Purpose

Proposed decision
That the Cabinet Member
for Adult Social Care and Public Health:
a) APPROVE the changes to the
Adult Social Care Charging Policy; and
b) DELEGATE authority to the
Corporate Director Adult Social Care and Health to revise the Adult
Social Care Charging Policy and to take relevant actions, including
keeping the policy updated as necessary, to implement the
decision
 
Reason for the decision
 
In line
with the approved Budget Book, Kent County Council (KCC) is
proposing to change its policy for charging for adult social care
provided in a person’s own home or in the community. This
means we are reviewing how much some people may have to pay towards
the chargeable services that KCC provides or arranges, which
include:

·      
Care and support provided at home (for example
homecare including supported living); and

·      
Care and support provided in the community (for
example daytime support).

 

This policy does not impact on people who live in
and receive care and support in a residential care home.
 

We are proposing to stop disregarding the
higher or enhanced rates of Attendance Allowance (AA), Personal
Independent Payment (PIP) and Disability Living Allowance (DLA)
when we calculate a person’s income (we already take into
account the lower, middle or standard rates of these
benefits).

 

This would mean that individuals in
receipt of care who receive higher rate of these benefits would
have more income taken into account in their financial assessment
which would mean that they are likely to pay more for their care
and support than they do currently.
 
We need to look at the
amount of income we can generate by people contributing towards the
cost of their own care. This is why we are proposing a change to
the charging policy.
 
Background
 
KCC
provide adult social care services to approximately 16,394
residents aged over 18 years old (data taken January 2024).
Approximately 15,806 of these people receive chargeable social care
services, this includes providing services like residential care
and support and care in a person’s own home or in the
community.

 
When
people living in Kent need adult social care, as well as assessing
their care needs, we also assess their income to decide how much
they pay towards their care. This is known as means testing. Some
people don’t pay anything, and the council picks up all of
the cost, some people pay a contribution, and some people pay for
all of their care (these people are known as full
payers).

 
KCC
sets out what and how people need to pay in the Adult Social Care
Charging Policy.
 
KCC has
already made substantial improvements and efficiencies to the way
social care is delivered in Kent, alongside trying to limit the
impact on the people that draw on care and support and help make
the service sustainable.
 
Whilst KCC continues
to strive to provide the best services we can, we continue to have
the following growing pressures:
 

·      
Significantly less government funding compared to
nine years ago and we are expected to fund services through council
tax contributions and income from other sources such as charging.
The Revenue Support Grant (which includes adult social care as well
as other council services) has reduced from £246.7m in
2013-14 (the first year of current funding arrangements) to
£11.8m in 2024-25. There have been a number of separate
social care grants which have been provided progressively since
2016-17 (not exclusively adult social care) which amount to
£192.9m in 2024-25 but these grants have been provided in
recognition of the pressures in social care and to fund
improvements rather than replace the Revenue Support Grant
reductions.

 

·      
Increasing demand (an additional 1,152 people from
March 2022-March 2023) for adult social care services, including
people having complex care and support needs.

 

·      
Significant annual increases in the National Minimum
Wage (NMW) since 1999, which have impacted on the fees charged by
care and other providers.

 

·      
Continuing impact of inflation, which means we face
growing pressures in the care market, including workforce
challenges and rising costs for delivering care
packages.
 
Options (other options considered but not taken
forward)
 

Before deciding on the preferred proposal presented in the
consultation, a number of options were considered:

Alternative
option considered

Why the
option has not been taken forward to consultation

Only apply the proposed change to people
new to receiving care and support from KCC’s adult social
care service from the date the new policy is implemented. This
would mean that existing people receiving adult social care
services would not have the higher or enhanced rates of disability
benefits considered when KCC calculates a person’s
income.

Whilst this would reduce the number of
people impacted by the proposed change it would not be fair and
equitable for all people who draw on care and support and does not
reduce the current funding gap.

Introduce the policy in
stages, no more than a £12 increase to anyone’s charge
per year, for existing people who draw on care and support to give
them time to adjust.

Whilst this would reduce the
impact of the proposed change it does not reduce the current budget
gap as quickly. This would also be quite challenging to
administrate both manually and on the case management
system.

An increase to the level of Disability
Related Expenditure (DRE) for everyone from
£17.00.

This would reduce the funding available
for adult social care and increase the budget gap further and would
be applied to all rather than just those who receive the higher and
enhanced benefits.

Increase Minimum
Income Guarantee for basic living expenses such as utility bills
and food.

This would reduce the
funding available for adult social care and increase the budget gap
further.

Automatically review
DRE for all individuals who could potentially be
impacted.

This would have an
incredibly significant impact on operational resources and would
redirect resources away from frontline services.

Offer DRE assessments
for all 3,784 individuals directly impacted.

This would reduce the
funding available for adult social care and have a significant
impact on operational resources.

Do nothing.

Due to the significant
financial challenge being faced by KCC, if we do not raise
additional income from this proposed change, then other options
would need to be considered.

 
Our
preferred proposal would reduce the funding gap for adult social
care services in Kent in year. However, we recognise that these
alternative options could help to lessen the impact on
individuals.
 
How the proposed decision supports
Framing Kent's Future - our council strategy
2022 to 2026
The
proposed decision aligns with the ambitions set out in Framing
Kent’s Future to place Kent on a sustainable footing for the
medium and long term and also aligns with Objective 2 of Securing
Kent’s Future to identify opportunities to set a sustainable
budget and MTFP.

 

Financial Implications
 
The
latest budget monitoring presented to Cabinet on 21 March 2024
shows £30m budget gap for 2023-24, of which £31.3m
relates to the Adult Social Care and Health Directorate before
management action and one-off use of reserves are considered.
Members have agreed the immediate actions needed to reduce spending
in the short term and have set the course for getting the council
back to financial sustainability, securing the services that
residents in Kent need the most.
 
Spending growth in KCC 2024-25 is £209.6m as stated in the 2024-25 budget. The
net change to the budget is £113.9m (matched by funding
increases through government grants, council tax, etc), leaving
£95.7m savings which need to be found.
 
Of the
above, the spending growth in Adult’s
2024-25 is £115.8m as stated in the 2024-25
budget. The net change to the budget is £61.7m (matched by
funding increases through government grants, council tax, etc),
leaving £54.1m in savings/additional income which needs to be
found, of which this proposal is included
within.
 

It has been estimated that the proposed
change could raise approximately £3.5million. We would use
this money to help reduce the funding gap so that we can continue
to provide council services to those who need them. If this
proposal is not implemented, then the income would need to be
achieved elsewhere.
 
Equalities implications
 

An initial Equality Impact Assessment
(EqIA) has been completed and can be found on the consultation
webpage: www.kent.gov.uk/adultsocialcarecharging
or upon request. This is a live document
and will continue to be reviewed and updated following the
consultation.

 
Age,
disability, sex, race and carer’s responsibilities have been
identified as having potential for negative impact if we were to
implement the proposed change.
 
We have
taken the following information from two sets of data, these
are:

·    
Young people drawing on care and support aged from
18 to 25, who are moving from children’s social care into
adults’ social care.

·    
Adults aged 18 and over drawing on care and support
from adult social care.

 
In the
data for young people, there are 612 active individuals who receive
care at home, in the community or have a direct payment that may be
affected.
 
In the data for
adults, there are potentially 9,011 individuals who receive care at
home and in the community that may be affected.
 

Decision

As Cabinet Member
for Adult Social Care and Public Health, I agree to:
 
a)   
APPROVE the changes to
the Adult Social Care Charging Policy; and
 
b)  
DELEGATE authority to
the Corporate Director Adult Social Care and Health to revise the
Adult Social Care Charging Policy and to take relevant actions,
including keeping the policy updated as necessary, to implement the
decision.