Agenda item

[Report of the Director for Adult Social Care. To be introduced by the Cabinet Member for  Adult Social Care and Culture.] Report setting out the findings of the consultation with proposed recommendations with regards to the proposal to bring disability related expenditure disregard more in line with other London Boroughs by April 2019.

The Cabinet Member for Adult Services and Social Care introduced the report which set out the outcome of the consultation which was undertaken between 17^th July and 4^th September 2017 on the proposal for Adult Services to operate a DRE [Disability related expenditure] of 40%, (£22.04 per week) by 2019/20 to deliver £328k savings.

The Cabinet Member provided assurance that there would be a phased reduction to meet the 40% threshold by 2019/20. It was important to note that residents would still be entitled to an assessment. Whilst being expected to make a fair contribution to their care, they would have protected from experiencing financial hardship.

In response to questions from Cllr Engert:

• Individual Assessments would ensure that no one would be in a situation where they cannot pay contributions to their cost of care.

• The boroughs listed were not outlier boroughs but those which had responded to the Council’s request for information on their DRE policy.

• Given the level of cuts the Council was facing and the current wider financial climate, there was, unfortunately, a need to make smaller savings and this situation was unlikely to change.

RESOLVED

1.    To consider and take into account the feedback from the consultation undertaken.

2.    To consider and take into account the equalities impact assessment of the proposals on protected groups.

3.    To consider and take into account the actions proposed to mitigate the impact of the proposals on the protected group i.e. service users.

4.    To approve the phased reduction in DRE disregard to 40% (£22.04) by 2019/20 and the offer of individual financial assessment for service users who are concerned about financial hardship.

Reason for decision

The consultation highlighted that of the 20% of those people who responded 75% disagreed/strongly disagreed to increase charges by reducing the standard DRE, 60% did not feel they could financially manage an increase in their contribution of between £5.00 to £14.00 per week and 62% disagreed/strongly disagreed with bringing DRE in more in line with other Councils by 2019. The quantitative responses showed that the reason for this was mainly due to concerns around financial hardship and having to spend more money on their care.

In responding to questions that would mitigate these concerns, 47% of respondents indicated that they would take advantage of an individual financial assessment. This will continue to ensure that concerns around financial hardship and having to spend more money on care are offset by the assessment helping to identify additional expenses related to disability over and above the standard disregard and if appropriate reduce the contribution.

Therefore, if the proposal is agreed, as part of the implementation, everyone directly affected will be financially reviewed and offered an individual disability related expenditure assessment to identify additional expenditure above the standard disregard.

It should also be noted that if the individual assessment results in the actual expenditure being less than the standard disregard, then the standard would be applied in the assessment to ensure that people are not paying more as a result of the assessment.

The consultation document also outlined that the proposed reduction would be introduced over a period of time rather than a single step, explaining that the increase would be phased in from 01 December 2017 to 01 April 2019. The majority of responses (over 80%) agreed with this proposal.

The table below illustrates the increase in weekly charges as the standard disability related expenditure disregard is reduced from December 2017 to April 2019, providing those effected with the time to manage the impact more proactively

(figures in the table are calculated using benefit rates and Department of Health guidance for 2017/18 and are subject to change).

It has also been identified that there are a number of further risks that may result from the introduction of the proposal, beyond those concerns of financial hardship and paying more for care. Firstly, that people will choose to reduce or cancel care and support which could have an adverse impact on their own health and wellbeing and secondly, and as a consequence of this, that this has a negative impact on their family carer(s), family members and/or friends who may have to provide additional care and support.

However, as it is proposed that everyone directly affected will be financially reviewed and offered an individual disability related expenditure assessment to identify additional expenditure above the standard disregard and the fact that the approach will be phased in over a 3-year period to allow people to plan and reorganise their finances, it is reasonable that these additional risks will be mitigated.

The financial context of this proposal is reflected in the Mid-Term Financial Strategy, 2017 – 2019, approved by Cabinet on 14^th February 2017 and Full Council on 27^th February 2017. This seeks to address the challenging financial climate faced by the Council over the coming years due to reducing funding and increasing demand. The proposal for Adult Services is to operate a DRE of 40%, (£22.04 per week) by 2019/20 supports this challenged position by delivering £328k savings over this time and reduces the disparity between Haringey’s more favourable level of disregard compared to other London Boroughs

Due consideration has been given to all the information available, that places an emphasis on balancing the response from the consultation, the concerns raised, the proposed mitigations and the challenged financial position of the Council.

Based on this it is felt that; the mitigations offered by the continued provision of an individual disability related expenditure assessment and a phased introduction of the proposal over three-year period; the requirements of the MTFS to deliver savings and the future financial sustainability of Adult Services; off-set the consultation responses which disagreed with the proposal and therefore mitigate the concerns raised. 

Alternative Options Considered

The main alternative option considered is that the current disability disregard of 65% is not reduced to 40% to deliver the MTFS savings proposal of £328k; however, this would result in serious financial gap, which would jeopardise the sustainability of services in the future, and leave Haringey as an outlier in terms of applying DRE disregard.

A further alternative considered was to move to a flat rate DRE disregard. This option could potentially deliver additional savings above the £328k by 2019/20, but has not been progressed at this stage as it was not proposed in current MTFS plans. 

No further options have been considered given that those available to the service are limited, the financial reductions required, the need to ensure compliance with our statutory responsibilities, our commitment to the continued delivery of high quality service provision that supports the needs of the people we support and ensuring future financial sustainability.