Financial Assessment Procedure

1. Using this Procedure

This procedure has been written to support front line practitioners carrying out Care and Support functions to understand their role within the local authority's wider financial assessment process, so that they can:

  1. Provide good information and advice to people in a timely way;
  2. Carry out their own functions within the financial assessment process; and
  3. Work effectively alongside the Financial Assessment & Benefit Team.
Although this procedure may be helpful to those people based within the Financial Assessment & Benefit Team, it does not provide specific guidance about the process of carrying out a financial assessment, or of any other subsequent action that may be required. Anyone carrying out such actions should refer to available local processes.

2. Understanding the Legal Requirements of Financial Assessment

Click here as required to access the 'Assessment of Financial Resources', which is a section of the wider Care Act 2014 area of this site containing information about the following:

  1. The Purpose of a Financial Assessment;
  2. General Principles of Financial Assessment;
  3. When to complete a Financial Assessment (and when not to);
  4. Methods of Financial Assessment;
  5. Financial Assessment for people who lack Capacity or do not manage their own finances;
  6. Financial Assessment of people in a Care Home;
  7. Financial Assessment of people living in the Community or other Setting;
  8. Financial Assessment of Carers;
  9. Examples of what must be taken into account when carrying out a Financial Assessment;
  10. Examples of what must be disregarded (or partially disregarded) when carrying out a Financial Assessment;
  11. Deciding how much to Charge;
  12. Communicating the Outcome of a Financial Assessment;
  13. Arrangements for Self-Funders.

3. The Local Financial Assessment Process

It is important that you have sufficient knowledge of both:

  1. The financial assessment process used by the Local Authority; and
  2. The local charging policy.

If you do not understand the financial assessment process, or feel confident to provide information and advice to people about it you should speak to your line manager to identify any additional support needs you may have.

4. Understanding the Possible Outcomes of Financial Assessment

It is important that you understand the possible outcomes of financial assessment, as this is likely to be a common question asked of you.

The possible outcomes from financial assessment are:

  1. A person will have to make no contribution to the cost of their Care and Support;
  2. A person will have to make some contribution to the cost of their Care and Support;
  3. A person will have to contribute the full cost of their Care and Support service at the time that it is received; or
  4. A person will have to contribute the full cost of their Care and Support service at a later date as agreed by the Local Authority.

The latter option refers to a deferred payment. This is only available to people in a particular set of circumstances and can only be offered by the Financial Assessment & Benefit Team following a full financial assessment.

Click here to read more about deferred payments and when they may be offered.

5. Providing Information and Advice about Financial Assessment

General practice guidance

Information and advice about financial assessment should be provided at the earliest opportunity and good financial information and advice is integral to a person/carer's consideration of how best to meet both immediate and future Care and Support/Support needs.

People who have received good information and advice have a much better understanding of how their available resources can be used more flexibly to fund a wider range of care options.

Providing information and advice at an early stage also reduces the likelihood of disputes around financial contribution occurring.

The Care Act sets out the specific information and advice that must be provided about financial assessment. Click here to access it.

Providing general information and advice

You are expected to be able to provide general information and advice about the financial assessment process whenever:

  1. A person/carer asks for it (reactive); or
  2. You have identified a need for it (proactive).

This procedure will support you to provide general information and advice, but where required you should:

  1. Seek the support of your line manager; or
  2. Contact a practitioner from the Financial Assessment & Benefit Team.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

Frequently asked questions

Click here to access a tri.x practice resource that will answer some of the most commonly asked questions about financial assessment.

Specific information and advice

Although you are expected to provide general information and advice about financial assessment you are not expected to be able to provide specific financial information or advice that relates to the particular financial circumstances of a person/carer.

Where such information or advice is required you must however take steps to ensure that the person/carer has access to it, either:

  1. From the Financial Assessment & Benefit Team; or
  2. From an independent financial advisor.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

There are a range of agencies able to provide independent advice. Their details can be found in the Advice Agencies leaflet. Click here to access it from the Local Resources.

When signposting a person/carer to the independent financial advisor you should explain to them that:

  1. The advisor may charge them to access their advice; and
  2. That there are other sources of independent financial advice available.

Consent

If you find yourself providing information and advice that is specific to the circumstances of a particular person/carer, you must consider who you are providing it to, and whether it is appropriate to provide it to them.

Normally it will only be appropriate to provide financial information to:

  1. The person/carer; or
  2. Somebody else where clear consent of the person/carer has been given; or
  3. Where the person lacks capacity, a Deputy appointed by the Court of Protection to make decisions about financial matters; or
  4. Where the person lacks capacity, a Donee of a Lasting Power of Attorney who is authorised to make decisions about financial matters; or
  5. Where the person lacks capacity, and there is no Deputy or Donee a person that you deem it in their Best Interests to provide the information to.

Accessibility

All information and advice that you provide must be given in a way that the person/carer receiving it will best be able to understand and use. This is a legal requirement of the Care Act.

Click here to read more about how to provide information in an accessible way under the Care Act.

If you provide information and advice but feel that person/carer for whom it is intended will need additional support to understand it then you should consider:

  1. Whether the information can be provided in a different way;
  2. Whether you can take any additional steps to support the person/carer to understand it (for example talking through the information on the telephone or in person);
  3. Whether it would be appropriate to appoint an independent advocate to support the person/carer to understand and use the information.
Need to know

For the sole purpose of understanding information and advice there is no duty under the Care Act to provide an independent advocate. This must be a local decision, taking into account the available evidence and presenting circumstances.

If you are not clear what the local arrangements are for the provision of independent advocacy for information and advice you must speak with your line manager before making a referral.

6. Requesting a Financial Assessment

When to request a financial assessment

A financial assessment must be requested when:

  1. Eligible needs have been established (or urgent needs are being met without a needs assessment having yet been completed); and
  2. The person is ordinarily resident is the Local Authority area (or present in the Area with no settled residence); and
  3. It is known that the person will be receiving a chargeable service; and
  4. The Local Authority intends to use its powers to charge for that service; unless
  5. The person/carer who will be receiving support (or a person with legal authority to make financial decisions) has requested that a financial assessment take place earlier (see below).

Note: In Swindon carers are not financially assessed, so an assessment should not be requested.

Need to know

Under the Care Act the Local Authority must not charge for the following services:

  • Intermediate care and reablement services for up to 6 weeks;
  • Aids and minor adaptations (up to the value of ¬£1000);
  • After-care services/support provided under section 117 of the Mental Health Act 1983.

For all other services the Local Authority has the power to charge but there is no duty to, meaning that decisions can be made to waiver a charge or not charge in specific circumstances.

In Swindon a financial assessment should not be requested for respite, pre-assessment, crisis support or any equipment.

Early financial assessments

You should only request an early financial assessment when:

  1. Requested by the person (or a person legally authorised to make the request); and
  2. Completing the financial assessment will not have a negative impact on the person's individual wellbeing (for example, alleviating or causing anxiety); and
  3. The person is likely to have eligible needs for Care and Support (if a person is not likely to have eligible needs the Local Authority has no duty to provide a service or to assess finances); and
  4. It is likely that a chargeable service will be provided (if a non-chargeable service is likely then a financial assessment is not required); and
  5. The person's financial resources are not likely to change by the time that they are in receipt of a Care and Support service.
Need to know

Early financial assessment should not be carried out:

  1. To ease the administrative burden of the Local Authority; or
  2. If the outcome if to be used to restrict a person's access to a Care and Support service; or
  3. If the service to be received is non-chargeable under the Care Act; or
  4. If the Local Authority does not intend to make a charge.
Need to know
A financial assessment should never be requested if the person with Care and Support needs has been diagnosed with Creutzfeldt-Jakob disease. This is because all services must be provided without charge.

Financial reassessment

It is not lawful for:

  1. The Local Authority to charge a person more than they can afford for services; or
  2. For a person receiving services not to contribute (if they can afford to do so and the services are chargeable).

During statutory reviews (and any other Care and Support process) you should therefore consider:

  1. Whether there have been any changes in the person's financial circumstances; and
  2. Where there have been changes, whether the person can still afford to make the financial contribution.

If there have been any changes, or you are concerned about the affordability of the contribution you should notify the Financial Assessment & Benefit Team who will be able to review the current contribution.

How to request a financial assessment/reassessment

Financial assessment referrals should be made via Eclipse, following the guidance provided in the Eclipse procedures.

7. Recording the Outcome and Notifying Others

Notification

The assessor at the Financial Assessment & Benefit Team should notify you of:

  1. The outcome of the financial assessment; and
  2. The date that financial contributions should start (if this is not the date the Care and Support services start); and
  3. If the person has been assessed as able to make a full contribution, whether a deferred payment agreement is to be made.

Recording a Financial Contribution

Following notification the financial contribution should be recorded:

  1. On the person's Care and Support Plan;
  2. On any electronic financial contribution records.

The start date for any financial contribution should correspond with the start date for the associated Care and Support services unless a decision has been made otherwise through the financial assessment process.

Notifying the person of the outcome

The person should be notified of the outcome by the assessor at the Financial Assessment & Benefit Team who carried it out. This should be done as close to the time that the outcome is decided as possible.

If the person is unhappy about the outcome

If a person tells you they are not happy with the outcome of any financial assessment process you should establish if they have been in contact with the assessor at the Financial Assessment & Benefit Team about the matter.

If the person has not yet contacted the assessor you should:

  1. Recommend that they do so, on the basis that the assessor is best placed to discuss the information upon which a decision was made; or
  2. Contact the assessor and request they make contact with the person to discuss their concerns; but
  3. If they do not wish to/feel able to speak with the assessor, make contact with the assessor yourself to establish the rationale for the decision made; and
  4. Provide information to the person to support their understanding of the decision.

If the person remains unhappy with the outcome you should advise them of their right to complain about it.

8. Delays in Financial Assessment

The impact of delays on services

Delays in financial assessment must not cause delays in the meeting of eligible needs (or urgent needs).

If a financial assessment cannot be carried out in a timely way you should proceed to arrange for the required services and support to be provided as required.

Roles when there is a delay

It is your responsibility to explain to the person (or their representative):

  1. The reasons for the delay; and
  2. That a financial assessment will still be taking place; and
  3. That if chargeable services begin before the assessment is completed, any contributions will be payable from the date that services start; when
  4. You did not request the financial assessment in a timely way.

It is the responsibility of the Financial Assessment & Benefit Team to contact the person (or their representative) and explain:

  1. The reasons for the delay;
  2. When a financial assessment may take place; and
  3. That if chargeable services begin before the assessment is completed, any contributions will be payable from the date that services start; when
  4. The Financial Assessment & Benefit Team has not been able to respond to the financial assessment request in a timely way; unless
  5. The person has contacted you directly about the delay, in which case you should take steps to establish and provide this information to them.

9. Supporting People who need to make a full Contribution

Using this section of the procedure

This section of the procedure should be used when the Financial Assessment & Benefit Team has notified you that:

  1. A person with Care and Support needs has been assessed as able to make a full contribution; and
  2. A deferred payment agreement is not being made.

The decision to be made

The person will need to make a decision about the best way to arrange and manage the service they will receive from the options available to them.

The options available

There are normally 3 possible options:

  1. The person will arrange, manage and pay for their own Care and Support services (self-funding);
  2. The person will manage and pay for their Care and Support service directly but the Local Authority will make the initial arrangements; or
  3. The Local Authority will arrange and manage the Care and Support service on behalf of the person and seek reimbursement from the person for the full amount (full charge).

Reduced Options for People needing Care Home Provision

The Local Authority has a duty to arrange Care and Support services (options a) and b) above) for anyone making a full financial contribution that requests this unless:

  1. The person requires residential or nursing care; and
  2. The person has capacity to make their own arrangements; or
  3. The person lacks capacity but there is an appropriate person able to make the arrangements on their behalf.

In this situation the Local Authority does not have to arrange the service but may still choose to do so on a case by case basis if it would:

  1. Be of benefit to the person; and
  2. Reduce the risk of further support being required from the Local Authority in the future.

Charging to arrange services

The Local Authority may charge an administration fee to arrange services if the person is:

  1. Self funding; and
  2. Does not require residential or nursing home provision.

Supporting the person to make a decision

Your must support the person to make a decision about the best way to arrange and manage the service they will receive. You should do this by:

  1. Making sure they understand the options available to them;
  2. Encouraging them to weigh up the risks and benefits of each available option.

As defined in the Care and Support statutory guidance, these are the things that you should try to encourage a person or carer to consider:

  1. What their preferred option is;
  2. What the impact on their individual wellbeing would be from the available options;
  3. Whether the person lacks capacity to make decisions about Care and Support, and if so whether there is an appropriate person to do so on their behalf;
  4. Whether the person is at risk of abuse or neglect;
  5. Whether the person has complex needs, or needs that are likely to change (if so it may be beneficial for the Local Authority to arrange their service and maintain a statutory review function);
  6. Whether the person's situation is unstable, or at risk of becoming unstable without support from the Local Authority; and
  7. Whether the person's circumstances limit the options available to them (i.e. if they require residential or nursing home provision they may not be able to request support to arrange this).

The Advocacy Duty

If an independent advocate was appointed to support the person to take part in previous Care and Support processes you must:

  1. Consider whether the person is likely to continue to require advocacy support; and
  2. If so, ensure that it is provided.

If an advocate has not previously been required you should consider whether the duty to provide an advocate applies now.

Click here for information about the advocacy duty.

When the decision is made

Refer to other relevant procedures as required to carrying out other Care and Support functions, such as planning and arranging services.

10. Third Party Contribution Agreements (Top-Ups)

Click here to access information about Third Party Contributions (top-ups), including when a top up is payable, who can pay a top-up, how top-ups should be paid and what should be included in a top-up agreement.

There is also information about top-ups in the Local Resource area. Click here to access it.

11. Contributions when the Service is not Provided

The Local Authority cannot lawfully charge a person more than the cost of the services they have received.

You must therefore notify the Financial Assessment & Benefit Team if you are aware that:

  1. A person has not received a service (either one-off or over a period of time); and
  2. They have made a financial contribution during that period.

The Financial Assessment & Benefit Team will then determine whether:

  1. The person is entitled to any reimbursement of monies paid; or
  2. Whether a review of their regular financial contribution is required.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

Need to know
Not receiving a service may have no impact on the amount of the person's financial contribution if the total cost of the services they have received in that accounting period is greater than the financial contribution they have been assessed to make.

12. When Chargeable Services End

You must notify the Financial Assessment & Benefit Team as soon as possible whenever all chargeable services are no longer required or being provided.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

The following must also be updated:

  1. The person's Care and Support Plan; and
  2. Any electronic financial contribution records; so that
  3. No further financial contributions are made.

13. Changes to Chargeable Services

You must notify the Financial Assessment & Benefit Team whenever:

  1. There is a change to chargeable Care and Support services; and
  2. There is also a change to the Personal Budget amount (increase or reduction).

You do not need to notify the Financial Assessment & Benefit Team when:

  1. There is a change to Care and Support services; and
  2. There is no change to the Personal Budget amount.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

The Financial Assessment & Benefit Team will notify you of any changes to the person's financial contribution. If there has been a change the following must be updated:

  1. The person's Care and Support Plan;
  2. Any electronic financial contribution records.

The start date for any financial contribution should correspond with the start date for the associated Care and Support services unless a decision has been made otherwise through a financial reassessment process.

14. Refusing a Financial Assessment

The right to refuse a financial assessment

Any person has a right to refuse to engage in a financial assessment process.

Implications for refusal

By refusing to engage in a financial assessment process the Local Authority is permitted under the Care Act to reach the conclusion that:

  1. The person has sufficient financial resources to pay for the full cost of their care; and
  2. Seek a full financial contribution as such (through the courts if necessary).

Notification of intended refusal

If a person informs you that they intend to refuse to engage in a financial assessment process you should:

  1. Establish why they intend to refuse; and
  2. If required, provide information about the process and purpose of financial assessment; and
  3. Advise them of the legal implications of refusing an assessment; and
  4. If they reaffirm their intention to refuse, explain that you must notify the Financial Assessment & Benefit Team.

You should then:

  1. Request a financial assessment in the normal way; but
  2. Also advise the Financial Assessment & Benefit Team of the person's intention to refuse the assessment; so that
  3. The Financial Assessment & Benefit Team can make a decision about how best to proceed.

The impact on services

The Local Authority has a legal duty to meet eligible needs and must not delay or decline to do this on the basis that the person has refused to engage in a financial assessment.

This means that:

  1. You should proceed to arrange for the required services and support to be provided as required; and
  2. The Local Authority should arrange to seek reimbursement of any monies owed to them (through the Courts if necessary).

15. Declining to make Contributions

The impact on services

The Local Authority has a legal duty to meet eligible needs and must not delay or decline to do this on the basis that the person has declined to make financial contributions.

This means that:

  1. You should proceed to arrange for the required services and support to be provided as required; or
  2. Continue to provide any existing services; and
  3. The Local Authority should arrange to seek reimbursement of any monies owed to them (through the Courts if necessary).

The role of the Financial Assessment & Benefit Team

If a person declines to make a contribution it is the responsibility of the assessor who carried out the financial assessment (or tried to carry out the financial assessment) to contact them and:

  1. Establish why a contribution has not been made;
  2. Assess any new evidence provided by the person that suggests the assessed contribution may require review;
  3. Make arrangements for the outstanding contributions to be paid; and
  4. Ensure arrangements are in place for future contributions to be paid.

Your role

The assessor at the Financial Assessment & Benefit Team may ask you to support them to have the above conversations, especially if you have a good rapport with the person.

Under the Care Act you must provide support to other professionals when requested (as part of the duty to co-operate) unless doing so would:

  1. Prevent you from carrying out another duty under the Act; or
  2. Put the person at risk of abuse and neglect.

Deprivation of Assets

It is not lawful for a person to deliberately deprive themselves of an asset for the purpose of avoiding making a financial contribution and, if a person has deliberately deprived themselves legal action can be taken under the Care Act to seek reimbursement.

Examples of possible deprivations include, but are not limited to:

  1. Making a significant purchase that is out of character;
  2. Transferring large amounts of money to another person;
  3. Transferring the deeds of a property to a family member.

You must take action if:

  1. A person informs you of their intention to deprive themselves of an asset; or
  2. You suspect that it is the person's intention to do so; and
  3. The deprivation is, or appears to be for the purpose of avoiding making a financial contribution.

If it is clear what the person's intentions are you should:

  1. Advise them that proceeding could be unlawful; and
  2. Advise them of the possible legal and financial implications.

In all cases you must notify the Financial Assessment & Benefit Team, whose responsibility it is to make enquiries to satisfy themselves that a deprivation of assets has or has not occurred.

The Financial Assessment & Benefit Team can be contacted on 01793 463279.

16. Financial Contribution Waivers

Any view you have about the person's inability to afford to make a contribution should:

  1. Be evidence based; and
  2. Be based on information not previously considered by the Financial Assessment & Benefit Team.

(Evidence could include information about Disability Related Expenses that the person failed to declare to the assessor).

In the first instance you should discuss your evidence with the assessor who carried out the financial assessment. They will decide whether or not, on the basis of this:

  1. The original assessment should be reviewed; or
  2. The original assessment stands.

If the assessor decides that the original assessment stands (either straight away or following review) you should only take further action if you believe that the assessor has not taken into account the new evidence that you provided.

If you believe this to be so you should:

  1. Discuss this with your line manager; and
  2. Agree whether a waiver request should or should not be submitted.

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