Care charges — our Open Letter to Brent Council

16 December 2023

To: Cllr Neil Nerva, Cabinet member, Public Health and Adult Social Care cllr.neil.nerva@brent.gov.uk

Andrew Davies, Head of Commissioning, Contract and Market Management andrew.davies@brent.gov.uk

Open letter
Response to Brent Adult Social Care Charging Policy Consultation

Consultation info

We are writing from WinVisible (women with visible and invisible disabilities), a multi-racial grassroots self-help organisation, based at the Crossroads Women’s Centre. We are London-wide with a UK network, and part of the Scrap Care Charges Campaign and Disability Poverty Campaign Group. We include Brent residents in Kilburn, Harlesden & Kensal Green and other wards.

We condemn the Brent proposals to increase care charges, especially as disabled people reliant on homecare are struggling with the cost of living crisis and extra costs of disability such as special diet and adequate heating, and the cost of energy is due to rise again in January 2024.  We are facing a hostile benefits system and government threats to our disability benefits.  We struggle to get PIP, only to see a chunk of the money taken in care charges.  It is harder to qualify for council support, yet many people in need have dropped out of getting homecare because the homecare charges are unaffordable. 

We know the parlous state that care and support services are in, when we are having to wait ages to be assessed for vital homecare, and even longer for adaptations for daily living (OT assessments).  We are very worried that day centres and other places where people can get out of the house, socialise, be warm and get a meal, are under threat.  (In neighbouring Camden, vital long-established support for people with mental distress and other disabled people was destroyed when a number of community centres were closed and sold off to developers to build private rented flats.  The number of sell-offs also drove up rents in the borough.)

We are opposed to cuts in social care generally, see WinVisible’s submission to the Health and Social Care Select Committee inquiry, Social care: funding and workforce.  We support the right to free homecare as in Labour council Hammersmith and Fulham since 2015.

These proposals will hit disabled women/women of colour, who are the majority reliant on support services (as disabled/family carers), immigrant and UK-born people of colour, and people with high needs who cannot do without support services from the council.  We have held public workshops on care and charges, including during the pandemic on Zoom.  Members of the Asian People’s Disability Alliance who took part in discussions we hosted over recent years, have all been very worried about charges, how we are treated, and know the impact on our quality of life and survival.

In a legal challenge against Norfolk County Council by a disabled woman and her mother, the judge ruled that NCC’s increased charges were discriminatory, as unwaged disabled people with high support needs were charged disproportionately more from our income of disability benefits (amounts taken across ESA and PIP), compared to disabled people in waged work whose wages are protected. While other councils denied that the ruling applied to them because their local schemes vary, the discriminatory nature of care charges is undeniable.

In the first year during COVID when social care was deprioritised, at least 25,000 more people on the homecare register died than usual — mostly NOT of COVID, but of thirst and other causes linked to neglect. In Brent there was a 59% increase in deaths, 84 non-COVID to 13 COVID, compared to 61 non-COVID in 2019.  We are worried that these preventable hastened deaths will continue, as any increase in charges increases the number of people who drop out of services because the charges are unaffordable.

Without support services, women alone are living in squalid conditions, our health deteriorates without basic daily living help, or otherwise we have to turn to acquaintances who can turn abusive or even violent.  Women in couples face increased relationship pressures, dependency and risk of domestic violence.

The charging regime in Brent is not the most harsh, however debt and fear of debt is still another pressure on those of us charged for homecare, see: Tax on disability.

Proving disability-related expenses (DREs).  It is already unfair that charging can start before a financial assessment is begun. Proving our DREs usually takes an enormous effort and paperwork, especially for those of us who have any issues with reading and writing, including physical disabilities and visually impaired.  It is unacceptable to charge us full cost of our care if we are unable to supply the information for a financial assessment within a certain deadline.  It is hard to find independent support and effective advocacy, especially at short notice.

Minimum Income Guarantee (MIG) – the amount set by government which we must be left to live on. We object to Brent reducing the amount you add to the MIG from 25% more, down to 10% more.  The MIG is already too low and mean for disabled people, see here.

Homecare charges during hospital stays. It is unjust not to refund charges to people for the first 7 days of homecare charges while they are in hospital, 28 days if they are in hospital from residential care.  The council says that this is to enable continuity of services, and so the person doesn’t lose services.  In that case, the council itself should pay the agency or provider, and also ensure that the pay goes to the paid carers.  Agency carers on zero-hour contracts lose calls and jobs when people go into hospital, causing resentment – but it is not the fault of ill people that their carer goes unpaid by the agency!   

Those of us from communities of colour suffer harsh health inequality due to poverty, deprivation, denial of medical treatment due to immigration status or fear of having children taken, discriminatory medical treatment which harms our health, and language barriers, so we are more susceptible to ill-health and disability within the community.  More people have high support needs. 

Family carers are impacted by increased charges which reduce the whole household income and many women have the added work of challenging the charges on behalf of loved ones we support.

Severely disabled mothers fear that if we are faced with unaffordable care charges, and get into difficulty financially, social services will deem that we are neglecting our children, and they will call in child protection.  Already, disabled mothers face disability discrimination whereby we are denied Care Act support to look after our children, and disproportionately have our children taken away (Channel 5 News)  

We can’t let another council flout the expressed needs, welfare and wishes of disabled/older residents, as some of us have seen with higher charging policies railroaded through despite real hardship. 

We know that councillors, including the Leader, have taken a stand on other human rights issues, and urge councillors not to vote through these increases in social care charges but to seek support from the community to demand increased central government grant.

Sincerely,

WinVisible

This letter was acknowledged as received for the consultation.

Here is a background article about the state of services in Brent.