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Paying for extra care services


Extra Care is specially designed housing with on-site care and support to offer older and disabled people an alternative to moving into a care home. Extra Care encourages people to live more independently. The Extra Care scheme makes sure that there are care staff available 24 hours per day and 7 days per week

You will receive a full care assessment from your care co-ordinator and the services that you need will be shown in your care plan.

Where you receive an Extra Care service arranged by us, a financial assessment will be carried out with you to see if we can help towards the cost of your service. 

The cost of your Extra Care service

The cost of your service includes a standard charge for each Extra Care tenancy.  This standard charge includes a charge for an overnight and emergency response by care staff. If you are going to be away from your home on a temporary basis you will continue to pay this charge. 

You will also be expected to pay a Care Charge per hour as directed by your Care Plan up to your maximum weekly contribution.
 
There are additional costs that apply to Extra Care housing and the costs vary depending on the Extra Care scheme. These are:

Rent

Flats are leased on a private tenancy basis from the housing provider. The housing provider will inform you of the amount of rent you have to pay and how to make these payments.

You may be able to apply for help from Housing Benefit, but some costs are not covered by Housing Benefit, and you will have to pay these yourself. These costs include charges for water, heating, and some meals. 

Payment of Housing Benefit will depend on your financial circumstances and the Extra Care Estates Manager will help you to make an application for Housing Benefit if you qualify.

Council Tax

You may not have to pay Council Tax if, for example, you receive Guaranteed Pension Credit. The Estates Manager will help you to apply for a Council Tax Reduction if you qualify.

Other costs

You would also be required to pay for electricity charges, telephone costs (if you have one) and any other personal expenses.

Estate Managers Charge

This covers some tasks including the day-to-day maintenance of your home and the management of these tasks. This also includes maintaining the security of your home and controlling access to the building. If you are going to be away from your home on a temporary basis you will continue to pay this charge. 

Couples

If you are part of a couple and only one of you requires a care service, the person receiving this care will be charged the standard overnight and emergency response charge. If that person moves out of the scheme, and their partner is still living there, the partner will be charged for this cost.  
 
If both you and your partner receive care services, there will be only one standard overnight and emergency response charge.  You will both need a financial assessment to see how much each of you has to pay towards your care and whether you are able to get help from us towards this cost. 

We advise that you do not make a decision on taking an Extra Care tenancy until you are aware of all of the costs.

How the cost of your care is calculated

The Government has set down very detailed regulations and guidance to calculate an individual's contribution towards the cost of your care, which the council must follow. To enable us to do this, we will need to carry out a financial assessment.

If you have savings or capital over £23,250 you will need to pay the full cost of your care. 

If you do not want to give us your full financial information, you will be asked to sign a form to say that you do not want a financial assessment and you will need to pay the full cost of your care.

The cost will depend on how much care you receive, but the most you will be asked to pay is £582.00 per week.

Arranging a Financial Assessment

The Financial Assessment Team will contact you to arrange an appointment to undertake a financial assessment. You may be contacted by a member of the financial assessment team by telephone or by our outbound telephone service which is an electronic messaging service.  Calls from this service will display the number 0191 313 0650.

A financial assessment is the way that we work out whether we can help you with the cost of your care and what the cost will be to you.

The financial assessment takes place over the telephone at a time pre-arranged with you.   We will also check to see if there are any other benefits you can apply for.  If you want us to, we can either help you to claim these benefits or we can pass your details on to someone else who can help you.

During the financial assessment, you can have a member of your family or a friend present if you wish, or you can arrange for someone else to support you. If you would like a face-to-face appointment, you can arrange to visit our office to complete the financial assessment. We will treat any information you give us in the strictest confidence.

We can only come out to your home to complete a financial assessment in exceptional circumstances.  All members of the Financial Assessment Team carry identification with them so please check this before allowing anyone into your home.

Our Financial Assessment Team are very experienced and well trained and will help and guide you through the financial assessment. Don't be afraid to ask any questions or raise anything that you are not sure about.

We will complete the financial assessment form for you.  You can ask that a blank financial assessment form is sent to you so you can complete it yourself if you wish. 

Information sharing

Under the Welfare Reform Act 2012 and The Social Security Act (information sharing in relation to welfare services etc.) Regulations 2012, we can access information on your benefits from DWP to help us with your financial assessment.  This will also help us to offer you advice on any benefits you may be able to apply for.

This will also help us to complete the financial assessment quicker as we will not need to ask you as many questions about your benefits.

Information needed for a Financial Assessment

You will need to have the following information available in order to complete a financial assessment:
 
Details of income

  • All Pensions - state/private/occupational/inherited
  • All Disability Benefits eg Disability Living Allowance/Personal Independence Payment/Employment Support Allowance
  • Any other income 
  • Partner's income if Guaranteed Pension Credit, income related Employment Support Allowance, Universal Credit or Income Support is in payment

We will also need to know whether you have any ongoing benefit claims

Details of all capital and assets

  • Bank balances (inc. current accounts, any savings accounts and post office accounts)
  • Details of stocks and shares (PEP, ISA etc.)
  • Bonds such as Pensioners, Savings or Income/Premium Bonds
  • Any property owned, including the home you live in and any other property you own (for Residential Care, Extra Care & Supported Living services)
  • Any property owned that you do not live in (for non-residential care services) 
  • Any other capital, savings, or investments (including life assurance)

Details of home expenses 

Please note that home expenses can only be allowed for up to 6 weeks for permanent residential care.

  • Rent/mortgage
  • Council Tax
  • Water Rates (for residential care only)
  • Buildings insurance (for residential care only)
  • Care Connect
  • Daily Standing Charges for Utility Bills (for residential care only)
  • Disability related Expenditure (for non-residential care only)

How we assess you if you live with a partner

If you receive a non-residential or temporary care service, we may need to ask for details of your partner's income and capital/assets.

If you are in permanent residential care the following information does not apply to you.

If you live with a partner and you are paid benefits as a couple, you will need to have your partner's information ready for the financial assessment because we must assess you as a couple.  If you are not paid benefits as a couple it may still be better to assess you as a couple as it may be cheaper for you.   We will also check to see if there are any other benefits you can apply for with your partner.

How the Financial Assessment for Non-Residential Care is calculated

This is worked out from your income and your capital, savings and assets. The Department of Health guidance sets out the minimum income levels required to cover daily living-costs such as food, clothing, energy bills, water rates, insurance, leisure activities, TV licence, telephone, and subscriptions for satellite/digital television etc.  This is reviewed annually and is called your Basic Living Allowance.

In addition to your Basic Living Allowance, we may consider other expenditure/disregards such as Disability Related Expenditure, Housing Costs etc.

When working out your contribution towards the cost of your care, the calculation we use is:

Income - Basic Living Allowance Expenses/Disregards = Maximum Assessed Contribution (Cost to You)

If the cost of your care is less than your maximum assessed contribution, you will only pay for the care you receive.  Your maximum assessed contribution is the maximum amount you can afford to pay, no matter what level of service you receive. You will not be asked to pay any more than your maximum assessed contribution.

The most that anyone would pay towards their non-residential care services is £582.00 per week.

Income not taken into account for the Financial Assessment 

There are some income and benefits which are not taken into account when we work out how much you will have to pay towards the cost of your care.  These include:

  • War Pension for veterans
  • War Widows Pension (we disregard the first £10 only)
  • War Widows Supplementary Pension
  • Mobility Allowance
  • Carers Allowance
  • Wages/salaries (we do not disregard those paid to partners/spouse)
  • Tax Credits

Personal capital taken into account

If you own a second property that you do not live in, we will include the value of this property in your financial assessment.

If you have capital/savings under £14,250 your capital/savings are disregarded in the financial assessment and your contribution will be assessed based upon your income less your expenditure.
 
If you have capital/savings over £14,250, we will take into account £1.00 for every £250 capital/savings you have over £14,250 and up to £23,250, when calculating your contribution towards your care.  This is called tariff income.
 
Example:

  • For someone with savings of £15,750. The first £14,250 will be ignored, leaving £1,500.
  • We divide this remaining £1,500 by £250 which gives us 6. Therefore £6.00 per week tariff income will be added to your income for financial assessment purposes.

If you have capital of £23,250, or over, you will not receive any help from us with the cost of your care.  If you receive residential care, you will be responsible for paying the full amount of your care as a self-funder. If you receive a non-residential care service, you will be responsible for paying the full cost of the service you receive up to a maximum of £582.00 per week.  

Gifting your capital/assets to another person

If we believe that you have given away your assets, such as money or a house, to reduce the amount you pay for your care, we may still include the amount you have given away in your financial assessment.   

We will consider the timing and the reason why you gave away your assets. For example, we will look at whether you gave away your assets at a time when your health meant that you would be likely to require care services from us in the future.

If this happens and you are unable to pay the cost of your care, then the people you gifted your asset to may have to return the asset to you or pay your outstanding care costs.

How a property is treated for Financial Assessment Purposes

The treatment of your property during a financial assessment will depend upon the type of care service you receive.

Non residential care (excluding extra care and supported living)

The value of any other properties you own will be included in the financial assessment. If the value of your other properties and your capital/savings are £23,250 or more, you will have to pay the full cost of your care.

Extra care and supported living

If you move into Extra Care or Supported Living, and own a property, the value of your home will usually be included in the financial assessment from the date you move into your new tenancy. If your property and/or capital totals more than £23,250, you will have to pay the full cost of your care.

Short term/respite/temporary care

The value of the home you live in will be ignored if your stay in a care home is only temporary, and it is expected that you will return home usually within 52 weeks. The value of any other properties you own will be included in the financial assessment. If the value of your other properties and your capital/savings are £23,250 or more, you will be charged in full for the services you have received, and you will become a self-funder after 12 weeks. You will then be charged by the care home direct.

Permanent care

For permanent residential care the value of the home you lived in will usually be included in the financial assessment 12 weeks after your stay becomes permanent.  During the 12 weeks you will only pay what the financial assessment shows you can afford from your income and savings.

If the value of your other properties and your capital/savings are £23,250 or more, you will be charged in full for the services you have received, and you will become a self-funder after 12 weeks. You will then be charged by the care home direct.

If you sell your home before your stay has been permanent for 12 weeks, then the money from the sale of your home will be included in the financial assessment from the date your home was sold.

When the value of your property is not included in your Financial Assessment

Sometimes the value of your home will not be included in the financial assessment if one of the following people still live there:

  • your partner
  • a member of your family who is aged 60 or over, or is aged under 18 and is a child for whom you have responsibility to care for
  • a member of your family who is ill or disabled (this means they are receiving or could be receiving a disability benefit)

We also have an option to ignore the value of your home where someone continues to live there and does not meet the criteria in the above categories.  This may be discussed during the financial assessment.

If your property is taken into account for a Financial Assessment

If your property is taken into account in the financial assessment, you have a number of options for paying your care fees:

  • If you do not wish to sell your property during your lifetime you may choose to sign up to the Deferred Payment Agreement. This agreement offers you a loan from Durham County Council.
  •  If you wish to sell your property, you may be able to use your savings to pay your care fees or you can apply for a Deferred Payment Agreement for a loan from us, until your property sells.
  • You may choose to rent out your property. The rental income you receive, along with your other income and savings, may cover the full cost of your care fees, if not, you may wish to apply for a Deferred Payment Agreement.
  • You could release equity from your property. This would mean you would have access to some of the capital tied up in your home. You would need to discuss this with a financial advisor.
  • A family member may choose to pay some of the costs of your care for you.

You should take independent financial and legal advice to help you decide which option would be better for you.

Deferred Payment

If your money is tied up in your assets, eg your property, you can apply to enter into a deferred payment agreement with us. We may loan you the extra money that you need to enable you to pay your care fees until you choose to sell your property or other assets.  A financial assessment will show what you can afford to pay and what you need to borrow to pay your care fees.

If you decide to apply for a Deferred Payment Agreement and are successful, you will enter into a legal agreement with us by signing an agreement document. We then place what is called a 'legal charge' on your asset (usually a property) to safeguard the money we have loaned you. There is a charge for entering into a Deferred Payment Agreement plus an interest charge on the loan.

Find out more at The Deferred Payment Agreement (DPA).

Other expenses you might have

The Basic Living Allowance set by the government is expected to cover your basic weekly costs such as food, clothing, utilities, telephone, internet and other essentials. 

Therefore, we cannot make an allowance for any of the following:

  • Water rates
  • Insurances
  • Loans including hire purchase and catalogues
  • Pets
  • Energy bills (unless costs are above the regional average set by the Government)
  • Television licence etc.
  • Telephone bills & monthly broadband costs

Disability Related Expenditure (DRE)

We can make special allowances if you have additional expenses caused by your disability. This is called Disability Related Expenditure.

During the financial assessment certain costs relating to your disabilities will be taken into consideration. The additional costs should be over and above those of a person without a disability.

This may include things like:

  • Community alarm systems
  • Laundry costs or bedding because of incontinence
  • Energy costs - these must be over and above the national average
  • Specialist disability equipment
  • Privately paid for care, cleaning, domestic help or gardening

Please click on the Disability Related Expenditure link below for more examples of disability related expenditure we may be able to consider.  Our policy is to assess you, taking into account your individual needs and circumstances. You may have some costs relating to your disabilities that are not listed but we may still be able to take these into account.

During your financial assessment you will be asked questions about disability related expenditure to see if we can make any additional allowances. We will need you to provide evidence of these expenses. This may be a copy of a receipt/invoice for a one off purchase, or receipts/bills covering a number of months for regular costs.

We can only make allowances when we are sure that you qualify.

The following Disability Related Allowances are based on the National Association of Financial Assessment Officers (NAFAO) guidance which is updated on an annual basis.

Disability Related Expenditure

Amount

Evidence

Community alarm system

Installation Costs (calculated over a 12-month period)

Actual weekly cost, if reasonable

Bills from or payments to provider

 

Privately arranged care

Actual cost where this is not provided as part of the Care Plan, but the amount is reasonable and necessary for their care and support

Evidence of employment arrangement and/or legally correct payments to an employee under UK employment and tax law. Where agency arranged evidence of billing and payment.

Private domestic help

Actual cost where this is not provided as part of the Care Plan, but the amount is reasonable and necessary for their care and support

As privately arranged care

Specialist Laundry/washing powder

  £4.74 per week

The assessment or care and support plan may identify a need. If not evidenced from other sources and consideration of the nature and impact of any health problem or disability may provide a guide.

(Identify more than four loads per week)

Special Dietary Needs

Discretionary.  Reasonable amount where above average dietary costs are demonstrated

The assessment or care and support plan may identify a need. If not evidence from other sources, which may include medical evidence, and consideration of the nature and the impact of any health problem or disability may provide a guide.

 

Details of special purchases, including evidence of payment

Special clothing or footwear/exceptional wear & tear

Additional cost for bedding

Reasonable amount for extra cost due to disability. 

Discretionary as may not be more costly or required more frequently than usual

 

The assessment or care and support plan may identify a need. If not evidence from other sources, which may include medical evidence, and consideration of the nature and the impact of any health problem or disability may provide a guide.

Evidence of purchases, payments and receipts.

Internet access

Reasonable amount for additional cost due to disability

Evidence that costs are higher due to disability.

 

Evidence of purchase and payment.

Transport Costs necessitated by illness or disability

Reasonable amounts over and above the mobility component of PIP or DLA.

 

Where support with costs is available from other sources but have not been used this can be considered for reasonableness. For example, transport to hospital appointments or council provided transport to a day centre.

 

Evidence of payment and purchase

Gardening

Discretionary based on individual costs of garden maintenance

As privately arranged care

Wheelchair/
mobility scooter

Actual cost divided by 500 (10-year life) up to a maximum of

£4.94 per week manual

£12.00 per week powered

 

Evidence of purchase. No

allowance if equipment

provided free of charge

Powered bed

Actual cost divided by 500 (10-year life) up to a maximum of £5.46 per week

 

Evidence of purchase if

available

Turning bed

Actual cost divided by 500 (10-year life) up to a maximum of £9.55 per week

 

Evidence of purchase if

available

Powered reclining chair

Actual cost divided by 500 (10-year life) up to a maximum of £4.33 per week

 

Evidence of purchase if

available

Stair-lift

Actual cost divided by 500 (10-year life) up to a maximum of £7.71 per week

 

Evidence of purchase

without Disability Funding Grant input

Hoist

Actual cost divided by 500 up to a maximum of £3.79 per week

 

Evidence of purchase

without DFG input

Costs associated with holidays - once per year

Additional costs as a result of a disability such as ground floor room with wheelchair access would allow difference between that room and a

standard room; additional leg room on flight etc.

 

Evidence of booking and costs

Other costs

Discretion in consultation with social worker and reference to the care plan

 

Evidence of expenditure

Social Care Activities

Social care activities are distinct from leisure activities.   They must be included in the Care Plan/social activity plan as essential to meet the care need.

 

Actual cost over a 3-month period is divided by 13 weeks up to a maximum of £10.00 per activity.

 

Leisure activities (e.g., cinema visits, access to entertainment/events, swimming etc) are not allowable and are either accessed free via the local community or funded by the service user.

Evidence of purchase over a three-month period.

Cost of meals for carers/befrienders when supporting a service user as part of a social care activity

Discretionary as part of a Social Care Activity. This must be detailed in the Care Plan.

Clarification of why it is necessary for the cost of the carer's meal to be included.

 

A maximum of £5.00 per meal.

 

Meals are not allowable where Durham County Council funded care provision is in place for the same period (e.g., day care).

 

Evidence of purchase over a three-month period.

Funeral Plans

Funeral Plans are allowable.  This includes pre-paid plans and those paid in instalments.

 

Actual cost — the full amount or instalments calculated over 52 weeks

Evidence of purchase

Additional heating Costs

Actual cost less average heating costs - see table below

 

 Evidence of bills of last year

 

Average heating costs

Annual cost

 Single person - Flat/Terrace

  £2302.16

 Couple - Flat/Terrace

  £3034.24

 Single person - Semi Detached

  £2445.22

 Couples - Semi Detached

  £3220.12

 Single - Detached

  £2972.95

 Couples - Detached

  £3919.77

Receiving both Non-Residential and Residential Care Services

If you receive both non-residential care and a residential care service (including temporary or respite care), two separate financial assessments will be carried out to see how much you will have to pay towards the cost of each service.

If you receive residential care and non-residential care services in the same week, you will pay for both services.  However, the most you will have to pay will be no more than the higher of the two contributions.

If you pay the full cost of your services, you will pay the full cost of both the respite and non-residential services received.

The outcome of your Financial Assessment

Where your financial assessment takes place over the telephone, in most cases we will be able to tell you how much you will have to pay on the day of your financial assessment.

The Financial Assessment Team will always confirm your contribution in writing and send a copy of the financial assessment form and calculation sheet to you. All contributions will be backdated to the start of your service.

If you have a query regarding your contribution you should get in touch with the Financial Assessment Team by telephone on 03000 268 232 or by email at finance.assistants.fateam@durham.gov.uk.

If you are unhappy with the outcome of your financial assessment, you may appeal in writing to the Financial Assessment Team.

If you are unhappy with the outcome of your appeal, you can use our Corporate  Complaints Procedure. You can obtain a copy of this procedure from your Care Co-ordinator or by visiting our complaint's page.

If you are unhappy with the outcome of your formal complaint, you can contact the Local Government and Social Care Ombudsman.

Ways to pay your care costs

We will collect your contribution every four weeks. We will invoice you every four weeks any you can pay in any of the following ways:

  • Direct Debit - we prefer that you pay this way
  • At the Post Office/Pay Point with the invoice
  • By debit card (details are provided on the invoice)
  • By telephone or online banking (details are provided on the invoice)
  • On our website (details are provided on the invoice)
  • By returning the payment slip with a cheque to the address supplied
  • By PayPal

Unpaid Care Costs

If you are struggling to pay your care costs, you can contact our Collection Team by telephone on 03000 268 280 or by email at resourcesadultssocialcarebilling@durham.gov.uk.

They will discuss payment options with you.  Sometimes we can agree a payment plan with you to pay off the amount you owe.

Where you are able to pay your care costs but choose not to do so, the government has said that if an individual has been assessed as needing a service, that service should not be withdrawn even if they refuse to pay their care costs. However, we can take a person to court if they refuse to pay the cost of the services they have received.

Before any decision is taken to refuse a service because of the contribution you will have to pay, you should get in touch with your Care Co-ordinator.

Changes in your circumstances

If your circumstances change following a financial assessment, you must contact us as soon as possible.  For example, if your living arrangements change, or your savings/capital or benefits change, this may affect your contribution and you may need a financial reassessment.  Not telling us of a change in your circumstances could result in additional charges being backdated, and you could end up with a large bill, or possible funding assistance towards the cost of your care from us may be overlooked.

We will reassess your contribution towards your services in April each year to take account of annual increases in benefits, private pensions, and Basic Living Allowance/Personal Allowance. This is known as a financial reassessment. 

Your contribution may go up or down as a result of a reassessment. 

Getting financial advice that's right for you

There is a range of information to help you understand the way in which care can be funded and other issues to consider. You may also wish to take independent financial advice before taking any decisions.

If you would like further information on our formal charging policies and guidance, visit how much will I have to pay for care and support services?

Age UK provide independent information and advice on finding and paying for care.  You can contact Age UK Advice on 0800 169 2081.

You can access both general information about paying for care and information about accredited financial advisers in your area through the Society of Later Life Advisers (SOLLA).

The Money Advice Service, set up by the government to help people make the most of their money, offers impartial information and guidance about your money to help you work out what's right for you. Visit their website for information and interactive tools to help you make informed decisions about money. It also explains what options may be available and what you should think about before making a decision about long term care.

If you are in residential care, the Department of Health has arranged for a voluntary organisation to produce a Care Home Handbook which explains all of your rights both in choosing a care home and once you are living in a care home. You can get this free of charge from Independent Age, 6 Avonmore Road, London, W14 8RL, 0800 319 6789.

Here are some useful benefit contact numbers:

  • Attendance Allowance - 0800 7310122
  • Disability Living Allowance - 0800 7310122
  • Personal Independence Payment - 0800 1214433
  • State Pension/Pension Credit - 0800 7310469
  • Carers Allowance - 0800 7310297
  • Income Support - 0800 1690310
  • Employment and Support Allowance - 0800 1690310
  • Universal Credit - 0800 3285644



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