Regulation 86D
[F1SCHEDULE 4AAPPLICABLE AMOUNT OF A JOINT-CLAIM COUPLE WHERE A MEMBER IS IN A RESIDENTIAL CARE OR NURSING HOME
Textual Amendments
F1Sch. 4A inserted (19.3.2001) by The Jobseeker’s Allowance (Joint Claims) Regulations 2000 (S.I. 2000/1978), reg. 1(1), Sch. 2 para. 55
1. In this Schedule, “the relevant member” means a member of a joint-claim couple to whom regulation 86D applies.
2. The weekly applicable amount of a joint-claim couple where one member of that couple is a relevant member shall be the aggregate of—
(a)the weekly applicable amount which is applicable to a member of the couple who is not a relevant member calculated in accordance with regulation 83(a), (c) or (e) as if that member was a single claimant;
(b)subject to paragraph 4, the weekly charge for the accommodation, including all meals and services, provided for the relevant member increased, where appropriate, in accordance with paragraph 3 but, except in a case to which paragraph 11 applies, subject to the maximum determined in accordance with paragraph 4;
(c)a weekly amount for personal expenses for the relevant member determined in accordance with paragraph 12; and
(d)where the relevant member is only temporarily in such accommodation any amount applicable under regulation 86A(d) or 86B(e) (housing costs) in respect of the dwelling normally occupied as the home.
3.—(1) Where, in addition to the weekly charge for accommodation, a separate charge is made for the provision of heating, attention in connection with bodily functions, supervision, extra baths, laundry or a special diet needed for a medical reason, the weekly charge for the purpose of paragraph 2(a) shall be increased by the amount of that charge.
(2) Where the weekly charge for the accommodation does not include the provision of all meals, it shall for the purpose of paragraph 2(a), be increased in respect of the relevant member by the following amount—
(a)if the meals can be purchased within the residential care or nursing home, the amount equal to the actual cost of the meals, calculated on a weekly basis; or
(b)if the meals cannot be so purchased, the amount calculated on a weekly basis—
(i)for breakfast, at a daily rate of £1.10;
(ii)for a midday meal, at a daily rate of £1.55; and
(iii)for an evening meal, at a daily rate of £1.55,
except that, if some or all of the meals are normally provided free of charge or at a reduced rate, the amount shall be reduced to take account of the lower charge or reduction.
4. Where any part of the weekly charge for the accommodation is met by housing benefit, an amount equal to the part so met shall be deducted from the amount calculated in accordance with paragraph 2(a).
5. Subject to paragraph 11, the maximum referred to in paragraph 2(a) shall be in respect of each relevant member, the appropriate amount in respect of him specified in or determined in accordance with paragraphs 6 to 10.
Residential care homes
6. Subject to paragraphs 8 to 10, where the accommodation provided for the relevant member is a residential care home for persons in need of personal care by virtue of—
(a)past or present mental disorder but excluding mental handicap, the appropriate amount shall be [F2£243.00] per week;
(b)past or present drug or alcohol dependence, the appropriate amount shall be [F3£243.00] per week;
(c)mental handicap, the appropriate amount shall be [F4£276.00] per week;
(d)physical disablement, the appropriate amount shall be [F5£314.00] per week;
(e)any condition not falling within sub-paragraphs (a) to (d) above, the appropriate amount shall be [F6£229.00] per week.
Textual Amendments
F2Sum in Sch. 4A para. 6(a) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(a)(i)
F3Sum in Sch. 4A para. 6(b) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(a)(ii)
F4Sum in Sch. 4A para. 6(c) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(a)(iii)
F5Sum in Sch. 4A para. 6(d) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(a)(iv)
F6Sum in Sch. 4A para. 6(e) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(a)(v)
Nursing homes
7. Subject to paragraphs 8 to 10, where the accommodation provided for the relevant member is a nursing home for persons in need of personal care by virtue of—
(a)past or present mental disorder but excluding mental handicap, the appropriate amount shall be [F7£343.00] per week;
(b)mental handicap, the appropriate amount shall be [F8£349.00] per week;
(c)past or present drug or alcohol dependence, the appropriate amount shall be [F9£343.00] per week;
(d)physical disablement, the appropriate amount shall be [F10£387.00] per week;
(e)terminal illness, the appropriate amount shall be [F11£342.00] per week;
(f)any condition not falling within sub-paragraphs (a) to (e), the appropriate amount shall be [F12£342.00] per week.
Textual Amendments
F7Sum in Sch. 4A para. 7(a) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(i)
F8Sum in Sch. 4A para. 7(b) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(ii)
F9Sum in Sch. 4A para. 7(c) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(iii)
F10Sum in Sch. 4A para. 7(d) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(iv)
F11Sum in Sch. 4A para. 7(e) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(v)
F12Sum in Sch. 4A para. 7(f) substituted (coming into force in accordance with reg. 1(3) of the amending S.I.) by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001 (S.I. 2001/1785), regs. 1(1), 3(b)(vi)
8. The appropriate amount applicable to a relevant member in a residential care home or nursing home shall, subject to paragraph 9, be determined—
(a)where the home is a residential care home registered under Part I of the Registered Homes Act 1984, by reference to the particulars recorded in the register kept by the relevant registration authority for the purposes of that Act; or
(b)where the home is a residential care home not so registered or a nursing home, by reference to the type of care which, taking into account the facilities and accommodation provided, the home is providing to the relevant member.
9.—(1) Where more than one amount would otherwise be applicable, in accordance with paragraph 8, to a relevant member in a residential care home or a nursing home, the appropriate amount in any case shall be determined in accordance with the following sub-paragraphs.
(2) Where the home is a residential care home registered under Part I of the Registered Homes Act 1984 and where the personal care that the relevant member is receiving corresponds to the care received by a category of residents for whom the register indicates that the home provides accommodation, the appropriate amount shall be the amount, in paragraph 6, as is consistent with that personal care.
(3) Where the home is a residential care home which is so registered but where the personal care that the relevant member is receiving does not correspond to the care received by a category of residents for whom the register indicates that the home provides accommodation, the appropriate amount shall be the lesser or least amount, in paragraph 6, as is consistent with those categories.
(4) In any case not falling within sub-paragraph (2) or (3), the appropriate amount shall be whichever amount of the amounts applicable in accordance with paragraph 6, 7 or 8 is, having regard to the types of personal care that the home provides, most consistent with the personal care being received by the relevant member in that accommodation.
10.—(1) Where the accommodation provided for the relevant member is a residential care home or a nursing home which is, in either case, situated in the Greater London area and the actual charge for that accommodation exceeds the appropriate amount in his case by virtue of the preceding paragraphs of this Schedule, the amount shall be increased by any excess up to—
(a)in the case of a residential care home, [F13£48.00];
(b)in the case of a nursing home, [F14£53.00].
Textual Amendments
F13Sum in Sch. 4A para. 10(1)(a) substituted by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001, (S.I. 2001/1785) reg. 1(1), reg. 3(c)(i)
F14Sum in Sch. 4A para. 10(1)(b) substituted by The Income Support and Jobseeker’s Allowance (Amounts for Persons in Residential Care and Nursing Homes) Regulations 2001, (S.I. 2001/1785) reg. 1(1), reg. 3(c)(ii)
Circumstances in which the maximum is not to apply
11.—(1) Where a relevant member who satisfied the conditions in sub-paragraph (2) has been able to meet the charges referred to in paragraphs 2 and 3 without recourse to a jobseeker’s allowance, income support or supplementary benefit, the maximum determined in accordance with paragraph 5 shall not apply for the period of 13 weeks or, if alternative accommodation is found earlier, such lesser period following the date of claim except to the extent that the claimant is able to meet out of income disregarded for the purposes of Part VIII the balance of the actual charge over the maximum.
(2) The conditions for the purposes of sub-paragraph (1) are that—
(a)the relevant member has lived in the same accommodation for more than 12 months;
(b)he was able to afford the charges in respect of that accommodation when he took up residence;
(c)having regard to the availability of suitable alternative accommodation and to the circumstances mentioned in paragraph 12(5)(b) of Schedule 2 (housing costs), it is reasonable that the maximum should not apply in order to allow him time to find alternative accommodation;
(d)he is not a person who is being accommodated—
(i)by a housing authority under Part III of the Housing Act 1985 (housing the homeless); or
(ii)by a local authority under section 20 of the Children Act 1989 (provision for accommodation for children: general) or, in Scotland, section 12 of the Social Work (Scotland) Act 1968 (general welfare); and
(e)he is seeking alternative accommodation and intends to leave his present accommodation once alternative accommodation is found.
(3) Where—
(a)the relevant member was a resident in a residential care home or nursing home immediately before 29th April 1985 and has continued after that date to be resident in the same accommodation, apart from any period of temporary absence;
(b)immediately before that date, the actual charge for the relevant member’s accommodation was being met either wholly or partly out of his resources, or, wholly or partly out of other resources which can no longer be made available for this purpose;
(c)since that date, the local authority have not at any time accepted responsibility for the making of arrangements for the provision of such accommodation for the relevant member; and
(d)the Secretary of State is satisfied that, unless this provision applies in the relevant member’s case, the joint-claim couple of which he is a member will suffer exceptional hardship,
the maximum amount shall be the rate specified in sub-paragraph (4) if that rate exceeds the maximum which, but for this sub-paragraph, would be determined under paragraph 5.
(4) For the purposes of sub-paragraph (3), the rate is either—
(a)the actual weekly charge for the accommodation immediately before 29th April 1985 plus £10; or
(b)the aggregate of the following amounts—
(i)the amount estimated under regulation 9(6) of the Supplementary Benefit (Requirements) Regulations 1983 as then in force as the reasonable weekly charge for the area immediately before that date;
(ii)£26.15; and
(iii)if the relevant member was entitled at that date to attendance allowance under section 64 of the Benefits Act at the higher rate £28.60 or, as the case may be, at the lower rate, £19.10,
whichever is the lower amount.
Personal allowances
12. The allowance for personal expenses for the relevant member referred to in paragraph 2(b) shall be—
(a)for the relevant member, [F15£16.05]; and
(b)for the other member of the joint-claim couple, [F15£16.05];
(c)for a young person aged 18, [F15£15.25];
(d)for a young person aged under 18 but over 16, [F15£10.55].]
Textual Amendments
F15Sums in Sch. 4A substituted (with effect in accordance with art. 1(2)(i) of the amending S.I.) by The Social Security Benefits Up-rating (No. 2) Order 2000 2001 (S.I. 2001/207), arts. 1(2)(i), 22(9), Sch. 15