Care home fees

[Dementiadad]

I want to preface by saying I have no issues about paying care home fees...

however...

my dad has dementia and until a year or so ago was just about managing to cope at home with carers coming in three times a day for an hour a time. He lives alone as my parents are divorced.

Last autumn he started wandering and getting lost. We got a tracker and for a long time my sister and I would find him and bring him home. We kept on at social services for help as we were exhausted from it - his last care call was at 9pm and often he would go out again afterwards. No help was forthcoming, we were told just to call the police. The police were involved on numerous occasions, each time they refused to take him home as he would be alone and they deemed him at risk and so we would have to go get him/ have him dropped to our houses (where he cannot stay long term for several reasons). Social services still maintained he was capable of living at home and would not agree to him going into a home unless he agreed (which he would not as he has no clue what is going on). We were basically on our knees begging for help but got nowhere.

It has just got worse from there culminating in him getting lost in torrential rain in May, no tracker on, social media, police all looking for him - he was found bloodied and bruised from an apparent fall 6 miles from home a day later and taken to hospital.

The hospital refused to release him home, he was kept in for a week before it was decided to move him into a home. Social services found a place and he has been there 5 weeks.

He now moves into self funding as he owns his home and has some cash savings. His income is £18k a year pre tax.

I have just received the form re financial assessment. The letter attached says the home has been charging the council £650 a week. My dad will be charged £1,700 a week as a self funder.

I asked why the difference and the home basically said that is all the council will pay and they charge self funders more to make up the difference.

We looked around at other homes, pretty much all in the area charge the same and he is settled now and so I don't want to move him.

I am disgusted by this. Not only will all his savings and home be gone within 2 years or so we then have to hope that the council will let him stay there - the care home says it will all depend on whether they have any council places when the money runs out. I hope that because the council moved him here that they will agree he stays here (the risk of moving him is that they say we chose to go elsewhere).

I just don't feel it is right - that dad is not only paying for his own care but also doubly subsidising those with council places (he still pays tax)? If the fees were £1,200 a week (which is probably nearer the true cost) there is a better chance of him outliving his money.

AIBU? The council should be paying the true cost and not making the unlucky ones pick up the tab?

£650 a week council rate for London sounds incredibly low. You may want to ask about TOP UPS, as many care homes charge them to people paying council rates, but its only a little boost for the home and nowhere near the self funder rate youre paying.

Is it fair? Of course not. The home would say that the self funder rate is the true rate and the council underpay. The reality is £650 may be enough and theyre just milking self funders for as much as htey can get away with, if you see what I mean. Is it fair that council rates (i.e. for people who qualify are lower), of course not, but thats the way of the country. Same for pension credit etc.

Some homes will charge the same rate to self funders. You have picked a particularly greedy one.

Why is it unfair ?

That is literally how tax works. People who can pay it get charged more to fund the services of people who can't.

Interesting - so if we just left him to get into these awful situations we could have received a funded place? It really shouldn't be necessary for people to have to get to that point, where is the dignity?

Dad had already used up massive amounts of police time over the past six months - once a week at least he was picked up.

I used to work for a large national care provider and the LA funded residents and private residents got exactly the same service facilities and care.
The difference between LA and private costs per bed weren't quite as big, but as the LA is thd biggest customer and on whom the home depends for income, they can negotiate lower costs as they hold the purse strings.

But not everyone gets dementia? Just those with dementia and more than £23,250 to their name have to pay.

Some people don't have children but their tax still pays for schools or should we charge those with children more?

This was exactly what the care home told me today - almost word for word.

I feel like this isn't common knowledge though.

Have you heard of 'continuing healthcare'? My friend obtained this for her mother who was in a care-home with dementia. The NHS paid for 100% of the care-home fees. You can download a free guide: https://beaconchc.co.uk/register-for-your-free-toolkit/
You can either apply yourself or ask a specialist firm to represent you. It is a minefield, that's why there are firms that will help you apply. My friend had a bit of a fight to get it but worth it in the end.

Have a look at this www.adviceoncare.co.uk/Immediate-Needs-Annuity.html#:~:text=Immediate%20need%20annuities%20are%20specialist,no%20maximum%20upper%20age%20limit. You would probably have to sell his house but at least he wouldn't be turfed out of the current care home.

Dad got 6 weeks because of his injuries and coming from hospital but I have been told that's it. But thank you - I will look into this.

The council (a London borough) has no care homes, they have negotiated places in private homes - all over the country as they asked whether we would consider a home over 50 miles away.

I doubt any councils run their own care homes. Its just not efficient so they leave it to the private sector. But please be aware, whether self funder or council funded you can pick anywhere in the country to live. The service user has a lot of choice in the matter. Also see my post above, in case you missed it.

It depends on what section of the mental health act was used. If section 3 was used then aftercare is free under section 117 however section 3 criteria are quite specific

https://www.legislation.gov.uk/ukpga/1983/20/section/3

You really think if a care home place costs £1,400 per week but LA fund £800 per week that self funders have to pay £2,000 to cover the shortfall?

Self funders will be paying tax on their income (quite rightly) which contributes to the LA £800 so it’s a double tax to pay part of another persons care costs on top is not fair.

I would be trying to find a place that only has self funders so the costs are spread fairly.

Sadly 950 is cheap. It can be up to 2500k a week for specialist dementia care. It average around 1000-1500. I see patients in community...no link to homes...just shocked how much. However yesterday I saw someone with dementia who sadly was spitting and scratching everyone. It's not the person but the horrible disease but the staff certainly are worth their weight in gold. They were calm and gentle with her despite the words and actions are gave back. They and I explained carefully what we needed to do. Patient was a lot more comfortable afterwards.

What you describe is absolutely the norm and has been for years and years. The self funders subsidise the council funded residents. It is really a massive additional tax on savings and pensions. The state can't afford to pay more though.

I am amazed you managed to get the figures out of them. So many care homes and councils are reluctant to give any figures.
When DM was in the care home the annual increase was always well above inflation and if you queried it then there was room for negotiation so I dread to think how much some people were conned into paying.
Whenever the big boss visited he always parked down the road so staff and relatives never saw his fancy car

Care home owners have clearly managed to spin this in their favour. They may say that self funder fees are propping up the council rates but the reality may be nearer that the council rates are fair and they are simply squeezing as much out of self funders as they can possibly get away with. They are all businesses at the end of the day - they care about the bottom line more than the residents. As I mentioned earlier, some care homes that are more moral charge the same rate to self funders as they do council funded.

However yesterday I saw someone with dementia who sadly was spitting and scratching everyone. It's not the person but the horrible disease but the staff certainly are worth their weight in gold. They were calm and gentle with her despite the words and actions are gave back

They could hardly be anything other than calm and gentle with her, with a 3rd party present! Not suggesting that those particular carers are anything but professional at all times, but it’s not always the case when carers are not being observed.

I really wasn't aware and I really do not think it is common knowledge. Maybe I am just naive.
Surely this could turn into a massive issue though - what if the proportion of self funders drop? Why are care homes allowed to profit out of people in desperate situations?

Didn't Boris increase NI by 2% to be ring fenced for social care a few years ago?
Then Rishi pulled the plug and reduced it by 4%.
We can't have our cake and eat it. I know we all want decent care in our later years, but it comes at a cost, which ultimately if we want to get rid of the situation you are in OP, then we need to be paying for it in our tax when working.
We are in a similar position with my mum, she has Alzheimers, and we are looking for a place at the moment. She has no money, no house, council house all her life, and we are being shunted towards private homes where there will be a large top up needed as the council will only pay so much. We are in Scotland btw, so everything is a bit different.
My understanding is she will get around £950 per week from the council, but everything we are looking at is costing £1200-£1500 per week.
it is very frustrating, because we will have to make some difficult decisions about the care we can afford vs the care we want for her.
As others have said, it also brings a huge amount of fear for the future for myself, and what my kids may have to do for me, but what can we do about it?

They are allowed to profit because if they weren't what would be their point?
They are private not NHS run, so ultimately you only run a business for the benefit of the owner/shareholders. Profits are the raison d'être

The letter from the council told me the figures - I asked them in that case could the council not pay and then we pay the council back but I was told no.

Maybe they say how much they pay to enable a conversation/ negotiation with the home.

its unlikely that the number of self funders will drop as the current & next generation of ppl going into care homes are home owners however the generation after are less likely to be home owners and then it will become more of a problem

small care homes have been going bust all over the place. It’s becoming more and more common for care homes to be larger and run by large corporate organisations

tbh the age charities have been doing their best to raise awareness of this for years but generally the public aren’t interested in social care until it affects them personally

When the proportion of self funders drops the self funders fees go up. 10 years ago the ratio was around £500:£1500. Same care home today is about £700: £2500. I know because my friend's husband is in the same home that my mum was in. It rattles through the pension and savings very quickly, with no guarantee you can stay in the same home when your money runs out. They have to maintain the correct ratio to keep the place going.

Its a marketplace and private rates are determined by local demographics. There will be parts of the UK where a private bed is still £650.

You generally can stay in the same home when your saving run out as if they kick you out it's bad for business. People would go to the papers and it causes reputational damage.

Are there any social enterprise care homes? They wouldn't be obliged to make a profit for the owner or shareholders.