When transitioning to adult social care a financial assessment is required to determine the level of support which may be required to assist you with paying for the care and support you require.
Everyone that has eligible care and support needs from the age of 18 onwards may have to make a financial contribution towards the cost of their care and support.
Councils in England must provide the following services free of charge:
- intermediate care, including reablement, which must be provided free of charge for up to 6 weeks; local authorities may apply their discretion to offer this service free of charge for longer than 6 weeks where there are clear preventative benefits
- community equipment such as aids and minor adaptations (a minor adaptation is one costing £1,000 or less); aids must be provided free of charge whether provided to meet or prevent/delay needs
- care and support provided to people with Creutzfeldt-Jacob Disease
- after-care services and support provided under section 117 of the Mental Health Act 1983
- any service or part of service which the NHS is under a duty to provide; this includes Continuing Healthcare and the NHS contribution to Registered Nursing Care
- any services which a council is under a duty to provide through other legislation may not be charged for under the Care Act 2014
- assessment of needs and care planning may also not be charged for since these processes do not constitute meeting needs
Any social care element of Residential Care/College placements prescribed by Education will not be subject to a charge, until Education has finished.
If you're over the age of 18 and have savings over the higher capital limit (currently £23,250) then you will be responsible for paying for any chargeable care and support costs in full, regardless of your income. Your care and support package for services provided in the community can be commissioned through the council subject to payment of an annual administration fee – details of which can be found in our Schedule of Fees, Charges, allowances and Rates.
The financial assessment and welfare benefits check
The social care team request a financial assessment when someone is considering or has agreed to receive care and support that is chargeable. Young people cannot be charged for care and support until they reach 18 years of age, but occasionally a referral is made before their 18th birthday.
The rules around financial assessments are set within the Care Act 2014, its Regulations and the Care and Support Statutory Guidance.
Councils have the power to charge for care and support services. City of York Council has a charging policy in place which supports the Charging Framework. Under this framework, people are permitted to retain income to spend on day-to-day necessities, such as food, and clothing.
If a young person is in a residential home, then the income they retain is known as the Personal Expenditure Allowance (PEA), if they reside in the community (at home, supported or sheltered accommodation or with a shared lives carer) then they retain what is known as the Minimum Income Guarantee (MIG). The amount of the MIG varies dependent upon age, circumstance, and level of benefits in payment. How a MIG is calculated is set out in our Schedule of Fees, Charges, allowances and Rates.
A Benefits and Contributions Adviser will be assigned the referral. It is their job to contact the young person or their family or legal representative. They will check the young persons entitlement to benefits and allowances and check what income replacement benefit is in payment.
If the parent or guardian of a young person with disabilities continues to receive child benefit, they can do so until the youngster reaches the age of 20. If at any point, the young person decides to claim Universal Credit, then the parent or guardian’s entitlement to Child Benefit ends. If the young person is moving out of the family home, at that point, they should claim Universal Credit.
Universal Credit is designed to provide and income and additional support for those with disabilities. If the young person is moving into supported accommodation, then Universal Credit (or in some settings Housing Benefit) should cover most if not all of the rent that the young person is expected to pay. The Benefits and Contributions Adviser will also provide advice and support relating to council tax and any other discretionary payments the young person may be entitled to receive.
Information is required to assess the young persons ability to contribute towards their care and support costs, including:
- details of the young person’s income (Benefits, allowances, and any private income such as earning or inherited pensions)
- evidence of monies being received into that person’s bank account
- 3 months’ worth of Bank statements for all bank accounts
Often, a young person may have their income paid into an account in the name of a parent or guardian, so its always worth considering the point at which the young person has an account in their own name, to receive their own income. Details of all bank accounts, savings investments are required to determine how much capital the young person has.
Details of any household expenditure for which the young person has a liability is required – for example, rent paid under a tenancy agreement, house and contents insurance, council tax, mortgage, etc. Finally, details relating to additional, necessary expenditure incurred because of the young person’s disability are required. This is known as Disability Related Expenditure (DRE) and can only be allowed within the financial assessment if the young person is in receipt of DLA or PIP.
The Benefits and Contributions Adviser will then calculate whether the young person is able to contribute towards their care and support.
There may be occasions where the young person is not claiming the correct benefits so may initially not have to contribute towards their care, however once the correct benefits are received, a contribution may be payable.
The Benefits and Contributions Adviser will help you claim the benefits you are entitled to. They can advise on claiming Universal Credit but cannot help with a claim as this process is online, or by phone where the young person has a DWP appointee in place. The Benefits & Contributions Adviser can advise about becoming an appointee and look at the benefit entitlement of others within the family should the young person become financially independent.
Financial assessments are updated each year in line with benefit and pension increases. Expenditure increases in line with the published CPR rate for the month of November, unless rates are set on a local basis (such as council tax and water). Each March, all assessments are automatically uprated for those in receipt of care and support. You will receive letter when this happens, and you are asked to get in touch if your circumstances have changed.
Failure to claim Universal Credit when the young person is eligible to receive this may be considered as income deprivation. The Care Act 2014 permits councils to financially assess people on the basis that income should be claimed and in payment.
Examples of financial assessments
Figures on these examples are for information only and may not reflect the current rates of benefits paid.
Non-residential care example 1
Sandy is turning 18 next week. He is living with his parents, but plans are in place for Sandy to move into supported accommodation in 6 months’ time. Until then, Sandy will be getting some support at home, paid for through a Direct Payment which the council is arranging for him.
Sandy receives PIP Enhanced Daily Living and the highest rate mobility component. The mobility component is never included within the financial assessment, but it is useful to know whether this is being claimed as the young person may have an entitlement to this allowance. Sandy’s parents are still receiving child benefit for him. It is their intention to help Sandy claim Universal Credit when he is ready to move, and they are DWP appointees for his benefits. The Benefits and Contributions Adviser provides them with information about opening a bank account for Sandy so he can receive his Universal Credit and PIP payments in due course, and the number to call to start the Universal Credit process.
All figures are converted to weekly sums. The financial assessment is calculated as follows:
Income:
- PIP - Enhanced Daily Living: £91.40
- Total income: £91.40
Deductions:
- Household Expenses: £0.00
- Disability Related Expenditure
- Additional Laundry: £4.12
- Additional Heating: £2.22
- Total deductions: £85.06
- Income minus deductions: £6.34
- Less Minimum Income Guarantee: £136.45
- Ability to Pay: £0.00
Non-residential care example 2
It’s 6 months later and Sandy’s parents have already claimed Universal Credit. Sandy has had an assessment regarding his ability to work with the DWP and he has been advised that he has limited capability for work related activity. This means he gets additional money in his Universal Credit each month and he doesn’t have to look for work.
He is moving next week, and his rent is £114.50 a week. His parents have submitted details of his rent to Universal Credit together with a copy of his tenancy agreement and confirmation that he is not liable for rent until his move date. His rent will be covered in full. He is not liable for council tax.
Sandy’s parents have bought contents insurance for when he moves, and specialist kitchen equipment that is needed to ensure that Sandy can enjoy his meals in his new surroundings.
Income:
- Universal Credit: Standard Amount (under 25's): £61.70
- Limited Capability for Work Related Activity: £82.39
- PIP - Enhanced Daily Living: £91.40
- Total income: £235.49
Deductions:
- Household Expenses:
- Contents Insurance: £2.10
- Disability Related Expenditure:
- Additional Laundry: £4.12
- Specialist Equipment replaced annually: £5.32
- Total deductions: £11.54
- Income minus deductions: £223.95
- Less Minimum Income Guarantee: £136.45
- Ability to Pay: £87.54
Residential care example 1
Samira is 19 and has spent most of her teenage years in a specialist care home. At the age of 18, her parents claimed Universal Credit for her. She has had a vehicle paid from her Mobility Payment since early childhood and is frequently taken out on day trips from the care home in her car. As Samira has been in care funded by the local authority, she no longer received the care element of PIP, however she retains an underlying entitlement to claim this should her circumstances change.
Income:
- Universal Credit: Standard Amount (under 25's), less tariff income: £25.70
- Limited Capability for Work Related Activity: £82.39
- Capital: £15260.52 - tariff income: £5.00
- Total income: £113.09
- Less Personal Expenditure Allowance: £25.65
- Ability to pay: £87.44
Tariff income within the financial assessment is charged on capital over £14250 at the rate of £1 per week per £250 over the lower capital threshold (or part thereof).
Residential care example 2
At the age of 25, advances in assistive technology and care provision mean that Samira can leave the care home and live with others in adaptive supported accommodation. Her entitlement to be paid PIP at the Enhanced Daily Living Rate is reinstated and as she is over 25, the amount of Universal Credit she receives increases. She also received a higher MIG allowance due to her age.
Income:
- Universal Credit: Standard Amount (under 25's): £80.21
- Limited Capability for Work Related Activity: £82.39
- PIP - Enhanced Daily Living: £91.40
- Capital: £4262.66 - tariff income: £0.00
- Total income: £254.00
Deductions:
- Household Expenses:
- Contents Insurance: £3.42
- Disability Related Expenditure:
- Powered Bed: £4.74
- Hoist: £3.29
- Continence Products: £5.65
- Specialist Internet Access: £4.32
- Additional Bedding: £2.70
- Additional Laundry: £4.12
- Clothing: £6.55
- Total deductions: £34.79
- Income minus deductions: £219.21
- Less Minimum Income Guarantee: £156.00
- Ability to pay: £63.21
Also see
Income Services Team
Telephone: 01904 552044 or 01904 554684