Paying for Care Home Fees

[jpbee]

I'm hoping there is someone here in the know as I'm struggling to find an answer to this.

So I understand the means test and that you get help to pay for care costs if your estate is worth less than £23,250.

First Question - Is is correct that the £23,250 refers to your entire estate, or does it just mean your savings accounts? I've read conflicting information on this.

Second Question: Your estate/savings is worth over £23,250, lets say you have £100,000 - is the money spent until it is at £0 before the council will step in and fund? Or will they step in when your estate reduces to the £23,250 level?

Reason for asking: family member is being placed in nursing care at young age (63). Their estate will be automatically used to pay for the care fees. There is a possibility that due to their young age, the entire estate may end up being spent on the care fees, leaving £0 to pay for a funeral and cover the legal costs we are currently incurring to arrange power of attorney.

He will pay for himself until he reaches £23,250 which he will be allowed to keep.

Legal fees for his POA need to be paid for now, out of his estate, and while your at it I would just purchase a pre-paid funeral at the same time.

I'm no expert but my partner has recently gone through this, and I believe the family member's property, if they have one, is counted among their total assets, as well as savings accounts. So they (or you on their behalf) would have to sell the home and everything else, and then use the proceeds to fund care until you hit £23,250.

@ThisIsStartingToBoreMe

Thank you very much for your quick response. This was how I understood it, yet family members thought otherwise.

I hadn't heard of pre-paid funerals. I assume we can't pay for anything out of their estate until they die and we inherit the money though? Or does POA enable family to do this?

@Squiblet

I'm no expert but my partner has recently gone through this, and I believe the family member's property, if they have one, is counted among their total assets, as well as savings accounts. So they (or you on their behalf) would have to sell the home and everything else, and then use the proceeds to fund care until you hit £23,250.

Yes this was what I thought. So no matter what, there will always be a sum of money when they die? (Which we would use to pay for the funeral and the legal costs we are paying at the moment).

If the family member has a spouse or civil partner living in the property it will be disregarded.

Can't he just purchase his own funeral? With your assistance of course.
Does he have dementia?

Sorry - to answer your question, yes POA does give you authority to purchase a funeral, or anything else necessary for his health and wellbeing.

@countrygirl99 They live alone so it will be counted in their estate.

@ThisIsStartingToBoreMe They have brain damage caused by recent organ failure. It is similar to dementia and they are now in a dementia focussed care home. This is why we are applying for POA. The trouble is we know little about what money they have, and are assuming most of it will be spent on their care. It is going to take until next Summer to finalise the POA, and I assume we wont be able to find out what money they have until then.
But that's good to know that once the POA is finalised we should be able to purchase a pre-paid funeral there and then (on their behalf).

One of the troubling things is that we have been told they have 6 weeks care funded by NHS, then at that point they have to start paying.
However they will not be able to sign any forms and arrange payment for the fees or sell their property as they are not in a fit state of mind. And we can't do it either as we have no POA. So I wonder what happens in the meantime, surely they aren't thrown out onto the streets. I'm assuming the NHS will continue to pay for their care past the 6 week mark, but then expect it to be paid back to them once the arrangements have been made (this could take 9 months we've been warned).

I think it might be Deputyship you need, not POA. The other party has to agree to give POA away and if they are brain damanged they don't have capacity to do this.

Therefore Deputyship more complicated to obtain than POA, but outcome the same in that you will be able to purchase the funeral.

Anything they have over £23,500 they will pay towards care fees at the full cost of that care.

Once they reach the £23500 threshold they then pay a contribution towards their care on a sliding scale depending on what other income they have still coming in (e.g. pensions, benefits) with the local authority making up the shortfall.

Once that £23500 reaches around the £16000 mark then they will stop taking a contribution from savings/assets and will only take a contribution from income (pensions, benefits etc) that £16000 is then left to pay for funerals, legal costs etc.

They will also be allowed to keep approximately £20 a week of any of their income instead of it all going on care fees so that they can e.g. pay for haircuts, chiropody, new clothes and toiletries.

If they have nursing care needs then the NHS will pay £187 a week in England (slightly less in Wales and a different system altogether in Scotland) towards the nursing costs of their care, but this won't change the amount they pay as this is on top of what ever they/the council are paying for social care costs.

I'm sure you have covered this but at their age with that type of condition please make sure that they have had a fully funded continuing healthcare checklist as if their needs are complex they may be eligible for the NHS to pay the full cost of their care.

@ThisIsStartingToBoreMe Ah ok, this is possibly what we are applying for then. It is actually our BIL who is applying for it and dealing with the solicitor, and he has continued to refer to it as POA, but may have just done this to not confuse everyone. He did mention there would be a court order required to complete it, hence it taking potentially 9 months.

It is possible they may not live until it is approved anyway, they have been given a prognosis of 3-12 months, however have already outlived previous expectations so we are going to assume they will live a further 20 years just to be prepared for that and ensure we have everything in place to deal with costs etc.

You may get some help with fees (or get them all paid) you need to get continuing health care to assess (Google NHS continuing health care). Even if you don't get full funding you may get part funding and they will be able to assist you in what is included in 'the estate'.

@hatgirl Thank you very much for your detailed reply. That all makes sense and is very reassuring.

That is helpful to know about the checklist, it is still early days and we are waiting for a final report from the occupational therapist at the hospital (they were discharged 5 days ago). But I'm assuming off the back of this report the checklist will be completed.

@Thepowerofthelook That's good to know, thank you.
It may not work in their favour that the cause of their illness is self-inflicted (alcoholism). I don't know if this would make any difference though.

@jpbee

One of the troubling things is that we have been told they have 6 weeks care funded by NHS, then at that point they have to start paying. However they will not be able to sign any forms and arrange payment for the fees or sell their property as they are not in a fit state of mind. And we can't do it either as we have no POA. So I wonder what happens in the meantime, surely they aren't thrown out onto the streets. I'm assuming the NHS will continue to pay for their care past the 6 week mark, but then expect it to be paid back to them once the arrangements have been made (this could take 9 months we've been warned).

We cross posted.

The six weeks NHS care is likely to be some kind of discharge to assess arrangements - essentially the NHS pay for a place in residential care to free up a hospital bed whilst all the assessments that used to have to happen before someone could leave hospital would take place.

Before the end of this six weeks your relative should have had all of the relevant physio, OT and social care assessments. They will also be checklisted for fully funded continuing healthcare care (CHC) and funded nursing contribution (FNC).

If they have a rapidly deteriorating condition that is terminal then there is every chance that they will be eligible for something called Fast track continuing healthcare, which again means the NHS pays the full cost of the care but the process for getting this funding is much quicker and more straightforward.

If your relatively isn't eligible for Fastrack CHC or CHC then the local authority will then offer a financial assessment where they will explain what will be charged. If no one has managed to get deputyship by then (and there is a huge delay at the COP it is taking easily 6-9 months at the moment) then the local authority can place a charge against the estate called a deferred payment which can be paid either when deputyship is achieved or when the person passes away.

[quote jpbee]@Thepowerofthelook That's good to know, thank you.
It may not work in their favour that the cause of their illness is self-inflicted (alcoholism). I don't know if this would make any difference though.[/quote]
It makes zero difference.

Continuing healthcare is awarded if the person's care needs are of a nature that is complex, unpredictable or intense to manage, or if they have a rapidly deteriorating /unstable condition that is expected to be terminal.

The assessment doesn't look at diagnosis or cause. It just looks at the current presenting needs and how difficult they are to manage or how rapid any deterioration might be.

It makes no difference how it was caused its about their current health and social care needs. It's quite complex but breaks down their needs into different 1) Behaviour; 2) Cognition; 3) Psychological/Emotional Needs; 4) Communication; 5) Mobility; 6) Nutrition; 7) Continence; 8) Skin Integrity; 9) Breathing; 10) Drugs/Symptom Control; 11) Altered States of Consciousness. Then he is assessed against various criteria, being graded either: no needs, low, moderate, high, severe or priority for each, based on the intensity, frequency and unpredictability of each of the criteria. A decision is then made and could be fully funded/ part funded or no funding.

The cause being alcoholism will make no difference

I have had work situations where we (the local authority) have had to step in and pay for someone even if they are a self funder because no one has access to the persons money and the deputy ship order is pending. We’d then recover it once the deputy ship is through.

Agree you should do a pre paid funeral from their money. That would mean it decreases to the threshold faster but it’s legitimate use of their money.

And others are correct that the LA will step in at threshold (contact them 3 months before they reach 24000) but your relative would still have to pay a contribution based on capital and income.

Of course the above doesn’t apply if the relative is awarded nhs continuing care funding but this is relatively rare.
If you think it’s borderline and worth fighting though beacon are good for chc advice and advocacy.

@hatgirl Thank you so much for the information. That makes sense now why they have been put in a care facility before final assessments are complete. We just thought it was bad organisation. And that is interesting that the cause of illness does not make any difference to potential funding.

@User2638483 I will definitely make the suggestion of a pre-paid funeral to BIL who is running with this. And thank you for re-confirming the fact that some of the estate will be retained, this is very reassuring.

I am surprised the solicitor is talking about POA. With no capacity to sign or understand the forms, you have to apply to the Public Guardian who will steward his affairs.

I found that AGE UK were brilliant when it came to this sort of advice. It is worth calling them as they are the kindest most sympathetic people.

Also keep records of f any money you use of his as the Public Guardian will want to do an annual check.