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The Care Cap, explained for Lymington by Lester Aldridge

The Care Cap: more complicated than anticipated

Helpful explanation of the new social care charging arrangements by Lester Aldridge Solicitors - who are always happy to help you personally too!

Life Matters for Lymington by Lester Aldridge this month looks beneath the headlines of the long awaited reforms to social care charging arrangements.

Members of the Lester Aldridge team are always happy to help with individual enquiries and offer a free initial consultation of which you can take advantage at any time.

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Call 01202 786187 to speak with our health and social care laywers.

Carer helping elderly patient

Background to the "Care Cap"

The care cap has been a long-awaited reform to social care charging arrangements. Some will remember the 2011 Dilnot Commission, chaired by Sir Andrew Dilnot, which argued that a cap on care costs that a person would pay over their lifetime was necessary to avoid the catastrophic cost of accumulated care costs. Proposals made at that time for a cap on the cost of care, were later scrapped.

Nearly ten years later, the Government has now again announced the implementation of a cap on care costs and an extended means test. From October 2023, a cap on personal care costs will place a limit of £86,000 on the amount that people will need to spend to meet their eligible care and support needs. In addition, the charging reform will change the threshold at which someone would become eligible for local authority means testing support. Currently, people with capital below the upper capital limit are eligible for some financial support with care costs from the local authority. The upper capital limit is currently £23,250 but will increase to £100,000 and the lower capital limit will increase from £14,250 to £20,000. Whilst this reform, on the face of it, sounds beneficial and has been publicised as being straightforward, there is a range of complexities and concerns about the implementation and practical workings of this charging reform that people need to understand. 

What does and does not count towards the cap?

Where a local authority is paying for a person’s care needs, it will be their responsibility to produce a “personal budget”, or to produce an “independent personal budget” where a person is a self-funder. To calculate this budget, the council will need to undertake a care cap assessment of a person’s needs and it is understood that the council will use the same principles that underpin the calculation of personal budgets under the current system to do so. A key point to note is that the only figure that will count towards the care cap is the amount that the local authority has agreed to pay (either itself under the personal budget or what it would contribute if it were paying). This means that a self-funder may choose to pay more for their care needs in a slightly more expensive service and the amount that they actually pay will not count towards the cap, it will only be the amount the local authority sets under the personal budget.

The cost that counts towards the care cap will also not include any daily living costs. Daily living costs have been described by the Government as including things like food, and utility bills and this will apply equally to residential and domiciliary care. So, for example, in a care home placement, it will only the part of the cost which the local authority deems to be a reasonable cost of providing care which will count towards the cap, not any part of the care home fee which covers accommodation or food, or any enhanced aspect of the cost recognising superior accommodation, location or facilities. People will also remain responsible for their daily living costs after they have met the cap. The Government’s response to daily living costs has been that it is not supposed to be a “precise science” and that the current national notional amount of the daily living costs has been suggested to be £200 per week in 2022.

Furthermore, if a person is receiving any kind of local authority means testing support to meet their personal care needs (even partial support), none of the local authority contributions will count towards the cap. 

Concerns have been raised:  about both the fairness of the system and local authorities' capacity to cope 

Commentators in the sector, including House of Lords peers and the King’s Fund, have raised concerns in relation to the fairness of the system and have concluded that it will be those who receive some means-tested support who will take far longer to reach their cap than a person receiving no local authority contribution (approximately twice as long). People will still need to pay their daily living costs whilst working towards, and after they have met the cap and many people will be required to sell their homes to pay their care costs despite the charging reforms.

As of April 2022, it was estimated that there are almost 300,000 people who arrange their own care at present who will now be required to receive a care cap assessment to open up a care cap account with the local authority to start to progress towards the cap. Local authorities have stated that the influx in the requirement to get a care cap assessment and the huge influx in work required will not be feasible. Local authorities are still catching up from the disruption caused by the pandemic - only last week it was reported that there is a current backlog of approximately 500,000 people awaiting a social care assessment. The Local Government Association has stated that it is “extremely concerned” about local authorities’ capacity to cope with the changes.

Which costs do and don't count towards the cap?

It is essential for people to understand the small print behind the £86,000 care cap and to appreciate the implications of the reforms. Individuals need to be aware of the costs that will and will not count towards the cap to be familiar with the full details behind the reform and what this means for them. Some of the changes to the law have been amended since the Government’s original announcement in September 2021 without much publicity.

People will need to be aware of the need to apply to the local authority for a care cap assessment and to set up a care cap account, to enable the fees being paid to count towards the cap. This is important because only the eligible sums paid after the local authority account is set up will count towards the cap so any delay in setting up an account may mean someone is paying more than is necessary. Individuals may want to know how their care providers will work with them to help facilitate a care cap account, for example. However, at this stage, precise details and timescales are not known.

Further guidance about the care cap had been anticipated in “spring 2022”, however, to date we have not yet seen this. We encourage people to look out for this and keep abreast of the changes.

We understand and can explain the small print: let us help you! 

Lester Aldridge regularly provides advice in respect of care contracts and funding queries and have extensive experience in the sector. If you have any questions in relation to the care cap and what this means for you, contact our health and social care lawyers to discuss how we can help on 01202 786187 or This email address is being protected from spambots. You need JavaScript enabled to view it.. The photo below is of Alice Straight, solicitor in the Lester Aldridge Healthcare team, who wrote this article.

Call 01202 786187 to speak with our health and social care laywers.

 

Alice Straight solicitor with Lester Aldridge

 

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