Aberdeen City Health and Social Care Partnership aims to help people live at home independently, safely, and for as long as possible. To help us to continue to be able to provide services to people with a range of needs, we ask them, if they can afford it, to make a contribution towards the cost of certain aspects of their care and support services.
Decisions made in relation to charging are set within the overall context of increasing demand for services as a result of a growing, ageing population with increased incidences of multiple and complex needs and a corresponding reduction in the budget available. We are continually reviewing our service delivery and changing the way we do things to try to reduce costs, increase efficiency and achieve best value to avoid increasing the charges to those who use our services. Some level of charging is, however, inevitable.
The charges are carefully considered to ensure they are reasonable for people to pay; they take into account the type of service provided and the recipient of the service; the person’s ability to meet the cost; and what others in similar circumstances but living in different areas across Scotland are asked to pay. Any charge made will not exceed the actual cost of providing the service.
What We Charge For
Those services that are in scope for charging, are:
- Care at Home – Non-Personal Care
- Supported Living
- Housing Support
- Day Care
- Day and home-based Respite services
- Social/Educational/Recreational Support
- Community Alarm Telecare
- Overnight/Residential Respite Services
- Meals provided at Day Care, Very Sheltered Housing and in the Community
Respite services are only chargeable if they are provided for the benefit of the cared for person. If the respite is provided to meet the needs of the carer as identified in an Adult Carer Support Plan or a care assessment, then the charges must be waived.
Exemptions
The following are exempt from being asked to contribute towards the cost of their care and support:
- People who have a progressive disease where death as a consequence of that disease can be reasonably expected within 6 months. The exemption is not limited to the 6 months.
- People aged over 65, or under 65 who are deemed to require it, receiving Personal Care in their own home (Personal Care element only)
- People aged over 65, or under 65 who are deemed to require it, receiving new or additional care in their own home following a one-off hospital discharge for 42 days in accordance with national guidance, and subject to the eligibility criteria.
- People with a mental illness who are subject to Compulsory Treatment Orders under the Mental Health (Care and Treatment) (Scotland) Act 2003
- People in receipt of Criminal Justice Social Work Services, including those who are subject to Compulsion Orders under the Criminal Procedure (Scotland) Act 2003
- Services for people who are subject to the conditions of a Short Scottish Secure Tenancy (SSST)
- Outreach Housing Support Services to people in receipt of support as a result of the Housing Support Duty (Scotland) 2012 where the support is likely to last under two years.
- Carers who are eligible for the provision of services to allow them a break from their caring roles, where this need has been identified following an Adult Carers Support Plan or care assessment
- Any service provided to children under 18 years of age.
Financial Assessment
Once it has been determined that an individual is eligible for a service and that service is chargeable and no exemptions apply, the individual’s level of contribution will be determined using a process known as a financial assessment.
The services received will always be based on the supported person’s needs and the contribution will be based on their ability to pay. Many people either contribute nothing to the cost of their care or only pay part of the cost. Everyone is liable to pay their contribution from the day the care and/or support is provided and, normally, invoices will be raised from that date.
Payment of Contribution
If, following a financial assessment, an individual has been assessed as being able to make a contribution, the charge will be based on the allocated individual budget. How this is paid will be determined by the SDS option they have chosen although, regardless of the selected option, contributions are made from the day the care and/or support is first provided and, normally, the calculation will be made or the invoice raised from that date.
For option 1 Direct Payment, the payment will be made net of the amount of the assessed contribution (i.e. the assessed contribution will be deducted before the payment is made). This will be paid 4-weekly in advance. Where a managed payroll provider is being used payments will be made gross and the supported person will be invoiced for their contribution on a 4-weekly basis.
For option 2, individuals will be invoiced by their chosen provider for their contribution to the care and support that they receive. If an Individual Service Fund arrangement is preferred, the budget will be paid to the 3rd party net of the amount of the assessed contribution (i.e. the assessed contribution will be deducted before the payment is made).
Where the supported person chooses to engage with an agency whose charges are higher than the amount allowed for in the budget there is an expectation that the supported person will be liable for the additional cost. Before deciding to go ahead with an agency, the supported person should ask questions about the fee and what it covers. They will be supported to do this by their care manager and/or the SDS team.
For option 3, where an individual’s care and support is arranged by ACHSCP, the supported person will be invoiced for their contribution on a 4-weekly basis.
Reconciliation
Arrangements for care change constantly. Supported people’s needs and their personal circumstances change. A spell in hospital means that planned care is not received, or a fall or illness could mean care provision needs to increase on a temporary basis.
Individuals are liable to pay their contribution as long as the care is being received. If a person goes into hospital, into residential respite or is away on a planned break for a period of time, they are not liable for a contribution as long as they are not receiving the care. If care is arranged but is not able to be delivered, for example if carers are refused entry, the supported person is still liable for their contribution. Invoices will be raised to an individual’s estate, after death, as long as there is a Next of Kin or Power of Attorney dealing with this. Invoices will be raised as soon as possible, and the Next of Kin or Power of Attorney will be advised of the anticipated final value.
Review
A review of the financial assessment can be undertaken if the assessment has been carried out in ignorance of, or with a mistake as to, a material fact, in which case the new decision takes effect from the date of the decision (i.e. retrospectively) it replaces or there has been a relevant change in the supported person’s circumstances, in which case the new decision takes place with effect from the date of the change in circumstance.
If you have any queries about this information, please don’t hesitate to contact either your SW practitioner or the SDS team.
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