Care Home Top Up fees.

[diddl]

Can anyone explain these to e & more importantly-how much might they be?

Elderly parent now in full time care after a couple of stays in hospital. Has been deemed to not have capacity.

This has been so far paid fro pension but full cost will be expected shortly.

Savings will pay for about 3yrs.

What happens after that?

Have a list of (3!!!!) places that don't ask top ups, but tbh, don't fancy any of them.

Also, what is continuing care funding?

Continuing health care is also called a chc. It involves an assessment often by a social worker or a nurse in a carehome to assess what level of nursing care someone needs, you can Google it, look up chc checklist. Depending on the assessment people can have their fees paid. Not everyone is eligible and there are articles in the news this week about councils cutting funding. If your relative is in a nursing home and doesn't qualify for chc funding you can apply for funded nursing care also called F.N.C. which does go to the home as part of the fees. Is the home your parent is in a private home or run by the council.

Originally they were there due to being discharged from hospital but not fit to be home alone & waiting for needs assessed for an appropriate care package. However, dementia suspected & they have been assessed as no longer having capacity so this is it now, so up until now have been paying a relatively small amount. They want to move & will be self funding, but I a worried about what will happen when the money runs out. If they will be forced to move if top up fees cannot be afforded.
A place that they were in once before for some rehab after a fall tha they particularly like is privately run.
Will have a google at what you have suggested, thanks.

If they have been told they now lack capacity then someone would need to take over their finances. Power if attorney can do this if there is one in place, if not you may have to apply to the court of protection. This may apply also if they are being moved as they may not be able to understand and agree to that.

Already have POA. They have stated a wish to move. It was said that they lack capacity to make decisions about their care, not a blanket lack of capacity, sorry for confusion.

For that checklist I would but them at 5 Bs with a couple of those heading towards As.

Well, we can only see!

Thank's for your help.

I consider myself well educated, but some stuff is hard to make sense of-if you can even find it!!

Carehomeuk website has lots of info about funding, top ups.

Will look at that, thanks. It's a minefield, isn't it?

Also, Age UK have lots of info that might help.

Care home top ups are ‘third party top up’
If your relative is having some of their placement funded by the local authority, then the top up has to be paid by a third party. It can’t come out of the persons own money.

So, I’m my LA (I’m a senior social worker btw), we fund roughly £500.

Towards this, your relative will pay an assessed contribution, ie £300 per week.

Say the the care home is £700 per week, that will be:

Client contribution - £300
LA - £200
Third party top up - £200.
Per week.

It’s not achievable for most families.

Continuing healthcare funding is a funding stream for when someone has a primary health need that are in excess of what the local authority can reasonably fund, which would be fairly high and complex to manage. You can ask for an assessment but be warned that the threshold is very high.

Happy to answer any questions if you PM me.

Yes it is and you have to fight to get the assessments done and social services aren't always forthcoming at the home ask the GP to visit, make any recommendations and then social services will need to do the assessment. Good luck with it all. Their is a,so age uk and the Alzheimer's association who can help.

Adult social care, the district nurse, or the CHC nurse assessor can do a CHC checklist - if they have a positive checklist it will be a DST - a multi disciplinary meeting where the social worker will complete an assessment, as will the nurse and any relevant professionals.

It’s not that social services ‘aren’t always forthcoming’ - we don’t make the decisions on cHC and they will not accept a checklist if the person isn’t at their baseline anyway - so if there’s any new medication, any infection, currently unwell, or any obvious new medications that might improve the persons condition for example.
It’s frustrating but it is what it is - the % of my clients who get this funding is tiny - even those who I would argue should have it, so please don’t pin your hopes on it

So I have a list of "approved" places.

If they doesn't go into one now & then in future can't afford to pay, presumably they would have to move?

You need to ask if the home will accept the local authority rate in future - some will accept it if the person has been there for over x years when the money runs down, for example, or they will sometimes negotiate if the person moves to a smaller room, or a shared room.

But if they won’t negotiate then usually yes, the person will need to move.

Yes, thanks-best just to ask.

I asked about this when both my parents were in a care home. Apparently that particular chain would keep clients when the money ran out if they'd paid fees for more than two years.

That's interesting, thatnks.

It's all so difficult isn't it?

Who knows what the needs might be in the future & what they might be eligible for by then?

Some top-ups can be low as £10 p/w. It depends on the home.

For that checklist I would but them at 5 Bs with a couple of those heading towards As.

Good luck with that! As a pp stated, it's very hard to get healthcare (CHC) funding. Nursing assessors can be very strict and it's often a matter of phrasing and presented evidence that it's a healthcare need.

That said, the social worker may go for 'shared funding' (cost divided between LA and Health) if full healthcare funding is declined at the DST. You could ask social worker about this beforehand.

Have a look at this youtube lecture on healthcare funding:

Oh I'm not having hopes about funding at all.

It would be great if some idea could be got of what top ups might be when self funding is no longer possible.

It would vary according to the home, I expect. Care homes vary enormously and too ups at the moment can cover a few different things. Not everyone gets funding at the moment either.

Many LAs have moved away from care hone placements due to costs (cheaper to keep people in the community with various types of support). If this isn't possible given their needs then Extra Care is often looked at before Residential Care Homes as it, arguably, promotes more independence (a key duty in the Care Act 2014). Have you considered Extra Care accommodation? There are different levels and some specialise in dementia care

Has there been some change to how he is paying for his care or the amount that needs paying. How have the home been getting paid until now.

Because he was discharged from hospital to there & waiting assessents he has been paying a reduced amount.

Now that it's long term & he has money above the threshold, presumably full fees will kick in?

Just an update.

Have got parent into the most fantastic place that will take LA rates when can no longer self fund.

Almost didn't bother to go as thought it would be way above our means.

Room fairly basic- wardrobe, chest of drawers, bedside table desk, chair, armchair, tv.

Nicely decorated & nice furniture though.

Ensuite shower room.

Communal rooms & grounds fabulous.

Great news, really hope it works out and your parent's happy there.

Thank you-they'd better be happy!!