APPENDIX 16
Memorandum submitted by Social Services
and Housing, Herefordshire Council (SF 27)
INTRODUCTION
1. This paper has been written following
consultation with several workers from social services in Hereford.
Other than the general comment that loans should all be replaced
by grants, it identifies three key themes. Paragraphs 2 to 5 discuss
some of the difficulties social services staff have in planning
provision for clients where Community Care Grants are identified
as one of the resources to be accessed. Paragraph 6 discussed
problems relating to the size of funds allocated to local offices
for Community Care Grant provision. Paragraphs 7 to 9 discuss
the part that Budgeting Loans could play to alleviate poverty
for certain people in receipt of Incapacity Benefit who are forced
to live, in effect, below Income Support levels as a result of
their need to pay for medication.
COMMUNITY CARE
GRANTS
2. When Community Care Grants were introduced
they were done so with the idea that they would, in effect, create
a partnership between the benefits system and local authority
social workers—
"The aim will be to develop a more effective
and responsive system than exists at present, and one which can
bring the resources provided by this part of the benefit system,
by local authority personal social service departments, and by
health authorities together in a more cost-effective way to meet
needs" ("Programme for Change", Cmnd 9518, 1985,
para 2.98.)
This partnership would ensure that vulnerable
and needy people living in the community received some additional
financial support to allow those at risk of requiring residential
care to remain in the community, or re-establish themselves in
the community following a period in residential care. The grants
also provide support for certain other groups of people with low
benefit based incomes during periods of severe financial hardship
who require specified items, or help with transport costs to make
certain journeys e.g. hospital visits.
3. Whatever the hopes for the "partnership"
between social workers and the Social Fund might have been, the
reality is that many social workers experience difficulty accessing
the financial help they need for their clients to remain in or
to enter into the community. It is almost unheard of for social
work staff to have any active communication with Social Fund staff
in any way other than, perhaps, a supporting letter that is written
by the social worker to accompany the claimant's application.
Given this situation, it is frequently the case that where an
eligible claimant is refused any or some of the requested assistance,
the claimant is unable to meet the basic requirements that s/he
needs to survive adequately without danger of a deterioration
of the situation. Current practices do not allow Social Fund staff
to make any realistic risk assessment of what the likely consequences
would be of disallowing some, or all, of the claim. Active (re)development
of the links between social services and the Social Fund would
reduce the risks for some of the most vulnerable claimants that
come with inadequate resources to meet their needs.
4. Obviously a move to a more collaborative
process would require social workers to act with integrity and
responsibility where they influence the award process so that
there is no indiscriminate, blanket support for any given worker's
clients. This could be ensured to a large degree by linking supportive
statements with what has been recorded within the claimant's Community
Care Assessment. Making links between Community Care Assessments
and Social Fund payments would ensure that resources are targeted
at those most in need of help. It should be noted that this does
not imply that Community Care Assessments are shared with Social
Fund staff, but rather that the social worker is able to confirm
that a Community Care Grant would facilitate meeting the needs
of the individual as identified in the Community Care Assessment.
5. If this "partnership" also
allowed for "agreements in principle" on awards in advance
in situations such as when a person is moving out of residential
care, it would allow those planning resources and services to
do so from an informed position. At the moment social work staff
may be engaged in the planning process to move someone into, or
maintain them in their own home in the community, not knowing
until plans are too far advanced to either cancel or postpone
whether or not there will be sufficient funding for the client
to purchase essential household items or not. This is clearly
an unsatisfactory situation.
6. Recent developments in the way disabled
and vulnerable people are supported, including the forthcoming
Supporting People provisions, mean that more and more people are
seeing community provision as a viable option instead of traditional
residential care. As a consequence more people are either moving
out of residential care or are seeking to access greater levels
of support to live in the community. This in turn means that there
are larger numbers of people "competing" for Community
Care Grant funding. This being the case we now find that there
are people being offered no or reduced Community Care Grants who
previously would have been successful in their application, as
the formula to calculate the funding available to local offices
does not allow this increased demand to be met as it occurs. In
order for the Social Fund, and Community Care Grants in particular,
to meet the needs they were set up to deal with, additional funding
has to be made available to meet basic standard needs. If this
does not happen yet another "perverse incentive" will
be created where residential care becomes the favoured option
for financial reasons rather than a community placement.
BUDGETING LOANS
7. The system for budgeting loans appears
to work reasonably well for those people who are able to access
this facility. At present these loans are only available to those
in receipt of Income Support or Income-Based Jobseeker's Allowance
after a period of 26 weeks of being in receipt of one of the benefits.
The rationale behind the loans are that those people on very low
income will be able to access funding for foreseeable larger purchases
that are not of an every day nature. The effect of the regulations
on eligibility mean that those on or just above the Income Support
level of income are not able to access this facility, even where
essential spending on disability or illness related costs means
that many people are, in effect, having to live on income at less
than Income Support levels.
8. Several cases have been identified locally
where a claimant is in receipt of Incapacity Benefit, and, other
than housing related benefits, has been assessed as not being
eligible for any other benefit. These people have been experiencing
severe difficulties arising from their illness or disability,
but, due to the way in which the rules are framed, do not meet
the eligibility criteria for Disability Living Allowance. People
experiencing mental health problems or those with certain forms
or stages of cancer are particularly likely to fall into this
group. In order to cure or reduce the impact of the illness such
people are often reliant upon high levels of medication. Not being
on Income Support or Income-Based Jobseeker's Allowance these
people have to purchase their medication at the current rate.
It is not unusual for such people to require two or more prescriptions
a week. After buying the necessary medication these people are
then forced to live on less than Income Support rates. It is often
suggested that the answer is for them to purchase pre-payment
certificates that allow significant savings on the cost of prescriptions
for those needing frequent multiple prescriptions. The problem
is that for those living hand to mouth on sub-Income Support levels
there is not any money available to do this. Equally these people
do not have any provision to meet the identified needs of people
on Income Support based benefits for larger purchases as allowed
for in Budgeting Loans regulations.
9. Recently published Department of Health
(DoH) and Department of the Environment, Transport and the Regions
(DETR) guidance and consultation documents ("Fairer Charging
Policies for Home Care and other non-residential Social Services,
Draft Guidance" January 2001, DoH; "Fairer Charging
Policies for Home Care and other non-residential Social Services,
A Consultation Paper", January 2001, DoH; "Charging
and Means-Testing, Supplementary consultation document",
January 2001, DETR) clearly state that local authorities shall
not leave people with less than Income Support levels after charging
for either or both of non-residential social services or Supporting
People services. The way that prescription charges are managed
breach these requirements. In the absence of a change in the charging
system for prescriptions, a (partial) solution would be to extend
the scope of Budgeting Loans to allow those on Incapacity Benefit
to access these funds to allow for the purchase of pre-payment
certificates for medication. Again this would allow funds to be
targeted at those most in need of help, and reduce the situation
which currently exists where some people are being forced to choose
between food, fuel, or vital medication.
Mike Fry
Welfare Rights Officer
January 2001
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