SELF-HELP INFORMATION:

against rationing and charges for homecare services

Councils have been sending social workers, mostly from private companies, to reassess our care needs and reduce our services.  But Councils are not allowed to reduce the services we were allocated unless they can show we don’t need them anymore.

There are two kinds of assessment – a care assessment, which decides how much personal help you need in your daily life, and a financial assessment, which decides how much money the council will try to get out of you to pay for your personal care.

If you need help, either to lead a full and independent life or to take some of the strain off family and friends, it is in your interest to have a care assessment so that you may have the council service to which you are entitled. The following information should help you.

However, there are many reasons why you might resist having the financial assessment.

• People have found the financial assessment very stressful and upsetting.  Some people have been humiliated by it, only to find that the council did not charge them in the end
• You can postpone or avoid the financial assessment if you are not well and if the stress will affect your health – you can write enclosing medical evidence
• Some people have boycotted assessments and have kept their service without paying, by not replying to letters and calls.

THE CARE ASSESSMENT

• When the Council contacts you to say that someone will visit you to carry out a care assessment, make sure that you are prepared
• Ask the Council to send you their Assessment Guide
• Tell the Council you will need an advocate, which they say they will provide
• Make sure the visit is at a time that suits you
• Think carefully about all your care needs and daily living - if possible, make a list
• Always have someone with you during the visit, a friend or family member
• Give the list to your supporter in case you forget things, so they can remind you
• Be aware, some of the assessors can be intimidating.  Remember you don’t have to answer questions which you feel are intrusive – all council staff are bound by the Disability Equality Duty which says how they have to treat you.
• During the assessment, it is useful to ask them to recap often and make sure the assessor is writing down the things you say, accurately
• Make sure you get a copy of everything written down before the assessor leaves
• Don’t sign anything unless you understand and are happy with everything
• Remember you are in your own home which is private; they are your guest and should behave appropriately.
• If you need a break or rest, stop the assessment for as long as you need

After The Assessment

If your care service has been cut and you are not happy about this -

• First write or telephone Social Services and ask for a Review
• If nothing changes and you’re still not happy, you can go to your GP, the CAB, get legal advice, or go through the Camden formal complaints procedure
• If your reduced care package is affecting your health you can ask your GP, consultant, councillor, representative organisation … to write to Social Services. 

THE FINANCIAL ASSESSMENT

• When the Council contacts you to say that someone will visit you to carry out a financial assessment, make sure that you are prepared – Before the visit:

• Ask for the national guidelines on charging for services
• Ask for Camden’s booklet on charging for care
• Ask for their charging policy, because you will want to know about how much of your savings, benefits and income may be taken away from you
• Get all the information you need in advance and in a format which suits you and which you can understand
• Ask for an advocate
• If you need someone to help you because of any communication difficulty, don’t agree to the assessment without this person being present
• Make a list of all your expenses, especially those extra costs you have because of your disability
• The council assessor will want to see your bank statements and savings books – only show the details you have to; remember, this is private information
• The assessor should see all your bills; have them ready, including receipts for disability related expenses
• Don’t allow any of your papers to be taken away
• Make sure the assessor is writing down all your living expenses
• If you disagree with anything being said or written, tell the assessor
• Take as long or short a time as you want; take a rest or break if you need it, even finish the assessment on another day if you are too tired to continue
• Make sure you get a copy of everything written before the assessor leaves
• Try to keep your own record of what was said at the assessment
• Don’t agree to anything at the time and certainly don’t sign an agreement to pay, especially without knowing how much you are going to be charged.

After the Financial Assessment

The council will write to you with an account of how they have worked out how much they want you to pay for your care; this will be based on the assessment. If the amount is NIL you have nothing to worry about. But if they want money from you every month and you feel that this is unfair or will cause you hardship, there are a number of things you can do.

• Write or telephone Social Services and ask for a Review which could begin with another meeting to discuss the assessment
• If you feel that the assessment was not carried out properly, ask for another assessment
• Get advice from a Law Centre, a Solicitor or a Citizens’ Advice Bureau
• Don’t pay anything until you reach agreement with the council
• Challenge the charging assessment using the notes CHALLENGING CHARGES
• Remember, if the council has already agreed a plan for your personal care, they can not cut or take away this service even if you don’t pay for it.

CHALLENGING CHARGES

• Councils cannot take away services if you challenge charges – they are legally obliged to provide what you need, as set out in your care plan.  It is potentially illegal for them to cut your service if you say you could only afford lower charges.
• All your living expenses count against any charges.  These can be general living expenses or disability expenses.  They are not allowed to leave you with less than Income Support level + 25% to live on.
• Count existing and new costs, including having to pay unexpected extra fuel costs, higher food costs, and so on.
• For disability expenses, Councils are saying there are national limits on how much from each expense they can allow.  But we can’t find proof of these limits in the Department of Health “Fairer Charging” policy which makes the rules for Councils.  This does not set limits on how much of people’s disability expenses should be counted.  On the contrary, they say charges should not interfere with independent living.  They say expenses which people have no choice but to pay, should be recognised.  Examples would be dog-grooming for a blind person’s guide dog, or breakage due to disability.
• Disability expenses include: payment for the Careline alarm; payment for privately-arranged care services including respite; laundry; special diet or vitamins; clothing or footwear; wear and tear on clothing; bedding; added heating or water costs; reasonable costs of basic garden maintenance, cleaning, or domestic help, if not met by social services; purchase, maintenance, and repair of disability-related equipment, including computer or other equipment for waged work; or hire costs; personal assistance costs; transport costs which are not covered by DLA mobility component; disability supplies which are not available on the NHS; expenses while you are waiting for an NHS wheelchair or Council adaptations.
• With WinVisible’s help, a Camden woman got her charges cancelled completely, when she challenged the fixed amounts allowed for disability expenses, as well as their implied threat to reduce her care to fit paying lower charges.
• Earnings are disregarded (you are allowed to keep all your earnings and they are not included in the financial assessment).  Unwaged people have all their money to live on, assessed.
• Check that the Council has not over-calculated your income.  Direct payments from Social Services are counted as part of your income, but they sometimes get the amounts wrong.
• The mobility component of DLA is not included in the assessment.
• Get support, advice and legal representation if you are being sent homecare bills you cannot afford or if you are being taken to court for non-payment.
• If you have already done the financial assessment and have started to pay charges, and you are in difficulty with continuing these payments, stop payments and seek advice.  You may be able to get a refund where you can show that the charges were unfair or discriminatory.

NOTES

See:  Dept of Health “Fairer Charging Policies for Home Care and other non-residential Social Services.  Guidance for Councils with Social Services Responsibilities. 

September 2003. p.21

These pointers were put together by the Campaign Against Care Charges and WinVisible (women with visible and invisible disabilities) from our experience.  They are for general guidance only and don’t replace individual advice and legal representation.

 Places to go for advice and legal representation:

·       CAB – 0845 120 2965.  Camden CAB Housebound Service 7482 4747

·       Disability Law Service Tel: 020 7791 9800  Minicom: 020 7791 9801  Monday to Friday 10am - 1pm, 2.00pm - 5pm. E-mail: advice@dls.org.uk

·       Leigh Day solicitors Tel: 7650 1200 Fax 7253 4433

    Email postbox@leighday.co.uk