Paying for care home fees

[RainbowCookie]

Hi hoping someone knows more on this as the advice is very conflicting.

My Dad has gone downhill rapidly, he’s currently in hospital with little cognition, he’s unable to hold a conversation or be understood. He is doubly incontinent and unable to walk or stand.

Drs have recommended a care home due to high needs. However my parents have a fair amount of savings so would have to self fund. I understand that he will have to use all his savings and half his joint savings to pay for care, however this will only last 18 months or so and his illness is not terminal he could be there for years.

The social worker said when the savings run out, as my parents own a house together they will have to do equity release on 50% of the house value and use that money before the council will fund anything.

My Mum is terrified of equity release, this will essentially trap her in her home as if she ever sells she’ll have to pay off the equity release (I guess the interest will mount up as well so she could end up with very little). She won’t be able to downsize as flats are only a little cheaper than the cost of her 3 bed.

So my Dad is moving home, Mum is getting a hospital bed and a hoist in the lounge. I’m very worried how she’ll cope. She is going to get carers in twice a day, but she’ll be trapped in the house mostly. I live a 12 hour flight away so can’t help on a regular basis.

Has anyone been through this with self funding care, there has to be a solution that doesn’t involve my Mum getting into debt or killing herself being a carer for someone who should be in a nursing home.

Thanks very much

Cannot echo enough the advice you've had to get a CHC screening. Don't take no for an answer. You must insist on the screening. Good luck. It's not an easy road ahead💐

Feral, free home care is really difficult to get in the UK, it sounds as if he would need four times a day double up care minimum which is also difficult, there just aren't enough carers and they have very little time with each resident. What happens when the carers are not there with hygiene and toilteting, pressure relief, it's a full time job. I would seriously reconsider a carehome.

Thanks hugely for everyone’s responses.
Dad has had a needs assessment and was given a few options - including a care home but all he would have to pay for. Mum has POA sorted, she will apply for attendance allowance when he gets home, she can’t apply for carers allowance as she gets a state pension.

She was told she would get CHC but the max is only 150ish a week not enough to pay care home fees, when I checked online though there doesn’t seem to be a limit so I will ask her to check again with social worker.

On Friday an OT is coming to measure up for a bed, no idea where it will go without taking out all the furniture. My Mum is tiny and in her 70s so she won’t be able to lift him at all, he will need 2 carers at a time apparently to lift him so double the cost.

The house issues is complex, she knows they can’t kick her out while she lives there, but it’s this charge thing that is the issue. When she sells the house she will have to pay off the charge, which won’t leave her enough money to downsize or move overseas to be with us. She is also that generation that hates debt so the thought of not fully owning her home will terrify her.

They have already moved his hospital this week as they had run out of beds, he was on a long stay geriatric type ward to a short stay hospital, he has fallen out of bed and has a large pressure sore, his blood pressure is very low at the moment. I don’t see how they can send him home like this.

From your update it does not sound as if your father should be sent home but there is such a shortage of beds that this is what the hospital will try to do. I am assuming you are trying to help from abroad which is difficult, is there a family friend or relative in the UK who could help your mother deal with the hospital, Social Workers etc? The 150 pounds a week is a contribution to Nursing Care, so if your Father went into a home this would be a contribution to the cost, CHC if awarded meets the whole of the costs. You can ask for the decision not to award CHC to be reviewed, you have to familiarise yourself with the domains which are assessed and be prepared to challenge the assessor as they will the minimise the care your father needs to keep him under the threshold for awarding CHC. There are solicitors who specialise in helping with CHC funding so it might be worth finding one in your mother's area. You can find out more about how CHC is assessed by googling CHC Toolkit which is what the assessors follow during the process.

Thanks **trickofthetail1 just spojen to Mum now, he hasn’t had a proper CHC assessment, she had requested one this week, his hospital is in a different county to where he lives so there is paperwork to transfer. I have looked at the checklist and i’m sure he would qualify as severe in a couple of categories so let’s hope the assessors agree.
Is it an all or nothing type of assessment?

The first stage is for the Check List to be completed and if this shows there may be Health Needs then a full assessment using the CHC Decision Support Tool ( google this not Toolkit )is made. You need to familiarise yourself with both and be prepared to challenge any assessments which you feel do not reflect the true situation, I did this for a relative who was initially assessed as not meeting the criteria and was successful. If 2 domains are assessed as Severe then CHC is awarded.

Following on from what halcyondays said upthread, can someone clarify if the following scenario is correct.

Couple own their own home equally.
Husband goes into care home, spends down his savings. Wife stays on in the house, and husband dies after a few years.

Wife carries on living for a few years and eventually dies at home.

Can the local authority, many years later, now claim back the husband’s fees from the wife’s estate?

There really is no paperwork to be transferred if the hospital is in another county to where your Dad lives - this should not be pushed on you.

The hospital does the CHC checklist - it's a national tool. If he checklists positive then they complete the full paperwork (again a national tool) and submit it to his county's CHC team. It shouldn't be a situation they haven't been in before given they must have patients from the neighbouring county all the time.

As trick says, ask to see what they write and be ready to challenge anything you think has underplayed his needs. I've seen all kinds of madness written on them, usually just because someone just didn't put their brain in gear.

It is all or nothing, you either qualify or you don't. If they say no, you can appeal. The most important thing is to ensure the checklist, and subsequent assessment are accurate. Ones that fail have usually understated what the patient can do - the tool is very clear about what is and isn't A/B/C etc.

parrot...no, i am an adult care social worker and care fees stop when the husband dies, they don't transfer to wife

Reading this with interest, as I'm in the position of being my father's full-time carer - he has carers in 4 x a day to transfer him from bed to chair and back again via hoist. He was discharged from an intermediate home at the end of November, and we're still waiting for a CHC assessment - and paying £430 a week for his care in the meantime. You need to push and push for the assessment - I'm (I think) close to getting ours, but it's taken weeks of phone calls to doctors, social workers and district nurses. I was told it was in hand when he was discharged - but it seems it wasn't! Hoping he qualifies - he's only got one leg, mixed dementia, terminal prostate cancer and a massive hydrocele, can't self-administer his meds, can't feed himself - but he 'performs' well when he gets official visits - they don't see the half of it - so make sure you document everything - and get familiar with the criteria they assess on. Be prepared to fight - and let your Mum know what she might be letting herself in for if he comes home - this is a 24/7 job - I don't leave Dad's flat unless someone comes in to Dadsit!

Neckless - thank you for that useful information.

Thanks everyone and sorry for anyone going through a similar situation.
Mum had 2 OTs come for an assessment yesterday and they have made a plan to get the bed in the lounge and the hoist. The social worker had found 2 carers to come in twice a day and for twice a week they are going to come and sit with him so Mum can get to the shops etc. I’m not sure twice a day is enough as he is doubly incontinent.

I’m amazed there seems to be complete confusion over whether the house gets included or not if a spouse still lives there. This should be something that’s clear and transparent surely, so people can make care decisions. On the plus side for now, it does seem that if you have care at home then they can’t take any money out of the house, so I think Mum will try to manage for as long as possible with him at home.

No news on the CHC assessment it seems there are people in much worse positions than Dad that have been turned down so i’m not hopeful at this stage.

Furry, that’s not right at all! If your DF’s condition is medical rather than social then he should be funded.

Rainbow - so your DM is being forced into being career? I honestly would think very carefully about allowing him home. He needs specialized care. Once he’s home, you’ll struggle to get him elsewhere if/when he needs it.

Your mum simply won’t be able to manage and the whole situation will be distressing for all. Sounds like the nhs are pushing him out because they need the bed but you must insist on him staying out until this is sorted. Forget about the cost for a moment and think about how your mum and dad will cope.

Staying put not out

I think my Mum would rather have him home than in care, I think the frustration is that she isn’t being given a choice because she has been told a charge will be put against my Dads half of the house to pay for a care home that she will have to pay back if she ever sells the house.

This would be ok if she was in her eighties and the house was somewhere she could live safely on her own, until she dies. The problem is it’s a 3 bedroom semi with a very steep drive on top of a big hill so what happens in 15 years when she is struggling on her own but can’t afford to sell up and downsize.

As much as we’d like to say screw the money let’s get the best care for Dad now, we also have to think about the potential financial consequences of that decision in future. It’s a horrible situation.

My Dad had spent probably 6 months out of the last 12 in hospital, so I doubt he will be at home for too long before he gets another infection.

Surely if we refuse to have him home, then they’ll send him to a home anyway and presumably send us the bill?

Could you get advice from Citizens Advice Bureau about the financial situation?

RainbowCookie - AgeUk Factsheet 38, titled “Property and Paying for residential care “ , Section 4.5 might be helpful.

Hi Op, just wondered how things are going?

My mother's home had to be sold because she was on her own and no one else lived there. If my father had still been alive the house would not have been touched.

Well, I think you need to see your accountant and maybe an Independent Financial Adviser your cash situ. I mean, it's true, Social Services target the spouse - and the house. They can't touch the house if the wife/husband is still living there, as the law stands.

Problem is, all this stuff catches you on the hop really, at a bad time when one parent is ill.

Can't your dad get antibiotics if he has an infection at home? My Mum went into a home after she got a UTI, but later on down the line she got them two a penny with no repercussions, they handed them out like sweeties. No repercussions, we noticed and got her on antibiotics and bang! She was eating again.

I just kick myself thinking back that we just waved a white flag and bunged her in a care home because she had a UTI. Once she went in, she sure as hell wasn't coming out, no matter the failings in care that Surrey County Council's so-called Safeguarding teams turn a blind eye to... no slur incidentally, no defamation there. Turns out if you're self-funding the Safeguarding teams are under no obligation to investigate any concerns you make against one of their failing care homes... though they can have you barred from said care home, and will investigate spurious Safeguarding concerns raised by the care home against you. We learned this after we reported them to the Local Govt Ombudsman.

Sorry, bit of a rant there.

Hello bit of an update, after lots and lots of chasing we are having the full CHC assessment tomorrow. The nurse who did the original assessment marked him severe in 4 categories so we’ll see what the full assessment says, we’ll appeal straight away if he is declined.

Dad is still in hospital as they haven’t sorted out what he needs at home yet, he’s missing a special mattress.

He has also developed an antibiotic resistant infection so he is tucked in a corner of the ward. He is unable to sit up in bed at all now and needs to be supported at all times.

I will book a flight home as soon as he is released.

My Dad owns his own house all paid for - My brother who is 49 lives there as well although is only there Sat and Sun as he works away as a lorry driver. Dad has about in total £12k savings and a private pension of £398 per month.

He has a carers in that is funded by the council only Mon - Fri as my brother cares for him on a weekend. It's looking like we may have to look for a care home in the future .

Im confused as to whether or not he would have to sell him home to fund a care home? Ive read through all of the posts and still abit confused.

Your dad can be assessed for Continuing Health Care funding. He sounds quite bad so he may be awarded it but they are very strict. My mum was awarded it and she couldn't do anything for herself.