care home - council contribution

It does vary - but my council gave us a list of the local homes and asked us to select a list of 3 that we'd be happy for my grandfather to go into - however because he had only one stipulation - that there was more than 1 other male resident we could only find one that matched that.

The fact that he was self funding meant that they were patient to a certain extent to wait for a place to come up in that home - though I don't think they'd have waited much longer.

Hi Frankie
I am afraid you have just entered the minefield that is care home funding.

My MIL is in a very good care home in the North Devon area. Luckily she is NHS funded under the Continuing healthcare system due to her complex medical problems. However prior to this she had council support under the 12 week disregard rule whilst she tried to sell her property. In this care home fully self funding residents pay £429 per week compared to council funded residents who are assessed in one of 4 care level bands.

The DCC funding bands for 2008-9 are
Level 1 £288
Level 2 £301
Level 3 £322
Level 4 £381 per week

Your FIL would have or will be assessed at one of these levels and the council have presumeably suggested a care home which will provide care at the assessed DCC funding level. If you are unhappy with the assessment level you can ask for a review. We managed to have my MIL's assessed care level raised on review and I know her care home regularly request and are sucessful with banding reviews.

Details of the DCC assessment levels and criteria are in this link.
http://www.devon.gov.uk/index/socialcare/social_services/charges-benefits/res-and--nurs-care-cb/bandings.htm

In addition to this it may be possible to obtain an additional funding in the form of a nursing supplement. If you believe your FIL requires additional care in the form of nursing you should request an assessment. Unfortunately this supplement is only payable if the care home has a nursing registration.

All residents of care homes are at least partially self-funded because an assessment of their income e.g. state pension is made, less a small weekly pocket money allowance of around £21.50 (certain state benefits are also excluded) and the council then top-up to the assessed level of care funding.

For a good general fact sheet on care home funding have a look at this link.
http://www.counselandcare.org.uk/assets/library/documents/16_Care_Home_Fees_Paying_them_in_England.pdf


If you are not happy with the council's care home selection I would challenge their choice in the first instance particularly if their CSCI reports are not good or if the home does not offer services which are a good match for your FIL's care needs. If you have the personal resources you can select another care home and pay a 3rd party top-up to make up the difference between the assessed care support band and the actual care home fees. Unfortunately I think it is not possible for your FIL to make a 1st party top-up from his savings as he has less than the fully self-funding savings limit.

Could I also suggest that if your FIL is not in receipt of Attendance allowance you could look at applying. This is a non means tested benefit paid at one of 2 weekly levels.

If you would like details of my MIL's care home or the other South Devon care home run by the same family please PM me.

Hi Frankie
We also had a period of at home care for MIL via DCC.

She had 3 visits daily, mostly of half an hour, sometimes 1 hour for bathing etc.. This arrangement was far from satisfactory for a number of reasons.

Medication. Care workers were not able to administer medication and could only remind MIL to take her pills. Even though these were repackaged in dosset boxes she often did not take her proper dosage and pills were found in her cardigan pocket from time to time. This resulted in her medical condition being unstable and repeated hospital admissions and rehabilitation stays.

Bathing. Perhaps understandably MIL was reluctant to accept help with bathing, would get up early on that day and say she had already had a bath but care workers knew she hadn't as she couldn't get out of the bath.

Lifting. Care workers are not supposed to lift clients. (Health and Safety!)

Eating. MIL would often forget to eat and care workers not involved in food preparation.

The most useful thing during this time was twice weekly day centre visits but these were discontinued when MIL went into a care home so she lost all contact with her friends there and was upset about losing contact.

DCC may offer your FIL a direct payment system for at home care. Be careful with this as the hourly rate DCC will pay may not cover the cost of your FIL paying for 3rd party care under the direct payment system. This resulted in my MIL paying twice as much per week as she had been as a DCC client. In addition quarterly financial returns had to be completed on a separate bank account so that DCC could monitor the use of the direct payment money. We also found that the care provider MIL used to charge double the hourly rate for bank holidays which again was an additional cost. So I would advise letting DCC arrange the care rather than accepting direct payments unless you have other reasons for wanting to buy in care.

Social Services do seem to have a priority of keeping people in their own home as long as possible. Obviously they cannot force people into a care home but we did feel that MIL's safety and well being were given a lesser priority than her overiding wish to remain at home. In the end it did take a major physical collapse and hospitalisation to change her mind and reluctantly consider a care home. Happily she settled quickly and thinks the care home is wonderful, also our concerns about her safety are resolved.

Hi Gavin
Thanks I had forgotren about the Attendance allowance. It isn't payable after the first 28 days in a care home (if council subsiding care home fees), hospital in-patient stay or Continuing healthcare award. In a another post I have also seen it mentioned that the 28days is cumulative in any 12 month period for multiple hospital stays but I have never seen this spelt out in any government documents.

Lifting. Care workers are not supposed to lift clients. (Health and Safety!)

No one is supposed to be lifted nowadays, whether a client or a patient!