Sorting out care package - what should/shouldn't we self-fund?

[vpillow]

Thanks for the adviceon my previous thread about care for my dad.

He has terminal lung disease, is in hospital, and has now reluctantly accepted he will need more care at home when he is discharged.

I have asked the hospital for a discharge plan, and they will arrange assessments for that.

But I am now clueless about what happens next in sorting out the care and what he should have provided by the state and what he will need to fund himself (he has his own home and quite a bit of money in the bank).

Someone on the last thread said it would be more cost-effective to engage carers directly, which we can do. What would be the employment implications for that? Would we have to pay employers NI, or would people we engage be self-employed?

We are in Wales, so things might be different here - any advice would be very welcome.

Thanks again.

I think I said that it might be more cost effective to employ agency carers directly. Probably the same agency that would be used by SS but you use them and so can negotiate who comes in and when, and more importantly as the client you feed back when you are not happy. I do not understand why there would be employment implications. (There would be if you found a local person you were employing directly.)

Have you actually spoken to adult Social Services. Local Authorities pay for care and each will have its own sets of charges etc. They will be able to advise on what they pay for and what you need to pay. They may also be able to help on what might constitute NHS continuing care, which the NHS will pay for.

Thanks again NMS. My dad would like his cleaner to help out more as he knows and trusts her but she is not a qualified care assistant, although willing to step up her hours. I presume he pays her cash in hand and I don't really want to be a part of that arrangement - too many pitfalls - I'll leave that as an arrangement between the two of them.

If he needs more professional care rather than this lady just coming in more often and making his breakfast etc, then the agency does sound like it's the way to go, but I know he will resist having strangers involved - I think we will have to enlist all the people he might just listen to to persuade him. We still don't know what he will and won't be capable of when he is discharged.

I haven't spoken to adult social services - again, that discussion will need to be between him and them, with me and/or dsis present. It's what constitutes NHS continuing care that I'm not sure about, and thanks for letting me know that they will have that information.

There is nothing to stop you picking up the phone and asking SS what they fund, names of agencies etc. You do not need to give your father's name. In many ways it is a bit like hiring a nanny or au pair. The state does not need to be involved unless there are concerns about his safety. My experience has been that SS are keen to be helpful to both family and self funders. They have no wish to take over either the organisation or funding. They should however be asked to do an assessment of your father's care needs and also an assessment of his home. The former can be used as a guide to the sort of care levels he might need. They may provide a financial contribution for the latter.

It is worth having this assessment done, not least because it is then on his file and may deter a hospital from making an early discharge in the future. They can also provide information about local volunteers, day centres etc, which may or may not be of interest.

This assessment could then be used to inform an application for Attendance Allowance. This is a non-means-tested allowance. The really good thing about this is that it is extra money which can be spent on anything. So on taxis, or anything that might make his life easier. And you can argue that it is money from the Government, so he can splash out a bit. I would anyway, but I am playing my mum's favourite carer to take her out twice a week. A change of scenery really improves her mood and helps ward off depression. If money were tight I could feel that the Government were paying...

And once you get Attendance Allowance you might be eligible to apply for Council Tax reduction or exemption. Put together the saving can be significant.

There is nothing to stop you picking up the phone and asking SS what they fund, names of agencies etc. You do not need to give your father's name. In many ways it is a bit like hiring a nanny or au pair. The state does not need to be involved unless there are concerns about his safety. My experience has been that SS are keen to be helpful to both family and self funders. They have no wish to take over either the organisation or funding. They should however be asked to do an assessment of your father's care needs and also an assessment of his home. The former can be used as a guide to the sort of care levels he might need. They may provide a financial contribution for the latter.

It is worth having this assessment done, not least because it is then on his file and may deter a hospital from making an early discharge in the future. They can also provide information about local volunteers, day centres etc, which may or may not be of interest.

This assessment could then be used to inform an application for Attendance Allowance. This is a non-means-tested allowance. The really good thing about this is that it is extra money which can be spent on anything. So on taxis, or anything that might make his life easier. And you can argue that it is money from the Government, so he can splash out a bit. I would anyway, but I am playing my mum's favourite carer to take her out twice a week. A change of scenery really improves her mood and helps ward off depression. If money were tight I could feel that the Government were paying...

And once you get Attendance Allowance you might be eligible to apply for Council Tax reduction or exemption. Put together the saving can be significant.

Sorry about the double post. Computers.... aaargh

Sorry if i am going over old ground. But has he been assessed for continuing health care? If he qualifies then all his care needs should be provided for free by the NHS. To be brutal about it, it is usually awarded when someone is thought to have a prognosis of 3 months or less, on a fast track basis.
If he gets CHC it applies whether he is in his own home or a nursing home.
Post again if you have any questions.

And, from what I remember, there is a fast track on Attendance Allowance.

Thanks for all the advice - it won't be needed - he passed away suddenly in a way a blessing, he was struggling.

vpillow I am so sorry for your loss

My DM self funds her carers but it was all arranged through a Social Care Assessment. Social Care arranged the care through an agency which cost about £14ph (has just gone up slightly). DM pays the LA by DD and I assume they pay the agency.

In Wales, I think there is a maximun amount that you can be charged for Care per week. It used to be £50pw but think it has just gone up to £60pw. If you just go directly to an agency (without SC involvement) then I presume that this cap won't apply.

You could ring Age Cymru for advice or look on their website at the various brochures they produce for info.

If your DH is currently in hospital and cannot be discharged until a care package is in place then the Hospital Social Worker should be involved. Ask to speak to them too. Ageing parents are very good at saying that they can cope or that their DCs will do everything for them - which is often not the case.

So sorry vpillow have only just seen your post at 07.47.

Sorry for your loss

So sorry vpillow.

Thank you so much for your support. He is at peace now - we didn't go through the nightmare I had envisioned of finding him on the floor because there wasn't the right support in place.