Paying for care Adult Care and Support can sometimes help pay for the cost of your care in a care home, although you will always have to make a contribution as well. Trained Adult Care and Support staff will carry out a financial assessment of your circumstances to work out exactly what your contribution should be; this will be calculated according to strict legal guidelines. It is important to note also that Adult Care and Support will only fund you at the level of care your assessment has shown that you will need at the home.
Legal Framework Adult Care and Support departments are required under the National Assistance Act 1948 to provide, and/or fund, residential care for those persons who are ordinarily resident in their area, and who are assessed as requiring that form of care. The rules governing financial assessment are contained in the National Assistance (Assessment of Resources) Regulations 1992, and are interpreted by the Charges for Residential Accommodation Guide (CRAG), which is guidance issued by the Secretary of State for Health. CRAG is a lengthy document which covers the treatment of all types of assets, and a person’s interest in those assets, in undertaking a financial assessment. The same charge calculation principles apply to nursing home care as residential home care.
The financial assessment for permanent residential or nursing home care How is a financial assessment arranged? Firstly a social worker will visit you to carry out an assessment of your care needs, and this will confirm if moving to a care home is the most appropriate course of action for you. If you think you will need help with care home fees, either straightaway or in the future, your social worker will arrange for a finance officer from Adult Care and Support to contact you, or someone acting on your behalf, to carry out a financial assessment. What financial details will I be asked for? When the finance officer contacts you, he/she may discuss your financial circumstances with you. All information that you give will be treated as strictly confidential, and all records of the conversation will be kept securely. You will be asked to give details of: »» Your National Insurance (NI) number »» Your income (eg retirement pension, private pension, Attendance Allowance etc) »» Your capital (eg details of any property you occupy or own, savings in a bank or building society, stock, shares or premium bonds etc) »» Any monies held jointly by you and your spouse or partner
What will happen during the assessment?
on how to make further claims for benefits and who to contact.
What will happen next? The finance officer will let your social worker know that the financial assessment has been completed, and the amount of contribution you will be asked to pay direct to the home. You and the social worker will then be in a position to discuss your move to an appropriate home in more detail.
What do I do if I am unhappy with the calculation of my contribution? If you disagree with your confirmed charge decision you can do one of the following: »» Request an explanation to get more information on the assessment and confirmed charge »» Ask us to reconsider the assessed confirmed charge »» Appeal against the confirmed charge. Explanations You can ask for an explanation of your financial assessment calculation and confirmed charge. You should make this request within one month of the date of your confirmed charge letter. Your request can be done in writing or by phone by contacting the Assessments (Charging) Team. You can ask for your confirmed charge to be reconsidered. You should make this request in writing within one month of the date of your confirmed charge letter. When you ask for a reconsideration, a different officer from the one who completed your original confirmation of charge will look at your financial assessment again and check whether the confirmed charge is correct. If we change your confirmed charge following the reconsideration, we will write to you to confirm this, detailing new appeal rights for this new decision. If we cannot change your confirmed charge, we will write to you to confirm this. This letter will also tell you if you can appeal. If you can appeal, you will have one month from the date of the letter to make your appeal. You have the right to make an appeal, where you have not received an explanation and/or a reconsideration. Your appeal will need to be in writing and signed by you. It should give the full reasons why you think that your confirmed charge is incorrect. Your appeal will be forwarded to an Assessment Appeal Officer for consideration. Following consideration by the Appeal Officer, you will receive a letter confirming the outcome.
When the finance officer contacts you, he/she will ask you to collate all relevant documents relating to your income and capital. The finance officer may arrange a time and date to call you back in order that you have time to collate all the relevant details. The finance officer will then record your financial details on a Financial Circumstances Form. When the form is complete, you will be asked to sign it and provide copies of the relevant supporting documents, and you will receive your own copy to keep.
More about the financial calculation Property Disregards
If all the relevant information is available at the time of the call, the finance officer may be able to calculate your contribution to the cost of your care there and then. However, where the situation is complex, or if all the necessary information is not available, a follow up call or a visit might be necessary, or you may be contacted later in writing with an explanation of your contribution.
The 12 week property disregard
During the assessment, the finance officer will also be able to give you guidance on any benefits that you are entitled to receive from the Department for Work and Pensions towards the cost of your residential or nursing care. The Finance Officer will provide guidance
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Under certain circumstances your property will be ignored as capital for the financial assessment. Occasionally Adult Care and Support’s Director will use his/her discretion to disregard a property where it is felt the circumstances are exceptional. For more information about this please see Charging for Residential Accommodation Guide (CRAG).
This provides a form of limited state financial support to people who are about to be provided with accommodation under Part 3 of the National Assistance Act 1948. This would apply where a person entering longterm residential care does not have income or assets which will cover the fees. The value of the property the person has lived in as their main home is not included in the charge assessment for the first twelve weeks of care. However, the applicant would still be assessed for a contribution based on their income and any other capital. The twelve week property disregard is also applied to residents who have been funding the full cost of their care from their income and capital but whose total capital has now
Care choices have you at a loss? Call on 01872 321 327 or see page 90 for more details