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?

Re the capping of fees, yes people with fewer assets could lose it all. Surely a percentage scheme would work though? If say 50% of assets was the cap everyone would keep something to pass to their children regardless of what they had.

The issue is between what are defined as medical needs and what are defined as social care needs because of how provision is split

Any medical treatment someone with dementia needs is provided free the same as it is for people with cancer, MND, MS etc

the problem is care that is non medical so being dressed, being fed, being bathed. Any care like that that is defined as personal rather than medical care is provided via social care and means tested

there is limited medical treatment for people with dementia sadly beyond drugs but huge need for care

cancer patients who need social care will be means tested but very rarely would they need to go into a care home

https://www.mariecurie.org.uk/help/support/terminal-illness/care-needs/paying-for-social-care

…on Continuing Health Care, my experience is that’s it very hard to get.
Mum had a severe stroke last year, she is now in a care home .. she’s paralysed down one side, she can’t sit up unaided, has no balance, can’t walk, had to be hoisted, is in “nappies”, can’t do anything like wash herself, shower etc, needs to be moved regularly to stop bedsore - and is in an EMI ward due to mental health (which is mostly made up of people with dementia). We do not qualify for CHC.

She is funded by the council, her state pension goes to fees, along with Attendance allowance. Her house is disregarded in the calculation, as there is a close relative over the age of 60 living there.

We pay too up … however, 12 months in we still haven’t had a proper Financial Assessment from the council - we are experiencing the highest level of incompetence.

I do understand what DNR means I used it just for simplicity.

There is a declaration we can sign at the GP which gives us the power to refuse medication to prolong life in certain circumstances.
As we wait for the government to agree to assisted dying it is the only right we have at the moment.
People are terrified of death but it is the method they should be terrified of.

@ShrinkingEveryDay ypu are slightly missing one point.

I am happy to pay for my care, I am happy to pay taxes on my income but why should I have to use my savings to pay for another person’s care because the LA won’t pay the going rate?

Care homes should not be able to charge to cover the LA shortfall for another person - that should be the tax payer which includes me.

How would you feel in a restaurant that charges £100 per head if the table of 4 next to your table of 4 only paid £200 and you had to pay £600 because the LA refused to pay the going rate.

@Harassedevictee it's not that the LA is refusing to pay the going rate, it's that it can't.

I work in ASC in our LA. We are experiencing huge funding shortfalls. The central government grant has been cut, we can't put up Council Tax more than the cap. Where do you think the money is going to come from? Our LA is selling off offices so that we can release money for social care. My pay has been cut in real terms by 25% over the last 15 years. Our pensions are pathetic - and don't get paid out until we get to state pension age, so 67 in my case - and discriminate against women as they are career average not final salary.

There is no spare money for care home fees. If LAs had to pay market rates, something would have to give.

Where I live the roads are in a dreadful state and people are always moaning about pot holes and how the council should fix them. I don't think people realise just how financially stretched councils are. There's not enough money for statutory services, let alone roads.

@EmmaGrundyForPM I know but it is fairer to raise taxes for all than make those who need a nursing home to pay for someone else as well.

My son is disabled and lives in a residential care home. The fees are £6800 per WEEK. It’s mostly staffing costs as he has 1:1 at all times.

@Dementiadad edit to add: why are only those with dementia forced to pay? There are plenty of other illnesses that require NHS treatment and the cost is shared by all taxpayers. Get dementia though and you are screwed.

It isnt just denentia though. There are many people in care homes who dont have any dementia, they're simply old and unable to safely look after themselves in their own home. If youve got 4 x visits a day in your home (morning, noon, evening and night)from home carers then thats as far as any sort of funded care goes so if you need more than that the residential care is the main option. It's usually down to poor mobility, risk of falls, seizures etc, also sensory impairment, physical disability.

Where has this whole notion come from? It's coming from the companies that own these care homes. Why is everyone taking their word that they charge self funders so much more solely because councils pay too little? Havent people actually thought that maybe the councils pay a fair rate and that the care providers are simply on the make, shafting the self funder because they can get away with it? How does anyone know what the going rate is?

@Pinkbits as @EmmaGrundyForPM says it’s not LAs refusing to pay the going rate it’s they can’t.

No offence but you cant just take one persons word. Care homes will peddle this narrative to everybody they come into contact with (including social workers) as it suits them to make out like they're poor. It makes for good headlines and causes awful division between people. I can assure you that the directors and managers of all of these care homes wont be living in poverty and driving around in rubbish cars!

I'd suggest you're thinking about this the wrong way, and you're angry at the wrong people.
The amount the council pays is the standard rate - it allows for a small percentage of profit (the care home wouldn't do it otherwise - they aren't forced to take council clients). The rate they are charging your dad is the rate that makes them a big profit. Despite what they may say, he isn't subsidising the cost of the other council-funded residents - he's just giving the owners/shareholders a bigger profit.
It's market rates - and the homes in the area will set it between them, knowing that they have families over a barrel.

@Pinkbits I don’t disagree care home providers make a profit, it’s a business after all.

However, if care homes have two rates one for LA funders and one for private funders that is wrong and is a business model that uses self funders to pay for LA funders shortfall. That is not fair on self funders.

But there isn't a shortfall. They aren't forced to take council clients. They make a profit from them too - it's just a smaller profit. Same as nurseries.

Good to know the LA rates cover all the costs as it undermines the rationale for the private client rate being so much higher.

@caffelattetogo Thanks for saying it like it is. If homes didnt make any profit at all on council rates they wouldnt be in business. They'd do something else instead. Often they do - if you delve into care home providers many have their fingers in other pies - property usually, including student lets, hotels, casinos etc basically anywhere money can be made from real estate.

Again this talk of a shortfall is incorrect. They may make considerably more money from self funders, but that doenst mean they are making a loss over the council funded. However it sounds great when they go to the press, and causes division between residents and families. Its nothing more than business.

Unfortunately, homes that care for dementia patients know they can make up the fees to include huge profits and residents (or usually their families) aren't in a position to question or make deals over finances. Nobody goes looking for a care home on a 'good' day. It's rarely a decision families want to make. There's often a lot of guilt and sadness, often felt by daughters who have to make decisions in difficult times, plus a huge sense of urgency. So most people meekly put up with paying a huge amount over the odds - money that goes in profits to the businesses.

@caffelattetogo you make a good point about researching potential homes prior to need, just to take off some pressure if and when the time comes. Many people are in a flap and understandably so if they feel they need to make a quick decision, and get lead by hosp discharge teams or social workers and probably dont realise how much say they have in the matter.

Hi, do you recall their name, so we can look into this?