Concern at new care charges

AN extra £400,000 a year looks likely to be raised by Scottish Borders Council from charging for adult day care services, housing support, 24 hour care and intermediate care, all of which were free until November last year.

Figures from November 2010 to March this year shows that £179,000 was raised in charges for the services during the first five month period. Following a financial assessment of clients using the services 45 per cent (129 people) were not required to pay while 179 were asked to make a proportionate contribution towards the services.

Charges for 24 hour care have brought in most revenue (£100,000 from November to March, expected to rise to £230,000 a year).

A review of the revised charging has just been done and shows that some people have stopped using the services, particularly housing support, rather than pay for it, and so far 36 appeals have either been heard or are pending.

Of the appeals heard 19 were unsuccessful and five resulted in charges either being waived or reduced.

An update on the new charges and the feedback received since their introduction is being discussed today (Thursday) by councillors.

The report states: “A number of responses indicated they were unhappy with the principle of charging for services, while others understood the need to introduce charging for those able to contribute to ensure services continued.

“There was some concern within some services that individuals were reducing the amount of support they received or cancelling appointments.

“Several services reported a small number of people had left the service citing charging as one of the reasons.

“However, it is important to note that if concerns were raised regarding this, individuals were notified to social work and a clear risk assessment undertaken and in some instances charges were waived.”

“Some services reported that referrals to the service had remained the same when compared with last year.

“However, for a small number of services there was felt to be a reduction and one service highlighted that extra referrals had been directed to a health service as this was a free service.

“A number of responses talked about the practical difficulties in collecting the charges and for some day services invoicing arrangements have had to be implemented for relatively small sums.”

There has been criticism of the consultation process, lack of advance notice about changes that were being made, and the tone of letters being sent out to clients who were in arrears with their payments for the services they were using.

All this has been taken on board by social services and a number of recommendations have been made which councillors are being asked to approve: improved communication and consultation processes; timescales for implementation need to be manageable; increased staffing capacity to implement the changes would have speeded up the queries and appeals; consideration should be given to clients being given the opportunity to have independent representation during the appeals process; the arrears letters are to be reviewed and the wording changed where necessary; monitoring of take-up of services should be undertaken.

Charging clients for using the four services was brought in to bring the council into line with COSLA (Convention of Scottish Local Authorities) guidelines of equity, transparency, fairness and compliance with national guidance and legislation - but also brings in “significant additional income to social work”.