To think it’s not fair that we cut public services so that older adults pay less for care?

[Bristol2021]

I work in a local authority which is facing an unprecedented budget deficit, like most councils across the country. Most of the deficit is due to the government demanding that councils pay the ‘fair cost of care’ - demanding they negotiate with local care providers so that the same rate is charged to councils as to people paying out of pocket (who are not eligible for free care). This brings the cost to private payers down a bit, but raises the cost to most councils by £tens of millions. As a result all councils are having to cut hundreds or thousands of jobs, and cut back any services (things like arts and leisure, homelessness prevention, remaining children’s centres) to what is required by law, and lower standards of what’s left. This is all so that relatively affluent older adults pay less out of pocket for care. Those people still get the lifetime cap on care costs regardless of what they pay per week of care. This is the main reason so many councils are facing bankruptcy (with a few exceptions where there’s been serious financial mismanagement). It seems to me that most tax payers are going to see far worse public services, all so that some older adults can pass on more inheritance at the end of their lives. They’re not going to spend much on themselves once they’re dependant in care, so I find it unbelievable that the ‘injustice’ of paying more than a local authority (who are a bulk purchaser) for a care package is being used to justify driving councils to bankruptcy and decimating services for everyone else. Do people not realise this is happening, or do people just care more about their inheritance than they do about schools, rubbish collection, roads, child protection, public health..?

It's not just care home costs. Ofc most people don't go into care homes. But loads need adaptations, little bit of help with cleaning, frames, scooters, home visits etc. None of that is cheap.

I think what the govt is doing to local government is dire.

But isnt ok to ask private individuals to subsidise social care of others

I think what the govt is doing to local government is dire.

But isnt ok to ask private individuals to subsidise social care of others

Agree with this

So far, so Mumsnet, so predictable. The usual errors.
Lets Blame the Tories.
Trust Funds to avoid taxation. My understanding is that over recent years many of the old loopholes have been closed. So that has gone.
Many tax levels have increased over the last 10 years.
Where is the pool of untaxed income that Labour can drain?
Or shall we completely revolutionise the tax system and levy a tax on existing assets. A Wealth Tax? Shall we Confiscate Orphan Assets in banks?
To us these look simple but they would be revolutionary. Fierce debate at home and there would be huge disquiet around the world. It would be about trust in the UK..

To be in a care home (certainly of funded by the LA) you would expect someone to have a level of need which means they need support available all the time, or close to. If you can manage at home with 4 visits a day from carers that's all the LA will fund.

There are 168 hours in a week, so at 1kish that's under £6 per hour for care / food / laundry / accommodation / heating / cleaning.

A room in a house share near me costs around £100 - 175, including bills. So that takes it down to about £5 per hour for care.

Take off say £10 a day for food, another say £20 a week for cleaning, £5 for laundry. That's £4.50 per hour for care.

Also need to pay a proportion of the cost for care home manager, deputy, kitchen staff, care taker etc. let's say a total of 2k per week? So for a home with 40 residents that's another £50.

So we are now down to £4.20 per hour for the actual carers. Carer's probably actually get £9-12 per hour but will cost the company a bit more than that for training, pensions, payroll etc.

There are other costs I've not included I'm sure.

So one person's 1k actually probably pays for maybe 1/3rd of a carer per hour? If that?

I don't know if that's good value but if you pay for care at home you are probably paying around £30 an hour for the care you receive, so would get maybe 24 hours, 3.5 hours a day for the same care costs.

@Bristol2021 wht do you think it is fair for those who can pay for their own care to pay more than a council funded person for the same level of care?

My understanding is that people funding their own care effectively pay a premium to subsidise those being funded by councils. Why do you think that is fair?

I believe those who can afford to should contribute or fully pay for care. I don’t subscribe to the why should they sell their home - they no longer need it, why should our inheritance be used - it’s not an inheritance until they have died and they deserve to be in a place they are looked after.

WRT care costs, a basic calculation I do is NMW £10.42 x 24 hours in a day x 365 days in a year = £91,279.20. That doesn’t include employer NI & pension contributions plus cover for annual leave etc. Effectively if you had carers in your home 24/7 it is £100k a year plus all the standard utility bills, council tax, insurance etc. Residential and nursing homes achieve economies of scale but no way should self funders subsidise council funded places.

The reality is if we want services we all need to be prepared to pay more tax to fund councils etc.

My understanding is that people funding their own care effectively pay a premium to subsidise those being funded by councils. Why do you think that is fair

Exactly, I spoke to someone who runs a carehome business and he quite freely told me this is what happens. They have to keep certain level of private residents in order to be able to accept any local authority referrals, because they private payers subsidise the local authority ones.

It's disgusting.

I have no issue with more taxation if needed, but the current set up where particular individuals (those that need care) take a huge hit for the state is completely unfair.

hmmm. I’m not sure you’re right. The budget for children / children in care , working age adults with LD / Autism / sensory etc is much more significant. Older population has increased, but they aren’t to blame for the disastrous state of local authorities budgets ( blame the government and they’re misguided view that money to the nhs is the answer to everything!) ! I’ve known of packages of almost a million a year for young people.

Absolutely.Wouldnt wish my mother's last six years on my worst enemy, couldn't even shuffle into a different position in bed herself. Completely immobile and terrible contractures in both arms and legs curled up in a tight ball, ,aspirating her food and could only drink tea through a straw in a baby cup (she loved a cup of tea aswell😪). She was kept alive with a massive cocktail of drugs ,of which only a couple were pain relief.
Not to mention even with council help it cost about 60k . We fought for CHC but the system was so corrupt it was impossible so gave up and never got any inheritance to speak of that our parents had always wanted us to benefit from after working hard all their lives.

Effectively if you had carers in your home 24/7 it is £100k a year plus all the standard utility bills, council tax, insurance etc.

One of my relative recently paid for private care in the home (the state provided service just wasn’t there), cost approx 2k a wk. Yes expensive but it meant they stayed in their home & they were happy.

@Bristol2021 your comment "Many people are not eligible for free care and yet struggle to pay,"

Can you explain what you mean by this? I think very few people are eligible for completely free care as their income (pension etc) is used in part. However, I understand that the amount they pay is based on a financial assessment so it doesn't make sense that anyone is struggling to pay (unless they are selecting to top up to choose a more expensive care home).

Frankly the standard of assessment and basic competence in adult social care leaves a lot to be desired and I for one amsick of it being blamed just on funding.
It costs little to give staff access to adequate supervision, debrief and management support and yet the humanity seems to be sorely lacking. Social work should not it's very essence be a human endeavour and relational alongside statutory provision, there is also no reason why statutory care can't be delivered nicely but it isn't. More time and energy seems to be put into justifying poor practice and covering backs than actually utilising the art of being with people.
Really winds me up!

The budget for children / children in care , working age adults with LD / Autism / sensory etc is much more significant.

How do you separate the figures spent on adult social care for working age vs older people?

Another point worth making is that we all know what has happened to inflation over the past year or so, and how much energy prices have shot up (and please note care homes as businesses are not protected by any price caps, we're now paying about 5 times the cost we did a couple of years ago and you can hardly just decide to turn the heating down to save money). But Council fees in many cases have not increased at all over the past few years, so even the money they are able to pay is not going as far. And that's mostly because they are frequently getting less, not even the same, from central government.

Something is not right about this

Firstly the bill is his, not hers and the house would be disregarded as she still lives and joint owns it I assume

Secondly if it has been medically assessed he needs the care then that should come under continuing health care costs.

Why should those with more money subsidise those with less? They already paid more taxes. At 50k a year how long do you think the money will last? You don’t even need to have much money before you have to start paying. And there is no cap. Even if there was it’s for care costs not living costs which is actually the majority of the cost, most people would die long before reaching that and the government knows that. Blame poor government not people unfortunate enough to have done well financially in life.

Why should those with more money subsidise those with less? They already paid more taxes.

How can you ascertain someone with more money as an older person paid more tax?

Many people are not eligible for free care and yet struggle to pay
for someone to not be eligible for free care, they have to have savings over £25k as a minimum.
My stepfather has to pay towards his care so that means all his state pension, less £25 a week, is taken. The LA pay the rest. He’s not ‘struggling to pay’ because he literally has nothing else to spend his money on. The care home provides for his every need.

You could have a situation where one half of a married couple has to go into care, they’ve both paid taxes all their lives and bought their own home. They both earned minimum wage so had no way to pay into a private pension or save up to possibly pay for care costs. They both receive full state pension. As one half of the couple is still at home, the house can’t be sold to pay towards care costs. So the LA has to pay, and their state pension is also taken - less £25 a week.

Someone may have more money due to an inheritance - they may have paid bugger all in income tax!

the house would be disregarded as she still lives and joint owns it I assume

His half won’t be disregarded and her living there is irrelevant if she’s under 60.

What taxes someone has/hasn't paid is a total red herring.

It strikes me as fraud/deception that care homes are charging private individuals substantially more than local authority placements for the same services

The whole system needs a complete shake up. It's totally exploiting some of the most ill people in society

Will my home have to be included in the means test?
In some situations, your home won't be taken into account in the means test. There are a few circumstances where this applies:
If you need short-term or temporary care in a care home, your home won't be in the means test.
If your care home is permanent, it won't be counted if it's still occupied by:

• your partner or former partner, unless they are estranged from you
• your estranged or divorced partner IF they are also a lone parent
• a relative who is aged 60 or over
• a relative who is disabled
• a child of yours aged under 18

https://www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/do-i-have-to-sell-my-home-to-pay-for-care/

If the house is owned as joint tenants, then it’s irrelevant how old the remaining person is.