Step 4 - check your charges

This advice applies to Scotland

This advice doesn't apply to paying for residential care in a care home, nursing home or another type of housing. Read about how care home fees are worked out.

Some community care services are free but for some the council might ask you to pay a charge. Councils can do this as long as the charge is reasonable. The council will assess your income and savings to see how much you can afford to pay. You might be eligible for financial help to pay for your community care, which you can decide how to use.

You have options if you can't afford to pay or you think the charge is too high.

What the council can charge for

The council can charge for:

day care
lunch clubs
temporary stays in residential, including respite care
domiciliary services, including meals on wheels
wardens in sheltered housing
community alarms
personal care and support in the home for people under 65
laundry services
aids and adaptations for people with disabilities
practical assistance in the home and meals provided to people with physical disabilities
after-care services for people with a mental illness
Services provided under the Chronically Sick and Disabled Persons Act (CSDPA) 1970 can be charged for, so long as the charge is reasonable.

Charges for respite care

A person needing care may go into residential care for a temporary period, in order to give her/himself, and any carer, a break. A local authority can charge for temporary residential stays (including respite) of up to eight weeks, but does not have to charge. If the period is over eight weeks, then they must charge, using the rules on charging for residential care. These rules make special allowances for temporary stays.

Some beds used for respite care may be in a NHS nursing home or hospital and no charge is made for these. However this will normally happen only if a GP, not the social work department, arranges the bed.

How the charges are worked out

There are no set charges for community care services in Scotland and councils can decide what to charge for services. What you pay for a service in Edinburgh might be different to someone in Glasgow. But what they charge has to be 'reasonable'. There's no definition of what's reasonable. However, the amount charged can take into account the full cost of providing the service and administrative overheads.

After you have a free care needs assessment you should be given information about the charges for all the services you may need before you're asked to agree to the care plan. You

If a local authority is going to make a charge, it should provide written details about the charge before the person receiving services is asked to agree to the care plan which will specify the services. If a local authority fails to provide this information, it should be challenged.

In addition, it must be reasonably practicable for an individual person receiving the service to pay the charge. This is a separate test from the one in the paragraph above. The charges may be reasonable in themselves, but if the person has little income or capital, or has extra expenses (such as high heating or laundry bills), it may not be reasonably practical for her/him to pay the charge. If s/he says that it is not reasonably practical for her/him to do so, the local authority must consider her/his means. There is no clear guidance on what level of income a user has to have to make it reasonably practical for her/him to pay the charges.

COSLA (Convention of Scottish Local Authorities) has published guidance to Scottish local authorities on how they should charge for services. The guidance makes the following points:-

only the local authority can legally assess for charges although it can authorise another organisation which is providing service to collect them on its behalf
a person receiving social security benefits is not automatically exempt from charges
the local authority should, when deciding if it is reasonably practicable for someone to pay the charge, take into account the person's other financial commitments
if the person cannot afford to pay, a local authority can waive or reduce the charge.

Who has to pay the charges

It's the user of the community care services who may have to pay for the respite care, not the carer. The carer's financial position is generally irrelevant, unless s/he is the spouse or civil partner, when, in some situations, the local authority may be able to recover charges from carers.

What the council can't or shouldn't charge for

The council can't charge you for:

assessing your community care needs - assessment should always be free
personal care or personal support you're getting if you're 65 or over
advice and information about the availability of services

There's guidance that says that councils shouldn't charge if you:

have mental health problems and are subject to supervision or community care orders
are terminally ill
are 65 or over and have to get any new or additional home care services after leaving hospital - they shouldn't charge you for these for 4 weeks, but you might still be charged for any services you were getting before you went into hospital .

Free personal care for people aged 65 and over

Anyone aged 65 or over who receives free personal care or personal support at home should receive this free from the care service that provides it. If it is not the local authority that provides the service, the care agency should be paid by the local authority. The Community Care and Health (Scotland) Act 2002 lists the services which are defined as personal care or personal support. These include help with washing, dressing, mobility, and food preparation.

Help with paying for services

26aYou may want to carry out a check to see that the client is receiving all the benefits s/he is entitled to, or if there are any other ways of increasing her/his income.

More about increasing income

The Independent Living Fund (ILF

27Some clients may already be receiving help with paying for services from the Independent Living Fund (ILF). The ILF is currently closed to new applications.

More about the Independent Living Fund

Problems with charges

28A client who wants to challenge a local authority decision that s/he will be charged for services, or the amount s/he will be charged, should be warned that if her/his challenge is unsuccessful s/he will be expected to pay any outstanding arrears.

The charges are not "reasonable"

29A client may wish to challenge the level of charges because/he considers that they are not reasonable. To date, there have been no cases on what are reasonable charges. If a client wants to challenge whether a charge is reasonable, you will probably need to refer her/him for specialist advice.

The client cannot afford to pay

30A person paying for services has a right to ask for a review of the charge at any time when s/he considers s/he cannot afford to pay it. This is because it must be reasonably practical for an individual person to pay a charge. This is in addition to the charges being reasonable and it applies whatever charging system has been used and however charges have been calculated. There is no clear guidance on what reasonably practical means. However, even if a means test has already been carried out, the local authority must consider whether a persons means really are sufficient to pay the charge.

31The person receiving services should tell the local authority why s/he cannot afford to pay the charges. The reasons could include any special circumstances which apply in her/his case but could include, for example, extra costs of living due to disability which the local authority has not taken into account.

31aCOSLA guidance recommends that local authorities consider each case individually and if necessary, reduce or waive charges which a client cannot afford to pay. The guidance also says that local authorities should provide information about their policies for waiving and abating charges. The local authority may have a specific review or appeals procedure which the client can use.

Can the local authority withdraw a service if the client refuses to pay

32If the client refuses to pay for a service, the local authority cannot withdraw the service. It must continue to provide the service and will have to try to recover the debt, through the sheriff court if necessary. In some cases, the client may be willing to accept being taken to court because the court is likely to make a more realistic assessment of the client's ability to pay the debt based on her/his income and expenditure. However, a court judgement can have serious effects on a client's credit rating and ability to get credit in the future.

The local authority delays sending a bill

33A client may be told that s/he will have to pay for a service, but not be told how much or s/he may not receive a bill until the end of the financial year. The client may then find it difficult to pay the charge. A client in this position should complain about the delay and, if s/he feels s/he cannot afford to pay the amount s/he is asked to pay, challenge the local authority for acting unreasonably.

Care at home

6It is possible for a client to arrange and pay for private care at home. It may still be in the client's best interest to apply to the local authority for an assessment of her/his care needs. There are different options available for organising care and support services. For example, a client may be able to use a direct payment to purchase services her/himself rather than have the services arranged by the local authority.

More about ways that community care services can be organised

Self-directed support

http://guidance.selfdirectedsupportscotland.org.uk/

The client must be offered the following four options:

to receive a direct payment - a cash payment given to the client so that s/he has complete control over how it is spent in meeting her/his assessed needs
the local authority holds the budget but the client makes the decisions about how the money is spent and which providers it should be allocated to. This is sometimes called an Individual Service Fund
arranged services - where the local authority manages the budget, makes the decisions and arranges the support and services on the client's behalf
a mix of the first three options.

62bThe local authority must ensure that information and advice is provided to help the client make an informed choice about the way that they would like their care and support needs to be organised.

62cIf a client doesn't want to choose how her/his support services should be arranged, the local authority will decide on the support and make the arrangements on her/his behalf.

62dThe Scottish Government has published useful guides about self-directed support for people who need support and care, carers and practitioners. These guides are available from the Self-Directed Support (SDS) guidance website at http://guidance.selfdirectedsupportscotland.org.uk. More information is also available from the Self Directed Supported Scotland website at www.selfdirectedsupportscotland.org.uk.

More about self-directed support

62eAdvisers and clients can get information and advice about self-directed support from the charity MECOPP. Their 3 R's project is available throughout Scotland to anyone who needs help with issues around self-directed support. MECOPP can provide telephone advice and information, as well as casework to help deal with more complicated issues.

MECOPP
Maritime House
8 The Shore
Edinburgh
EH6 6QN

Tel: 0131 467 2994
Email: info@mecopp.org.uk
Website: www.mecopp.org.uk

Direct payments

62fA direct payment is cash paid by a local authority to someone who has been assessed as requiring community care services, services for children or housing support services (people assessed as needing equipment and/or temporary adaptations are also included). Local authorities also have the power to offer direct payments to carers who have been assessed as requiring support services. The payment allows the recipient to purchase services her/himself rather than have the service arranged by the local authority. For example, a client may use direct payments in order to employ her/his own carers or a personal assistant (PA). In this situation, the client will need to be aware of the responsibilities that s/he will have as an employer. Direct payments can also be used to purchase services from a registered care provider or from the local authority itself.

More about direct payments and organisations that can provide further help

What happens to the direct payments if someone has to go into hospital

73bWhen someone has to go into hospital for treatment any direct payments made to the person by the local authority, for personal care or support that is free, can be continued for a period at the discretion of the local authority. The local authority needs to be told that the person has gone into hospital. When the person returns home or is discharged from hospital and goes to live elsewhere the local authority should reassess the person's entitlement to free personal care and support.

How are services arranged

62If a local authority has assessed a client as needing support to meet her/his care needs, it must offer the client choice about how her/his care and support should be arranged and how the budget should be spent to best meet her/his needs. This is called self-directed support.

62aThe client must be offered the following four options:

to receive a direct payment - a cash payment given to the client so that s/he has complete control over how it is spent in meeting her/his assessed needs
the local authority holds the budget but the client makes the decisions about how the money is spent and which providers it should be allocated to. This is sometimes called an Individual Service Fund
arranged services - where the local authority manages the budget, makes the decisions and arranges the support and services on the client's behalf
a mix of the first three options.

62bThe local authority must ensure that information and advice is provided to help the client make an informed choice about the way that they would like their care and support needs to be organised.

62cIf a client doesn't want to choose how her/his support services should be arranged, the local authority will decide on the support and make the arrangements on her/his behalf.

More about self-directed support

MECOPP
Maritime House
8 The Shore
Edinburgh
EH6 6QN

Tel: 0131 467 2994
Email: info@mecopp.org.uk
Website: www.mecopp.org.uk

Direct payments

More about direct payments and organisations that can provide further help

How to challenge charges

34A client can challenge a charge by:-

asking for a review if s/he cannot afford to pay
using the general local authority complaints system for social work services, or seeking other remedies.

Advocacy

35It may be useful for some clients to have the help of an independent advocate to assist in expressing their own views about what they need. There may be a service locally or you can check what is available on the website of the Scottish Independent Advocacy Alliance at www.siaa.org.uk.

36There is no paragraph 36.

Reviews and appeals

37A local authority may have a system for reviewing charges, although it is not obliged to do so. If it does, the system should be fair and easy to use and clear information given to a person who is appealing against a charge. Reasons must be given for rejecting an appeal. A client who is not satisfied with the result of a review, or how the system operated, can complain through the local authority's general complaints procedure or to the Scottish Public Services Ombudsman - see paragraph below.

Other remedies

38The local authority's general complaints procedure about social services can be used for complaints about charges.

More about the complaints procedure and other remedies

Organisations which can help

Disability Rights UK

41Disability Rights UK produces the Disability Rights Handbook and has some useful information on its website. Its contact details are:-

Disability Rights UK
Ground Floor
CAN Mezzanine
49-51 East Road
London
N1 6AH

Tel: 020 7250 8181 (admin only) (Mon - Fri 10.00am - 12.30pm and 1.30pm - 4.00pm)
Disabled Students Helpline: 0800 328 5050 (Tues 11.30am - 1.30pm; Thurs 1.30pm - 3.30pm)
Fax: 020 7247 8765
Email: enquiries@disabilityrightsuk.org (general)
Email: students@disabilityrightsuk.org (Disabled Students Helpline)
Website: www.disabilityrightsuk.org/

Royal National Institute of Blind People (RNIB)

42The RNIB can help people who are blind or partially sighted wishing to challenge a community care charging decision. The contact details are:-

RNIB Legal Rights Service Helpline
105 Judd Street
London
WC1H 9NE

Tel: 0303 123 9999
(Monday to Friday from 8.00 am to 8:00 pm
Saturday from 9:00 am to 1:00 pm)

Email: helpline@rnib.org.uk
Website: www.rnib.org.uk

Age Scotland

43Age Scotland can provide information on charges for non-residential services:-

Age Scotland
Causewayside House
160 Causewayside
Edinburgh
EH9 1PR

Age Scotland does not provide advice at its office. People who want advice should contact the Helpline.

Age Scotland Helpline: 0800 12 44 222 (Mon-Fri 9am-5pm)
Email: Contact form available on the website
Twitter: @agescotland
Website: www.ageuk.org.uk/scotland

More about help with community care generally

Care Information Scotland

Care Information Scotland
Helpline: 0800 011 3200 (local rate) (every day 8.00am - 10.00pm)
Website: www.careinfoscotland.scot

45Care Information Scotland is a telephone and website service that provides information about care services for older people in Scotland and their carers and families. It offers detailed information on the range of community care services available from local authorities, the private and the voluntary sectors.

Endnotes

1 Scottish Executive Community Care Circular No CCD2/2001

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