4.2 FEES,
CHARGES AND
GRANTS
4.2.1 Could the Department provide an
update of Tables 4.2.1 and Figures 4.2.1? [4.2.1]
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 fell from 39% in 2000-01 to 38% in 2001-02
and 36% in 2002-03. 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.
3. 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
recoupthe amount recouped rose from £1,388 million
in 2000-01 to £1,434 in 2001-02 and £1,535 million in
2002-03.
4. Note that residential allowance is no
longer available to individuals entering independent care homes.
Transitional arrangements were in place for residents in receipt
of the residential allowance prior to April 2002. It ceased entirely
for existing residents from October 2003. The fall in the recoupment
rate in 2002-03 may, in part, reflect the inclusion of former
Preserved Rights clients for whom local authorities assumed responsibility
in April 2002.
5. The amount recouped for home care and
home help service also rose from £200 million in 2000-01
to £211 million in 2002-03; in each year it represented 12%
of gross expenditure.
Variations in charges for domiciliary services
6. 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.
7. At the local council level, there is
a wide variation in the amounts raised in sales, fees and charges
made for 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 observedalthough
the first statutory guidance published on charges for domiciliary
services was not required to be fully implemented until April
2003.
8. 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 fully reflected in
the table covering 2002-03.
9. 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.
10. 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 five authorities to 25% or more
also in five authorities. The middle 50% of authorities had recoupment
rates between 8% and 15% compared to rates between 7% and 16%
for the previous year.
11. For meals services the overall England
recoupment rate was 43%: LA figures range from zero in 23 authorities
to 96% in one authority (six authorities reported no expenditure).
The middle 50% of authorities had recoupment rates between 18%
and 54% compared to rates between 28% and 58% for the previous
year.
Variations in charges for residential services
12. 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.
13. 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
36%. LA figures varied between 0% in one authority and 52% in
two authorities. This may again just reflect misreporting by local
authorities. The middle 50% of authorities had recoupment rates
between 32% and 39%, as against 33% and 42% in the previous year.