Local authority vs private care homes

[ForthegracegoI]

I keep reading on here that people need to be prepared to save up / conserve assets / sell their homes etc to avoid going into local authority care homes, so that they have the option of going into a private home and that if they don’t have any savings etc, then they’ll end up in grotty LA owned home.

this wasn’t our experience at all. MIL has no assets to speak of, save her half of the property she owns with FIL. She has a tiny pension, and that’s about it. When she went from hospital into a nursing home, there was zero discussion of local authority vs private. She’s in a private care home (it’s certainly not LA owned) and gets exactly the same care as all the other guests in there. There’s no difference between what she gets and what her self-funded neighbours receive. She pays maybe £400 a month, which is basically her pension minus the pocket money allowance. There is no charge on the house AFAIK - it was entirely disregarded as Fil still lives there.

we are in Scotland - not sure of that makes a difference? And it’s a nursing home rather than a care home. I’m not disputing others experience, just wondering why it didn’t happen this way for us. I kept expecting the social worker to tell us some care homes weren’t available because she wasn’t self funding, but that didn’t happen. It seemed like they were all an option.

My Mum got funded care because she was blind and - latterly - deemed palliative care. It was the same as everyone else’s care and if she has been more well all activities would have been open to her

There are barely any LA care/nursing homes now anyway. Most are privately run.

My stepfather is in a private care home but he’s partially funded by the LA

Care homes are mostly privately owned and run, often by big companies. Some care homes accept state-funded residents, but the rate the council are prepared to pay is considerably lower than the market rate for private-paying residents. In homes that accept a mix of state and private residents you generally find the private residents are subsidising the state funded residents: getting the same food/care/rooms etc. Round where I am the council pays about £800/week for the same care that a private resident will pay £1000-1200 for.

Homes that only take private residents are, in my experience, quite a bit nicer than those that take state funded residents - they can afford to be.

Tends to be a bit different round here. People stay after the money runs out or after care is deemed palliative and is funded

I keep reading on here that people need to be prepared to save up / conserve assets / sell their homes etc to avoid going into local authority care homes, so that they have the option of going into a private home and that if they don’t have any savings etc, then they’ll end up in grotty LA owned home. People who say this are misinformed. There are very few LA homes nowadays, most people are in private homes.

What they should be saying is if you have the means, you can choose which home you go into, but if you don not have the means, you will need to go into one that the LA are prepared to pay for, and they are not prepared to pay for the most expensive ones.

The most expensive homes are not necessarily better than cheaper ones. There are good and bad homes at all price levels.

My MIL was in a council run home (but self funded initially). One of the few these days. It was infinitely better in every way, than my mum's BUPA home. I think not being run in order to line the pockets of shareholders or an owner with a Merc with a personalised number plate (my friends mum's care home owner) has a lot going for it when it comes to care.

I've told my kids that I want ferrying up to Yorkshire to my MILs council's care home when I need one!

Hmm I just read another thread about self funded rooms being nicer / bigger / en suite.

MIL is immobile, doubly incontinent, cannot eat or drink by herself. she has Parkinson’s and dementia. So her care needs are both very high and very simple at the same time. If her room wasn’t en suite it would be a total pita for the carers as they do everything for her. But room decor, quality of food / service, entertainment are all pretty irrelevant to her. Maybe I’d have seen a difference if we’d been looking at care homes rather than nursing homes.

My Mum sounds similar stage to your MIL @ForthegracegoI . Does she get CHC funding because my Mum didn't meet the criteria and I am wondering just how bad someone has to be to get it. 🫤

@Horsemad didn’t even apply tbh. She’s fully funded for full nursing care, minus her tiny pension. We’re in Scotland and I didn’t get the impression money / cost of care was an issue at all 🤷‍♀️

I've had relatives in both - there aren't really many LA homes available any more. The LA pays for places at private homes, often at a reduced rate as it's in bulk. The care would be the same but the LA funded resident might get the worst/smallest rooms possibly with shared facilities rather than an en suite. There is less choose as some homes won't take LA funded residents.

The big difference is timing though. A frail person dependent on LA funding will be kept at home as long as possible just with carer visits multiple times per day. They have to have significant care needs to go into a home. For an elderly vulnerable person that means they're still responsible for a house and its maintenance/bills and someone needs to do shopping, laundry, maintenance, putting bins out. They might be very isolated.

Whereas someone who can afford to pay for care can choose to go into residential care before they need that level of care overnight, they don't need to worry about all those other things like bills, house security or shopping and laundry.

I suppose the other thing is lack of choice - if you can't afford to pay for care and suddenly need it (eg after hospital admission) it'll depend where has space and will accept LA funding. That might be miles from any friends or relatives who want to visit or not reachable by public transport.

@EmotionalBlackmail I’m starting to think MILs case was pretty unusual. The longest part of the process was convincing FIL that she couldn’t come back home from hospital as it wasn’t safe. Once that was formally agreed we got a list of homes from the social worker. But before we even got started on calling round them, FIL contacted the one closest to him, not sure if he phoned or just turned up at the door 🤷‍♀️. Next thing we know she’s got a room, pretty much fully funded , moving in asap, 10 minutes drive from FIL. I’ve no idea how it actually happened: he’s not usually the most organised of people.

i confess it hasn’t crossed my mind that some people might freely choose to move into a care home: I don’t know anyone who’s done that.

It probably varies by area. A couple of my relatives lived in very expensive parts of England and care homes in the more built up areas where land is very expensive/space at a premium tended to be very expensive. Others were in ex large houses in the middle of nowhere so difficult to get to.

It was noticeable that the distant relative who chose to go into residential care (not nursing care) didn't have children of their own so they had absolutely no expectations of anyone else being responsible for them. Whereas a lot of older people gradually their child(ren) do more and more and the older person isn't aware of how badly off they'd be without that help? Their friends were getting older and no relatives at all nearby so they really were on their own with organising cleaner and gardener, Wiltshire Farm Foods orders, all the medical stuff etc. They got to the stage of being very worried about security and organising everything so being able to sell up and move into a (very very nice!) home where everything was taken care of gave them a whole new lease of life. It was residential and some nursing care though - didn't take dementia patients - and had a full range of activities every week and an amazing menu.

Residential care is a lot more unusual now - nobody LA funded would get it. So it's really only for short term respite care and those who can afford to pay for it and choose/need to go.

It's a shame because it means someone very frail but without nursing needs can end up very lonely and isolated at home.

No LA homes or homecare in our county, they were sold off about 20 years ago. The LA pay for beds in homes, in most that accept both private and LA there is little difference, in a few, people may need to move rooms once they are below the threshold but it is unusual. There are a few mainly private homes that will take LA funded people but families will need to pay a top up if they want them to be placed there as the LA has to demonstrate best value. As PP said people will be kept in their own homes with homecare whenever possible, for as long as possible.

When looking for care homes for 2 relatives with dementia - and we visited a lot - we didn’t find even one that was council run.

That was within one private home.

In my father’s nursing home, the bigger rooms are more expensive. I presume LA funded residents would be in the smaller rooms, as would be self funding residence who didn’t want to pay the extra. The larger rooms would be for self funders paying (a lot) more and conceivably for LA funded whose relatives were paying a top-up fee.

That doesn’t contradict what people are saying about LA homes vs private homes

I don’t think that’s particularly unusual. I suspect the list of homes from Social Services didn’t include every home in the area. I suspect FIL was lucky, in that his chosen home was cheap enough to be funded by the LA, and that it had a vacancy.

Social Services consider it quite acceptable for someone to live in one room with a commode, 4 visits a day, and no-one there from 9pm to 9am. That’s the point at which a self funder or their family might feel a care home was appropriate.

We found the same. The care homes that had council funded residents as well as private weren't that much cheaper than the homes that were 100% private, however the difference in surrounds was massive.

I think it was an extra £150 a week for PIL's lovely care home (£1100 vs £950) but while theirs is like a 5* hotel, the other was like an NHS Hospital room. They definitely get more for their money.

I agree with this.

We found the same. The care homes that had council funded residents as well as private weren't that much cheaper than the homes that were 100% private, however the difference in surrounds was massive. The downside is a change of home when the money runs out.

Hello everyone, first post on here :-)

I came across this thread and was wondering whether anyone may be able to help. I am looking into care homes for my Grandma. She has vascular dementia and it is really getting to the stage where she is no longer safe living in her house alone. I go over as often as possible but she now really needs someone there all the time. I have been researching care homes and funding (we live in Scotland) and from what I can gather I would need to sell her house and use all of her savings to pay the care home fees, without any real help from LA or NHS. Has this been other people's experiences? This money would run out after a few years and then I worry that I would have to find the money to top up what the council would provide.

Any advice on how to navigate this would be extremely appreciated!

Hi @TurtleDove89 you might get more responses if you start your own thread.

This is the Age U.K. guide for Scotland about funding for care homes.
https://www.ageuk.org.uk/globalassets/age-scotland/documents/ia---factsheets/care/care-5-care-home-guide---funding-sep-2023.pdf

You're under no obligation to pay top ups yourself. Although some LAs will put pressure on.

You can find out what the likelihood is of the home accepting LA rates in advance and choose accordingly. If the sale of house will fund at least three years (homes often want evidence of this before taking someone in) then some homes will then keep them on at the LA rates anyway.

Sadly the average length of time in a care home is less than that though.

Thank you very much for all of your advice, including how to use the site! Very much appreciated :-)