Highly Charged - Howcharging for home care affects blind and partially sighted people

Campaign Report 14. RNIB 2000.

Executive summary

Introduction

This report looks atways in which charging for home care services affects the visually impairedpeople who rely upon the help that local authority social services provide forthem in their own homes. It draws upon a number of recent studies, as well asupon new RNIB research into the charging policies of local authorities acrossGreat Britain. One hundred and eighteen local authorities responded to RNIBsrequests for information on their charging systems, providing a valuableoverview of the current national picture of home care charging.

The report concludesthat this picture is confusing and often unfair. Visually impaired people whoreceive home care find the charges they are asked to pay vary vastly accordingto where they live, the levels of service they receive, the social securitybenefits they receive and the savings they have managed to accrue. In short,the situation is one of a "postcode lottery", where the lack ofstrong national guidance and a lack of co-ordination has led to iniquities andinequalities across the country. The recommendations listed below are aimed atnational and local government, and their swift implementation, RNIB believes,would lead to a fairer system for all.

Findings and recommendations

RNIB, along with manyother organisations which represent older and disabled people, continues tocampaign for free home care and the introduction of national standards. In theshorter term, the swift implementation of the following recommendations bylocal, regional and central government would begin to deal with the worstinjustices that charging for home care causes.

Charging systems

The current situationis confused and confusing, with a number of different systems of charging inuse, contributing to the postcode lottery of care.

There is an urgentneed for strong national guidance

from centralgovernment in both England and the Scottish Executive on individual councilscharging policies. This guidance should address systems of charging, income andsavings, levels of service and appeals against charges, and should form thebasis of a national system of home care charging.

Flat rate charging isunfair, as it takes no account of people's ability to pay or the amount of helpthey need or receive. RNIB wants to see flat rate charging abolished.

Systems of chargingwhich take account only of the hours of service a person receives are alsounfair, as they do not consider an individual's ability to pay; such systemsshould also be abolished.

Means testing can beintrusive and confusing; RNIB believes that any means-testing should be basedupon simple, clear principles.

Eligible income

The confusion causedby different systems of charging is further compounded by the ways in whichlocal authorities calculate charges and the sources of income they take intoaccount.

People who receiveIncome Support are amongst the very poorest in society, and to ask them tocontribute to the cost of their daily care needs impoverishes them further.RNIB believes that no-one in receipt of this vital benefit should have to payfor home care.

Attendance Allowanceand Disability Living Allowance

are benefits whichare aimed at helping people meet the general extra costs of disability. RNIBbelieves that they should not be regarded as sources of income against whichcharges can be made.

There should be alimit on the amount of an individuals savings which can be counted whencalculating a charge. People living in their own homes have daily costs to meetand bills to pay, and therefore, this limit should be greater than that forcharges for residential care where people do not have these costs.

Only the person whoactually receives home care should be charged; the savings and income ofspouses and partners should not be included in any charging calculations made.

Any means-testingshould always include a clear assessment of the extra costs of being disabled,and ensure that people are left with adequate resources to meet these costsbefore any charges are levied.

All home care serviceusers should have a statement of

the calculation oftheir charges made accessible to them, including the use of braille, tape andcomputer disk for those people who prefer those formats.

Appeals and reassessments

Appeals proceduresare not always fully explained or accessible, meaning that some people arepaying more

for their care thanthey actually should.

Local authoritiesshould not rely upon the appeals procedure as a means of identifying thepoorest people.

Appeals proceduresshould be made more accessible and open, with appeals being dealt with swiftlyand independently of social services or social work departments.

An appeals procedureshould never result in a reassessment of need, nor in a reduction of service;

the service a personreceives should be dependent upon their need alone, and not their ability topay for it.

Investing in care

As the populationgrows older, more and more people are likely to need home care services. Thesepeople's needs can only be met if central government plays its role andprovides adequate resources to local authorities. RNIB calls upon the UKgovernment and the Scottish Executive to ensure that all visually impairedpeople have the right to a secure and independent future by releasing the fundsnecessary to provide them with the help they need in their own homes.