Review of Adult Social Care charging for Respite

Last autumn, North East Lincolnshire Council proposed some changes to its approach to charging for respite care. Between October and December 2022, it asked for people's views on the proposed changes. 

In February 2023, the Council’s Cabinet made a decision about the proposed change. The change will take effect from 27th March 2023. You can read more about it below.

What is respite care?

Respite is a short-term placement in a residential care home which can last anything from one night to eight weeks. 

What is the current approach to charging for respite?

Unlike health services, adult care and support services are not free to access. The Care Act 2014 sets out the legal basis for means testing access to care and support services. The law allows councils to recover some of what they spend in meeting people’s needs. This means that:

  • Some people will pay the full cost of their care and support
  • Some people will share the costs of their care and support with the Council
  • Some people will receive their care and support for free. 

For some years, the Council has offered four flat fee bands, which are: 

Individuals with:

Pay:

Savings over £23,250 (this is the nationally set upper capital limit)

The full cost of the service

Savings between £14,250 and £23,249

(£14,250 is the nationally set lower capital limit)

£115 pw

Savings below £14,250 and not in receipt any of Pension Credit Guaranteed, or Income Support or Employment and Support Allowance or Universal Credit

£90 pw

Savings below £14,250 and in receipt of any of Pension Credit Guaranteed or Income Support or Employment and Support Allowance or Universal Credit

£70 pw

Note: Those with assets above the upper capital limit pay the full cost of their care. Those with assets below the lower capital limit make no contribution from capital to the cost of their care, but may contribute from their income. Those with assets between the lower and upper capital limits make a proportionate contribution, subject to financial assessment. The upper and lower capital limits may change in future. 

What is the change?

Instead of charging one of the above flat fee bands, from 27th March the Council will charge individuals using the same rules that apply to charging for care at home. This means that each individual will contribute what a financial assessment based on those rules indicates they can afford to pay.

There is no change for those with assets above the upper capital limit; they will still pay the full cost of their care.

Does the change mean more people will have financial assessments?

Yes. A majority of people who access respite also receive other care and support services, so they already have annual financial assessments. That’s not true for everyone, however. For those people who do not access care and support services other than respite, they will need to be financially assessed to establish how much they can afford to contribute to the cost of their respite stay.

Does the change mean people will pay more, or less, for respite than they have been paying?   

It’s not possible to say definitely, without an individual financial assessment. But, it is likely that after the change, more people will pay less for their respite than they did before the change. Some people may not pay anything for it at all, if they are already contributing the maximum sum they can afford for other care and support services they get. There could be some people who pay more as a result of the change, but they will pay no more than a financial assessment shows they can afford.

How many people are likely to be affected by the change?

Between 200 - 300 individuals accessed respite in the preceding year, some of them on more than one occasion across the year. This number might be low when compared with the years before the covid-19 pandemic. 

Why is this change happening?

The Council thinks that the new approach is fairer. By financially assessing what each individual can afford to pay, it will be more confident that people are being charged no more than is reasonable. Those with the lowest level of assets will probably benefit most from the change. This is particularly important at a time when concern about the cost of living is high.   

The Council is keen to ensure that those who can benefit from respite are able to access it on an affordable basis. This is important for individuals with needs, and their carers. The Council recognises that carers really value the assurance that respite can provide, in allowing them to take a break from their caring role. 

How did the Council make its decision about this change?

The Council consulted on its proposal for change for eight weeks between October and December 2022.  A report was written to summarise the responses that people gave during the consultation. You can read the consultation report by clicking this link:  https://www.northeastlincolnshireccg.nhs.uk/data/uploads/care-act/respite-charging-consultation-report-03-01-23-accessible.pdf 

The Council’s Cabinet used this report to decide whether to adopt the change or not. The Cabinet made its decision on 15th February 2023. You can read more about what information the Cabinet used to make its decision by clicking on this link: https://democracy.nelincs.gov.uk/wp-content/uploads/2022/06/6.-Revised-Approach-to-Respite-Charging-Cabinet-Report.docx.pdf   

The change takes effect from 27th March 2023. 

More information?

For questions about your individual charges for adult social care (including respite), please contact the Finance Team at Focus Independent Adult Social Work by telephone (0300 330 2870) or by email (focus@nhs.net).   The Finance Team at Focus acts on behalf of the Council.

If you are worried and want to talk to someone independent of the Council, you could contact Healthwatch.  Healthwatch is the independent champion for people who use health and care services. Healthwatch can’t answer questions about your individual financial situation or charges, but if you want a general independent chat, you can ring Healthwatch on 01472 361459, or email them at enquiries@healthwatchnortheastlincolnshire.co.uk/