Live-in care funding

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Mil has hit that point where the family can no longer cope, and she needs around-the-clock care. The family are exploring options and are considering getting a live-in carer - they would like to use MIL's savings to pay initially, with Social Services/ Local Council continuing to pay when her savings ran out.
Has anyone managed to make this work?

I'm afraid it's highly unlikely that SS would take over funding of live-in care because residential would be cheaper. And if she's then relying on SS funding then the care home she goes to may not be great. Perhaps consider using her savings to find a lovely home now that you're all happy with - the case for keeping her there when she hits the savings threshold will be easier to argue. Possibly not what you wanted to hear, sorry.

This is unlikely to work. Councils usually fund up to four carer visits a day, not live-in care as it’s a lot more expensive.

Is there a reason you’re not considering a care home? Having experienced both with relatives and friends, the care home was by far the better option. The live-in care just created loads of work!

Thank you for your thoughts.
@EmotionalBlackmail The thinking behind this approach is that MIL is very resistant to moving into a care home, despite her increasing needs - the family thought this option would be more palatable to her. As with all things to do with social care funding, it's not exactly clear what they will or won't fund and whilst we are trying to find a solution to this situation, we wanted to explore all available options.

Having just been through the process, the maximum as per a pp is 4 calls a day. The calls offered to my df weren't actually going to support with what we needed. For example an 8pm bed time call, when he doesn't go to bed until 10pm. Unfortunately picking and choosing times isn't an option due to lack of carers. They do not provide care post 10pm. You may source that independently, but that comes with the complexities of employing people, as it will be more than one or two in order to cover sickness etc. You will then be responsible for NI, tax, holiday pay, sickness etc. Quite a challenge and finding the right person could be difficult also.
I don't want to be so negative, but this is the reality.

Do you have a social worker currently?

There have been a few threads on here about live-in care, which are worth looking for. Nobody wants to go into a care home but it can often mean a new lease of life once they’re settled.

My experience of live-in was that it doesn’t solve the major issues, eg the house still needs to be maintained, the flooded washing machine dealt with by someone, shopping organised/purchased. Carers vary in quality, sometimes there’s one that totally gets it, others it’s disastrous. There were some cultural issues around diet and what the carer had the knowledge to prepare for meals and what the elderly person wanted to eat. A lot of live-in carers are young, late teens/early 20s, often trying to save money for studying or travel, sometimes from overseas, so there may be language difficulties or simply a massive generational divide.

No social worker currently - we did ask, but were told social workers are as rare as hen's teeth around here.
The social care provided by the hospital rehab team has been very hard to predict. They released MIL without informing the family - just left her at home on the sofa. We don't seem to have a person who's managing MIL's care or rather the person managing MIL's care is so overwhelmed that communicating with the family isn't their top priority. We have tried repeatedly to find out.
All the carers arrive with a different opinion on what happens next - it's quite a mess.

Just want to agree with Humanswarm. My mother had the maximum four calls a day but you couldn’t rely on when the carers would come. It was generally the same two at regular times but then they would have to cover for other staff who were off and would come at 10.00am instead of 7.00. The evening call was quite early and one of us would keep mum company and see her safely into bed later on. Mum had no savings and was on benefits/ pension and attendance allowance but we still had to pay to cover the cost of the carers. Our local council refused to pay for a nursing home - when she was completely immobile - as they now only pay if you have dementia. It is also worth bearing in mind that if social services are paying for a home you do not necessarily have a choice. They prefer the cheapest. I’m sorry to be so negative but the situation is very difficult these days. 30 years ago when my father was taken ill he told the social worker that he preferred to go into a home and she just told us to find one and they would pay! I think the best solution would be to find a nice home now and sell her house to pay the fees. If she does run out of money you will then be in a good position to argue with social services.

There were some other set ups described on previous threads but my experience is of one carer coming for three months, then being replaced by another, so training them up on repeat. They didn’t provide night-time care (there is an expectation the carer will get a full night’s sleep), but were in the same building so could call an ambulance in the event of a fall. They had a full 24 hours off per week, plus three hours a day on other days, this was then covered by other carers - organised by the same
agency. Ideally we wanted carers who could drive but this wasn’t always available so shopping tended to be organising a supermarket delivery.

So we went though something like this with my dad a couple of years ago. Obviously while MILs savings are being used it is up to MIL what she pays for. When MILs savings run out, the council will ask social services to do a needs assessment and they will offer the most cost effective way of providing for her needs. If she needs more than 3 (maybe 4?) care calls in 24 hours, they will be offering the budget for a suitable nursing home place. If she needs more care than this, she will either need to accept that place, or self fund the difference in cost between the nursing home place and home care. Unless MILs needs meant she was going to need to be watched by a dedicated carer in a nursing home 24/7, there is no way social services would fund this for her at home, when she could get this in a nursing home shared with a number of other residents.

Social services will not fund more than 4 visits a day.

CHC will fund 24 hr care at home - but only if you have demonstrated a very high level of complex need.

What families think is a need for round the clock care and what Social Services/NHS think is a need for round the clock care are often worlds apart.

The reason why carers come at different times is because their visits before can overrun/ in hospital/at appts which change their schedules. This happens with ever care agency and isn't due to a lack of carers, it's just happens when dealing with people.

Social care don't just pay for people with dementia!

SS will fund care for up to 4 visits a day generally, and if more is needed they would fund a care home. Obviously this is where someone doesn’t have the funds to pay for their care themselves.

Its worth noting you cannot move any relative to a care home without their consent, if they have capacity. Its illegal.

We started with 4 care visits a day then moved to live in care arranged through an agency. At that point we dropped the 4 care visits and we were given a payment from social services equivalent to the cost of those 4 care visits. We put that towards live in care but we had to pay the rest until we no longer needed the care

Can I just point out that a live in carer is not the same as the 24 hour care she'd get in a care home? The carer also has to be able to sleep in order to complete quality care in waking hours. It's ok for them to get up as an emergency but say checking on someone every hour or two overnight every night is not on. In a care home there's separate night cover for that. So you really need to work out what's needed before you plump for that option.

I do know someone who the council continued funding live in care for after their savings ran out, but it's by far from the norm (and was a good few years ago). Budgets are being cut so much still councils will look to provide the very cheapest they can get away with.

Also worth considering how many carers does she need at a time. As well as the fact they need to be able to sleep undisturbed over night.

If she needs more than one carer at a time to do her care, then live-in care is basically a non starter as you are looking at having 2 carers all the time, including a night shift.

I've just been through similar. My 75 year old stepfather needs round the clock care and we had no other option than to put him in a care home. This is currently being funded by his savings which we estimate will run out in 12 months at which point his house will be sold to continue to fund the care. It's very concerning as his house is only worth about £120,000 (one bed house in the north), and his care costs are £6.5k per month !

I just don't understand how it works as I have a friend who's mum is in a fully funded (via CHC) care home and yet she has cash assets of just over £850k, as well as monthly bank, pension and dividend income, rental income and state pension totalling approx £4000. So whilst she's being cared for at zero cost, her wealth is increasing. I know all this because I complete her Tax Return. Can somebody shed some light on this??

CHC is awarded on the basis of health needs, not social care needs.

Presumably there is something different about your friend's mum's situation which qualified her for CHC.

Thank you. I visit her twice a week as i wash her hair and do her nails! From what I can see, she is unable to cook for herself and clean herself as she has mobility issues.

CHC is non means tested unlike social care so if you qualify for CHC you don’t need to pay however much money you have

However the barrier is very high to getting it. It is not enough just to need 24-7 care. Your needs have to be very severe, health related (like a PEG feed or something) and unpredictable. Most people do not get it. Also it is not forever and can be taken away if your needs reduce and then you have to pay.

The only other way to avoid means testing for care that I am aware of is to get detained under S3 of the mental health act and thus to qualify for S117 aftercare. This is only a tiny subset of people.

Thanks for your concern. Do you think a care home would agree to moving a resident in without their consent? Seems unlikely to me!

Thank you for this explanation. She isn't PEG fed and eats normally, although she often refuses to eat the food provided and her daughter brings in homemade stuff!

To OP I would say to go ahead and organise the live in care (usually via an agency) and when the money is close to running out review at that point but do not assume social care would pick up the bill as that is unlikely. They will do their own needs (and financial) assessment at that point.

However things can change very fast when you are old and frail with health needs and it may well be that by the time it comes to her needing a care home she will accept it. Usually 4x a day care is the max for social care but I have known people to have live in care packages at home funded, even very expensive ones but usually for niche reasons eg that care homes cannot meet their needs.

As others have said you need to factor in carer breaks and holidays and if she has needs regularly at night would require a night carer and a day carer which is more than most people could afford.