold. Members noted that the proposed £165.47 fee would be a one off fee, not an annual fee,
• Further queries explored the administrative costs and whether the fee was being introduced to raise income. Officers confirmed that around 234 people currently received this type of arrangement, with an estimated 135 expected to take up the option each year. The administrative cost remained £165.47 per arrangement. Expected income was around £19k in year 1 rising to around £113k in year 5. Officers reiterated that the council was legally required to break even and could not generate profit from the fee.
• Members questioned why the department needed additional income when it had underspent in recent years. It was explained that the wider local authority continued to face financial challenges and that underspends could not be relied upon in future.
• The discussion broadened to consider the wider position of self-funders. Members highlighted that the £23k savings threshold had not increased for many years and no longer reflected current costs of living. Concerns were raised about growing financial pressure on residents, especially where hidden costs were involved.
• Examples were shared of day to day expenses faced by people receiving care, including paying for alarms or purchasing items privately when standard provision did not meet their needs. Members noted that such costs often accumulated unnoticed until people were directly affected.
• Officers confirmed that the proposed fee would not apply if a person’s savings dropped below the £23k threshold. They emphasised the intention to provide clear advice and support and highlighted the importance of early help.
• Members proposed adding a deeper exploration of self-funders to the scrutiny work programme. They felt it would be valuable to understand how many self-funders lived in the city and what their experiences were compared to other areas. Reference was made to checking previous minutes where similar issues had been raised.
• The importance of involving voluntary and community sector partners in any future work was noted to ensure a fuller understanding of resident experiences.
• Members also wished to hear from larger care providers to better understand business models and pressures in the sector. Concerns were raised about the small consultation response, the potential for repeated fees as care needs changed and the risk of residents falling into arrears. It was stressed that any fee collection process must avoid causing additional financial strain.
• Officers confirmed that small changeswould not trigger repeat fees, and this detail will be agreed ahead of implementation. Care packages could increase as needs changed and support would be adjusted accordingly. The concerns raised about debt and unintended consequences were acknowledged in full.

AGREED:  

1.    The contents of the report were noted.

2.    Self-funders would be added to the work programme.

3.    Providers of care services would be invited to present their experience of working with self-funders and the local authority.