Managing regulated care services

Leeds City Council has been developing its payment system to enable payments to care homes to be made as soon as a care plan is approved, currently payment awaits the completion of a financial assessment. This will go live for all new care packages approved on or after 1^st June 2020                                                         

What will the system do initially?                                                         

• For all NEW clients, as soon as the care plan is approved in the system, it will generate a payment (weekly rate less minimum client contribution) to be paid on the next 4 weekly payment run– This will be known as a provisional payment.
• The system will automatically send an email to the relevant email address (where the current remittance advice goes) to advise of the payment.
• The email will include an automated Provisional CHISA (P-CHISA) and the clients support plan details

The system will automatically refer for a financial assessment.                                                         

What happens when the full financial assessment is completed?                                                         

• The financial assessor will send a letter to the client, detailing the outcome of the financial assessment
• The letter will advise clients what they need to start paying for their new assessed charge to the care home from the day after the last payment period (as the Council pays in advance)
• The Council will email the care home with the outcome of the financial assessment.
• A final CHISA will be issued to the care home as soon as possible following the financial assessment.
• The Council will arrange for debt recovery from the client for any overpayment of financial assistance made by the Council during the provisional payment stage.
• In rare cases, should the client have overpaid their contribution to the care home (i.e. they have been assessed to pay less than the minimum contribution following a full financial assessment), the Council will, in the first instance, credit the care home with the shortfall in financial assistance on the next payment cycle.

What is required by the Care Homes?                                                          

• We would encourage care homes to promote the on line Ready Reckoner to ascertain at an early stage if any new client is likely to qualify for Local Authority assistance. This could help care homes in early identification of funding status.

Ready Reckoner                                                         

And promote the Council’s web pages                                                         

Paying for social care services                                                         

• We would appreciate assistance in ascertaining any legal representative for clients without capacity. This will ultimately help the care home in their debt recovery processes, and potentially enable an early indication of what could be a self-funding client. If the Council receives no response from family/friend who we thought would be applying for financial representation after 2 months the Council will commence taking the case on as last resort (either Corporate Appointee or Deputy)

• We would appreciate assistance with chivvying along clients to provide the financial evidence we need to undertake a full financial assessment. This will also assist the Care Home in cases where self-funding is the outcome, as the care homes can charge private rates quicker.

• We would appreciate assistance from the care homes in obtaining signatures on the PCHISA and the final CHISA and returning the signed copies to the Council – this can be electronic and to the same email address as the remittance advice returns.

• The Council will advise Care Homes what values to invoice clients for whilst in the Provisional payment stage and following the full financial assessment. It will be care homes’ responsibility to recover these client contributions (the Council will take responsibility to recover any overpayment and will not try to recover from the care home for any provisional payments). If there has been an underpayment by the Council this may be adjusted on the next payment run to put the client in credit – the care home should advise the client they are in credit.

Exclusions                                                         

The following will be exclusions from the process above                                                         

• the system will pay gross from the start on a CHISA (there will be no P-CHISA)

S117 clients                                                         

Supported Living clients                                                         

LD clients who are CHC funded                                                         

• Respite only cases

The Council will continue with the current arrangements and pay net of the respite rate. There will be no P-CHISA.                                                         

• Ex-self-funding clients

There has to be a financial assessment in these cases to ascertain when funds fall below threshold, therefore payment cannot be made until start date is ascertained. We have started to advise all clients (and it is in our booklet for 20/21) to approach us 3 months prior to funds reducing to the upper threshold.