Results of public engagement about proposed changes to the Wiltshire Council charging policy for adult care

This report presents the findings from public engagement undertaken by Healthwatch Wiltshire on proposed changes to Wiltshire Council’s Adult Social Care charging policy. The engagement took place between April and May 2016 to understand how the proposed changes would affect people who receive care and support, their families, and unpaid carers. A total of 103 people attended seven public events and a further 25 people provided feedback by telephone. 

Wiltshire Council proposed changes because its charging policy had not been substantially updated since 2003, new requirements had been introduced through the Care Act 2014, the Council wanted greater consistency with other local authorities, and increasing demand for services was placing pressure on budgets.

Participants raised concerns about the consultation process itself. Some people reported not receiving consultation letters, the online survey was initially difficult to find, and people with learning disabilities sometimes found it difficult to understand the proposals or participate in the discussions. Despite this, attendees generally praised the engagement events and the helpful approach of Council officers. 

The proposal to take 100% of disposable income into account was the most unpopular change. Many people felt it would leave them with less money for social activities, transport, hobbies, and other aspects of daily life that support wellbeing and independence. Unpaid carers warned that higher charges could increase pressure on families and potentially lead to more people requiring residential care. 

Views on the proposed Attendance Allowance changes were mixed. Some people considered it fairer to assess the full higher-rate allowance, while others argued that the additional benefit was essential for paying for extra care and support beyond what family carers could provide.

Many participants were unaware of the existing Disability Related Expenditure system and had never seen the list of allowable expenses. They were concerned about the removal of continence products from the DRE list, particularly because many people felt NHS continence services did not always meet their needs in terms of quality or quantity of products supplied. Participants feared this could reduce confidence and independence, and some worried they would be less willing to leave their homes. 

Opinions on the proposed respite care charging changes were divided. Some people felt the proposals were fair, while others worried that higher costs would discourage the use of respite services, increasing stress on unpaid carers and creating additional pressures on families supporting people with dementia or other complex needs.

People with learning disabilities expressed anxiety that increased charges would reduce their ability to take part in social, leisure, and community activities. However, targeted sessions and clearer explanations helped address some misunderstandings and reassured participants that the proposals related to financial contributions rather than reductions in care provision. 

Healthwatch Wiltshire concluded that most participants accepted the principle that people should contribute what they can afford towards their care costs. However, many believed that the proposed changes would disproportionately affect vulnerable people and their carers. Carers were particularly concerned about cumulative financial pressures and the impact on family wellbeing. The report also highlighted the need for greater awareness of Disability Related Expenditure and recommended that information about allowable expenses be routinely provided during financial assessments. 

The report recommended that Wiltshire Council and NHS Wiltshire Clinical Commissioning Group address concerns about continence services, ensure Disability Related Expenditure information is shared with service users, provide easy-read information for people with learning disabilities, and monitor the impact of any changes on service users and carers. The findings were submitted to Wiltshire Council Cabinet to inform its decision on the charging policy.