Live-in care funding

[Essentialunmentionable]

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?

Live in care is extremely expensive and very hard to find reliable and good people.
My grandmother was a wealthy woman. live in care drained her savings and pensions in less than 10 months. She has had to move into a home and sell her house to pay for it. I would not recommend unless there is a lot of money around.

The PEG feeding was just an example of a health need that might qualify for CHC there are lots of other areas including continence, mobility, cognition, behaviour but you have to score a certain number of points overall to qualify and it’s a high bar.

Ah, yes, she's quite immobile and has incontinence issues but most definitely not cognitively impaired.

It’s very confusing managing all this.

The hospital -arranged cover is usually called an ‘enablement package’ deemed suitable until someone can be more self sufficient.

But the NHS can also provide a ‘continuing care’ package for health needs.

Have you approached the council’s Adult Services dept for a Care Assessment?

Though if she has substantial savings she will not be entitled to paid for carers.

However, Attendance Allowance is not means tested and can be spent towards any service that helps . A cleaner, gardener or live in carer.

Age UK can be really helpful in navigating all this .

The LA did pay for live in care for my parents but it was cost effective because there were two of them. But it was hard work. Agencies put carers on two or three week placements. You need to arrange two hours respite care to give the carer time off if the client cannot be left for two hours at a time all the usual household issues need to be dealt with.

There isn't much money - less than £30k in savings.

I think that whilst it might seem a "low change" approach to meeting her care needs, having someone living in your house is quite an intense situation (I would hate it), I think a care home would potentially provide her with more opportunity to socialise and enjoy her days - she is still mentally very switched on - just very physically disabled. I think she would benefit from more mental stimulation.

But it's not my decision and my opinion is not really relevant - I'm just trying to support dh with info - he's googled, of course, and we have a neighbour who is a social worker who has been very helpful, but we don't want to impose too much on her.

Having a chat with people who have had direct experience is invaluable and this forum has been so helpful in the past when I have been dealing with my own elderly parents.

It’s almost impossible to get CHC funding, even if someone is bed-bound, immobile and can’t wash themselves, needs help with eating etc. That still wouldn’t meet the criteria.
It either means they have very very high, fluctuating care needs and/or are terminally ill and in the very last part of their life. There is a fast track CHC for those who are terminally ill.

Hmm yes £30k will not go far in either scenario of live in care or care home. I think the social care threshold is 23k.

In that scenario I would ask social care for an assessment now (you can usually call a central number on the council website) and then you know for sure what they might be willing to offer.

I have definitely seen live in care go badly wrong where there is resentment about the carer being there or cultural differences. In a care home if you don’t like one carer at least you can ask for a different one. Maybe if she looked around a few places she might be persuaded. With savings so close to the threshold you would still need to choose one that social care would be willing to fund if you went down that route or they might move her if it’s too expensive. I would recommend trying to get them involved although they can be reluctant to assist ‘self funders’

For anyone interested, here’s a link to the CHC funding screening tool. Only if people meet enough of the domains ( as mentioned in the guidance notes) will someone be recommended for a full assessment, unless they are deemed to be fast track, in other words expected to die within the coming 3 to 6 months.

https://assets.publishing.service.gov.uk/media/630399dae90e0729db4b59f9/NHS-Continuing-Healthcare-Checklist-guidance-2022.pdf

She is most definitely not at end of life or terminal. As I said previously, she's basically bed bound.

Yep - people can actually have very low social care needs but still qualify for CHC because of high health care needs.

So for example unstable diabetes that requires a registered nurse on hand 24 hrs a day to manage, a physical condition that requires carful positioning to manage to prevent aspiration, anything involving titrated medications, or regular altered states of conciousness requiring a health professional to respond.

Also for fast track continuing healthcare because they have a terminal condition in which death within 12 weeks could be expected.

There is so much misinformation about CHC, it is hard to get because it's and NHS service to meet health needs. Washing, dressing and eating are social care needs whether they appear because of physical infirmity or mental decline.

The trouble with residential care for someone who does not have dementia is that most other residents in council funded homes do have dementia and the activities etc are more oriented to their needs. It might be worth checking round local care homes that accept council funding to find one that has a higher proportion of non-dementia residents.

First step is definitely to get a council needs assessment for her to see what they will and won’t fund for her.

CHC is funded by Health . The NHS is 'free'. Social care is means tested but the social care budget pays for the majority of the bill.

Thank you. It's very confusing and just seems unfair that some have to pay and some don't.

Well this particular lady has been fully funded for 7 months so far.

Its not unfair if you think about it. Those with complex health needs (and ultra complex!) needs qualified nursing. Those with social care needs such as immobility, dementia and needing to be fed etc does not need a nurse therefore doesn't qualify.

A live in carer's role for an elderly person is surely only going to be a magnet for a con artist!

I think you get them from an agency and they have been vetted!

My late OH's live-in care was paid for by the health authority via Continuing Health Care Funding. It may not apply to your Mum but is worth investigating. Free advice is available from Beacon: www.beaconchc.co.uk

Well it might seem unfair, but what would be the alternative provision for people who can’t afford to pay? It’s the same argument that occurs when you look at general health care, people who have abused and damaged their bodies with alcohol, drugs , nicotine, excessive bad food choices etc, are still as entitled to treatment and care as those who have looked after themselves carefully but still been struck down with illness, accident or infirmity.

We look after people who need help and don’t judge, or reserve care for those who can pay and turn a blind eye to those who can’t pay and let them rot.

It’s an in exact science predicting how long someone will live after a terminal diagnosis.

I think you misunderstood. What confuses me is that my stepfather, who appears to have the same issues as this extremely wealthy lady, has to pay for his care, but she doesn't. I absolutely feel that everyone should be provided with care. My question is: why does my stepfather have to sell his one bedroom house to fund his care, but an extremely wealthy woman whose bank balance is increasing, doesn't have to pay anything? Is it dependent on area?

No it's dependant on health needs which you might not be aware of

It has been explained to you that it is because her care is funded by NHS CHC which is free and his is funded by social care which is means tested.

She must have very significant health needs which you are unaware of in order to be funded by CHC. If she does not or no longer does it will soon be taken away I am sure

It is a national system which applies the same in all areas. Your dad will have had an NHS CHC screen and been deemed ineligible as most people are. Someone posted the actual criteria upthread so if you think he does score highly on those then by all means you can ask for a reconsideration. Ask his care home to refer him to the local CHC assessor.

Thank you, I will do this.

Most people are deemed ineligible for CHC funding - this should not be taken at face value. My OH got this on appeal after two refusals. Hence my advice to contact Beacon (see above) and they will give you an objective view on whether he qualifies. If he doesn't, they will tell you; if he does they will help you to apply.

The advice is free up to a certain time allocation and a charge only applies if you ask them to conduct an appeal for you. I had several free conversations with a Beacon solicitor and advice about the content of the appeal I had written and it all came within the free allocation.

Staff in the NHS (hospital or community) are trained in patient care and not in the administration of CHC funding. Their snapshot decisions when filling in the initial form are very often wrong. It is in fact quite shocking that people are given misinformation that has such a big impact on their lives. .