Purpose

Proposed decision
To introduce a one-off
Self-Funding Arrangement Fee for new self-funders.
 

Reason for the decision

 

Kent County Council (KCC) is proposing to
introduce a one-off Self-Funding Arrangement Set up Fee for new
self-funders. This fee would be in addition to the existing annual
Arrangement Fee.
 

Background

 
KCC
provides 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 do not need to contribute towards their care, some pay a
contribution, and there are people that pay for all of their care
(these people are known as full payers).
 
If the
person has more than £23,250 in savings and other capital
(not including the value of their main or only home) they must pay
the full cost of their care and support. Self-funders can choose to
arrange their care themselves or ask the council to do it on their
behalf.
 
Where
KCC makes arrangements for self-funders’ care the
Care
Act 2014 enables us to charge an
“Arrangement Fee” to cover the cost to the council for
doing this work. This only applies to non-residential care and
support and only for certain categories of people who would pay the
full cost of their care and support. KCC currently charges
self-funders an annual Arrangement Fee (paid weekly). 

 

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/additional option considered

Why the
option has not been taken forward to consultation

Increase the weekly
Arrangement Fee only (no new initial set-up fee)

The majority of the
work is the initial set up of care and support arrangements by KCC,
which is reflected in the proposed one-off set-up fee.

Despite current
self-funders not having had to pay a set-up fee it was felt that it
would be unreasonable to increase the cost of the weekly fee to
cover work that had taken place in the past and unfair to include a
one-off cost in an annual fee.

Introduce a
fee for changing provider

The review
of other councils showed some had introduced a fee for changing
provider. Changing a provider adds additional work and costs in
making changes to care and support arrangements.

This option
was considered as part of the review, but due to the complexities
in applying this fee, it was agreed not to progress this
further.

Do nothing

Due to the significant
financial challenge being faced by KCC, we need to ensure we make
the best use of our resources. By introducing the proposed initial
set-up fee, we will cover the costs associated with supporting new
self-funders. If we continue to not fully cover these costs, then
other options will need to be considered.

 

How the proposed decision
supports
Framing Kent's Future - our council
strategy for 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 ASCH 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.

 
The
proposed one-off arrangement fee would be for all new self-funders
only. In 2023 there were 400 new self-funders. Based on this
figure, it has been estimated that the proposed change could raise
approximately £140,800 a year. We would use this money to
help increase income so that we can continue to provide council
services to those who need them.
 

Equalities implications

 

An initial Equality Impact Assessment
(EqIA) has been completed to help us to
understand how this proposal could impact on people due to their
protected characteristics (age, disability, gender reassignment,
race, religion or belief, sex and sexual orientation) and those
with carer’s responsibilities. The full EqIA 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.

 

Whilst the proposed policy change does not actively
promote equal opportunities, KCC uses the financial contributions
that people make to ensure we are able to continue to help as many
people as possible with the limited resources that are available.
This proposed change would contribute to our objective of
protecting front line services and continuing to provide the level
of care and support needed by people in Kent.

 

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.

 

The EqIA has identified
that the highest proportion of
self-funders currently paying the Arrangement Fee are older people
aged 61 to 101 and females.

 

There are specific health and economic inequalities
that need to be considered in terms of the impact of raising
charges for social care. People from ethnic minorities are more
likely to suffer from
underlying health conditions. Therefore, new self-funders from
ethnic minorities could be more negatively impacted by this
proposal.

 

Some people may not want to pay the proposed
Self-Funding Assessment Set up Fee and may choose to put their own
arrangements in place. This may not be of the same quality of care
organised by the council. Alternatively, those impacted may decide
not to access the right levels of care and support or may decide to
not access care and support at all. As a result, any carer may be
required to provide more unpaid care, thereby affecting their
economic, social and emotional wellbeing. This might also result in
an increased need for support from other KCC services and an
increase in safeguarding concerns due to carer
breakdown.
 

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.