Proposed Domiciliary LCO Committee - The National Assembly for Wales (Legislative Competence)(No. 4) Order 2008 relating to charging for Non-Residential Social Care (Domiciliary Care)

1.  What are your views on the general principle that legislative competence in the area identified in Matter 15.9 be conferred on the Assembly?

Help the Aged in Wales welcomes the general principle that legislative competence in the area identified as Matter 15.9 be conferred on the National Assembly for Wales. Whilst the aspiration of Help the Aged in Wales is for the abolition of home care charges in Wales, we believe that conferring power in this matter will enable the Assembly to achieve a more consistent approach to charging whilst it still exists.

Fees for domiciliary care are currently a highly contentious issue in Wales, on a number of levels, not least because in 2006 the Welsh Assembly Government abandoned its pledge to provide free home care for disabled people.   In addition to the principle of the charge itself, the levels of charging and variations in the way charging policies are applied across the 22 local authorities in Wales, and the inherent discrimination against older people also cause anger and confusion.   Moreover the lack of affordability in some cases can lead people to a position where they do not receive the support they need to maintain their health and wellbeing.

The great majority of those in need of long-term care are older people.  With an ageing population, it is expected that the numbers of people who need support will rise substantially over the next 25 years before levelling off.   This issue of home care charges is one that affects and concerns a large proportion of the population of Wales.

We support the principle that the Welsh Assembly Government should have the powers to bring forward proposals for 'Measures’ in respect of the issue of charging for non-residential social care based on Welsh priorities and timescales.  We support the shift from residential care towards support at home and a switch towards more preventative services envisaged in 'Fulfilled Lives, Supportive Communities’ and we believe that this LCO will facilitate that switch by ensuring that local authority charging arrangements support the strategy.

The Principle of Charging

The 'means test’ leads many people who have built up assets to feel that they are no better off than had they not saved at all.   Small private pensions and savings are quickly diminished.  Moreover, it is not until they need to access the care system that most people discover that it is means tested and that they will be expected to pay.

Charges can be a huge barrier for vulnerable people at a time when they are in need of care and in many instances will prevent an older or disabled person from accessing the care that they need because paying for this help leaves them without enough money to meet other essential expenditure.  This may also hasten the need for more acute social care or even medical care and moreover the point at which an older person feels that they have to give up their independence.

The Level and Variation of Charges

In 2001 new 'Fairer Charging’ guidance to local authorities was designed to ensure that whilst authorities were able to set their charges, they needed to ensure that service users receiving basic Income Support plus a 25% buffer were not required to pay for home care services.  It also advised that although authorities could take into account disability related income, users could not be left without the means to pay for other care arising from their disability.  Despite intending to provide for a consistent approach, this guidance still resulted in wide variation of application across Wales.  With some authorities applying a broad disability disregard and others not, leading to wide variations in the levels that people across Wales were expected to pay for similar services.

New Guidance in Wales that has been applied since April 2007 increased the income buffer to 35% and implementing a 10% disregard for disability related expenditure.  This has reduced the number of people in Wales having to pay for care, and reduced the level of charges for others, nevertheless, those who continue to pay still have to contend with the postcode lottery.  In addition, those who continue to pay also in some instances saw large increases in charges implemented from 2007.

The charges range from a maximum of £16.20 per week in Rhondda Cynon Taf to £185 in Powys; other Welsh authorities do not have a maximum charge and in these instances authorities could potentially charge even higher rates per week.  Such variations are unacceptable, particularly when you consider that these charges are being levelled at individuals that are largely reliant on low, fixed incomes. In addition, there is a lack of clarity regarding the ways in which authorities arrive at the charges an individual is expected to pay which adds to the confusion.

The system remains bureaucratic and leaves people with the impression that they are being penalised for hard work and thrift in the past, as small private pensions can be easily diminished by such levels of charges.

Age Discrimination

A further reason for wanting change to the current system is the inherent discrimination against older people in the 'Fairer Charging’ guidance. The guidance enables local authorities to disregard earned income for the purposes of calculating charges, but takes into account income from sources such as, pensions.  It is older people that are most likely be in receipt of pensions, so this clause adversely impacts on older people and is therefore discriminatory.

We strongly believe that this can be tackled within the current powers of the Assembly and should not be delayed whilst the LCO is sought.  Eradicating age discrimination was a priority for the first phase of the Strategy for Older People in Wales, and will continue to be so through the second phase of the Strategy.  We believe that tackling the age discrimination within the Fairer Charging Guidance, will provide a clear commitment on the part of the Welsh Assembly Government to making this priority a reality.

Caution

Whilst Help the Aged in Wales supports the aim of the Welsh Assembly Government to seek power in this area to enable them to mitigate the variations in charging, we are concerned to ensure that charges are not levelled up.  Levelling up of charges would mean that recipients of home care would be levied at the highest level of existing charges.  This would be detrimental to the health and wellbeing of both the older people in Wales and those with disabilities.

Our overall aim remains free home care, and we will continue to press this case, whilst supporting steps towards such a position.  We believe that competence in the area of home care charging should be viewed as such, particularly as the Deputy Minister has confirmed that the LCO would be broad enough for the implementation of nil charges.  

2.  What are your views on the terms of the proposed Order e.g. are they too narrowly or broadly drawn?

Help the Aged in Wales supports the terms of the proposed order, we believe that the order needs to be drawn widely.

We hope that the proposed definition of 'social care’, whilst relating specifically to 'non residential’ services, will encompass the broadest range of support available to older and disabled people including day centres, etc.

We would urge the Assembly to make use of definitions and terminology that are widely understood and that have been tested, to ensure that the Order and future measures are clear and unambiguous.

3.  Do you consider that the excepted matters would hinder the effectiveness of any future proposed Measures brought forward under Matter 15.9?  If so, please explain why.

At this point we have no comment on the potential of the excepted matters to hinder the effectiveness of any future Measures.