Council requesting third party top-up for care home fees.

monkeyspanner

My BIL's father has been a council assisted resident of a care home for some years. The original care home placement was arranged by the council social services and no additional 3rd party top-ups were required.

The council have recently approached my BIL for a third party top-up payment which he cannot pay due to recent redundancy and the size of the top up required. My BIL is uncertain if this is simply a fee increase, the home withdrawing from an agreement to provide care at the councils "usual rates", or a disagreement over the care needs assessed need level.

The council have assessed care needs at Level 2 which would provide assistance up to £309/week (their "usual payment") against the homes wish to charge £500+/week.

The council wish to move my BIL's father if a third party top-up cannot be made and their suggested alternated home would mean a 40mile round trip for the family make a visit.

Does anyone know if there are any guidelines which detail how a council have to approach this situation. I am particularly interested in issues like timescales/notice period, distance, and consultation with relatives. The social worker seems to have put forward a suggestion of an alternative care home and left it to my BIL to either accept this suggestion or find an alternative.

monkeyspanner

I have one government guidance to social service departments on choice for people entering a care home but it is not specific about proceedures if a council wishes to move a resident to a cheaper care home.

http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4090987.pdf

So if anyone has any more info or first hand experience of this situation advice would be appreciated.

CHCscandal

monkeyspanner wrote: »

My BIL's father has been a council assisted resident of a care home for some years. The original care home placement was arranged by the council social services and no additional 3rd party top-ups were required.

The council have recently approached my BIL for a third party top-up payment which he cannot pay due to recent redundancy and the size of the top up required. My BIL is uncertain if this is simply a fee increase, the home withdrawing from an agreement to provide care at the councils "usual rates", or a disagreement over the care needs assessed need level.

The council have assessed care needs at Level 2 which would provide assistance up to £309/week (their "usual payment") against the homes wish to charge £500+/week.

The council wish to move my BIL's father if a third party top-up cannot be made and their suggested alternated home would mean a 40mile round trip for the family make a visit.

Does anyone know if there are any guidelines which detail how a council have to approach this situation. I am particularly interested in issues like timescales/notice period, distance, and consultation with relatives. The social worker seems to have put forward a suggestion of an alternative care home and left it to my BIL to either accept this suggestion or find an alternative.

Monkeyspanner, sorry to hear about this situation but not surprised given that both the local authorities and the NHS focus on exactly this vulnerable group of people to shore up their failing financial controls.

Can I ask, is the persons placement funded totally by the council, where they charge an assessed contribution or is it 'arranged' and placed by the council but the person is a self funder?

This case brings to mind the subject of recent threads regarding care homes clubbing together as an association, appoints a law firm, who have appointed Cherie Booth!! as their barrister.

The care homes, residential and nursing have formed and association in order to challenge the councils block contract arrangements, which they have had in place for many years, where as with home care contracts, the councils drive down as much as possible and pay a fixed contract to the homes, whether or not the beds are occupied, supposedly forcing the homes to overcharge/extra charge 'self-funders' to make up for the shortfalls in income.

But if councils provide, place & charge a person, but the person is in essence a self funder, where the council invocie the person each month, then they ususally are charged the council rate, not the direct contract self funder rates.

In your case, what are the contract arrangements? i,e, council to care home, recharge back to person,(self funder) or council to care home, full payment of contract fee for person.
Are any assessed contributions applicable under CRAG, charging for residential accommodation rules.

http://www.dh.gov.uk/en/Managingyourorganisation/Financeandplanning/Residentialcare/index.htm

A number (if not all) councils are attempting to cease contracts, in order to recharge / change long term agreements to assisted people when finding a placement, where the council pay for the placement under block contract and recharged to the service user,

Example from devon cc from their website: http://www.devon.gov.uk/index/socialcare/assessment-and-eligibility/facs-policy-adults/facs-self-funding-care-home-residents.htm

Quote:-Policy Statement

Where service users have sufficient resources to be self funding Devon Social Services will no longer offer to arrange a placement or a contract for residential/nursing care except where the individual is unable to do this for themselves and has no-one able to do it for them.

These actions by councils could be driven by the fact that if a person is placed by a council & is a self funder, the person comes under the human rights act & the LA is responsible for any redress, if the person is classed as direct self funders they do not have the protection of the human rights act.

Local Governement Ombudsman site link re a case where unfair contract terms were imposed:-
http://www.lgo.org.uk/GetAsset.aspxid=fAA2ADMAOAB8AHwARgBhAGwAcwBlAHwAfAAwAHwA0

Also the LGO currently don't have powers to address complaints for direct self funders, this is about to change:- http://www.lgo.org.uk/news/2009/nov/lgo-gets-new-powers-resolve-complaints-adult-social-care/


From Oct 2010, these new changes are maybe it is being set up to coincide with many more people being faced with 'self funder' contracts, in all self funder cases.

Another avenue is Yvonne Hossack, the solicitor in the news recently, several councils tried to get her struck off, as she is dedicated to helping the vulnerable elderly in care homes, where the councils want to close them down, move the residents etc.

http://www.hossackssolicitors.com/

she may know more about the intricacies of these actions and contract arrangements.

monkeyspanner

Thanks CHC
This care home placement was arranged and contracted by Social Services about 3 years ago. I believe at the time my BIL was given a list of homes with which the council had arrangements to take residents at the councils "usual rate" and my BIL visited several and selected one from the list

The placement has been council funded from the start with an assessed contribution from my BIL's father. I believe this is essentially his state pension less weekly allowance so amounts to a little over £300/month. If he has any savings it will be minimal, I would guess £2000 to £3000.

My BIl is unclear what has caused this situation to arise other than the care home want more fees than the council usual rates. There are a number of questions I have already asked him to clarify.

-When was the last care needs assessment done? He says his father is assessed at Level2 which equates to £309/week.
-There was some query about his father occupying a double room on his own is this relevant to the increase in fees?
-His father had a hospital stay some months ago, was there a temporary increase in fees on his discharge for extra services, and has this had some impact on the homes fee expectations?
-Is the home withdrawing from "usual cost" arrangement with the council or is there a disagreement between the home and the council regarding the assessed care needs level?

It is interesting you mention Devon CC, have you picked this up from my previous posts or is your mention of it coincidental?

As usual the social worker has dumped this in their laps to sort out either without a proper explanation or without my BIL understanding why this has arisen. He is understandably angry that the alternative care home is so far away, is pretty poor in comparison to the current home and has less than ideal inspection reports. His father is almost 90 and whilst passive is actually in a confused state. He feels safe where he is in a familiar environment and my BIL is concerned about the effect of a move on his father's emotional and physical wellbeing. This being the case I have suggested he asks to see the risk assessment which is supposed to be carried out in this circumstance. I suspect, having had past dealings with this social services department, that no assessment of the risk will have been carried out.

Thanks for the other suggestions I will follow them up.

Primrose

I'm afraid I don't have any helpful suggestions to offer except not to take this passively and refuse to accept this lying down. I suspect it is another case of Councils trying to reduce their costs and trying to bulldoze relatives into coughing up the extra money required on the basis that some of them don't know how to, or not sufficiently assetive to fight the sytem. Have your thought of contacting your MP for some advice here. If you don't know who he/she is, you can find them via Writetothem.com. Put in your post code and the name of your MP will appear, together with a template form for emailing them.

monkeyspanner

Primrose wrote: »

I'm afraid I don't have any helpful suggestions to offer except not to take this passively and refuse to accept this lying down. I suspect it is another case of Councils trying to reduce their costs and trying to bulldoze relatives into coughing up the extra money required on the basis that some of them don't know how to, or not sufficiently assetive to fight the sytem. Have your thought of contacting your MP for some advice here. If you don't know who he/she is, you can find them via Writetothem.com. Put in your post code and the name of your MP will appear, together with a template form for emailing them.

Thanks, you are probably right.
Latest update is that the present care home is advising against moving my BIL's father. This hopefully will give BIL some amunition to beat the SS with.

Most of the guidelines are all about the patient's rights regarding selection and choice of a care home rather than what rights the resident has when the council decide to save costs.

We have spoken to the local MP previously on another related issue and although sympathetic was not very effective. We found the best approach was to be better informed than the people administering the system and to be very persistent whilst remaining as calm as possible. Unfortunately I don't think my BIL will be able to stay calm.

However the first issue is to get a truthful answer as to why the change of situation and then address that issue.

weanie

Good luck - you and your BIL have my sympathies. In our situation, we were presented with a form to sign BEFORE my mother went into the home.
The social worker said that 'Nobody else has a problem with this...' We told the council's financial assessor that we were not prepared to sign a document agreeing to future third party top ups [after Mum's funds have dwindled to agreed levels in the future]
I suspect that after all Mum's house sale 'profits' have been handed over to the care home, we will be pursued again in the same way as your BIL.
Once again - good luck and thanks for sharing your experiences,