Issue - meetings

[Report of the Assistant Director for Commissioning. To be introduced by the Cabinet Member for Adult Social Care and Culture.]This report sets out a suggested approach to implement care act guidance on choice and third party top-ups for placements in Adults accommodation-based services (i.e. care homes, shared lives, supported accommodation) for cabinet sign-off. A third party top-up is where a relative or a family member of a person pays the difference between the person’s personal budget, and the actual cost of a service.

The report outlines a policy tantamount to the formalisation of existing practice. The policy sets out how residents will be given a choice of service if they are accessing accommodation-based services, and when a third party top-up may apply.

The Cabinet Member for Adult Social Care and Culture introduced the report which set out the obligations of the Council to ensuring that residents were given an appropriate choice of good quality care homes. The policy also put in place a framework to manage circumstances where residents choose to live in a costlier environment, and how they can use ‘third party top-ups’ to access their preferred choice.

The Cabinet Member outlined that this policy builds on existing practice and seeks to ensure that residents have a consistent experience in choosing a care home or other service. The policy also ensures that the Council was compliant with its obligations under the Care Act (2014)

RESOLVED

1. To agree the approach for calculating service users’ personal budgets as set out in paragraph 5.3 of the attached report.

2. To agree the third party top-up policy for accommodation based services attached as Appendix 1.

Reasons for decision

The Care Act 2014 and The Care and Support and After-care (Choice of Accommodation) Regulations 2014 allows local authorities to apply third party top-up arrangements where service users/families choose accommodation-based services to meet identified needs which are more expensive than the local authority usually pays and exceeds the service user’s personal budget. A third party top-up is an arrangement whereby a person known to a service user pays the difference between the cost of a service and their personal budget.

Currently, personal budgets are calculated based on the market rates of placements identified to meet individual needs. Haringey does not currently have a formal choice or third party top-up policy for accommodation-based services. This in practice means that fees paid for given placements varies widely. This fee variation is not always a reflection of differences in need or limits in supply, but in some cases may reflect service users and family members choosing particular placements that are of higher cost. This in effect leads to a higher personal budget than the assessed needs would require.

The Council does occasionally reach agreement with service users and their families for a ‘third party top-up’ where there is a difference between the care home a service user/family chooses to live in and their personal budget, based on the costs of a placement which meets their needs. However, this is not implemented consistently.

All of our North Central London neighbouring local authorities have a top-up policy. These are summarised in Annex 1 but the approach taken is largely consistent within each borough. In essence, where service users are presented with a choice of services which can meet their needs, but reject these in favour a more expensive option than their personal budget allows, then the service user must fund the difference between their preferred placement fee and their personal budget via a third party top-up.

In most instances within Haringey’s neighbouring local authorities the difference between a service user’s personal budget and the total cost of a service is funded via a third party top-up because a service user’s income and savings  ...  view the full minutes text for item 82