Care home demanding more money.

[Mutunus]

Apologies for posting in AIBU but desperately need some advice and not sure where to post.
97 year old father in care home. He's been there 5 years. Poor soul doesn't have a life as such now, just stays in bed sleeping 23 hours a day.
Care home have now asked for an extra £250 a week to keep him, but I can't afford that.
3 other homes nearby but all charge much the same. Awaiting decision from council re; upping their contribution but not holding out much hope. Is there anything I can do to keep him there. I might have to consider a bank loan but the thought of him being there another 4 or 5 years is upsetting from a financial and quality of life point of view. Thankyou for reading

And your father shouldn't really be being left in bed 23 hours per day. Although it can be very hard to get some residents out of bed at times. If I had a pound for everytime I heard "I'm 97 years old and I'll stay in bed if I want to young lady" (or similar) I could afford to buy a care home!

My dad (vascular dementia) deteriorated to the point where he couldn't move/speak. He just had to lie in bed and look at the ceiling. Should they have been getting him up?

(Sorry, haven't had the chance to RTFT so apols if this is duplicated above.)
I don't understand why you are having to contribute, unless you have chosen a care home that's more expensive than the going rate in your Council area. If he has no house to sell (which would involve a charge being levied against the property for when it was sold eventually) and savings within the max limit, the Local Authority would fund the difference between his pension income and the care home fee, at the rate agreed with the Council. In some cases, families agree to fund the difference between the standard rate applicable in that area and a higher-spec and more expensive res care home.

This may give you some info:
www.gov.uk/government/publications/charging-for-residential-accommodation-guide-crag-2011

It was half a dozen years ago now but when my DM was in a care home, paid for by the LA, the owner tried to charge me top-up fees (despite the manager off the home telling him it was not allowed. )
The local authority confirmed that he could not do that -- he was , as someone upthread said, trying to guilt me into paying extra.

If he has no savings then the LA should fund his care in the normal course of things. HOwever, it sounds, with such a big jump that his care needs may have changed.

I would guess from the fact that he is bedridden, that he is now needing and receiving nursing care. If this is the case, then the increase in fees could be - at least the majority - covered by the Nursing Care Contribution which is payable by the County Healthcare budget.

Either way, you should stick to what you can afford. They cannot force you to contribute, as others have said and although they would be within their rights to say that you have to find an alternative home for him with a local-authority-priced placement, this almost never happens.

I am CF8 qualified so have dealt with a number of Long Term Care funding situations.

Nobody should be required to pay the bill (or part of the bill) for their relative's care.

A friend who has been through this warned me when my parents went into care last year that the home would probably try to get me agree to plug the gap if necessary, and to be sure to resist the pressure. I know other people in the home have their care fees covered in full so if / when my parents' assets fall to the lowest threshold I intend to hold my nerve and push for them being funded in full.

I'm sorry you're having to deal with this OP......I know how stressful it is and you have my sympathy.

Sorry. Should have said there would be some exceptions to the staying in bed all day. But if that's the case then I would assume he would need nursing care, not residential, which would explain the rise in prices.
Although even the nursing ward of the home where I work get 99% of patients out of bed. They have a variety of specialist chairs that mean they can safely sit up. My manager calls disciplinary meetings if residents are regularly left in bed. Even the ones who can speak and tell him they want to be there we get in trouble!

You shouldn't be contributing. Ask for an urgent assessment from social services. They can make an application for CHC funding if necessary. But if he has no savings / property/assets and his assessed need is to be in residential care, and it sounds likely he does, then they will need to pay until CHC funding comes through (if it does at all). If it doesn't then they will need to fund him. It may be there, it maybe somewhere else.

A lot of people here saying about CHC funding, in our area you can only get CHC funding if your within the last 12 weeks of life. But by all means ask about it.
If he has no assets and saving of under £23000 the care should be provided and you should not be paying a Penny.

You shouldn’t be paying at all, it sounds like

Do they know the £70 is yours and not his?

You should not be paying anything op. Did they guilt trip you into it. If you don’t have a contract with them then I would stop paying this. It is not your responsibility.

Are you paying a top up because there was a cheaper suitable alternative and you chose for him to stay in the home? Did you sign a top up agreement?

I pay the £70 top up as it was something Mum agreed to.
He has vascular dementia hence the sleeping and unresponsiveness.
The staff are wonderful and do treat him well which is the reason for not wanting to relocate him.
I phoned the home this evening and arranged a proper meeting for Friday. I'll also try the social worker tomorrow although from past experience that might be easier said than done.
Many many thanks for your responses. I'll keep you informed

That is £13000 extra a year. Ridiculous to expect you to find that from nowhere.

Do not take out a loan, do not start paying the new rate.

Stop paying the top up. Social services have to fund him and TBH if his dementia is that bad he won't know if he has to move home.

I'm sure there must be some sort of rules which mean they have to justify the huge increase. Ask them for a full breakdown of the increased workload or expenses that your father needs to justify the extra £250 a week.

If the other homes all charge similar rates then it must be this home that has been charging below the going rate until now, which isn't hopeful. But it's good that they're nice and you can have a dialogue with them. Hope the meeting goes well, and as others say, you are not compelled to pay the extra.

Snowpatrolling

A lot of people here saying about CHC funding, in our area you can only get CHC funding if your within the last 12 weeks of life. But by all means ask about it.
If he has no assets and saving of under £23000 the care should be provided and you should not be paying a Penny.

that is not true

CHC funding here is like hens’ teeth. You have to be violent and a danger to yourself and other people to get it. There’d be no chance OP’s dad would get it. Nursing care is another matter and the NHS should be paying that component of his care.

It is so difficult but there are a number of things you can do and your care home manager should help you with what you next move is.

The social services will be willing to pay up to a certain amount and if the home wants more than that then the family top up or the council find a cheaper home. However, now your father is established there the council are under obligation to keep him there and to put pressure on the care provider to lower their costs or come to a compromise. If £70 is all you can afford then dig your heels in.

You should expect to be looking at around £1k-£1300 per week for dementia care (in most areas of the country excluding London) and the council will be expecting that figure. If most of the local homes are the same and he’s settled then you have a pretty good bet that the council will cover it. The home just has to justify the cost to them.

It’s something I do day in day out at work x

that's a massive increase OP... you need a breakdown of exactly why ? good luck amd sorry to hear of this and many others awful situation. 🌺

Just being realistic, someone who is in bed 23hrs and not ‘causing trouble’ is not going to meet threshold for CHC funding I’m afraid.

My OH was in a nursing home for months (and had had complex needs for years prior to that) and Continuing Care funding was consistently refused, even though he met the criteria; and an appeal has simply been ignored for months.

When he was put on end-of-life care it triggered CHC funding. At the point when he was dying and virtually unconscious 24 hours a day his needs were not at all complex (wash him, turn him, make sure ripple mattress was functioning), but he still got the funding for those few days.

Prior to that he had extremely complex needs, but funding was refused.

Totally barmy - and wholly iniquitous.

It would seem that you signed to pay a "voluntary top-up" over and above the amount SSD are prepared to pay. The home has the right to up its fees, but unfortunately SSD does not up their contribution - unless his needs have changed, then they could theoretically reassess and put him into a higher band, as far as SSD contribution is concerned.

If his savings are now nil (including any value in a home that has been sold) then SSD have to fund their contribution; but not the extra required to top up to the cost of a decent home.

Worth (re)applying for continuing health care funding if his needs have changed for the worse. But don't hold your breath - my OH was literally dying before they stumped up any money - for 3 days!

AGE UK a good to talk to as they are on top of all this.

And also the continuing health care funding does nor pay the full cost - they too have a ceiling.

They did not used to have this - and indeed I would query the legality of this - but certainly they did in this area.

I have been through this with my Mum over the past few years she was cared for at home.

As with what everyone else is saying there is a series of things you need to do.

1. You should not be topping up the care fees. If you find your father is eligible for CHC funding then you will not be able to do this anyway.

2. Phone and phone and phone Adult Social Care in your father's area and get them to do an assessment. They will mean test him, which shouldn't include any of your financial information. But also they will help you to do an assessment for Continuing Health Care.

3. Speak to Beacon CHC. They are an amazing organisation, funded by the NHS, to help people with CHC funding. They are free to talk to and very knowledgeable.

4. The other thing to consider, which is what we did for my Mum and Dad is to hire the services of an Elder Care Consultant. The one we used had worked in health services for years, I think she was a nurse and whilst we had to pay she saved us a huge amount of stress and the money we received in CHC funding and additional benefits more than paid for her services.

The thing to constantly remember is neither the LA or CHC want to fund your father's care because it is all about their budgets. But your Father has an absolute right to that care and with the full care that is required. Myself and my family learnt very quickly not be quiet about it, not to sit back and wait. Don't afraid that if you speak up that will put you to the bottom of the pile. You need to get your fight on and not accept anything less than you want and what you want for your father.

My Mum went from 3 visits a day to full 24/7 care because we fought for it.

I am sorry that you are going through this, it is shit and it is the last thing that you should have to deal with at this stage in your Father's life so I really wish you and your Dad well.