The Board considered a report of the Strategic Director – People, advising of the costs relating to full cost domiciliary care clients who receive support from two carers, with the Council covering the cost of the second carer. Approval was sought to charge these clients for both carers with effect from 1 September 2021.
Members were aware that within Adult Social Care, a Full Cost Clients Task and Finish Group was established in 2019, to look at full cost clients in residential care and the level of support provided by the Council (which went beyond the legislative requirements) to those that were deemed able to afford the cost of their own care.
In November 2019, Executive Board agreed some changes to practice relating to this group, allowing the Council to continue supporting vulnerable people whilst also mitigating the risks to the Council. Due to the Covid-19 pandemic, it had been necessary to put those changes on hold. The Task and Finish Group had now re-convened to consider when it would be appropriate to progress with the changes.
During the course of its work in relation to the above, the group had also examined practice relating to domiciliary care clients (as well as those in residential care) and discussions took place in relation to the fact that clients with care provided by two people were only charged for one carer, with the Council paying the provider for the other.
The report outlined details relating to legislative obligations; the impact of changing practice; and the proposed course of action should the Board agree that both existing and new domiciliary care clients with two carers, who were deemed able to meet/contribute to the cost of their care, should pay for both carers.
Reason(s) for Decision
Executive Board approval is required to enable the Council to begin charging full cost domiciliary care clients with two carers for both carers (rather than one which is currently the case) in line with the Care Act.
Alternative Options Considered and Rejected
Continuing to subsidise the cost of domiciliary care provision for those with two carers who were deemed able to afford the cost of their own care was neither fair nor cost-effective. It was simply not equitable that full cost domiciliary care clients with two carers were only paying for one carer, which represents half the cost of the actual package of care.
Consideration was given to whether clients with two carers could move to single handed care, however, it was felt that two carers would only be put in place for those genuinely in need of assistance of two as determined through the assessment process. As detailed at paragraph 3.12, a review of care needs revealed that in most cases two carers were required due to the equipment that was in place and in order to ensure the safety of staff.
I September 2021.
RESOLVED: That Executive Board
<![if !supportLists]>1) <![endif]>note the contents of the report: and
<![if !supportLists]>2) <![endif]>approve the plans to charge full cost domiciliary care clients for both carers with effect from 1 September 2021.