How are care homes funded?

[AutisticLegoLover]

Should my mum need to go into a care home how are the fees paid? Would she sell her house to pay for them? Would the local authority pay some of it? How are care homes chosen? If she can't afford to pay, what happens? She has no income bar her state pension.
She's not in any urgent need of going into one but it would be helpful to know how it all works should the need arise.

One of my in laws is in a home. Their house hasn’t been sold but the council have put a charge on it so that when they die, the debt will be paid.
TBH it would be preferable for it to be sold as the family have to maintain the empty house, and paying the window cleaner etc is a pain.

IF she needs to go into a care home then the local authority will do at least two assessments

one will be a 'care act assessment' which determines if she has eligible needs for a care home

the other will be a financial assessment which will determine how much she needs to pay towards the cost of her care.

If she owns a house and it will be empty once she goes into care then yes the local authority will ask that it's sold to fund the care before they start to pay for it.

care homes are usually chosen on what is available that can meet the assessed needs at the time it's needed.

Thank you. Mum has been told by a family member that she'll go where she's told and won't have any choice at all.

If she owns a house and it would be empty if she went into a home then she will have a choice where she goes as she will be finding it from house proceeds.

Thank you. That's reassuring. She'd have about £200,000 in equity.

NHS page says “If you need to live in a care home, you have the right to choose where you live. The council must give you at least one affordable choice. Some councils have a list of homes they recommend.” Although a choice of one isn’t much choice , the principle of having choice is there.

Even if she is a self funder (sounds like she will be) choice is limited by who has a vacancy - care homes try to run full and generally only have a vacancy when someone has just moved on.

Since your Mum can’t do anything to change her situation, what the family member said was not just inaccurate but also cruel

Jesus that’s awful

Have a look at the CQC website which lists care homes in your mums area

Have a look at https://www.carehome.co.uk/advice - they have loads of advice and videos about all aspects of care homes, including who pays for what.

You would ring the homes you are looking at and request a show-round before signing up.

Ask questions like what activities take place, how many nurses are at the home. How many carers work on the floor am & pm, ask to see a daily food menu.

Ask to meet the manager of the homes you look at - see what vibe you get from the manager.

Look at the general conditions of the homes and rooms in the homes you visit.

Good luck

Ask about turnover of staff. Watch the staff, see whether they’re happy in their work, see how they interact with residents. Do they just do whatever is needed or do they talk with them as they do it?

Don’t worry so much about tired paintwork, do worry about food stains on chairs or residents clothing. Also, a smell of urine is not normal!

Find out about visiting - any restrictions? What about beftimes?

Does the home use the same GP is your elderly person is used to?

Others have said about the funding, but in addition to what pp have said about viewing homes you do need to look at them with the eyes of your parents needs. And what I mean by that is that some might have beautiful gardens but unless there is level access and a secure area (depends on their needs) your parent might be stuck looking through a window at just plants. Pretty rooms but only one communal space means they are either on their own or stuck with whatever is in that space and so on.
My mum had a stay in a respite place which looked tired, no grounds to speak of, and in the middle of a housing estate. But it was brilliant - they had a totally secure courtyard garden which was visible from all sides with several doors, raised beds with trowels stuck in them to encourage 'gardening', the whole place was laid out to accomodate wandering safely, several communal areas with different themes, snacks and drinks at different places. And what you might think of as a very boring view had people coming and going, children off to school - things changing all the time and a normal tether to the day.

I agree with all @MereDintofPandiculation has said re choosing a care home.

Assuming your mother is self funding (from the proceeds of her house sale) she can move to a care home of your choice, the chosen care home will then do an assessment to ensure they can meet her needs. My mother is self funding and she has been in the care home I chose for several years. When I walked in there was a nice atmosphere - calm and cheerful - and no smell of wee! Many of the staff had been there for many years, and are still there now.

The 'one choice' only comes up if the local authority is funding her placement.

Thank you for the link, I'll watch it with my mum. She's being scared by family and being told she'll not have any access to her own money, that she won't get a pension, that she will lose all her money and god knows what else.

The 'one choice' only comes up if the local authority is funding her placement. and even then the NHS webpage makes it clear they try to give a choice. Why would they not?

£200,000 by itself would buy about 4 years care, average stay in a care home is about 3 years. She would also apply for Attendance Allowance which would give another about £5000 (if the LA is contributing to care she can’t continue to get AA). And she has her pension too.

The longer she is in a care home, the more basic her needs become. My father is now happier than he has been for years - he is comfortable, warm and well fed, and that is now what he needs. He’s no longer fussed about independence, contributing to society, intellectual stimulation etc.

Sorry, that was quite a grim post to read if you’re at the start of the old age decline journey. My Dad’s over 100 so as you can imagine I’ve had a long time to get used to his decline

She'd retain her pension. Even if she was assessed as needing funded care they have to leave at least some of the pension so the person can pay for stuff like toiletries and clothes.

Why is the family member trying to scare her off going into a care home?!

What if a person is v poor, let's say a social tenant with only their state pension? What would be the options? Will the local authority do an assessment?

Yes they will do an assessment and pay for care. It's means tested and means choices are limited but they don't put people on the street.

Your Mother definitely gets to choose where she goes if she has Mental Capacity and is self funding. If she lacks MC hopefully her family will be thoughtful regarding where they choose. Staff turnover,staffing levels , atmosphere when you walk in,activities,staff interaction,food choices ,smell ,all far out weigh the decor and shiny 5star hotel look that care homes are now trying to sell .

There are a lot of options between own home and care home.
In many ways, as long as she's well enough, staying in your own home longer can be safe and good for wellbeing. Bringing in extra care as needed.
Or some kind of sheltered accomodation - where there are services and support.
Most of the people in care homes are there because they can no longer be safely supported in their own homes. Dementia/incontinence etc.

There are a lot of horror stories about care homes but some people do thrive as a pp said about her dad. People often don't want to leave their home not just because it was their home for a long time with memories and their community but because they are scared of the change.

If your mum has capacity right now then it's good to have an idea about where she would want to be eg close to you. She can arrange to see homes and ask them what's on offer and how they would view her if she were a private customer.

There's also sheltered accommodation if she feels that she will not be able to manage at home or is isolated there and doesn't want or actually need to go to a care home.

If she has capacity she will be managing her own money the same way she does now. If she lacks capacity she would need someone to do it for her (good idea to talk about LPA whilst she's able to make the decision).

I would have a look at her benefit entitlement right now. Does she have needs that would mean she is entitled to PiP/ AA? Is she entitled to pension credit top up to her state pension? Calculators are on the .gov website and very easy to use.

As we privately funded part of my Nans care home we were able to choose where she went

Thanks @Clymene