Funding nursing care in Scotland

[CitiesInDust]

We will find out from social services at some point, but I’d like to know in the meantime. My mum is going to be going into a nursing home, so once her needs assessment is done, I will start thinking about choosing one. She has some money/property to pay for this for now. What happens when this runs out? I know in England she would need to move onto a home where the fees are under the threshold that the council will pay.

As far as I'm aware it will be the same in Scotland. Family or your Mum herself can top up to avoid a move.

Thanks. I was guessing that. I’m meaning once her house is sold and all the money used up, so she wouldn’t be able to top up herself. I’m not sure what any shortfall would be and whether we could cover it.

How many months of care do you reckon she can afford before the money runs out?

About 3 years? I’m not sure how much the care costs though, I’ve only looked at one place.

If you place DM in one of the high amenity care homes, it is perfectly possible they will only let you view if you can produce evidence DM can cover fees for three years. (That happened to us and we couldn't provide so didn't get over the threshold.) It is likely though that these places have no provision for 'Council placed' residents so that if you did run out of funds in year 4 then you would have to move her.

If you start her off in a mid amenity care home where there is a mixture of entirely private funded and some Council funded, then I think they consider it on a case-by-case basis. We had care home experience in a mid amenity from 2015 to the end of 2022 and in all that time I never knew of anyone forced out. However, had the resident been 'difficult' and needed extra support, then that might have been treated differently. My friend's MIL ran out of funds three years ago and was not moved. She is 99. With rising staff costs, difficulty in recruiting staff, and people living longer, these policies might 'tighten' and they might be less able to let people stay.
When you find a place for DM (visit at least three) you are looking for the least worst option. You sometimes need to put your wishes to the side. Yes it would be lovely to have a cinema room, a private dinner area, a bar etc but if DM is at the stage where these aren't useful to her, then maybe her funds would last longer elsewhere. My tip is to look for the place with the best Manager, longest serving staff and staff are trained. People make care homes. Ask your friends and neighbours for any recommendations.

Thank you for all that. It’s such an unknown to navigate.
I have googled and not found exactly what high or mid amenity means - does it just mean more of the ‘nice’ stuff or is it more about the level of care?

Ha! Yes, it was my made up term. Just means less of the 'unnecessary and over hyped' stuff that puts the price up - mostly cinemas, intimate dining etc. You still want DM to have a sense of space, opportunities to take fresh air, enjoy sunshine etc and for you to be able to wheel her outside for a walk to the shops or the local streets. Don't underestimate my next tip. Try for somewhere on a bus route so the staff can get to their work by public transport. If you go for somewhere quite remote, the care home will have staff recruitment issues. If the place is easier to access, the staff won't need to fork out on taxis and if the facility requires agency staff, there is a bigger pool to choose from. Staffing is a big issue these days.

Ha that makes sense. My mum is almost bed bound so I think the extra stiff is less relevant anyway.

I had been thinking about location for us, but not the staff so that’s really interesting. That might just swing it one way rather than another.

Thank you so much for all of your thoughts, it does make sense.

@CitiesInDust If DM still has approaching full faculty, but needs to be hoisted for personal care etc, add into your search criteria, the likelihood of her having company from similarly sharp residents.

I've done this, also in Scotland.

Once the person reaches the personal threshold (it's about £24k total), then the local authority takes over funding.

Speak to the CH before and ask if she can stay there when she moves from self funding to LA funded. This happened faster than anticipated for us as the CH fees went up when her care needs went up. She was able to stay in the same place, even then same room, which was a relief.

There is a lot of paperwork to fill out (and FA1 form) which the social worked helped me with. I'd advise to send it off at least six months before you calculate she'll reach the threshold as there was a huge backlog and delays. Hope it goes ok.

That’s a good point. Thanks.

I wonder if there’s a way of predicting which places would be funded by LA and which wouldn’t.

Thats helpful, thanks.

@CitiesInDust
We just asked when we visited. I'm not sure if the info might be available elsewhere, like on the website of the CH company? Or if there's a social worker involved, they might be able to help.

There's so much to take into consideration when choosing a care home, and I think this point is really important too. Ideally, you'd want them settled and not to have to move again.

@PatchworkOwl is right, ideally you don't want to move them, but it is not impossible. DM was in 3 care homes (her first was shut down by CC with just three weeks' notice and then we moved to the 2nd knowing it was too expensive, until we could find a third.) .
DMIL over 400 miles away, had to be moved twice as she was agitated and needed additional support.
Just marking your card @CitiesInDust, if your DM has her faculty, this jumps right to the top of the search criteria. You'll want her to have stimulus and conversation, so it could be possible that you need to look to the high amenity places, as they tend to have a higher proportion of people. (Staff/residents)
I have another friend whose DM is the only non-demented person in her place. It brings lots of extra challenges. The reason my friend hasn't moved her is that it is close to a long time friend who pops in to see her once a week.
All I would say is, you don't want to move her, but don't be fearful of moving her.

Thank you so much for that suggestion. I went to look round the first place, all going well, and then I asked how many residents would be up for a good chat. The answer was that there are a couple who would, but they wouldn’t remember it the next day. I’m so pleased I asked.

Social services have been in touch and advised me on which places will be ok with council funding once the money runs out, which has been helpful.

@CitiesInDust It's very stressful sussing out care homes. You just don't want to be in that position. Nor do you want to make a mistake.
I have every confidence you will find the best fit for your DM. (Or in truth, the least worst fit.) Keep us posted.