Care Home funding - the basics

[titchy]

Anyone know the basics of what elderly relative has to pay/can claim?

Has carers currently, but now assessed as needing an assisted living place. Have found a care home (not visited due to covid but has decent reputation locally). My god they're expensive aren't they?!!!!

Anyway house on market so presume will have to self fund the lot is that right? Relative currently receives pension and attendance allowance? Will they be able to continue to receive both?

Not what we thought we'd be dealing with a week before Christmas but there you go... Advice gratefully received.

@hatgirl may be able to advise but certainly contact social services- she may be eligible for some funding from nhs continuing healthcare etc... depending on her needs.
Our la allowed deferred payments until the house was sold.
Care home admin may be able to advise- or age uk?

Sorry you are having to deal with this- before Christmas is extra hard.

They will have to self fund until their savings go below £23.5K then you will have to complete a financial assessment declaring savings and any other assets. Depending upon the care home cost and where you live a contribution will be calculated and the remainder will made up of pension contributions and any other income but not attendance allowance.

It's taken 9 months with my council to get them to fund anything, partly due to Covid but partly due to incompetence.

Good luck

My dad is completely self funding. Has absolutely top notch care - physical and emotional. The proceeds of his house has funded it completely.

If your parent entirely self funds they are still entitled to attendance allowance. If they only partially fund themselves or are funded by eg council or NHS, their attendance allowance will be stopped.

You may want to look into whether NHS continuing care funding is an option if appropriate but it is extremely difficult to obtain as in my experience the NHS will do everything they can not to grant it.

I think she might have already had continuing care - she had a couple of weeks in a home following hospital discharge (one of many hospital stays....) and SS/NHS said they'd fund six weeks of carers. That's run out but the carers still turn up - she is having a financial assessment done and expects to have to fund that from now on. Is that the same thing?

House will be sold very soon, and even if she had to fund the entire cost that gives her 5 years before we need to think about means testing.

She doesn't need nursing care, but does need to be somewhere with 24 hour care, so could that qualify for any state help given she'll have the proceeds from the house sale?

Can she still claim attendance? The home said they normally take the entire pension - is the normal?

Ah ok thanks mrsfez that's helpful re attendance.

Our council allow attendance allowance to continue if you get funding from them. It's not counted as part of income and they deem it to be used for transport to appointments or other non caring help. Saying that they are not big value funders in the first place.

We live on the border of 3 council areas and I looked in to what each give and the one DPs house is in is the lowest value funders.

That's not continuing care that will be a "rehab" care package.

You can apply for free nursing care contribution if she requires nursing care but it sounds more like it's a care hone without nursing you're looking at.

You say she has been assessed for assisted living, would an extra care facility be an option? The person gets their own flat (either leased or bought or a combination) and then there are carers on site 24/7 who provide a care package. How flexible the carers are about ad hoc care depends on the scheme. They usually have a restaurant, social area etc but access may be limited at present.

I think the six weeks of funding is different to NHS continuing care (am obviously only an expert when it comes to my own parents though, sadly both now deceased), and I guess all councils may be different. Our local council funds up to six weeks’ care while they are assessing the exact nature of the needs, but after that a financial assessment is done and if you have sufficient assets you have to self fund thereafter. Many care home residents require 24 hour care but that alone would not entitle them to automatic state help. If you Google NHS continuing care it will give you a list of criteria for qualifying (you have to fulfil a certain number and severity of conditions).

you may find a social worker can advise...one helped my aunt find a nice home, and she paid for it all....i think she got the attendance allowance and an increased amount later on for night care duty....and yes its very expensive....my aunts fees started at 1200 a month and then when she passed away after 10 years in the home, she was paying about 4k a month !

Our CCG and local council are offering most people discharged from hospital what they are calling a Discharge to Assess placement in a care home for 6 weeks while they do further assessments such as CHC, financial assessments etc. I imagine there is something similar in the community.

The six weeks is rehab funding. If she does not need nursing care then the continuing health care funding does not apply.

So that leaves self fund and/or SSD contribution.

If she has less than £23.5k in available savings now then SSD can step in and help while she sells her home. Once that is sold she will have to repay SSD what they have contributed, and self fund.

When the proceeds of her house sale dwindle to £23.5k then an application can be made to SSD and they will assess her for what they will contribute and what she will be expected to contribute. Broadly speaking they will expect her to contribute her pension/s and leave her a small personal allowance.

Be aware that SSD will assess her care needs at that point and put her in a fee bracket; and if the home she is already in is above that in cost, they will only make the money up to the bracket that they have assessed.

Go to the Age Concern website - here is the link to the bit about paying for care: www.ageuk.org.uk/information-advice/care/paying-for-care/

I have recently been through all this for my OH who died in February so it is all fresh in my mind. It is a bit complicated, but once you get it set up then things get easier.

Also on the Age Concern website is advice about Power of Attorney and my strongest advice to you would be to get that set up - it was an absolute godsend when I was facing these challenges.

Ah ok thank you everyone. So won't meet continuing care criteria as doesn't need nursing. Just bad enough to need someone there 24/7 (falls a lot, gets confused, and is lonely).

Have financial PoA. Need to sort health one.

Looked at sheltered housing, but local ones only have warden there part time. And she won't consider moving away.

Plan is to be here for Xmas, then home to carers till mid Jan when house sale completes. All very quick and odd to move someone without seeing the inside of the home.

My stepmother is in a care home as her needs are too great to be at home with us, sadly. Because my Dad co-owns the house with her the money is locked up (as are her personal savings as she has Alzheimer's). So we get an invoice every week which is being stacked up until such time as my dad no longer needs the house (he is staying with us but still likes to go back there every now and then). The bill is currently at about £80,000. She gets excellent care there though, so it's worth every penny. I'm worried about the future though. If my Dad also needs the same level of care in the future but the funds have been depleted would he have to go to an NHS care home rather than a private one? There doesn't seem to be provision for him to hold some funds back for his own care.

Our local care homes appeal sometimes for personal care items for the residents- shampoo, body wash etc.

I was a bit shocked that it wasn't supplied. Old folk there who have no visitors get no new clothes, no shampoo etc.

I've not approached management to find out why- better if someone who is actually involved raised it- but I do wonder.

I would definitely explore Extra Care as an option. As a poster has explained above, it's very different from sheltered housing as the flats are within one building with 24/7 care. In order to get a place your relative will need as assessment from Adult Social Care which States that she needs an Extra Care placement.

You say she has been assessed as needing residential care. Was this a formal social care assessment or was it a health professional saying this? In my professional experience, health care professionals tend to suggest care homes at an early stage without exploring other options, often because they are not aware of them. So if you and she haven't talked to a social worker I would arrange that.

In terms of residential care funding, be aware that, if your relative has less than £23,250 in savings, then she will be eligible for 12 week property disregard funding from the Local authority. This means that the LA will fund up to the first 12 weeks of the Care home placement to give her time to sell her home. However, they will only fund up to their own threshold. For example, if your relative chooses a home that costs £1000 per week, but the Councils limit is £600 per, they will only fund that amount and the £400 shortfall will need to be made up privately. Some Homes will be prepared to wait for the difference until the house is sold but others won't. You / she also needs to have a plan if the house doesn't sell quickly, including being prepared to sell at a lower price to achieve a quick sale.

@picklemewalnuts

Our local care homes appeal sometimes for personal care items for the residents- shampoo, body wash etc.

I was a bit shocked that it wasn't supplied. Old folk there who have no visitors get no new clothes, no shampoo etc.

I've not approached management to find out why- better if someone who is actually involved raised it- but I do wonder.

I work in care, I don't know the ins and outs really just what I see day to day, sometimes someone doesn't have family and cannot access their funds themselves and it's going through the channels with social services (and trying to get anything from them is a task itself, they're so busy that dropping off some soap and deodorant is not high on their priorities understandably) and the home has to be very careful about taking money from someone over and above the care fees even for a member of staff to pop to the shop and get them something, when they can access their own money. For people with families, who have financial poa, sadly some don't provide these personal things. Everywhere I've worked, the basics are provided, soap and shampoo and toothpaste (we wouldn't just leave someone stinking and unwashed) for instance, but not things like bubble bath or moisturiser, combs and brushes, sterident or fixodent or deodorant. Or new clothes when someone loses weight for instance. It's not uncommon for these things to be bought from a residents fund (raised by staff and visitors for things like Christmas and birthday presents for residents) or donated by staff. I usually take all the things out of the toiletries sets I get that I don't want and give them to the ladies that don't usually get things like that, hand cream and the like. Where I work now each resident is allocated an amount from the residents fund for Christmas presents from 'the home' and it's usually tailored to what that person needs in general.

The care fees don't cover everything, for example if someone likes a particular tipple every evening, there might be a few bottles of sherry or port around for special occasions but in that situation, the person would be expected to provide it themselves. If they can't access their own money they're reliant on the person (or body) holding poa to actually release the funds.

Gosh hasn't even thought about buying toiletries or new clothes! I think we assumed toiletries would be provided. Need to ask care home how they get extras to them when needed then.

I take the point about an Extra care placement, but there aren't any in the immediate area and she won't consider moving even 5 miles away. Plus she's very lonely and wants to be able to at least eat with people.

I don't know who did the assessment a SS I think...

She will still get pension, and also £150 winter fuel allowance. I believe that once means testing kicks in, they can also keep a small weekly allowance for "sundries".

The 6 weeks as people have said is rehab or "re-enablement" funding. It's not actually 6 weeks, it's "up to 6 weeks". They can stop it as soon as either the person no longer needs it or it becomes clear they will need continued care. But they won't leave people in the lurch, and in practice they won't manage to get the long term package together before the 6 weeks is up - I think we ended up with about 8 weeks before we started having to pay.

Our nursing home provides soap, toothpaste has to be bought, and they add it to the end-of-month bill. I've never seen shampoo added so I don't know what they're doing about that. Dad never has used fancy toiletries, he always used to wash his hair with washing up liquid.

Home also rings to say things like "can you buy him some new underpants?" Remember everything needs to be named and no matter how good the home, things will get lost occasionally.

All very quick and odd to move someone without seeing the inside of the home. We did the same.It was an emergency admission. He decided to go in at midday, the home manager and deputy came to talk to him and assess him at 2pm and we delivered him after tea. It's a small home, not very well equipped (he doesn't have an en-suite bathroom), but low staff turnover, happy staff, staff know everyone and make an effort to talk, manager is very hands on and has long conversations with my father. He claims to be happy there, likes the food, and has long conversations with the cook.

Thank you SweetFelicity! That really helps understand what's going on.

Remember everything needs to be named and no matter how good the home, things will get lost occasionally.

Oh my, so we're going to spend Christmas labelling an old lady's knickers.... makes a change from charades I suppose

Oh my, so we're going to spend Christmas labelling an old lady's knickers.... makes a change from charades I suppose confusedgrin

Ha yes this is a good point! The iron on labels you can get aren't great and liable to come off after a couple of washes, I'd advise a good laundry pen and write on the label of the clothes themselves. Care staff do come to recognise clothes over time, but there's nothing more confusing than 3 nighties all the same and the same size in the washing to be put away..... 😁
At the moment with Covid, I'd also advise a mobile phone or tablet if you can, and showing your relative how it works so you can keep in touch with them independently (if it's possible) and getting it set up and going before they go in. We do help our residents with calls/video chats but it has to be appointment based so there's someone there to help if needed, if your relative can use a device without help it's much better for them and you when keeping in touch while visiting is restricted, so that care staff don't get called away to other things and you and your relative can chat when it suits you both the best.
Lots of pictures and favourite things like a cushion or blanket from home etc will help ease the transition too.

The problem at the moment of course is that your relative cannot visit the home before she goes there because of Covid. And she may find herself isolated in her room for several weeks before she can join in ay activities in communal areas.

Bit of a challenge and very sad.