DELEGATED POWERS REPORT NO.

1821

SUBJECT: Independent Ageing Improving Information and Advice for People who Fund their Own Care Control sheet All of the following actions MUST be completed at each stage of the process and the signed and dated report MUST be passed to the Governance Service for publishing All reports
1. Governance Service receive draft report Name of GSO Date 2. Governance Service cleared draft report as being constitutionally appropriate Finance clearance obtained (report author to complete) Name of GSO Date Name of Fin. officer Date Name of Res. officer Date Name of SPO Date Name of Legal officer Date Name of P&P officer Date Name of officer Date Name Date Name of GSO Date Name of GSO Date Name of GSO Date Key decisions only: 13. Expiry of call-in period 14. Report circulated for call-in purposes to Business Management OSC members & copied to Cabinet Members & Head of Service Date Name of GSO Date N/A N/A N/A Andrew Charlwood 26/09/12 Andrew Charlwood 27/09/12 Anisa Darr 1/10/12 N/A N/A Nanette Young 9/10/12 Sheila Saunders 16/10/12 Andrew Nathan 26/09/12 Julie Pal 26/09/12 Mathew Kendall 22/10/12 John Murphy 29/10/2012 John Murphy 30/10/2012 John Murphy 30/10/2012

3.

4. Staff and other resources issues clearance obtained (report author to complete) 5. Strategic Procurement clearance obtained (report author to complete) 6. Legal clearance obtained from (report author to complete) 7. Policy & Partnerships clearance obtained (report author to complete) 8. Equalities & Diversity clearance obtained (report author to complete) 9. The above process has been checked and verified by Director, Head of Service or Deputy 10. Signed & dated report, scanned or hard copy received by Governance Service for publishing 11. Report published by Governance Service to website 12. Head of Service informed report is published

ACTION TAKEN UNDER DELEGATED POWERS BY OFFICER IN CONSULTATION WITH CABINET MEMBER(S) (EXECUTIVE FUNCTION)
Subject Officer taking decision Date of decision Date decision comes into effect
Summary

Independent Ageing Improving Information and Advice for People who Fund their Own Care Director of Adult Social Care and Health / Interim Director of Childrens Services 25 October 2012 1 November 2012
This paper sets out the implementation of an improved information and advice support offer and pathway to a larger section of those people living in the borough who fund or are likely to fund their own care. This pathway will be delivered in association with My Care, My Home. Gary Johnson, Customer Finance Manager, Adult Social Care and Health, 020 8359 2289 Public All Appendix 1 Memorandum of Understanding between My Care My Home (MCMH) and the London Borough of Barnet N/A No

Officer Contributors Status (public or exempt) Wards affected Enclosures

Reason for exemption from call-in (if appropriate) Key decision

Contact for further information: Gary Johnson, Customer Finance Manager, Adult Social Care and Health, 020 8359 2289

Serial No. 1821

1. 1.1

RELEVANT PREVIOUS DECISIONS Not applicable.

2. 2.1

CORPORATE PRIORITIES AND POLICY CONSIDERATIONS The Joint Strategic Needs Assessment for Barnet has identified that the population of people aged 65 and over is set to increase by 21% over the next 10 years, and for the 90 plus age group to increase by 55% whilst at the same time resources to the Council to meet the needs of Barnets residents are set to decrease in line with the Governments Comprehensive Spending Review. Increasing access to information and advice is a key element of the councils strategic response to expected increases in demand for adult social care support. Better services with less money Increasing demand for social care is placing significant pressure on council budgets, this pressure is exacerbated by self funders (people who have savings/capital above the nationally set threshold, currently 23,250) who apply for local authority support following the depletion of their savings/capital. The recent publication of the governments interim statement on funding reform for Adult Social Care (July 2012) provides further impetus for the council to put in place an information and advice pathway for people who are likely to have to fund their own care. The establishment of an informal relationship and a pathway with My Care, My Home (MCMH) will provide readily accessible information and advice at an early stage. MCMH are an established national provider of information and advice, already successfully working with a number of other county councils. Through the pathway residents of Barnet will be able to access information and advice supporting them to plan care options for the future, including financial planning and options available to remain independent and living at home. The subsequent reduction in the use of residential care as a long term option, and a reduction of numbers of people whose capital become depleted to the point of requiring the council to fund care will contribute to managing resources effectively and sustainably across the public sector. Sharing opportunities and sharing responsibilities This relationship will be an addition to existing information and advice provision and access referral points will also be located within the older adults neighbourhood model and our NHS partners, supports wider self directed support and the vision for personalisation. It will also increase the offer for people who fund their own care support.

2.2

2.3

3. 3.1

RISK MANAGEMENT ISSUES The proposed arrangement will result in an informal relationship between the London Borough of Barnet and My Care, My Home (MCMH). The proposed memorandum of understanding with MCMH sets out the, informal, referral framework for the information and advice service and the responsibilities of both parties. As the Memorandum of Understanding between Barnet and MCMH will be a noncontractual, non-binding arrangement, the Council will have no entitlement to enforce the arrangement at any point. Consequently, if MCMH fails to comply with

3.2

the terms of the arrangement and decides not to continue with the arrangement, Barnet would be obliged to accept the, relevant, position. 4. 4.1 EQUALITIES AND DIVERSITY ISSUES The public sector equality duty in the Equality Act came into force on the 5th April 2011, Pursuant to section 149 of the Act, the council has a public sector obligation to have due regard to eliminating unlawful discrimination, advancing equality and fostering good relations in the contexts of age, disability, gender reassignment, pregnancy and maternity, religion or belief and sexual orientation. Pursuant to section 149 of the Equality Act, 2010, the council has a public sector to have due regard to eliminating unlawful discrimination, harassment, victimisation and any other conduct that is prohibited by or under the Act; advancing equality of opportunity between those with a protected characteristic and those without; promoting good relations between those with a protected characteristic and those without. The, relevant, protected characteristics are age, disability, gender reassignment, pregnancy and maternity, race, religion or belief, sex, sexual orientation. It also covers marriage and civil partnership with regard to elimination discrimination. The, proposed, non-contractual relationship with MCMH sets out an improved information and advice support offer to a larger section of those people living in the borough who fund or are likely to fund their own care, living in Barnet. It will improve Barnet Councils ability to deliver safe, individualised quality services that do not disadvantage any person and particularly those with protected or unprotected characteristics.

4.2

4.3

5.

USE OF RESOURCES IMPLICATIONS (Finance, Procurement, Performance & Value for money, Staffing, IT, Property, Sustainability) There is potential to reduce the number of self funders who come to depend on the local authority to fund their care. The financial savings for the authority is currently unquantifiable as it will be dependent upon the number of residents of Barnet who utilise the advice service pathway. Other councils who have implemented the pathway have reported a reduction in numbers of people living in residential care depleting their capital and requiring help from the council for on going funding. Collation of this data within Barnet will take place on a monthly basis following the pathway implementation. Customers will be re-directed to this service by customer services. My care, my home will collect the data and pass it on to Barnet. The cost of analysing this data will be absorbed within the Adult Social Care and Health budgets. LEGAL ISSUES The principal terms of the relationship between the council and MCMH are set out in a Memorandum of Understanding (MoU) between the Council and My Care My Home (MCMH). In accordance with the MoU, MCMH will offer information and advice to residents of Barnet.

5.1

5.2

6. 6.1

6.2

The MoU is expressed so as not to create a legal and binding contractual relationship between MCMH and the council. On this basis, the Council will not have the, usual, contractual remedies should MCMH fail to meet the terms of the arrangement or decide not to continue with the arrangement, at any stage There is therefore no need for the Council to procure a service and no contract will be entered into. CONSTITUTIONAL POWERS Council Constitution, Part 3, Responsibility for Functions, Section 6.1 Chief Officers can take decisions in consultation with the Cabinet Member in all matters where they have managerial or professional authority. Whilst the decision to enter into an informal relationship with MCMH for the provision of Information and Advice is a decision for the Director of Adult Social Care and Health, the Director has consulted with the Cabinet Member for Adults who has agreed to the proposed relationship.

7. 7.1

7.2

8. 8.1

BACKGROUND INFORMATION The Dilnot Commission on the funding of care and support in England has recommended a cap of 35,000 on individual contributions towards social care costs. The Government has now published its interim statement of intentions for funding reform in Adult Social Care. This indicates that though changes will happen, the timescale for change is not set and people who have sufficient capital will still require access to good quality information and advice. Meanwhile, people currently considering a decision about finding a place in residential or nursing care are often very worried about whether they can afford the fees and what will happen if their money runs out. The relationship will enable specialist financial advice to be offered to all residents living in Barnet, who wish to use the service, before entering the care system. Demand for social care is rising while the funding available to local authorities is being reduced. The pressure would be even greater if it were not for the 34 to 41 per cent of people (national figures) who are presumed to enter residential care as self-funders. However, if they are not a demand on local authority resources at the outset, they are potentially a future liability for the Council as their capital diminishes. Without appropriate and timely financial planning, self-funders may exhaust their own resources and depend then on local authorities to fund their care needs. There is evidence nationally that 25% of self-funders fall back on local authority funding each year and so they should be regarded as future resource demands on the Council's budget. In these circumstances, it is prudent for the Council to adopt a preventative approach which pro-actively helps residents of Barnet to avoid exhausting their own resources or reducing the rate at which they exhaust their own resources and, at the same time, allows individuals to make an informed choice on improved provision for their old age.

8.2

8.3

8.4

The number of older people living in the community is set to increase significantly by 2020. It is predicted that the numbers aged between 70-74 years will increase by 39% while those aged over 75 will increase by 36%. The increasing age profile brings increased dependency and so, despite the development of more communitybased services, the demographic trends pose a risk that more older people will require long-term care in a residential/nursing setting. Currently, if an individual has capital assets in excess of 23,250, they have to fund their own care home costs. Once their capital falls below 23,250, the Council is required to provide financial support to maintain the placement. Many people in the population believe that long-term care is funded by the NHS. Consequently, they do not plan for the possibility of having to fund their own care in the future and many of them do not know about long-term care funding products such as annuities. There is evidence to indicate that only eight per cent of selffunders receive proper and timely financial advice but only three per cent of local authorities in England and Wales signpost people to appropriately qualified Independent Financial Advisors. Currently ASCH does not routinely provide or sign post self funders to accurate, information and advice about care options and/or reliable and accredited financial information and advice required to plan how to meet the costs of long-term care. With expert financial advice, more residents in Barnet could have the finances in place that would allow them to receive the care they want in their chosen setting rather than being dependent upon ASCH for options and support. The benefits to the Council will materialise over time, preventing further demand through self funders who then become, at a later stage, reliant on local authority for support. The advantages of this single information advice approach to the Council are quality control, having a single point of contact to monitor take up rates and a clear end-to-end process. The independent residential/nursing sector would also benefit. As there is an economic benefit to providers in having financially secure residents, especially taking into account the cost of vacancies and attracting new residents. The proposed Memorandum of Understanding with MCMH will provide for a simplified pathway for residents in Barnet to receive advice about their care, including funding options. A second stage on the pathway will be a referral option to accredited Independent Financial Advice and in particular those advisers who are accredited to provide advice on long-term care financial products. (Note: there are currently 30,000 independent financial advisors (IFAs) in the UK. This referral option is not part of the relationship between the council and MCMH. Ten per cent of these satisfy additional competency criteria and so are qualified to advise on long-term care funding options. These are appropriately qualified SOLLA (Society of Later Life Advisers) and FSA (Financial Services Authority) qualified Independent Financial Advisors. MCMH will as appropriate refer to accredited members of the Society of Later Life Advisers). Appropriately qualified Independent Financial Advisors (IFA) can provide specialist funding care advice including the spectrum of options described above; accounting for income tax; inheritance tax; maximising income and return on investments. The Society of Later Life Advisers (SOLLA), a not for profit organisation, runs a gold standard accreditation scheme for IFAs.

8.5

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8.7

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8.9

The social care white paper, Caring for our future, sets out the governments long term plans for the reform of social care. Both the white paper and the draft Care and Support Bill put the individual at the centre of the care assessment and planning process. The MCMH advice pathway will enable people to make informed choices about care based on quality advice and information. MCMH were approached to offer an information and advice point within the borough as they have already established similar pathways in a number of large county councils and have an established track record in delivering good quality advice. The pathway will be offered alongside a range of other advice pathways and portals from a wide range of local and national information and advice access points that are already established on the website and in leaflets. The proposed model is one which reflects self funding advice services developed by other local authorities. MCMH will offer the following services to all residents within the London Borough of Barnet, who wish to use the service, at no cost to the authority or the customer receiving these services: A needs based care assessment; A care advice service including information on the available care services which appear able to meet the persons assessed need. This element will include advice as to what health and/or social care assistance may be available (from the London Borough of Barnet and the NHS) and how to obtain it. MCMH will offer this initial advice over the telephone and or in the residents own home. The time spent on this free service may be limited to one and a half hours at the discretion of the MCMH Adviser.

8.10

8.11

8.12

MCMH will, after the initial discussion, as appropriate and if requested, provide an introduction to a qualified Later Life Accredited Specialist Care Fees Adviser. This Adviser will provide options to support the funding of the required care service. This service will be provided to those residents who contact MCMH through the Council and other referral routes including self referral and wider information and advice partners such as the older adult neighbourhood model. . In addition to the free advice services listed in 8.11 above, MCMH will offer additional services they charge a fee for. These additional advisory and referral services are not part of the relationship between the council and MCMH. These additional services may include the following ; Advice on how to choose a care provider; includes a professional assessment of up to three care providers. Help in negotiating a contract with their chosen care provider. Advice on the quality of care an individual customer is receiving; this will include regular professional monitoring of the care being received.

8.13

 8.14

Where the customer own a property, a property letting and management service. A property clearance and sale service.

The Communications Plan for the launch of the initial part of the pathway which includes free advice is jointly agreed and all publicity materials are to be jointly branded between the council and MCMH. MCMH will provide monthly reports to the Council on its service activity and responses to its services. MCMH will also notify the council and all other relevant authorities of any safeguarding issues or quality concerns about care services which, in the course of their contact with a resident, come to its attention. The London Borough of Barnet will ensure, in conjunction with MCMH, that all relevant staff in the ASCH department are briefed by MCMH on the services which it can offer and how these may benefit residents of Barnet and the Council. It will also refer telephone enquirers who may benefit from the service for care advice to MCMH and facilitate electronic referrals through the Council website. ASCH will also ensure that health professionals, social care providers and relevant voluntary sector organisations are informed of the service and link them with MCMH to ensure that all first points of access are able to refer to the service. The agreed Communications Plan covers a range of promotional and awareness raising activities to all stakeholders including council staff, councillors, NHS partner organisations, health and social care providers, carers and existing and potential future adult social care users. Activities will range from press releases and newsletter articles to attendance at team meetings and community events. Materials will be distributed to GP surgeries, council offices and local voluntary sector organisations and a publicity campaign will also be conducted on local bus routes and through social media.

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9. 9.1

LIST OF BACKGROUND PAPERS Fair Funding for All (Dilnot Commission), July 2010 at: www.dilnotcommission.dh.gov.uk/ Caring for our future July 2012, Care and Support White Paper at: www.caringforourfuture.dh.gov.uk/ Draft Care and Support Bill, July 2012 at: www.dh.gov.uk/health/2012/07/careandsupportbill/

9.2

9.3

10. 10.1

CONSULTATION WITH CABINET MEMBER(S) The Cabinet Member for Adults has been consulted and has approved the action outlined above.

11.

OFFICER DECISION I authorise the following action

11.1

A Memorandum of Understanding between My Care My Home (MCMH) and the London Borough of Barnet for the provision, by MCMH, of an information and advice support service to Barnet Residents

Signed

Date

Kate Kennally Director of Adult Social Care and Health / Interim Director of Childrens Services 27/10/2012

Appendix 1

A MEMORANDUM OF UNDERSTANDING BETWEEN MY CARE MY HOME AND THE LONDON BOROUGH OF BARNET This Memorandum is dated PARTIES (1) LONDON BOROUGH OF BARNET of Building 4, North London Business Park, London N11 1NP (hereafter referred to as LBB) and (2) MY CARE MY HOME LIMITED whose registered office is at a company incorporated in England and Wales with company registration number 7611603 and whose registered office is at 1 Links Court, Links Business Park, St Mellons, Cardiff CF3 0LT (hereafter referred to as MCMH) day of 2012

(together referred to as the Parties)

The Understanding MCMH and The London Borough of Barnet have reached an understanding of which the following are the main principles agreed by both parties. The Parties agree that nothing in this Memorandum of Understanding shall constitute or be deemed to constitute a partnership pursuant to the Partnership Act 1890 between the Parties or shall be read and construed as evidence of a formal legally binding contract between them.

The Service on offer MCMH, shall offer the following services to all the people of LBB: 1. MCMH will offer at no cost to either LBB or any resident of the London Borough of Barnet who contact it, the following; A professional needs based care assessment; A care advice service including information on available Care Services which may meet the assessed residents need. This element will include advice as to what Health and/or Social Care assistance may be available (from the London Borough of Barnet and the NHS) and how to obtain it. MCMH will offer this initial advice over the telephone and or at the residents own home. This service is Free of Charge and the time spent providing the initial advice may be limited to one and a half hours at the discretion of the MCMH Care Advisor.

An introduction to a qualified Later Life Accredited Specialist Care Fees Adviser who will, provide options to support the funding of the required care service, for which a fee may be payable to the adviser.

2. In addition to the Free of Charge Advice Services listed in 1 above, MCMH will offer the following services which will be charged to the assessed resident (hereafter referred to as the Service User) at rates discussed with the Service User prior to signing the contract to commission them: Advice on how to choose a Care Provider; this will include a professional assessment of up to 3 Care Providers. Help in negotiating a contract with their chosen Care Provider. Advice on the quality of care an individual Service User will receive; this will include regular professional monitoring of the care being received. A property letting and management service. A property clearance and sale service.

3. MCMH will advertise and promote these services at its own expense throughout the London Borough of Barnet.

4. Once the service is formally launched MCMH will provide monthly reports to the London Borough of Barnet of its activity and of the responses it has received to its Services.

5. MCMH agree to alert LBB and the relevant authorities to any safeguarding issues or quality concerns about care services which, in the course of their contact with Service Users and provision of services, come to its attention.

LBB shall use reasonable endeavours to do the following: 1. Ensure, in conjunction with MCMH, that all relevant staff in LBB ASCH Department are thoroughly briefed by MCMH on the Services which MCMH can offer and how these benefit customers and the LBB. 2. To refer telephone enquirers who might benefit from the service for care advice to MCMH in the first instance. LBB is aware that the existing care pathways/processes need to be updated and that new processes are required. The necessary new processes will be agreed jointly between the parties. 3. To facilitate electronic referrals through the LBB web site. 4. To ensure, in conjunction with MCMH, that all GPs working within the London Borough of Barnet are made aware of the Services offered by MCMH and that it is working in partnership with LBB.

5. To assist MCMH to access prospective customers by introducing MCMH to relevant local organisations. 6. To work with MCMH to reasonably ensure that the Care Needs Assessment tool used by MCMH reflects the Council Supported Assessment Questionnaire. 7. To permit MCMH to include the phrase Working in association with the London Borough of Barnet subject to approval on leaflets whose appearance and content have been approved by the LBB. Each of the Parties shall keep confidential all information related to Service Users and agree not to disclose any confidential information except with the consent of the Service User in line with the Data Protection Act 1998 and subject to the Freedom of Information Act 2000. This Memorandum of Understanding is signed but does not establish a contractual relationship on the day and year first written Signed on behalf of THE MAYOR ) & BURGESSES OF THE LONDON ) BOROUGH OF BARNET acting by: - )

Kate Kennally Director, Adult Social Care & Health

Signed by MCMH acting by: -

) )

Director