Care home fees when savings run out - any advice?

[Minitoots]

We have 2 elderly parents in residential care and had to sell their house to pay for the fees. Their savings will run out in the next few months. We'd naively assumed that the local council in their area would meet the costs once funds ran out, but have now discovered that the most they will offer is about 50% of the total fee and we don't have funds to meet the top up either. Apparently the council may even decide they do not need to be in residential care. Has anyone else been in this very worrying situation?

I've contacted 'Age UK' for advice, and also 'Independent age', and also spoke to the Care Advice line (a charity which advises on financing care etc) - they were extremely well informed, but I'm wondering if there is anyone else we can talk to to find out more before approaching the local social services in their part of the country as we would like to be as well prepared as possible before they both have their care needs assessment, and before we discuss anything with them.

What a start to the new year!!

[TE44]

Hi, The link to contineing healthcare may be helpfull, it seems to be attached to NHS, there is a video at the bottom explaining in more detail. I hope they can help you.

https://www.continuing-healthcare.co.uk/continuing-healthcare-guidance/care-home-costs?rmsrc=1&gclid=EAIaIQobChMIgauigYv13wIVY7HtCh3rNQOZEAAYBCAA

Sorry forgot to add link

[JohnL]

Minitoots Wrote:

-------------------------------------------------------

> We have 2 elderly parents in residential care and

> had to sell their house to pay for the fees. Their

> savings will run out in the next few months. We'd

> naively assumed that the local council in their

> area would meet the costs once funds ran out, but

> have now discovered that the most they will offer

> is about 50% of the total fee and we don't have

> funds to meet the top up either. Apparently the

> council may even decide they do not need to be in

> residential care. Has anyone else been in this

> very worrying situation?

>

> I've contacted 'Age UK' for advice, and also

> 'Independent age', and also spoke to the Care

> Advice line (a charity which advises on financing

> care etc) - they were extremely well informed,

> but I'm wondering if there is anyone else we can

> talk to to find out more before approaching the

> local social services in their part of the country

> as we would like to be as well prepared as

> possible before they both have their care needs

> assessment, and before we discuss anything with

> them.

>

> What a start to the new year!!

Is this the issue ?

"If the person paying the top-up fee can no longer afford to pay it, the council has to carry out a new care needs assessment before deciding what to do. They won?t be able simply to move you to a cheaper care home to resolve the need for the top-up fee. For more information, call us on 0800 319 6789 to arrange to speak to an adviser."

https://www.independentage.org/information/support-care/paying-for-care/care-home-top-up-fees

[malumbu]

Have a relly who is paying for live in car (similar cost to a care home) and about to run out of dosh - still has the house so not sure what she can claim. Useful to find out thanks.

[Lynne]

My mother stayed in the same home even when her saving and house sale money had run out.

[Nigello]

It is frustrating and somehow "wrong", though I know that the state cannot afford to pay for everyone, especially as we all live longer (though, perhaps, iller) lives.

I think a penny or two on NI contributions is needed but can you see any party offering that on a manifesto? Get saving!

[tomskip]

When this happened in my family my mother, on behalf of her 93 year old mother, had to get in touch with everyone in the family - all cousins and inlaws - and ask for contributions towards keeping our grandmother in the same care home. Just an absolutely bog standard care home, nothing fancy. Sad and shocking.

[Sue]

Nigello Wrote:

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> I think a penny or two on NI contributions is

> needed but can you see any party offering that on

> a manifesto? Get saving!

Off topic, sorry, but that's similar to why the NHS and Education are in such a sorry state.

Years ago the Tories won an election because they said they would cut income tax (which they did).

Perhaps the people who voted for them didn't realise what their tax was used for.

So, no, people won't vote for anything which involves them paying a little more a month, even if they - and their parents and children - are the losers in the long run :(

I hope you sort things out, Minitoots.

[Pugwash]

Prior to your parents going into residential care, were they assessed by social services? If they were, the assessments would have indicated the level of care that they needed at that time. In most LA it would usually start as needing care at home from home carers and frequency. As their needs increased, a further assessment should have been undertaken and the care package changed. As a rule of thumb most LA social services have a ceiling as to the number of hours and cost of weekly home care. A financial assessment would have been undertaken as to the extent of weekly contributions based on each parent's income.

If an assessment of need was undertaken which indicated that at that time, neither of your parents NEEDED 24 hour care in a care home, social services will not pay. If however your parents WANTED to move to a care home (with or without an Assessment of Need) they would need to be financially responsible for all the care home fees.

I have dealt over the years of many older people who decided that they would rather have the companionship of others and 'care' than staying in their own home with weekly practical help. A few years down the line they realise that savings are running low and care home fees had increased. Since there were no social services assessment of need prior to care home admission, the older person had to now request the social services in the area of their care home now undertake an assessment which would determine as to whether they qualify on the basis of Needs for 24 hour care.

The Care Act 2014 lays down the 'eligibility criteria' in terms of an individual's well being, care and support. This is a detailed Act and defines the basis of all Adult Social Care Assessments undertaken by local authorities.

You mention that savings will run out in a few months time - will they be left with less than approx. ?23,000 each?. As part of the assessment they each will need to complete a Financial Assessment form giving a breakdown of their income from state and occupational pensions, income from investments etc. Also were they getting Attendance Allowance after they moved into the care home?

As many social services have a long waiting time for appointments, it may be wise to book a date for yourselves, social worker and parents asap. Even more so if their individual savings are less than approx. ?23,000.

Care Home fees vary from area to area - some starting around ?600 pw and other around ?1000 pw. Nursing home fees are usually a couple of hundred more per week.

Each LA will have a ceiling as to how much they will contribute each week to costs, Age UK and Independent Age leaflets explain this much better than I can. The ceiling in West Sussex for instance may be ?660 pw but in East Sussex ?600.

Having had 3 relatives in care and Nursing homes, I am well versed. My father due a unforeseen circumstances was forced to live in a care home - he was at that time self caring but partially blind and getting doddery on his feet. His level of savings were such that he paid the full cost of the care home fees. I had Lasting Power of Attorney to deal with his financial affairs, so when he was getting to the 'cut off point' (which at the time was around ?21,000) I contacted West Sussex Social Services for a full assessment of need. As his needs had increased - needed help with personal care, supervision with walking, also early stages of dementia - he was assessed as requiring 24 hour care and following a financial assessment - I paid on Dad's behalf around ?500 per month towards his care with LA paying the remainder. The care home fees were within the LA's ceiling. Years later, with my stepmother going into care- we needed to sell their bungalow, which meant that Dad was back to being self funding. At the time of my father's death, he had severe dementia, blind, deaf, incontinent, wheelchair bound and would under most situations requiring nursing home placement costing almost ?1000 pw. However as a long term resident at his care home, they felt that his needs could be met by them and increased their fees by ?50 pw. - their argument was that this was dad's home and they had the staffing and knowledge to care for him until be died (which was a few weeks later). Without this care home I would have been forced to find a nursing home within his financial means and whose fees would have been acceptable to the LA should his savings fall below the threshold.

Did you parents want to live in a particular area? It may well be that adjoining areas/counties have a wider range of care homes which cost less. It may be wise to find out what else is available in the area and if there are any waiting lists. Sometimes care homes will reduce their costs when self funders savings fall below the threshold. Generally speaking, self funders are charged at a considerably higher weekly fee by some homes, partially as the risk of debts is higher also they are subsidising others who are having part local authority funding. I have known care homes reduce the fees once LA part funding is guaranteed.

In the rare event that both of your parents are found not to be eligible on the basis of their needs, not to require 24 hour care - ask social services about extra sheltered housing in the area and could they be classed as priority need.

[Minitoots]

Hi Pugwash,

Many thanks for your detailed message which I have just seen. You certainly are very well versed in this!

Yes, individual savings from the sale of their house will be less than approx. ?23,000 each in the next couple of months, hence trying to find out as much as possible prior to contacting social services and explaining the situation to our parents.

I could reply in more detail to cut a long story short, my parents live in the country and their house was on a very steep hill down 35 large steps.

They were both hospitalised at the same time in summer 2015 - Dad with severe shingles which left him with delerium and exacerbated his dementia - my Mum had really been his carer before that but at 85 was suffering from extreme anxiety / stress and could not cope. At the same time, she fell down the stairs and broke her hip really badly.

Social services proposed that on release from hospital, both should be carried down the steps to their house and should live in the one downstairs room they had access to with a commode because neither could use the stair lift any more.

We have POA and agreed with my parents that this was not an option.

Provision for sheltered housing in their area is very sparse - there is no-where on the social housing list with an warden on site, and certainly nothing with any overnight staff nearby, or any extra sheltered housing.Neither would have chosen to go into care had it not been for their medical crises.

All a bit of a nightmare!

[Pugwash]

I agree what a nightmare!. It looks as though social services may have undertaken an assessment in 2015. Is it the same social services now as was in 2015?

By the sounds of things - Dad has dementia (which may or not affect his mobility) and your Mum may have reduced mobility as a result of her fractured hip.

If you calculate each parent's income and add on what social services may contribute each week - how much of a difference is there in terms of the fees? Given the fact that your parents appear to have been in the same home since 2015 -3 years plus - there may be a bargaining situation with the care home. Have they mentioned anything to you about the situation?

You may feel that you need an independent advocate to liaise between yourselves, social services and care home. More so if your father's dementia is such that he lacks capacity to determine his needs (Mental Capacity Act 2005). I have always found these professional advocates useful and you should be able to find a recognised advocate organisation in the region/area/county of your parents care home. Good Luck

[IlonaM]

Pugwash Wrote:

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> You may feel that you need an independent advocate

> to liaise between yourselves, social services and

> care home. More so if your father's dementia is

> such that he lacks capacity to determine his needs

> (Mental Capacity Act 2005). I have always found

> these professional advocates useful and you should

> be able to find a recognised advocate organisation

> in the region/area/county of your parents care

> home. Good Luck

Adding to Pugwash's advice, Cambridge House have a very good flowchart for advocacy support under the Care Act which may be of assistance (http://ch1889.org/our-work/advocacy/advocacy-services-southwark/). CH may be able to offer some advice on advocacy support in your parents' area and what to expect/ask.

[Pugwash]

What is the latest situation regarding your parents Minitoots?

Did you manage to sort things out ?

I had carers in whilst looking after my elderly aunt and they covered both day and night. She got on very well with them as It was only a few days. I think she would have got frustrated and bored with them for a longer period as she was not keen on sharing her home with others.

[peckman]

Having lost both parents last year due to dementia I really hope you get the best care you can find. Its such a difficult time and to be Frank seeing all the money disappear that they have saved for their grandkids etc but it becomes irrelevant when they need care . I know cambridge house well through work and they are a fantastic organisation . X I wish you and your parents well x