If you’re self funding care, does the LA get involved?

[blondeascustard]

We’re not there yet. But: want to be prepared and we’ve been running through various scenarios (and I don’t even think this is the worse scenario…).

MiL has dementia, FiL is her carer. Live many hours from us. One other sibling who is not at all interested. Lovely to us, but proud, stubborn people and FiL is often in denial (or hiding from us) that he can cope.

in the not unlikely scenario (he is older and has his own health problems) that FiL predeceases MiL, MiL could not manage by herself and will need to go into a care home, and we would prefer it to be one near to us. GMiL was similarly moved to a care home near ILs when she had dementia and couldn’t cope at home

She would be definitely self funding care - would her “home” local authority have anything to do with her once she has moved to a new local authority? What else would we need to think about in this scenario?

No. My mum was self funding and the local authority wasn’t involved at all. She was in the care home of our choice, sadly not as near me as I’d have liked but very much respecting her wishes. It might be worth looking round what’s available and getting a feel for them before it becomes a necessity.

No. No need to involve them at all if self funding.

But she may still be eligible for Attendance Allowance

No. aunt did have a social worker who only advised the savings thresh hold etcwhen savings went down to about 80k, they raised issue of funding but she passed away soon after so had funds to the end. they sniffed around asking about property but 70 % had been signed over to my mum over 30 years before so was out of the equation.

My mum still got attendance allowance as a self funder in a care home.

Yes and a care needs and financial assessment

Provided she agrees to go into a home and you don't need to worry about capacity assessments etc you're fine. If she resists it could get more difficult but only as far as the capacity assessment/DOL goes. Choosing a home will be completely up to you.

No, it's up to you to find a suitable care home for her. Make sure you choose one that has contracts with the local authority in case she needs funding at a later date.

Both FiL and my DM (both had dementia) were self funded, and we had no involvement from the LA or SS for either of them. We found suitable care homes for both ourselves.
For DM there was a ‘tick box’ short informal visit from a SW, arranged by the CH, just to ascertain that DM did need residential care, and we weren’t just having her put away!

So did mine. If you self fund, you still get it.

No, MIL would have been self funding, and the local authority/social services weren't remotely interested nor did they care at all once. Their first question was whether she'd be self funding or requiring state funding, and once they'd established she'd be self funding, they just shut it down and told us to contact care agencies/homes ourselves. No interest nor advice at all.

Bear in mind that since the family home wouldn’t be counted for care home funding purposes and your DFs own money isn’t taken into account, she might not be self funding for as long as you think. Care home fees at £1500 a week soon run down savings.

Thank you all.. it’s horrible to think about the various scenarios but “what happens next” might occur very quickly and I want to do what pre-planning I am able to. She already gets Attendance Allowance persuading FiL to spend anything on making their lives easier is much more of a struggle.

There is a (v pricey) care home v close to me that I have had three different good accounts of and does dementia care. That would probably be the best case if this scenario happened. From what FiL has said we would be covered for many years of funding, even at their rates. Having seen GMiL in a home for ten years with dementia I’m not totally naive to what that might look like. And where MiL might be heading :( in the end she has had only about six years of her life not shadowed by dementia, between her mum dying and her first symptoms.

(another scenario FiL has said is “if I have to go into hospital then she’ll just go into a home for a few weeks” but he seems not to consider the logistics about how that might happen and that maybe, just maybe, he needs to start trusting his kids in case this scenario presents itself)

PoA all done.

My friend was always funded by the authority that had first funded her care, despite living in two other authorities after that. So potentially MIL's home authority would always fund her care - not sure if that's always the case though.

It depends. My DF was ok at home (no dementia but very frail) and suffered a fall which left him so disabled that he had option but to go into a nursing home (house totally unsuitable). SS were involved in his discharge process and he went through the the NHS continuing care process with them, but once it was agreed he didn't meet the criteria and would be self funding we were able to just get on with it ourselves. They told us to get back in touch once he was down to his last £40k or so which he hasn't yet.

Unless they are very wealthy or don’t require care for long the first of a couple rarely self funds all of their care though. This is because the matrimonial home is discounted and so are all assets in the spouses name. At c80k a year it uses up savings fast.

if mil has hundreds of thousands in her own name she may well always self fund but its generally the second spouse who self funds since in their case the matrimonial home is no longer protected and has to be sold

Like @Serafee says. If FIL is still living in the house, how much of their assets are in MILs name and would FIL be prepared to spend longer term? If he won't spend attendance allowance on making life easier I doubt he'll spend savings.

Yes @Serafeeand @countrygirl99its the scenario of “if FiL dies what happens to MiL” that I’m trying to think about. Because if that happened MiL couldn’t be by herself.

The one where she needs care whilst he’s still alive - and dependent on his health and capability - is another scenario on my list (but probably won’t be complicated by geographical moves).

We thought we were going to get the first scenario but against all odds got the second. A far harder one to fight because he insisted in trying to care for her himself despite having terminal cancer. Wasn't a money issue with him, just pride.

Yeah, I reckon we may have that @countrygirl99but like I said, it’s a path they have trod (actually with both do their mothers) before so I hope he’s not completely naive to it. I do think that variations of the second scenario is probably going to be harder…

Depends is the answer. Anyone - self funder or not - can legally request a care act assessment to identify what care and support someone requires (and hopefully get advice and guidance on what care homes are suitable). The financial assessment is separate. It is worth doing this early is the assets that would be paying for care are likely to be eroded quite quickly, otherwise you can usually wait until much further down the line. Or if someone is actively caring at home, and requires a carers assessment.

If there is a hospital admission and there is not an easy route straight home, then social services should be asked to support discharge. This is incumbent on the hospital to sort, but more often than not it is the family that have to push for it, particularly if self funding.

If however, your loved one is deemed to have capacity to choose where to live and does not consent to moving to a care home then this is a whole other ball game and social care teams needs to be involved to conduct a DoLS.

In the scenario you describe it shouldn't hopefully come to that, but you need to be prepared if it does. DoLS currently is set up in such a way that it is can be a very long and drawn out process, even more so if there is a shift in local authority area in the middle.

My advice would be to speak to your local team as things advance, sooner rather than later and start balls rolling. A friend has just been through a hellish 12 months of capacity assessments and DoLS challenges to get their loved one in the right place.

Thank you @Thingamebobwotsitthats really helpful.