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Department of Health

Care Act 2014: How should local authorities deliver the care and support reforms? Please give us your views


Choice of accommodation and additional payments

Where a local authority is meeting a person’s needs for care and support and the planning process has determined that a person needs to live in a specific type of accommodation in order to receive care, the person must have a right to choose between different providers of that type of accommodation, subject to certain conditions.

In some cases a person will choose a setting that is more expensive than the amount identified in someone’s personal budget. In these circumstances, an arrangement can be made for a willing and able third party to meet this additional cost.

The drafts take the current directions and guidance and move them on to a firmer statutory footing, and expand the provision to cover certain other types of care that may also include an accommodation element.

The guidance on charging for care and support covers:

  • the principles underpinning choice and the making of additional cost payments
  • the conditions that must be applied in exercising choice
  • how an additional cost payment may be agreed
  • specific circumstances when a person may make an additional cost payment themselves
  • how additional cost payments should be managed
  • the responsibilities and liabilities for additional cost payments if there is any breakdown in the arrangement

The draft Care and Support and Aftercare (Choice of Accommodation) Regulations 2014 cover:

  • the right to a choice of accommodation
  • conditions for the provision of preferred accommodation
  • the application of choice to accommodation provided for mental health aftercare
  • the additional cost condition (top-up fees)
  • the types of accommodation the regulations apply to

See also:

The current provisions only apply to care homes. The draft regulations also cover other types of provision such as Shared Lives and Extra Care Housing. We understand that contractual arrangements for these types of provision can vary, particular if housing and social care responsibilities are split.
Respond to question 27 below.

From April 2016 the additional cost provisions will be expanded to enable a person to meet these costs themselves in more circumstances. This is being introduced to further support choice. Local authorities and the person involved will need to assure themselves of the affordability and sustainability of any such arrangements.
Respond to question 28 below.

Question 27: Does the guidance need to particularly cover these types of accommodation? If so, what would it be helpful to discuss?

Read: guidance on charging for care and support The Care and Support and Aftercare (Choice of Accommodation) Regulations 2014 Back to choice of accommodation and additional payments

Question 28: What are the risks of the expansion of the additional cost provisions so that the person can meet this cost themselves (to both local authorities and the person)? How can any risks be mitigated by regulations and guidance?

Read: guidance on charging for care and support The Care and Support and Aftercare (Choice of Accommodation) Regulations 2014 Back to choice of accommodation and additional payments

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