4. PERSONAL SOCIAL SERVICES
RESOURCES AND ACTIVITY
FIGURE 4.1.8(a)
4.2 FEES, CHARGES
AND GRANTS
4.2.1 Could the Department provide an
update of Table 4.15.1(a)-(e) [4.15.1]
1. Table 4.2.1(a) updates last year's
information and provides separate figures on residential care
for each client group. Figures 4.2.1(a) and 4.2.1(b)
illustrate the recent national trends in the percentage of
gross expenditure on home care/home help for all client groups
recouped through sales, fees and charges and the percentage of
gross expenditure on residential accommodation for older people
recouped through sales, fees and charges. The charges are not
a social services fixed rate.
2. The table shows that the percentage of
gross expenditure recouped in sales, fees and charges for residential
care for older people rose from 36% in 1999-2000 to 39% in 2000-01
(mainly as a result of increased use of the independent sector
where councils are able to recoup a higher proportion of their
recorded expenditure from charges) before falling back slightly
to 38% in 2001-02. The main reason for this is that prior to April
2002, higher rates of income support were available to people
entering independent homes compared with councils' own homes.
The chief element of income support accounting for the higher
rate is residential allowance (which equates to housing benefit
and was introduced in 1993 to give independent residential care
an edge over council homes). Most income support is taken into
account by the means-test for residential care. Therefore the
more people entering independent residential care prior to 2002,
the greater the fees and charges councils would recoup—the
amount recouped rose from £1,247 million in 1999-2000 to
£1,434 million in 2001-02. Note that residential allowance
is no longer available to individuals entering independent care
homes. Transitional arrangements are in place for residents in
receipt of the residential allowance prior to April 2002. It will
cease entirely for existing residents from October 2003. The amount
recouped for home care and home help service also rose from £187
million in 1999-2000 (representing 12% of gross expenditure) to
£207 million in 2001-02 (12% of gross expenditure, the same
as in 1999-2000).
Variations in Charges for Domiciliary Services
3. Figures 4.2.1(c) and 4.2.1(d)
illustrate the percentage of gross expenditure recovered in
charges by each local authority for home care and meals services,
the two main items of service provided in a domiciliary setting.
Table 4.2.1(b) sets out in tabular form the percentage
of gross expenditure on home care recouped through sales, fees
and charges.
4. At the Local Council level, there is
a wide variation in the amounts raised in sales, fees and charges
made from domiciliary provision. Local Councils are free to decide
on whether to levy charges and upon the level of charges, provided
that guidance on assessing ability to pay is observed—although
the first statutory guidance published on charges for domiciliary
services was not required to be fully implemented until April
2003. Wide ranges of charging policies were in operation during
2001-02, ranging from flat rate charges to income-related charges.
We have considered how best to improve the system in the light
of both the Royal Commission's report on the funding of long term
care, and the Audit Commission's study of local council charging
practices (published as Charging with Care in May 2000).
In November 2001, we issued guidance, Fairer Charging Policies
for Home Care and other non-residential Social Services. The
guidance should have been implemented in two phases, by 1 October
2002 and 1 April 2003 and will not, therefore, be reflected in
the table covering 2001-02.
5. There are a number of instances where
Local Authorities have reported that they raised no sales, fees
and charges income for home care services provided; at the other
extreme, some authorities reported recouping in excess of 25%.
Such wide variability of individual authority figures points to
issues of data quality and there is a risk that misreporting of
data by local authorities has had an effect. The current Performance
Management Framework for Best Value in Personal Social Services
will help to reinforce the message to Local Authorities that it
is important they report their PSS financial data accurately on
the central returns.
6. For England as a whole, 12% of the direct
cost of the home care service was recouped in sales, fees and
charges to clients. Within authorities, the actual figures reported
varied from zero in the case of 10 authorities to 25% or more
in five authorities. The middle 50% of authorities had recoupment
rates between 7% and 16% compared to rates between 8% and 16%
for the previous year.
7. For meals services the overall England
recoupment rate was 42%: LA figures range from zero in 16 authorities
to 93% in one authority (seven authorities reported no expenditure).
The middle 50% of authorities had recoupment rates between 28%
and 58% compared to rates between 32% and 57% for the previous
year.
Variations in charges for residential services
8. Figure 4.2.1(e) illustrates the
percentage of gross expenditure on residential accommodation for
older people recouped through sales, fees and charges. Table
4.2.1(c) tabulates these figures. Tables 4.2.1(d) to
4.2.1(f) provide similar information for adults with a
physical disability or sensory impairment, adults with learning
disabilities and adults with mental health needs.
9. The charges levied on individual residents
in care homes are determined nationally. The overall recoupment
rate for residential provision for older people in England was
38%. LA figures varied between 0% in three authorities and 56%
in another authority. This may again just reflect misreporting
by local authorities. The middle 50% of authorities had recoupment
rates between 33% and 42%, the same as for the previous year.
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