10.1 Following a care act assessment, the social care worker will refer to the financial assessment and benefits team when eligibility has been confirmed, and a chargeable service is likely to be put in place to meet an eligible need. The social care worker will also provide information around estimating a person’s cost of care and how to submit financial assessments online.
10.2 If someone chooses to complete the financial assessment online, once their information is submitted, a financial assessments and benefits officer will review the information provided and complete the financial assessment.
10.3 If an online assessment has not been completed, the financial assessment and benefits team will contact the person or their representative within 4 weeks, or as soon as reasonably practicable, depending on who will be completing the financial assessment and if they have legal authority to do so.
10.4 If the person does not have the mental capacity to complete the financial assessment and there is no-one with legal authority to undertake the financial assessment, the financial assessment team will not accept the referral, and the person will be referred to the social care team to ensure the person is adequately supported with their finances.
10.5 If the referral is refused as per provision 10.4, once the person has someone legally supporting them, a financial assessment can be completed and may be backdated to the date care started (see section 5).
10.6 The financial assessments can be:
- an in-person visit from a financial assessment visiting officer in the person’s home, their representative’s home, or another reasonable venue of their choice
- completed through an online portal
- A telephone appointment with a financial assessment officer
10.7 Alternatives may be provided when the above can not be completed such as via the post.
10.8 When a person or their representative has consented to the financial assessment and received a period of a chargeable service, but the financial assessment was not completed before the person died, the council may request a financial assessment is completed where they believe the person may have needed to contribute to their care.
10.9 The council will liaise with the next of kin or the executor of the estate to request the financial assessment is completed and any contribution is paid from a person’s estate.
Capital and income
10.10 The financial assessment looks at all of a person’s capital and income during the means-test, except where the regulations say it must be disregarded, like earnings for employment. More example of capital and income can be found in appendix 2.
10.11 The financial assessment does not include any income from other household members, or partners.
10.12 When a person has joint assets, for example a joint bank account, the assessment can only take into account the share which belongs to the person with care and support needs. It will be assumed their share is 50 percent, unless the person shows otherwise.
Capital limits
10.13 Capital limits are financial thresholds put in place by central government to determine when a person can ask the local authority for financial support to meet their care and support needs.
10.14 A person may be asked to pay for all of their care if they have over the capital limit. This is known as “self-funding”.
10.15 If a person has capital between the lower and upper limit, they will be asked to contribute from both their income and their savings. The contribution from their savings is known as a ‘tariff income’ (see appendix 2).
10.16 A person will not be asked to contribute from their savings once their capital reaches the lower limit, however they will still be asked to pay from their income, if this does not fall below the Minimum Income Guarantee after disregards.
Administration fees
10.17 Where a person has over the upper capital limit, the council may charge an administration fee for arranging non residential-care and support services.
10.18 The administration fee will be an annual charge, subject to review.
10.19 The administration fee will not exceed the cost actually incurred by the council for arranging care and support for someone with over the upper capital limit.
10.20 Where someone has under the upper limit, they will not be charged an administration fee.
Deprivation and notional capital
10.21 If during the financial assessment, a council officer identifies a person may have deprived themselves of assets or income to avoid paying for care and support the council will follow an administrative process, including asking questions about a person’s expenditure to determine intention.
10.22 If the council has made the decision that someone has deprived themselves of assets they will seek to recover the lost income by:
- Charging the person as they still possess the asset or income or
- If the asset has been transferred to someone else, seek to recover the cost from the person who received it
10.23 When the person will be treated as having this capital asset or income, they will have a notional capital or notional income included in their financial assessment.
10.24 The council can only apply ‘notional capital’ if they are satisfied that:
- The person has deprived themselves of an asset
- They have done so with the intent of reducing what they have to pay towards the cost of their care and support
10.25 Alternatively, where the person has transferred the asset to a third party to avoid the charge, the council can seek to recover the difference between what it would have charged and did charge the person receiving care from the third party.
10.26 Where a person has been financially assessed as having notional capital, the value of this must be reduced over time. The rule is that the value of notional capital must be reduced weekly by the difference between the weekly rate the person is paying for their care and the weekly rate they would have paid if notional capital did not apply.
10.27 Notional income is income which
- would be available on application but hasn’t been applied for,
- is due but has not been received
- a person has deliberately deprived themselves of for the purposes of reducing the amount they are liable to pay for their care
10.28 An example of notional income is: When a person is eligible to claim a certain benefit, but chooses not to the council will treat their income as though they are claiming, and support the person to get help to claim.
10.29 The council has a legal duty to protect and prevent the misuse of taxpayer funds and may share information with the Department of Work and Pensions (DWP), HM Revenue and Customs (HMRC) and other public bodies to investigate concerns. This may result in criminal prosecution.
Outcome of the financial assessment
10.30 Written notification of the completed financial assessment calculation will be sent to the person, or their legal representative within 7 working days.
10.31 The person or their representative will be provided with the calculation used to work out how much they should pay.
10.32 The outcome of the financial assessment may be higher than an adult’s personal budget (or their cost of care), but they will only ever be charged the cost of their care.
10.33 This information will be provided in a format that the person or their representative can easily understand, in line with our duties on providing information and advice.
See also: The Accessibility Information Standards Policy
Reviewing the financial assessment
10.34 We will review financial assessments:
- When a person requires a different type of care
- Annually in line with the Department Of Work And Pensions (DWP) state benefit increase
- When a person asks us to
- When there is a change of financial circumstances
The annual review
10.35 The council will review financial assessments every year, usually in April at the same time state benefits, pensions and allowances increase.
10.36 A written notification of this change will be provided, explaining the new calculation.
10.37 If any of the information is incorrect on the review notification, the person or their representative must complete the form sent out by the financial assessment and benefits team and return it to the financial assessment and benefits team for a review.
Requests for review
10.38 The council is committed to ensuring that invoicing for social care is accurate, therefore it’s important a person or their representative notifies the council of any changes that affect their ability to pay.
10.39 The person or their representative may ask for a review at any time, especially when:
- they feel they cannot afford the assessed contribution
- they receive an increase/decrease in benefits (see 8.28)
- their financial circumstances change to ensure their charge remains accurate
- their a change disability related expenditure (see Section 17)
10.40 If charges change as a result of benefits being awarded after a financial assessment has been completed, the council will take the benefit payment into account from the date that it has been awarded from, not the date it is paid and will consider any backdated payments.
10.41 Any review will be confirmed in writing, or in accordance with the person or their representative’s communication needs.
Further information on complaints and appeals can be found in section 18
