CQC Quality Statements

Theme 1 – Working with People: Supporting people to live healthier lives

We Statement

We support people to manage their health and wellbeing so they can maximise their independence, choice and control. We support them to live healthier lives and where possible, reduce future needs for care and support.

What people expect

I can get information and advice about my health, care and support and how I can be as well as possible – physically, mentally and emotionally. I am supported to plan ahead for important changes in my life that I can anticipate.

1. Who are Self-Funders?

Self-funders are adults who arrange and pay for their own care in full. This may be funded from their own finances, or another private source such as a family member. It includes people who receive direct payments who can choose how to spend their payments to meet their care and support needs.

2. Local Authority Duties

A local authority has a duty to meet the needs of all adults who are assessed as having eligible needs (see Eligibility chapter). There are two exceptions to this:

  1. when the person is a self-funder and does not want the local authority to meet their needs;
  2. where a person lacks mental capacity and there is a person authorised or in a position to arrange their relevant care and support.

If the local authority – having carried out a financial assessment (see Charging and Financial Assessment chapter) – is satisfied that the adult who wants to self-fund has financial resources that are over the financial limit (£23,250), the adult can ask the local authority to meet their needs. The local authority would charge for meeting the adult’s needs, as they have above the capital limit. It can also charge a fee for arranging the provision of care and support for the adult.

During the passage of the Care Bill, the government described this an “important and ground-breaking right” for self-funders to ask the local authority to arrange care and support on their behalf.

3. Local Authority Discretion

Where the self-funder asks the local authority to meet their eligible need for care home accommodation, the local authority may chose to do that but it is does not have to. Where the adult’s needs are to be met by some other type of care and support and not care home accommodation, the local authority must meet those eligible needs.

It was intended that the duty on local authorities to also meet the eligible needs of self-funders in a care home would be implemented on 1st April 2015. However, this reform (along with other financial reforms) has been delayed.

4. Mental Capacity

The exception outlined above in Section 2, Local Authority Duties does not necessarily apply to those adults lacking mental capacity.

Where an adult who lacks capacity to make such a request to the local authority has finances above the financial limit, it may be made by someone else acting on their behalf. The person making the request on behalf of the adult can only do so if this was in the adult’s best interests (see Mental Capacity Act and Code of Practice chapter).

The person or other interested party or the local authority could then arrange for the payment of the local authority’s charge through a deputyship.

5. Financial Differences in Who makes the Arrangement

If an adult or a family member makes the arrangements with a care home, the adult will pay the market rate for the bed in the residential accommodation.

A local authority, acting on behalf of the adult who has fallen below the capital limit, will probably be able to negotiate a lower rate with the care home than the adult who is a self-funder. This is often due to the local authority being able to ‘block book’ beds, which will not be available to the person who is self-funding.  The local authority will also have framework agreements with various providers in their area through which they can purchase the same services but often at a reduced rate.

6. Further Reading

6.1 Relevant chapters

Assessment

Care and Support Planning

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