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?

No we have no third parties involved in this decision, thanks, we do have some paid carers at the moment who have been outstanding when the council told us she didn't need care.
We also were told she didn't qualify for attendance allowance - it was only when I realised my neighbour who is still driving gets it, that we pursued that claim for the third time.
My neighbour does have serious issues, so i am not suggesting they don't need what they're getting, it was just a huge surprise that my mum did not qualify!! A lovely retired social worker told us how to correctly answer the questions asked - I think were in denial at the time about how bad mum's needs actually were.

We did try this - we did it for respite care a few times when we went on holidays/ needed a break.
There were a few issues - they were not allowed to physically keep him indoors which didn't solve the problem of him going out and getting lost (especially when he would disappear in the middle of the night). We also had an issue of the agency just failing to send someone/ no one turning up. This was an agency that was recommended by social services and the last time we did it was over Easter this year - social services ended up agreeing that it did not work and the plan was for a longer spell of respite over the summer in the home he is in now.

The live in carer still cost almost £1500 a week for respite care plus all the food/ running costs of the flat so not too different financially but higher risk. Dad definitely benefits from being around other people in the home and all the activities they provide.

Sorry, I meant "third party top up fees". What this means is that some homes charge a weekly fee to council funded residents which is ON TOP of the weekly fee. It could be £50 a week, it could be a lot more. Its called third party cos the resident themselves isnt meant to pay it, the third party is, like a family member usually.

Here's a link if anyone is interested though its not strictly accurate. The top up usually isnt to make up the shortfall, its usually just a little bit extra.

https://www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/top-up-fees/#:~:text=If%20you%20choose%20a%20home,'top%2Dup%20fee'.

Oh @Pinkbits I see what you mean, we have yet to declare our preferred home, so will look out for this. Thank you!

I have absolutely no issues if someone hasn't the money to pay care home fees - if they need it then they should absolutely receive it. I am pleased council and self funders get the same level of care at dad's home.
We are supposedly a civilised country - we should treat our elderly with a bit more dignity.
I dread to think what happens to elderly people with no one looking out for them- we have had to fight and keep on keeping on to get any sort of help for Dad.

Sometimes you can pay an admin fee to the council and they will commission the care and you pay them instead... whi
ch might work out cheaper

Yes you are right, councils need more money.
I actually think though it is quite a good thing that self funders and those who are fully funded are together, rather than a rich home and a poor home.
That's why I think more has to be done via tax and limits to assets, but it is a difficult decision to make, some people have saved very hard to get a small house and lots of people have assets of huge worth, how can anybody make a proper decision about this. People have very different lives and who can be the judge of who gets allowed to keep what.
But the cost is there and has to be met because no government has dealt with it properly.

I seem to think this used to happen but once the industry cottoned onto it then it was stopped as it was costing them too dearly. If it was true then Martin Lewis would be screaming it from the rooftops as it would save thousands.

I think all you can pay councils for now (if youre a self funder) is to help you find somewhere.

They said no! I guess they are only allocated a certain number of rooms at this rate and Dad would take up one which would then leave the council low on spaces - they couldn't do this for everyone.

No advice but right there with you.
My nan is fully cognitively intact and competent by has agreed to move to a care home because of poor mobility.

She is absolutely gutted that it looks like she will have to sell her house to fund care. She worked 3 jobs to buy her house and she wanted it to be a nest egg for me and my sister.

Obviously I just want her to be safe and happy but I fully get how galling it is for her

It's infuriating.

But the councils only pay so little because their own funding for social care has been cut to the bone - Institute for Fiscal Studies says council funding is 18% down in real terms per person vs 2010 and a huge proportion of council funding is spent on social care.

You need to do all the sums, but you may find you simply have to suck it up - if DF is settled, and his money is likely to run out before he dies, then it's not worth moving him to a private-only home. BUT he may have to move later for nursing care anyway.

There is no way he will qualify for CHC, but you can try if you like.

The council don't buy x number of beds from a home, they just contract with the home to agree to use it. Market forces decide how the homes fill up. If a home can get majority self funders then it will, likewise if it can only get council funded then it will. Vacancies/under occupancy are bad, so they'll offer any vacant beds usually to the highest payer at the time. Its a love/hate relationship between the two. The council needs the private sector to meet its responsibilities, the care homes need the council to make sure their homes are as well occupied as they can be. Wholly private care homes that dont take council funded are non existent round my way so no comments on those.

The poor self funder is stuck in the middle as nobody is negotiating their rates for them. Ideally it should be one rate for all but thats sadly not how it is.

There has been talk of capping the self funding but it never happens, government has failed this for decades.

Yes it's utterly unfair - if you're unlucky enough to get dementia then you could end up paying (say) £90,000/year x 10 years = a £900,000 tax at the end of your life.

I do wish there was a fairer way of doing it. I'd happily pay more tax to cover a fair share of it, but as someone said, no government will put that on a bus.

I also wish there was an easy Dignitas style way of opting out of life once you have dementia with a certain severity - I would sign up for definite!

I also think the issue with dementia is that it is not classed as an illness for these things?
Far more resource is available if you have cancer or some other life limiting illness, whereas dementia is seen somehting everybody gets once they are a certain age.
Which is factually incorrect!

I dont think it ever happens as these are businesses at the end of the day and profit isn't a dirty word. It's like the denationalisation of railways etc - councils got rid of their own homes so private sector took over. Although there is nobody fighting as such for the Self Funders, it again comes down to the marketplace. If people voted with their feet and chose the homes whose fees were lower then that may cause the more expensive ones to lower their rates. But there is no doubt collusion between differnet companies in the same area to ensure they're maximising profits.

As for CHC I think its when you have predominantly health needs rather than social care needs?? And dementia alone doesnt meet that criteria.

I agree with this. But you have to have a separate bedroom and bathroom for the carer and be able to fund or provide care on the carer's days off. My parents downsized but then couldn't have a live in carer because they only had one bathroom.

The state of self funder V LA funded care is shocking.

However, what I would say os if you can look into getting a live in carer the council cannot take your dad’s home as an asset (as he still lives in it) so therefore his financial assessment wouldnt include his house, so he may fall nearer/if not into the council assisted or council fully funded bracket.

The other thing you don't realise at first is that, (in my personal experience of 2 sets of elderly relatives), you have to visit every day. You have to keep track of the clothes, the glasses, the teeth, the hearing aids, the slippers, the shoes. You have to make sure they are getting their food, water, medicine. You have to buy toiletries, keep reminding about cutting their nails, etc.
Make sure they don't go in with anything valuable.
There may be wonderful places where these things are not a problem, but I haven't come across one yet.

My elderly relative’s care ended up being in excess of £8,000 a year. Each year it went up in excess of inflation, but there was no other option at that point. We also became aware at a certain point that she was paying more than other privately funded residents (we suspect because they knew she could afford it), but another resident’s family complained about the fees and the resident was asked to leave, so we never complained as moving my elderly relative would have had an adverse affect on her health. My relative lived for 7 years, so paid in excess of £500,000 by the end. It was disgraceful.

Also echo what @endofthelinefinally says above, after things kept going missing we removed all our elderly relative’s valuables and a relative visited every day to check in on her and restocked her toiletries, etc.

Care and funding desperately needs sorting out as the current system is not working, but the minute you suggest anyone in this country may have to pay for anything or pay more tax, people howl and refuse.
The greed of a lot of Brits appalls me.

Incorrect. MIL was severely disabled after a stroke. No dementia but hemiplegic, unable to talk read or write, incontinent and epileptic. She was below £23k but still above fully funded so had to contribute to her care costs.

Alternative is to have him live with you with the support of carers

Staff used to come into my mums room and take pads that we paid for, toiletries and she was often in other people's clothes even though we labelled everything, her glasses got broken, food was left out, bins overflowed, the ensuite was too small for a walking aid or commode, this was 1500 a week.