Care home top-up fees

[veryfondoftea]

We are starting to look at care options for my mother who has dementia.
Costs for this are outrageously expensive in our area. Around £1700 a week. If we sell her house we can self fund this for 3 years.
She has no other savings, so as I understand it, once the money from the house sale runs out she will be entitled to council funding.
What I cannot work out is how much this will before?
I am presuming it will not cover the £1700 and I see that there is usually an option for a third party ( this would be me) to pay a top up fee to keep her in the nicer/ more expensive care home.
Is anyone able to give me an idea of how much this top up fee is likely to be? I realise it will vary but anyone who can give an example from their own experience would be helpful.
Thanks in advance

Yes extra care placements are the go between home and care home. As long as she's not high falls risk and exit seeking it may be a good option. You could go and visit some local ones with her see what she thinks?

@olderbutwiser
I can understand that. Makes it tricky to know what to do for those who aren't quite severe enough for a care home

@helloyoutoo8
Ah ok. This is a different category, I've not heard of then. I will absolutely look into this. Thank you

To give you an idea, for mil pre covid. Care home fees were £1,400 per week. Council would only pay £800. We would have had to make up the difference. I negotiated that I would provide group activities two morning a week at my own cost and help on the volunteer committee for fundraising. In return the top up would
be fixed at £500 per week until
mil died regardless of how much the fees increased.
(I was an activities manager at another care company).

If she has capacity to state reasons why she should bot be put in a home, the social worker can't move on this as it would violate her human rights. Your POA won't kick in until she loses capacity re accommodation choices.

Social workers have to adhere to proportionate responses. So, they would look at Extra Care facilities first before considering 100% res care.

If your mum is self-funding, then she can choose a private home but even then they would want to assess if she is suitable to live there. The local authority could do an assessment, and they would be interested only insofar as they might be liable to pay care home fees if your mum ceased to be privately funded. This means that the care home must be on their council list.

CHC funding is notoriously difficult to get. Without knowing your mum, it's hard to say if she'd pass the very high thresholds to get this. Check out the facebook page 'Safeguarding futures. Health and Social Care support'. It has some really good information on it.

www.facebook.com/share/YaBZZPiPg3KYUcxv/?mibextid=K35XfP

If she just needs company, not care - and you think that might be the case for a while (although I know that involves a lot of guesswork) - might a Homeshare arrangement be an option?

https://sharedlivesplus.org.uk/get-to-know-our-members/homeshare-uk-and-shared-lives-plus/what-is-homeshare/

She will not have to sell her house. The council can put a charging order on it and the care home fees are paid from the value of the property. This is always an advantage too because the council will get the bed at a much lower rate than if you pay for it yourselves. My DM is in a care home that costs individuals £1100 per week. It costs the council around £650! The fees being paid against the charging order are £650. Some of this is also funded from her pension etc. Look on Age UK website for loads of useful info. You are rarely at any advantage by selling a property to pay for care home fees but the council may not necessarily tell you this upfront.

This is all so helpful. Thank you 🙏

@Alphabet1spaghetti2
I had feared that it might be figures like this. We just couldn't afford that and I don't have anything to negotiate with in terms of helping out

@veryfondoftea it’s still worth asking the care home what the local council would pay, stating your fears. Things have changed in the intervening years. They also vary greatly between councils. As other posters have stated there are ‘loop holes’ (for want of a better description) which may help you. It’s a sector where individual funding really is unique to each person it’s not a once size fits all.
It would have been a real struggle for us to meet the top up - overtime for Dh and a second job for me. It’s no wonder people feel both relief and guit when their lo dies.

Fees vary a bit with region, but yes, something like £1000 a week is quite common @veryfondoftea

@Alphabet1spaghetti2
Yes I think I'm going to have to be very upfront when speaking with the care homes.
This thread has helped me feel a bit more confident in doing that and knowing what questions to ask

Ok so I’ll try and make it clear:

The Department of Health and Social Care says top ups allow people and their families to make a genuine choice to pay more for a premium service but a person must not be asked to pay a top-up because of market inadequacies or commissioning failures; local authorities must ensure there is a genuine choice for the individual.

Basically if and when your mums savings drop below the threshold of £23,250 she will be eligible for SS funding. However if there is a ‘cheaper home’ that state they can meet her needs that is the maximum a council would pay. Ways around this are potentially arguing the case that this would significantly impact on her health/ mental wellbeing however the council may dispute this.

If when it comes to that time there are no alternatives which are cheaper the council cannot legally ask you to pay a top up.
my advice if contact social services several months in advance of her savings dropping to approx £24000. Waiting lists are huge and she would not be prioritised urgently if she is in a safe place.

wishing you and your family all the very best x

That does help.
Does anyone have any thoughts on the cap which is being introduced from October 2025?
I'm Wondering if this might help us not loose all of the money from the sale of the house.

I haven’t looked at it, but there will be a new government by then so I wouldn’t count on it.

Also note this - accommodation, food and activities will be a fair chunk of the bill

It’s important to understand that any other care-related costs – such as accommodation, food, entertainment, utility bills and consumables, do not count towards the £86,000 cap so residents or their families will continue to cover these costs.

From here https://www.careuk.com/where-do-i-start/what-affects-cost/what-the-care-home-fees-cap-means-for-you

The cap has been delayed once so it's hard to plan for this at the moment. I'd ask for a Care Act Assessment of her care needs for your mum from social services, she's entitled to one even if she's self funding. They might have ideas you haven't thought of depending on local services. I wouldn't put someone in a care home without trying carers at home first. You can't legally make someone go in a home against their will, unless there's been a capacity Assessment. If she does go in a home then runs out of money the local authority can move her to a cheaper one, but are reluctant to do so and might negotiate price down, depending on price gap. Local authorities pay around £750 pw in my area.

@NecklessMumster
She does have capacity and she doesn't want to go into a home.
The issue is that she has episodes of being absolutely when a he is on her own in the house. This is particularly bad first thing in the morning when she wakes up. I'm not sure how much carers to help with this but it sounds like we need to give this a go.
Care homes around us are £1700 a week so if the council only find something like £750 we'd be left paying £1000. Absolutely no way could we afford that

* absolutely terrified

Probably too late for her to learn it, but would an Alexa or something help, so she could ask it to play the radio when she woke up?

She's always been extremely resistant to technology unfortunately.
I am going to try and make her some photo books and social story cards because I've seen that recommended

Good idea

Following.

If she has over £23,250 in savings (in England, £50,000 in Wales, £32,750 Scotland) she has to pay full costs until it falls below £1450, then council steps in. There is a difference between third party top up, and paying privately. Third party top up is when council are paying for a home, say £700 pw but you want a home that charges £1000, then family/friends pay the extra £300 per week. But council can't make you do this and has to find and offer a home with no top up, otherwise people with no money would be left without care. Lots of homes charge more for private funded but then agree to drop to council prices once money has run out, sometimes move to a smaller room etc.
But I would still ask for an assessment at home, I'd want to check if other things would help, eg a morning care call, a welfare check, anti anxiety medication, day centre, Technology enabled care ( gadgets). Or try respite to see if she finds the experience of a care home better than she expects.