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Top-up fees for care home?
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# 1
Rosie75
Old 01-07-2008, 6:24 PM
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Default Top-up fees for care home?

I am posting this on behalf on my partner. His mother has been in a care home for the last 18 months as she has dementia - my partner and his brother had to go to the court of protection to get access to her financial affairs to pay the care home, and this has only just been resolved. Last month, their father was also placed in a (different) care home as his dementia means that he is unable to live alone. His care home has now sent my partner and his brother agreements to sign for a "third party top-up" of 200 per month. Obviously this is a different scenario to that they faced with their mother and they are reluctant to sign this. None of us has ever heard of children being expected to contribute towards the cost of their parents' care. :confused: Does anyone have any experience of this? Could the home refuse to accommodate their father if they do not pay? He is able to pay for his care himself, probably for a number of years, but his dementia means that his sons will have to go through the frustrating and lengthy process of applying to the court of protection and experience tells us that the home is likely to get impatient and start threatening legal action for unpaid fees (as was the case with my partner's mother).
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# 2
Savvy_Sue
Old 01-07-2008, 8:40 PM
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Assuming you are in England (because I know the rules are different elsewhere) then I recommend a read of this thread. Because you may find that either or both of your parents should be having their care paid for in full.

I really recommend getting advice from Age Concern or Help the Aged.

However, if it's clear that the father isn't going to be able to manage his own affairs anyway, then starting the process of going to the CoP would be a good plan ...
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# 3
Rosie75
Old 01-07-2008, 9:36 PM
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Thanks for the link. We are in England, and my partner and his brother are about to start the whole process of going to the court of protection again.

What confuses me is that the information I have been reading on the web this afternoon seems to suggest that my partner's father is not allowed to "top up" the difference between what social services would pay (and this is hypothetical because his income and assets are significantly above the threshold) and what the home charges by using his own money. This difference apparently has to be paid by a third party - I assume so that his assets don't dwindle away too quickly resulting in Social Services having to pick up the tab sooner than they would like. We haven't even been told how much the home charges a week - he was simply placed there in an emergency situation, and there was no choice of accommodation offered. Experience tells me that this is all going to be a nightmare - it feels like hospitals, social workers, care homes and banks are hell-bent on making all already stressful situation a hundred times worse...
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# 4
Savvy_Sue
Old 02-07-2008, 1:16 PM
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Another reason to get good advice quick! If you know what the regs actually say ....
I'm a Board Guide on the Cutting Tax; Charities; Small Biz & Charity Organisers; and Silver Savers boards, which means I'm a volunteer to help the boards run smoothly, and I can move and merge threads there. However, do remember, Board Guides don't read every post. If you spot an inappropriate or illegal post then please report it to forumteam@moneysavingexpert.com. It is not part of my role to deal with reportable posts.

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# 5
EdInvestor
Old 02-07-2008, 2:02 PM
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Some useful info on financing care

https://www.hsbcpensions.co.uk/nhfa/pdfs/is6.pdf
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# 6
Mojisola
Old 02-07-2008, 3:37 PM
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Quote:
Originally Posted by Rosie75 View Post
His care home has now sent my partner and his brother agreements to sign for a "third party top-up" of 200 per month.

He is able to pay for his care himself, probably for a number of years
I've never heard of this before. I understood that the person needing the care was responsible for any payment if they had enough assets and, if not, the Social Services budget paid the fees.

Do post if you get any clarification of this demand. It's always worth knowing about these things in case we get landed with them too.
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# 7
Primrose
Old 03-07-2008, 3:35 PM
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I strongly advise that you do not sign anything commiting you to top up your father's care home fees without getting proper legal advice. Relatives are often at the mercy of local authorities who deliberately seem to take advantage of the fact that relatives are at their wits end by the time a parent needs to be taken into care with dementia. My father sadly suffered badly from this problem and had to be sectioned. He ended up in residential care and not one single social worker or health care professional I was involved with at the time told me, as his Power of Attorney representative, that he was entitled to free care. I had to sell his home to pay for his care and only after his death did I discover that his care should have been free. I sued the Primary Care Trust involved and after a long fight they were forced to refund his fees.
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# 8
Rosie75
Old 03-07-2008, 8:47 PM
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What a sad story, Primrose. It does feel as though the people who are supposedly there to support the elderly and their families are often making a bad situation even worse. The social workers my partner and his brother have been dealing with only seem to care about money.
We haven't got any further with finding out about these top-up fees as my partner has been in bed with a migraine for the last two days (probably because of all the stress). However, I've told him not to sign anything and - until we know more - to ignore any correspondence from the owners of the care home.
If you don't mind me asking, Primrose, was your father's care paid for by the PCT because he had a particularly bad case of dementia?
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# 9
debtfreeoneday
Old 03-07-2008, 9:51 PM
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Hi, I know in some cases, homes can charge for a third party top up if they are a particular quality of home or if they are in demand. Increases paid to care homes by local authorities are below inflation and some homes are unable to meet costs unless top ups are charged.

I know that doesn't make your situation any easier, but some local authorities have also been know n to pay these top ups as well.

Hope this helps..
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# 10
Mojisola
Old 03-07-2008, 10:37 PM
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Quote:
Originally Posted by debtfreeoneday View Post
Hi, I know in some cases, homes can charge for a third party top up if they are a particular quality of home or if they are in demand. Increases paid to care homes by local authorities are below inflation and some homes are unable to meet costs unless top ups are charged.
I can understand that care home fees may be more than the local authority wants to pay, but why does the extra have to be paid by a third party when the resident has money?
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# 11
Rosie75
Old 03-07-2008, 11:42 PM
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Quote:
Originally Posted by Mojisola View Post
I can understand that care home fees may be more than the local authority wants to pay, but why does the extra have to be paid by a third party when the resident has money?
I also find this strange. The cynic in me suggests that social services are anticipating a situation where the resident's assets may get used up quickly if they opt for an expensive care home. SS would then need to step in to pay. It would therefore be in their interests to keep the resident's expenditure down by insisting on a third party top-up so that their assets last as long as possible. Or is this too Machiavellian, even for local authorities?
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# 12
Primrose
Old 04-07-2008, 9:44 AM
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(This following info comes from a Care Directions e-mail newsletter I receive and the contact may be helpful to youin getting advice about your f-i-l's care funding.

"The fight for continuing care fees to be paid by the NHS or a Local Authority remains a consuming nightmare for thousands of families. Everything hinges on the definition and interpretation of the ruling as to whether the primary need for care is a health need.It becomes a matter of expert evidence and application and many
families are left floundering and bemused by delay, intransigence and complexity. It can be costing them many thousands of pounds. Challenging denial, securing eligibility

Robert Campbell & Company is a specialist legal practice handling continuing care cases for a wide range of clients all around the UK. One recent case, involved a son whose father, an Alzheimer's sufferer, was prevented from returning home after hospitalisation. For over a year, the son and daughter challenged the denial of NHS continuing care for their father without any success. Robert Campbell & Co. was asked to take on the case and, in a relatively short time, was able to establish a report reflecting the seriousness of the father's condition and secure an agreement that he was eligible for fully funded NHS continuing care. The father eventually was able to move into a nursing home paid for by the NHS. Delighted at this outcome, grateful son Chris Leeds, said: I do not believe we would have achieved this highly satisfactory outcome without Robert Campbell's involvement and I am very happy to recommend Robert's services to anyone. He is highly efficient, focused and good to deal with. At crucial points in the process, he gave us extremely good advice. The success almost certainly saved the family tens of thousands of pounds in care costs without,in any way,compromising the fathers care. Robert Campbell & Co. offer a free on line assessment of a person's potential to achieve Continuing Care eligibility. You can access this now by going to: http://www.carelaw.co.uk/nursing-care-assessment.html. Robert Campbell & Co will then offer a 'Capped Fee Scheme' to
clients, at 595 plus VAT. Full details of this scheme can be viewed at http://www.carelaw.co.uk/capped_fee_scheme.html "

Sometimes when you're desperately stressed, (and it sounds as if your partner is getting to this state) it may be worth the money to have an expert steer you through the Care Funding minefield. I wish I had known about this when I was trying to cope with my father's care. In the light of the subsequent battle I had it would have been worth every penny.
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# 13
EdInvestor
Old 04-07-2008, 10:53 AM
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Quote:
Originally Posted by Primrose View Post
My father sadly suffered badly from this problem and had to be sectioned. He ended up in residential care and not one single social worker or health care professional I was involved with at the time told me, as his Power of Attorney representative, that he was entitled to free care.

AFAIK anyone who has been sectioned under the Mental Health Act for dementia is automatically entitled to NHS funded care.

What is so disgraceful is that personnel in 'the system' take advantage of families' ignorance and distress on care issues to exploit them financially.

Anyone who has a relative who might need care in future is strongly encouraged to start researching the rules and the financial options NOW, so as to avoid being steam-rollered into incorrect choices in a crisis.

There is anecdotal evidence that the authorities do not "try it on" with those who are well informed and firm.
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# 14
Mojisola
Old 04-07-2008, 11:22 AM
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Quote:
Originally Posted by Primrose View Post
Sometimes when you're desperately stressed, (and it sounds as if your partner is getting to this state) it may be worth the money to have an expert steer you through the Care Funding minefield. I wish I had known about this when I was trying to cope with my father's care. In the light of the subsequent battle I had it would have been worth every penny.
I would have thought this would be a legimate expense which could be paid from the father's capital.
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# 15
Biggles
Old 04-07-2008, 2:40 PM
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As I understand it, top-up fees only apply when the local council is funding it and the costs are more than they are prepared to pay.

But in this case, both his mother and father are above the threshold for council funding.

Maybe the council are funding the father's fees temporarily, as he went in as an emergency situation, probably pending a financial assessment?

If he is already funding his own care fees, then third party top-up fees won't apply and the care home have got their wires crossed. Best to have a word with them.

But if they each have a significant amount of capital, consider an immediate care fees annuity (on the same site linked to by EdInvestor above https://www.hsbcpensions.co.uk/nhfa/pages/index.asp). This can avoid the worry of their funds running out.
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# 16
treliac
Old 04-07-2008, 8:13 PM
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That seems to be right Biggles. If both parents each have enough money of their own to pay for their care then they do so, without top-up fees coming in to it at all.

Once their capital assets reduce to the level at which the local authority will contribute to their care, only then does the question of top-up fees possibly arise depending upon the home / costs involved. If there is a shortfall in LA funded placements and top-ups are a possibility, they can only be made by a third party as the resident will already be contributing all they are considered to be able to afford.

It's worth exploring all the possible options though, including whether either or both might qualify for continuing health care funding, http://www.dh.gov.uk/en/Publications...ance/DH_079515

Do they have a property that could be rented out?

Is the care annuity a good option - weighing up and balancing costs against possible duration?

Also, Rosie, is there no way that both parents could be placed in the same home together?
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