CQC Quality Statements
Theme 1 – Working with People: Supporting people to live healthier lives
We Statement
We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce future needs for care and support.
What people expect
I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally. I am supported to plan ahead for important changes in my life that I can anticipate.
CENTRAL BEDFORDSHIRE SPECIFIC INFORMATION
Employee Information:
This chapter is a summary of national guidance in this area. If you are employed by / work for Central Bedfordshire Council, you will also need to follow the Council’s code / associated policies and procedures:
CONTENTS
1. Introduction
Disability related expenditure (DRE) is the financial cost that an adult incurs, specifically because they are disabled or have health problems. The local authority must take this expenditure into account in financial assessments to make sure that people who pay towards their care and support have enough money to live on (see Charging and Financial Assessment chapter).
Please note: Where a local authority decides to make a charge, it must comply with the provisions in the Care and Support (Charging and Assessment of Resources) Regulations 2014 (SI 2014/2672) (Regulations) and the statutory guidance Chapter 8 and Annexes B and C.
A local authority cannot impose charges which would cause a person’s remaining income (after the charge) to fall below a certain amount specified in the Regulations, Minimum Income Guarantee (MIG) (section 14(7), Care Act 2014).
Regulations 6 and 7 specify the personal expenses allowance for residents or temporary residents provided with accommodation in a care home, and the MIG amount for other adults and carers provided with care and support, or support.
Examples of DRE include additional costs for heating if someone feels the cold because of their impairment and needs extra heating to keep warm and additional laundry costs for someone who is incontinent. See Central Bedfordshire Council Charging and Financial Assessment Policy for further information.
2. Eligibility for Disability Related Expenditure
To qualify for a DRE the adult must be in receipt of the care component of Disability Living Allowance, Personal Independence Payment (Care) or Attendance Allowance.
Their assessment and care and support plan should also identify disabilities or medical conditions which demonstrate their need for DRE.
The local authority should assess the adult’s DRE as part of their financial assessment.
3. Financial Assessment
At the financial assessment meeting, the adult or their carer will need to provide the local staff member (usually a social worker or financial assessment officer) with the following information:
- the costs they have due to being disabled or having a health condition; and
- how much these costs are.
The adult will also need to provide receipts or any other evidence of these costs (see Central Bedfordshire Council Charging and Financial Assessment Policy).
When considering DRE, the local authority will:
- look at the information provided, including the receipts and any other evidence;
- check to see if the costs provided relate to the adult’s care needs as specified in their care and support plan (see Care and Support Planning chapter);
- check to see if any income the adult receives already covers these costs.
If the adult provides the evidence within 28 days, any reduction in charges will be backdated to the date of the assessment.
If the adult provides the evidence after 28 days, any reduction will only be made from the date the last supporting evidence was received.
The local authority will let the adult know the outcome of the financial assessment in writing, including explanations of:
- how the financial assessment has been carried out;
- what the charges will be;
- how they should be paid; and
- the reason for any change in charges.
4. Factors to Consider when Charging
The MIG amount in relation to adults who have needs for care and support or a carer who has needs for support, is the total of the amounts set out in Regulation 7(1).
Section 17 of the CA 2014 states that where a local authority decides to exercise the power to charge for care and support, it must assess:
- the level of the adult’s financial resources;
- the amount that the adult would be likely to be able to pay towards the cost of meeting the needs for care and support.
Apart from the limit set by the MIG, the regulations impose other constraints on a local authority’s power to charge services. When carrying out the financial assessment of resources under the regulations, in order to set the level of charge a local authority is prohibited from taking into account various items, including:
- earnings from employment or self-employment;.
- housing-related costs;
- the mobility element of PIP (but not the daily living element of PIP);
- any disability related expenditure paid for with disability benefits.
Otherwise, regulation 15(2) gives the local authority the discretion to decide what it will or will not take into account when carrying out the financial assessment in order to decide how much to charge a person for care and support.
See Appendix 2: Specific Regulations for further information.
5. Appeals and Complaints
If the adult or their carer / representative does not agree with the DRE amount they can appeal.
The Charging and Financial Assessment Team should examine the adult’s DRE calculations, to see if the amount is correct.
If the outcome of the appeal is that the correct amount has been calculated, but the adult or their representative is still not satisfied with the decision, they can ask the local authority to review their case. The Financial Assessment Team will let them know the process by which to do this.
If the adult or their representative are not satisfied with the panel’s decision, they can make a complaint (see Complaints).
See also: Central Bedfordshire Council’s Adult Social Care Charging Policy
6. Further Reading
6.1 Relevant chapters
Charging and Financial Assessment
Appendix 1: Summary of Disability Related Expenses
DREs are the costs associated with having a disability or medical condition.
The local authority may take into account and reasonable costs of help or support a person needs to live independently.
This cost must also have been identified in the person’s care and support plan.
Allowances for disability-related expenditure will only be made where those costs are:
- met entirely by the person;
- specifically relate to the disability in question;
- supported by documentary evidence
- exceed ‘normal’ costs of living expenses (that is, what an adult without the disability would reasonably be expected to spend).
Additional factors considered in relation to a claim for these DREs are:
- will the person be receiving a personal budget that will incorporate some of the identified disability-related expenditure?
- should any of the additional disability-related costs be paid for by the NHS, such as chiropody, physiotherapy, incontinence pads, and transport to attend hospital appointments?
- are any items being provided through, or facilitated by, other directorates within the Council?
Appendix 2: Specific Regulations
Earnings from employment or self-employment (regulation 14).
Housing-related costs (regulation 15(1) and paragraph 1 of Schedule 1).
The mobility element of PIP (but not the daily living element of PIP) (regulation 15(1) and paragraph 8 of Schedule 1).
Any disability related expenditure paid for with disability benefits (regulation 15(1) and paragraph 4 of Schedule 1).
