Vulnerable in West Sussex ‘left traumatised by massive care charge increases’

There was an outcry after a county council review of the financial assessment process for those receiving adult social care left some in debt and others giving up on support they could no longer afford.

During a meeting of the Health & Adult Social Care scrutiny committee (HASC) last week, cabinet member Amanda Jupp said: “I am sorry that some people were put under pressure and anxiety and stress by the process.

“The original financial assessment process was out-sourced and when we brought it back in-house, we immediately saw the problems and we acted upon it immediately.”

Care charges are paid for the use of services either independently or in a family home, such as attending a day centre or help with respite care.

The charges and the services vary from person to person.

The problems started in 2018/19 when, as part of the adults’ services medium-term financial savings plan, the council agreed to reduce the level of Minimum Income Guarantee to the lowest allowed by law.

The guarantee is required under the Care Act 2014 to ensure that those receiving care and support have enough money to cover day-to-day living costs.

It is used as part of the financial assessment and the decision to reduce it meant all customers had to be re-assessed.

Many were left with backdated bills for their care as well as massive rises in the payments they needed to make.

One such case saw a young woman who lives in supported accommodation reduced to tears when her charges rose from £92 to £515 a month.

A report to HASC said that, of the 3,750 adults assessed who receive non-residential care, around 750 issues or appeals were raised – 20 per cent of the cohort.

Mrs Jupp told the meeting that anyone who had contacted her or council officers had been ‘immediately supported and helped’, with some receiving re-assessments.

Describing social care payments as ‘complex’, she added: “We are bound by the Care Act, we are bound by our budget but I think we do our very best and it’s important that we make sure that we always engage with those people who need our help and support.

“We do our very best for our customers but obviously we’ve made mistakes and that’s unfortunate and regrettable but we will continue to make improvements – there’s always room for improvement.”

Those improvements have come in the form of an improvement programme, which was discussed during the meeting.

It includes a number of priorities, such as: resolving the complaints received after the reassessment process, improving communications and documentation supporting the process, and looking into the use of a pre-paid card to give each person choice and control over the provision of the care and support they need.

The committee also accepted a number of recommendations from consumer champion Healthwatch, which has provided input into what improvements are needed.

Spokesman Katrina Broadhill said care charges were the third highest concern raised with Healthwatch, behind access to GPs and dentistry.

Sharing the experiences of some service users, she said the financial assessment had been described as ‘a process that makes [people] beg and dis-empowers them’.

Others said it ‘makes you feel like you go cap in hand to a bunch of number crunchers – it’s demeaning to say the least’.

Keith Hinkley, the council’s director of adults and health, said working with Healthwatch had been helpful and there was a ‘commitment to continuous improvement’.

He told the meeting that around £60m of income was generated from charging people for care, ‘which is a fundamental part of our budget’.

He added: “We’ve all acknowledged that there are challenges in terms of demand, challenges in terms of funding.

“But to step back from a charging regime would mean we would need to be considering commensurate reductions in the support we actually provide to people.”

Alistair Rush, the interim deputy director of finance, advised councillors that the government had indicated that the Minimum Income Guarantee would be increased by inflation ahead of 2022/23. An announcement is expected in March.

In its report to the committee, Healthwatch said: “We appreciate the financial challenge facing the council and that this must be tackled in order to meet statutory duties and remain solvent. 

“However, this can and does not excuse harmful practice, as evidenced through peoples’ accounts, and the need for an improvement plan.”

It was an opinion shared by Dr Kate O’Kelly (Lib Dem, Midhurst).

Describing the assessment process and what followed as ‘a shameful episode’, she added: “I would like to see some acknowledgement of the fact that this has been incompetently handled and, as a result, a great many of our most vulnerable residents have been harmed. 

“To quote the Healthwatch report – people have experienced suicidal feelings, declining mental and physical health and numerous examples of financial hardship.”

Speaking after the meeting, a spokesman for Warrior Carers – a group of parents and carers set up to share support and information – described the improvement programme as ‘vague’ and ‘inadequate’.

They called on the county council to introduce a moratorium on any increase in charges ‘until disabled people in the county have a charging regime that is fit for purpose’.

They added: “Many vulnerable disabled residents, already struggling on some of the lowest benefit incomes in Europe, were left traumatised by massive care charge increases imposed on them out of the blue.

“Warrior Carers question whether the council fully appreciates the damage that their care charges are having on disabled people and their families in West Sussex. ”

The Adult Social Care Strategy (2022-2025) is scheduled to be approved at a meeting of the cabinet on Tuesday (February 1).