Self funding - but only for a matter of weeks?

[OhPleaseJustLast]

I’m hoping some with experience can advise! Following an incident where df, who has dementia, pushed my dm who fell and hit her head (police and ambulance involved) the family agrees it is time to look into a care home (they currently have home care). They have some savings, which I calculate will last around 10 weeks before they hit the local authority threshold. The local authority, because they have savings, have just said they are self funding, that they won’t do a financial assessment until they hit the threshold, and to basically sort ourselves out. But surely if he’s going to be in a residential setting a matter of weeks before they have to get involved it makes sense for them to be involved from the start? The care home want proof of 2 years’ fees, which we obviously can’t provide….the whole situation seems insane, should I be pushing adult social care to be more involved, or what?

Sorry that was poorly written, I hope it makes sense. My head is spinning a bit with all the red tape.

You do know that they are only entitled to take into account half of any savings in joint names, would that make a difference at all.

Yes, push for adult social care to be involved. Could you organise a couple of weeks respite. Fil was offered that for mil after he had been admitted to hospital himself then he simply said that he could not cope and she couldn't come home (she was violent towards him and stronger and more mobile than him). They had to do something.

Yes, the 10 weeks is half of savings. Dm is dead against respite in so far as she doesn’t want a temporary solution - because he’d be twice as difficult on his return.

I’m also worried that if we don’t get adult social care involved from the start, that when the money ran out and it was up to them they’d decide to send him home. He’s had an assessment of needs a few months back, and all that came out of it was a referral to a day centre that never happened because it’s not accepting referrals because of covid.
I requested the police made a safeguarding referral last night, but having seen the state of adult social care recently, I’m not convinced that it’ll make much difference :(

Please contact adult social care urgently. Your df needs an assessment of need now, not 10 weeks down the line. I highly recommend respite for him, and whilst he’s there he can be assessed fully. My stepfather is currently in respite, and my dm has told his socialcworthat she can no longer look after him. He is very violent now with his dementia. He is being kept in respite whilst a full assessment takes place to determine the best place for him. It’s incredibly sad,

IME social services assess what care is needed and then tell you you're paying. Then when the money runs out they take it on.

If you arrange care without SS involvement you run the risk that when they do their assessment they may decide that residential care is not needed.

I think your parents are allowed to make provision each for a gift of £3000 in this tax year 2021-2022 and the tax year immediately proceeding, so 2020-21 which will not count in their final figure. If they have not done this then you can reduce their funds by £6k each.

They can also make provision for their funerals by setting funds aside in a funeral plan or equivalent - which I believe to be around £4,000 each as the cost of an average UK funeral.

Age UK will keep you right.

Sounds a difficult and fast moving situation. Not easy, OP.

They can't just send him home. Well they can try but they cannot force your mother to accept someone back who has been violent towards her.

Yes, thats a good point. Fil had recently set up a funeral plan for them both into which he planned to pay monthly until it was paid off.

He was legally allowed to fully pay up both policies and that money was not taken into account for his assesment.

That’s my concern exactly.

But we had an assessment of need a few months back and they decided a day centre was what was needed, at that time. Adult social care informed my parents they were paying and to contact them when they got near the threshold.

So it seems to me I can a) request a re-assessment of need on the back of the recent incident, and make dm say she can no longer care for him and no longer feels safe, and hope they agree to the care home or

b) take steps to put him into a care home used by the local authority on a respite basis, and then have dm refuse to have him home.

A runs the risk that he won’t be able to go, but b runs the risk that he’ll have to come home and be more volatile when he does because he’s out of routine.

I really don’t know what to do for the best. I guess I could always tell adult social care that I’m removing dm from the situation if they do decide he should come home, that she’s coming to stay with me, so they can’t assume she’ll be his carer?

It sounds heartless but b worked for us. We were lucky in that we said to fil that if need be we would have him stay at our house for a few weeks knowing that they could not release mil back to an empty house.

But it didn;t come to that, it was clear she could not come home.

@Comefromaway

It sounds heartless but b worked for us. We were lucky in that we said to fil that if need be we would have him stay at our house for a few weeks knowing that they could not release mil back to an empty house.

But it didn;t come to that, it was clear she could not come home.

I’m leaving towards b. I feel like a heartless cow but am only coping with this by being completely practical. This was the first incidence of violence and it came on the back of dm shouting at him (lost her patience with him), but I can’t really expect her never to lose her patience with him. It feels like social services will be more likely to listen to her saying she feels unsafe if he goes straight into respite now, than if we wait weeks for them to come out and do a re-assessment of needs and she lives with the situation during that time, ifswim? Not to mention the risk of another incident in that time anyway.

@TrophyWinner

IME social services assess what care is needed and then tell you you're paying. Then when the money runs out they take it on.

If you arrange care without SS involvement you run the risk that when they do their assessment they may decide that residential care is not needed.

Yes, basically what happened with my friend. He paid for a few weeks and is now below the threshold, so partially finds himself.

OP please do t feel in any way guilty at having to take whatever steps are needed (including backing off/refusing to have him home) to get your parents the help they need. When I was involved with a relative with dementia I was advised by a friend who had gone through similar that the more the family was willing to do, the less likely that any official help would be forthcoming.

I would be inclined to try the respite route first. Once in the system it’s probably easier to stay there. And if you arrange a care home yourself there is no guarantee that it will fall within the cost the local authority are willing to fund later on so he might need to be moved then anyway.

@OhPleaseJustLast

That’s my concern exactly.

But we had an assessment of need a few months back and they decided a day centre was what was needed, at that time. Adult social care informed my parents they were paying and to contact them when they got near the threshold.

So it seems to me I can a) request a re-assessment of need on the back of the recent incident, and make dm say she can no longer care for him and no longer feels safe, and hope they agree to the care home or

b) take steps to put him into a care home used by the local authority on a respite basis, and then have dm refuse to have him home.

A runs the risk that he won’t be able to go, but b runs the risk that he’ll have to come home and be more volatile when he does because he’s out of routine.

I really don’t know what to do for the best. I guess I could always tell adult social care that I’m removing dm from the situation if they do decide he should come home, that she’s coming to stay with me, so they can’t assume she’ll be his carer?

I was about to jump in and say that the local authority has a legal duty to carry out a financial assessment when requested to.

Which is true, and if someone has actually said to you that they won't do the financial assessment until he reaches the threshold then that is potentially complaint worthy.

If what actually was said was more something along the lines of 'if you arrange the residential care placement yourselves (contrary to the local authorities recent assessment of need) and you are over the threshold and therefore a self funder you are entitled to do that if you wish. Once you reach threshold and approach us again for funding we will do an assessment (of need, and then financial) if you ask us to' then that is the correct advice.

Regardless of the outcome of this financial assessment the local authority will only pay for residential care placements that they have assessed are required. Residential care placements in homes that accept local authority rates are a scare resource. You can't just take it upon yourselves to put someone into residential care and then ask the local authority to pay for it. If you do that and the local authority still determines that FIL doesn't need to be in residential care then he may/will still be liable to fund that as it wasn't what has been assessed as needed by the local authority.

Sorry I meant DF not FIL. I'd like to add that unfortunately the correct course of action is for your DM to stop providing the care. Give the local authority notice that will be the case from X date (can literally be a few hours/days).

They cannot take into account informal care that is not safe or willingly provided.

Safeguarding probably will be involved if the police have referred, which may help.

Does anyone have LPoA for him?

Hi OP
Respite sounds like a good temporary solution, it will mean MIL is safer and it will give FIL a chance to see how he gets on in a care home environment. My advice would be to choose a home that accepts local authority funding (this will prevent a move to an alternative home when his funds run out). Your MIL has every right to say she no longer wants to provide the care and adult care can't expect this of her, so they should treat the situation as if he were going home to an empty house. Another benefit of respite is that the care home keep 'care records' these can be really useful evidence when assessing what level of care someone is eligible for from the local authority. In particular "does he have over night needs?" This will help you know whether the local authority will consider his need is for residential care rather than care at home.

The other thing to think about is whether he has Mental Capacity to make the decision to move into care permanently. If he can make this decision and chooses to remain at home then it can become more complicated. If he lacks capacity to make this decision then the LPoA holder can make the decision for him however he will still have the right to object to this and it could go to court.

Is his GP aware of the situation at home? They can sometimes support by providing medication to calm his agitated state.

All the best x

To answer a few questions:

We have LPA but for finances only. We’d be looking at the two care homes that the LA use, to avoid him having to move. There was a referral to safeguarding, I spoke to the social worker this morning, and he said he was happy to close the safeguarding case on the basis we were looking at a move to a care home, and that it sounded like the right decision. But his remit was safeguarding, not care needs assessment.

We had a care needs assessment in November. The outcome of that - prior to this incident - was that he was fine at home, with private home care, with additional support to be provided for my mum in the form of a day centre place for my dad. Which never happened, because covid. At that point, they said, well, you’ll clearly be self funding for the £60 or so a day for the day centre, but feel free to call us in the future if you drop below the capital limits and we’ll reassess. But, we were obviously talking about day center visits, not residential care.

So, today, I’ve requested a re-assessment of needs on the basis that after the incident yesterday we now feel a care home is safer, and that we want a financial assessment too. I think that’s the right thing to do? I’m so confused by the whole system.

Question is, would we be in a stronger position to move him into respite at the home the LA uses for permanent home care, in the meantime, and when they do the assessment of needs say that he can’t come home?

"we had an assessment of need a few months back and they decided a day centre was what was needed, at that time"

My uncle developed dementia over the last year or so, but in the summer he started to become more aggressive; I understood that the change came quite quickly. So I guess that the point I'm trying to make is that an assessment a few months back is out of date and has been overtaken by events.

The financial assessment for residential care is different to the financial assessment for day services.

Day services is financially assessed on just the income you have got coming in.

Residential care services is financially assessed on your share of anything owned (except for your primary residence if your spouse still lives in it) plus whatever income you have coming in (its more complicated than that as there are allowances etc that can be made for various things but that is the gist)

The re-assessment of need could literally happen in the next day or two if it is urgent. The financial assessment will probably happen later but will be back dated to the day of the care reassessment.

If no one has LPoA for health and welfare (only for finances) then it is the local authorities decision about when/ which home they will end up going to if the person doesn't have capacity to make that decision themselves.

OP - I work in an Adult Social work team - I would recommend you check any care home you use are happy to accept the local authority rate after your dads savings go below the financial threshold or you could end up paying a top up.

You are right that you need to be practical but be aware if your dad wants to go home, and he part owns the house with your mum, it can be difficult as social services will likely say he should go back to his home.

Whatever his financial situation, he is entitled to a care act assessment (of his needs).

PP’s are right that you could look at spending some money legally towards funeral costs. It is always a good idea to get independent advice on this though as local authority’s will consider some types of spending a deprivation of assets.

Hope this helps.

I'd be inclined to get him into respite now. On no account take your mum away from her home, otherwise she will be in a place of safety and your dad could potentially be returned to live in the house with carers coming in.

Oh I don’t know what to do. Thank you everyone for all your words of advice, lots to think about.

Moving him and having him come home would be horrific. I’ve seen what he’s like when he goes out for the day and comes home- really unsettled. I can’t see that working at all. If there is a realistic risk that that could happen, given we don’t have an LPA for health and social care, and he co-owns the house, then that seems like too big a gamble after all.

@EssaysOfElia

You are right that you need to be practical but be aware if your dad wants to go home, and he part owns the house with your mum, it can be difficult as social services will likely say he should go back to his home.

Would they say this even if she said she didn’t feel safe and off the back of the incident yesterday where he pushed her and she fell and hit her head? A safeguarding referral was opened, which was closed today on the basis that I said we were looking at moving him to a care home.

I ask without judgement or accusation, by the way - I know that we’re in an impossible situation trying to balance the best interests of both of them. Just trying to figure out how the decision would be made.

@hatgirl

The financial assessment for residential care is different to the financial assessment for day services.

Day services is financially assessed on just the income you have got coming in.

Residential care services is financially assessed on your share of anything owned (except for your primary residence if your spouse still lives in it) plus whatever income you have coming in (its more complicated than that as there are allowances etc that can be made for various things but that is the gist)

The re-assessment of need could literally happen in the next day or two if it is urgent. The financial assessment will probably happen later but will be back dated to the day of the care reassessment.

If no one has LPoA for health and welfare (only for finances) then it is the local authorities decision about when/ which home they will end up going to if the person doesn't have capacity to make that decision themselves.

Not correct. When my MIL needed to go into full time care, she didn’t have capacity. Her POA hadn’t come through either. (they lost the initial application causing a 3 month delay during which time she deteriorated). Following a needs assessment, we were told to look at the homes in our area, check if they took residents who were LA funded, and basically decide for ourselves. My stepfather is currently in hospital awaiting placement in residential care. He will be self funding for a short time as he has about 30k in savings plus a small private pension. He does not have capacity, no POA and my mum doesn’t have capacity either. We are currently looking for a care home and the social worker has given us a list of homes that may have places to meet his needs. A mix of LA run homes and private ones.

@Soontobe60 that’s pretty much word for word what I was told a few months back when my mum had a medical crisis and couldn’t care for either of them for a short time. You’re self funding, sort yourself out. So we got private home care.

And that’s basically the message I’ve been given today as well. You’re self funding, sort yourself out. The difference is that we haven’t had that care needs assessment, for social services to agree he needs residential care now. My worry is that we’ll ‘sort ourselves out’, do what we think is best, and then when the money runs out, social services won’t agree it’s best and will want him to come home. And if the situation isn’t safe now, I can tell you that that would 100% not be safe, because he would be super unsettled, and therefore volatile, so I want to avoid that at all costs. I’d like to think it’s unlikely, but I’ve had a baptism of fire with social services in the last few months and I’ve come to understand the bar is pretty low (and I understand why, I can’t let myself think in ‘should bes’, just what is and what isn’t).