Fees Charges
North Ayrshire Council · 6 February 2025
Back to Integration Joint Board — 6 February 2025 and its agenda
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Integration Joint Board 6th February 2025 Subject : Fees and Charges 2025-26 - Social Care Services Purpose : To outline the proposed charges for provided adult social care services for 2025/26 which will form part of the annual review of the Charging Policy and will inform the IJB budget setting process for 2025/26. Recommendation : To approve the proposed charges and remit this to a meeting of North Ayrshire Council for formal ratification. Direction Required to Council, Health Board or Both (where Directions are required please complete Directions Template) Direction to :- 1. No Direction Required 2. North Ayrshire Council X 3. NHS Ayrshire & Arran 4. North Ayrshire Council and NHS Ayrshire & Arran Glossary of Terms NHS AA NHS Ayrshire and Arran HSCP Health and Social Care Partnership 1. EXECUTIVE SUMMARY 1.1 Charging and contributing for social care services in North Ayrshire is aligned with the annual update of COSLA National Strategy and Guidance for Charging Applying to Non-Residential Care Services and the Charging for Residential Accommodation Guidance (CRAG). The National Guidance is intended to assist Local Authorities and Integration Authorities to determine whether to charge a person for social care support, and in calculating how much - which is usually done through a financial assessment process. 1.2 This report details proposed charges for social care services for 2025/26, which will be reflected in the Integration Joint Board’s Revenue Budget and seeks IJB approval to submit these proposals to North Ayrshire Council to approve these charges as part of their 2025/26 budget setting. The schedule in Appendix 1 sets out the current charges, proposed 2025/26 charges and indicative charges for the following two years. The revised charges are estimated to increase income by £547k in 2025/26, this will partly offset increased costs, a shortfall in current income collection and support the overall revenue budget position.
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1.3 The proposed charges for 2025/26 are informed by a review of current charges, benchmarking with other areas and with consideration of the costs of delivering services. The outcome of this being an individual charge uplift basis rather than a general inflationary increase to charges across social care services, this also includes the introduction of new charges for services. The proposals have been shared and discussed at the IJB Finance Working Group. 1.4 The approved charges will be included in the annual review of the Charging Policy which will be published on the NAHSCP website, service users directly impacted will also be communicated with in advance of the new financial year. 2. BACKGROUND 2.1 North Ayrshire Health and Social Care Partnership (NAHSCP) support adults to ensure they are able to live as well and independently as possible. To help the Partnership provide services which meet people’s identified outcomes, we may charge a contribution to the cost of the care. 2.2 The charging policy is reviewed annually and any revisions to charges and financial assessment rules are approved by North Ayrshire Council as part of the annual budget setting process. The legal basis for setting charges remains with the Local Authority, however Integration Authorities can agree charges as part of financial planning and budget setting processes. 2.3 What services do we charge for? • Administration of Blue Badge scheme • Community support (non-personal care only) • Day care • Meals at home • Telecare (includes community alarm, which is a chargeable service) • Respite care (when required for your care needs rather than to give your carer a break from caring duties) • Residential Care – including Montrose House What services do we not charge for? • Care management. • Children’s care and support. • Criminal justice social work. • Information and advice. • Needs assessment. • Respite care (when part of a carer’s assessment) • Personal care for all adults and children
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2.4 Contribution to services is determined on an individual basis by completion of a financial assessment form. This will take account of income, savings and other capital to work out how much each service user can afford to pay toward the cost of the services provided. Part of this assessment process will ensure that income is maximised and all appropriate benefits are being received. In North Ayrshire services users are supported by Money Matters to ensure benefits are maximised alongside their financial assessment for charges. Charges apply whether services delivered by the Health and Social Care Partnership directly, a provider or via a Direct Payment. 2.5 The Charging Policy is based on the following principles: • You will only be charged for the hours of care and support that you receive. • You will not be charged more than it costs to provide the service for which your charge has been assessed. • Where the charge is subject to a financial assessment, this will be based on your ability to pay, following an income maximisation assessment. • You will know how and why you are being charged. You will be treated in a fair, transparent and equitable manner. 2.6 The current charges have been benchmarked and compared to the cost of providing the service and with charges in place in other areas across Scotland. A standard increase across all charges is not being recommended for 2025/26 and instead increases will be informed by the benchmarking exercise and cost of service review, this has been shared through the Finance Working Group.
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2.7 The below from Public Health Scotland illustrates the current framework for social care charging in Scotland:
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3. PROPOSALS Maximum Weekly Charge 3.1 The 2024/25 maximum charge is £106.26 and it is proposed to increase this to £120. This will bring the maximum weekly charge in line with the other Ayrshire authorities. There are only 6 people being charged the maximum weekly charge in 2024/25. 3.2 Community Alarms- Charges for community alarms are based on a flat rate weekly charge rather than being means tested per the charging policy. 3.2.1 Revised charge for the digital community alarm service – the community alarm service is in the process of transitioning from an analogue to digital service. The digital service has additional recurring costs and this charge is being updated to fund this. Any additional income will be reinvested in the community alarm service to cover the additional costs of the digital community alarm service. 3.2.2 Introduction of a charge for a second community alarm in a household – at present we only charge for one community alarm irrespective of how many people in the house have an alarm. It is proposed to charge any second alarm in a household at 50% of the weekly charge for an alarm. 3.2.3 HRA Recharge – the 2024/25 budget included income from the HRA for the community alarms within sheltered housing. This recharge will be increased to reflect the introduction of the charge for the digital community alarm service. Any additional income will be reinvested in the community alarm service to cover the additional costs of the digital community alarm service. 3.2.4 Community Alarm – frequency of billing – It is proposed to change the frequency of billing from four weekly to quarterly in arrears to reduce the administrative burden of issuing accounts and dealing with queries. The proposed Community Alarm revised charges are set out in Appendix 1, for example the Community Alarm Service on the mainland for a 1st alarm connection will increase from £5.85 this year to £6.85 for 2025/26. 3.3 Day Care Charges for day care are means tested per the charging policy. 3.3.1 Day Care for Older People – it is proposed to increase the current day care charge of £16.49 by 20% each year from 2025/26 to 2027/28. The average cost of providing older people day care is £58.04 per day per person and it proposed to increase the contribution that day care attendees pay towards the cost of the service to reduce the gap between the cost of delivering the service and the contribution made to the service. 3.3.2 Day Care for People with Learning Disabilities – it is proposed to increase the current day care charge of £16.49 by 25% each year from 2025/26 to 2027/28. The
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average cost of providing learning disability day care is £100.49 per day per person and it proposed to increase the contribution that day care attendees pay towards the cost of the service to reduce the gap between the cost of delivering the service and the contribution made to the service. 3.3.3 Dirrans Centre – introduction of a new charge – at present services at the Dirrans Centre don’t incur a charge and it is proposed to introduce a charge equivalent to the rate paid for older people day care. The current cost of providing this service is £144.70 per day. 3.4 Financial Intervention Services – Introduction of a new charge. The Adults with Incapacity (Scotland) Act 2000 (AWI) was introduced to protect individuals with incapacity and provide support for their families and carers in managing and safeguarding the individuals’ welfare and finances. The financial intervention team has grown in recent years from one Financial Intervention Officer (FIO) to 3 FIOs, an assistant FIO and admin support due to the increased demand for the service. They cover all aspects of financial management including budget management, payment of utilities, rent, council tax, insurance as well as day to living expenses. It is proposed to charge £3.50 per week for care home-based services users and £5.50 per week for community-based service users. This will be a flat rate charge. For new cases, no charge will be made for the first 12 weeks from commencement of Appointeeship. This will allow a sufficient period of time to identify and budget income and expenditure on behalf of the individual. A waiver of charges (on an individual basis) will be applicable for those with limited funds where their annual budget does not cover the charge. This is particularly in relation to care home residents with no capital whose income is subject to an assessed charge and personal allowance. 3.5 Housing Support / Non-personal care – this is currently charged at £18.47 per hour and it is proposed to increase this to £23.08 (25%/£4.61 per hour increase), this rate is to align with the rate we pay to providers for the services. This charge is means tested per the Charging Policy and only applies to non-personal care aspects of an individual’s assessment. 3.6 Meals at home – a 5% increase is proposed for this service. This is a flat rate charge per the charging policy. Any additional income will be reinvested in the meals at home budget to reduce the current deficit that the service operates under. 3.7 Montrose House and Trindlemoss House – it is proposed to increase the weekly charge by the same percentage increase applied to the National Care Home Contract (NCHC). This is estimated as 6.3% pending confirmation of the 2025/26 NCHC rate. This charge is determined by an individual assessment and in line with separate guidance for Charging for Residential Accommodation Guidance (CRAG). 3.8 The HSCP publish annually a Social Care Charging Policy, 2024/25 version of this - Social Care Charging Policy - Non-residential and residential care services. The policy for 2025/26 will be updated in line with the approved charges and will reflect any updates from the COSLA guidance. The charging process can be complex for
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families and individuals, particularly when accessing different services and types of support, therefore there is a requirement to clearly set out our policy, this includes sharing worked examples of how financial assessments are calculated. 3.9 Anticipated Outcomes The charges proposed represent a fair and equitable approach which aligns with national policy and recognises the significant financial pressures for social care services and for some services will reduce the gap between the cost of providing the service and the contribution made by the service user. 3.10 Measuring Impact Charging income will be monitored as part of the 2025/26 budget monitoring reports presented to the IJB. 4. IMPLICATIONS 4.1 Financial The estimated financial impact is per below. The projected additional income of £186k will be incorporated into the financial plans for the IJB for 2025/26. Projected Additional Income (gross) £547,000 Less amounts to be reinvested to meet the additional cost of delivering the Community Alarm digital service (£161,000) Less the current under recovery of income (£200,000) Projected Additional Income (net) £186,000 4.2 Human Resources None 4.3 Legal None 4.4 Equality/Socio-Economic An EQUIA has been completed, this recognises that charges will continue to be applied on an individual basis by the completion of a financial assessment form, that the policy is applied equally to all adult service users and will not impact on the level of care provided. Although increased charges may impact on the ability to pay, the policy maintains mitigations around the ability to pay, ensuring continuing to ensure income is maximised including benefits. The introduction of a charge for financial intervention services could not be consulted on as the service users can lack capacity. The proposal was instead referred to the Chief Social Work Officer for consideration on their behalf and there is support for the proposal to introduce a charge.
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4.5 Risk The report falls in line with the agreed risk appetite statement which is a low-risk appetite in respect to adherence to standing financial instructions, financial controls and financial statutory duties and a high-risk appetite in relation to finance and value for money. 4.6 Community Wealth Building None 4.7 Key Priorities The ability to deliver on our strategic priorities may be compromised due to the greater financial risk faced in 2025/26. This report will contribute to reducing this risk by identifying additional income which will contribute overall to service sustainability. 5. CONSULTATION 5.1 The IJB Finance Working Group have considered the policy and approach for charging next year at two workshops. The proposals have been shared with North Ayrshire Council finance colleagues to ensure these are considered as part of the budget setting process for North Ayrshire Council. Following formal approval individual communications outlining the changes to charges will be sent to the following groups of service users: • Digital community alarm services – increased charge • Second community alarms in a household – new charge • Dirrans Centre – new charge • Older People Day Care – increased charge • LD Day Care – increased charge This communication will outline the approved charges for 2025/26. The actual contribution to services that each person will make is determined on an individual basis by completion of a financial assessment form. This will take account of income, savings and other capital to work out how much each service user can afford to pay toward the cost of the services provided. These assessments will take place from March 2025 onwards and service users will be provided with information on how to contact services if there are any concerns. Caroline Cameron, Director Author - Eleanor Currie, Principal Manager Finance eleanorcurrie@north-ayrshire.gov.uk Appendix 1 – NAHSCP Proposed Fees & Charges
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The figures highlighted in yellow are estimated pending the issuance of the Charging for Residential Accommodation Guidance (CRAG). This is usually issued by the Scottish Government in mid-February. North Ayrshire Health and Social Care Partnership Proposed Fees & Charges for 2025-26 to 2027-28 Ref Charge Description Current Approved Charge excluding VAT (2024/25) £ Proposed Charge (2025/26) Indicative Charge (2026/27) Indicative Charge (2027/28) 1 Maximum Weekly Non-Residential Charge £106.26 £120.00 £126.00 £132.30 2 Care at Home Adults £18.47 £23.08 £24.23 £25.44 3 Day Care - Older People (purchased and provided) £16.49 £19.79 £23.75 £28.50 4 Day Care - Learning Disability (purchased and provided) £16.49 £20.61 £25.76 £32.20 5 Day Care and Dirrans Centre (charges to Other Local Authorities) £267.42 £280.79 £294.83 £309.57 6 Community Alarms service - mainland (1st alarm in the household) £5.85 £6.85 £7.19 £7.55 7 Community Alarms service - mainland - weekly charge to HRA for sheltered housing properties £5.85 £6.85 £7.19 £7.55 8 Community Alarms service - Arran (1st alarm in the household) £2.86 £3.43 £3.60 £3.78 9 Community Alarms service - mainland (2nd alarm in the household) £0.00 £3.43 £3.60 £3.78 10 Community Alarms service - Arran (2nd alarm in the household) £0.00 £1.74 £1.83 £1.92 11 Meals on Wheels £3.70 £3.89 £4.08 £4.28 12 Care at Home Older People per hour £18.47 £23.08 £24.23 £25.44 13 Financial Intervention - Management of Service User Finances - residential service users £0.00 £3.50 £3.68 £3.86 14 Financial Intervention - Management of Service User Finances - community based service users £0.00 £5.50 £5.78 £6.07 15 Dirrans Centre £0.00 £19.79 £23.75 £28.50 16 Respite (for an individual's care need rather than to give the carer a break) Age 16-24 £76.52 £81.34 £85.41 £89.68 17 Respite (for an individual's care need rather than to give the carer a break) Age 25 - 64 £95.29 £101.29 £106.35 £111.67 18 Respite (for an individual's care need rather than to give the carer a break) Age 65+ £175.10 £186.13 £195.44 £205.21 19 Sleepover £14.50 £15.45 £16.22 £17.03 20 Trindlemoss House - permanent placement £1,190.70 £1,265.71 £1,329.00 £1,395.45 21 Montrose House - permanent residential placement (capital below £34,999)* £825.94 £877.97 £921.87 £967.96 22 Montrose House - permanent residential placement (capital above £35,000) £1,190.70 £1,265.71 £1,329.00 £1,395.45 23 Montrose House - permanent nursing placement (capital below £34,999)* £948.59 £1,008.35 £1,058.77 £1,111.71 24 Montrose House - permanent nursing placement (capital above £35,000) £1,378.13 £1,464.95 £1,538.20 £1,615.11 25 Sleepover £14.50 £15.45 £16.22 £17.03 26 Direct Payments - Personal Assistants £15.42 £16.94 £17.79 £18.68 27 Direct Payments - Agency Rates £18.47 £23.08 £24.23 £25.44 28 Direct Payments - Sleepovers £14.39 £15.83 £16.62 £17.45 29 Blue Badge (charge for a three year period) £20.00 £20.00 £20.00 £20.00