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3.4 Third Party Contribution Procedures

RELATED DOCUMENTS

  • Property Ownership - Charging Rules;
  • Waivers;
  • Brighton & Hove City Council maximum weekly fee rates for older people care homes.


Contents

  1. Introduction
  2. Third Party Checks
  3. Social Care Assessors Responsibilities Regarding Third Party Contributions
  4. Third Party Contributions from Organisations
  5. Third Party Responsibilities following Confirmation of the Care Home Placement
  6. Rules Regarding Top Up payments and 12 Week Disregards
  7. Increases in the Third Party Contribution
  8. Default in Payment of the Third Party Contribution
  9. Additional Information Relating to Third Party Contributions

    Appendix A: Third Party Declaration


1. Introduction

1.1 The Council has set maximum weekly rates payable to proprietors of care homes.
1.2 If a prospective resident wishes to live in a care home where the fees are in excess of these maximum rates they may only do so if they can arrange for a third party to pay the difference.


2. Third Party Checks

2.1 If the third party is a relative, civil partner, or friend it will be necessary to ensure that the arrangement is financially viable and sustainable for as long as the resident remains in the care home.
2.2

The following factors will be important and must be ascertained by the Social Care Assessor:

  1. The capital, income and outgoings of the third party;
  2. The age and potential financial status of the third party, e.g. soon to retire;
  3. The likely length of stay or prognosis of the resident.
2.3 The leaflet entitled "Third Party Declaration" (see Appendix A: Third Party Declaration) must be given by the Social Care Assessor for completion to anyone contemplating to anyone contemplating making a third party contribution, at the earliest possible stage in the discussions. A completed copy of this then needs to be given to the potential third party contributor, with a copy retained on the case file.
2.4

It is essential that the Council be provided with some documentary evidence from the third party contributor that they can meet the commitment indefinitely and the following guidance is given in this respect:

  1. When a care manager is seeking to confirm a third party contributor's financial viability to sustain their payments, ideally this should be established through the provision of a bankers reference, obtained by the third party, as evidence as to whether or not the person can meet the financial commitment. Failing this one of the following should be requested in order of priority: The last two bank statements (so to cover a full month of transactions) or a savings account. However, these items are not definitive, but are considered to be the most appropriate documents to ask for;
  2. The care manager then needs to make a judgement on the above, based on the amount of the contribution and where possible, an estimate about how long the contribution will be required. Clearly this is easier when the placement is short term, but may be more difficult to determine for long term placements;
  3. Where a person owns a property and is only needing funding for the 12 week property disregard period, the third party amount will be limited to the 12 weeks;
  4. The care manager should also ask the third party contributor whether they think that there are any foreseeable future events which way impede their ability to contribute making the contributions, e.g. retirement and record this conversation;
  5. It also needs to be stressed that a third party could regale on their commitment at any time and whilst this may be related to their ability to pay, it could also be a decision made through choice. The Council has limited powers to reclaim this money.
2.5 This evidence then needs to be verified by the Social Care Assessor's line manager, or Panel, through signing off the document in question. Any charges incurred for the provision of a reference will be the financial responsibility of the potential third party.


3. Social Care Assessors Responsibilities Regarding Third Party Contributions

3.1 As noted above, it is the Social Care Assessors’ responsibility to undertake third party checks. Ideally, this needs to be done before an individual service agreement can be drawn up, which might otherwise run the risk of making the Council financially liable for the additional cost of the care home placement. In the event that the third party contributor regales on their commitment following a placement being made, the Council reserves the right to terminate the contract and move the service user to a care home whose fees are within the maximum limits.
3.2

Additionally, the Social Care Assessor should:

  • Include on the case file the documentary evidence of the third party checks having been done, along with a completed copy of the Third Party Declaration;
  • Include in Panel applications the documentary evidence of the third party checks having been done, along with a completed copy of the Third Party Declaration;
  • Include in the notes field of the on line referral form sent to the Care Matching Team confirmation that the appropriate third party checks have been made; and the name, address and postcode of the third party payee. Please note that the Individual Service Agreement Team raise an individual service agreement based on the information provided by the Social Care Assessor.


4. Third Party Contributions from Organisations

4.1 If the third party is a charity or any other private, voluntary or public body the Social Care Assessor will need to agree the conditions with their nominated representative, and this representative will be required to sign the Third Party Declaration.


5. Third Party Responsibilities following Confirmation of the Care Home Placement

5.1 In all cases the third party must sign the Third Party Declaration.
5.2 In all cases, the third party must pay their contribution directly to the care home.


6. Rules Regarding Top Up Payments and 12 Week Disregards

6.1 If the service user owns a property and wishes to reside in a home where the fees are in excess of the maximum weekly set rates, they will need to arrange for a third party to pay the excess or to secure a loan on his property whilst he is awaiting sale.
6.2 However, during any 12 week disregard period the service user may choose to top up the care home fees from their own financial resources, though this is the only situation where this is permissible. As the service users’ ability to pay the top up will be dependent on their individual financial circumstances, it would be advisable to refer the matter to the Financial Assessment Team for any information that may be held with them. However, this information may not be available if the service user has not already been financially assessed, or if the information held by that Team is out of date. It should also be noted that the decision regarding the viability of the placement under these particular circumstances resides with the Social Care Assessor, based on the information that has been provided to them.
6.3 If the service user lacks the resources to pay the top up during the 12 week disregard period, the top up cannot be paid by the Council on a loan basis. Consequently, under these circumstances the fees during the 12 week disregard period will have to be at the maximum weekly fee rates.


7. Increases in the Third Party Contribution

7.1 The third party must consider the likelihood of their contribution being increased in the future.
7.2 Any increase in the resident’s income will be taken into account through a revised financial assessment and any resulting increase in their contribution will not reduce the third party contribution.


8. Default in Payment of the Third Party Contribution

8.1 If the third party ceases to pay the agreed contribution or does not agree to pay any increase in accordance with 7.1 above, then the Council may terminate the individual service agreement and hence the placement, by giving the required period of notice.
8.2 This means that a new placement will have to be found where the fees are within the maximum weekly fee rates.
8.3 It is essential that all parties understand these implications when signing the individual service agreement documents.


9. Additional Information Relating to Third Party Contributions

9.1 Guidance given in Local Authority Circular LAC (98) 8 indicates that residents must not act as their own third parties by using their personal expenses allowance to pay for more expensive accommodation than the Local Authority would pay.
9.2 The Charging for Residential Accommodation Guide also clearly states in 8.018 that "a resident cannot use their own resource to pay for more expensive accommodation, i.e. act as their own third party" (except under the 12 week disregard ruling).
9.3 Where service users have been self-funding at fees in excess of the Council's limits and their savings reduce to £23,250 so that financial assistance is required the Social Care Assessor should endeavour to negotiate with the care home for a fee within our limits. If this fails a third party willing and able to meet the balance will be required. If no such third party is available the Council can move the service user to a room or accommodation that is within the Council's maximum limits.


Appendix A: Third Party Declaration

Click here to view 'Third Party Declaration'.

End