Community care charges - what's included?!?

Cook_County

My 85 year old aunt suffers from dementia. She is still living in her own flat where she has several hours of carers visiting each day.
She lives near London and her local authority has said because her savings exceed the capital limit that she will need to pay towards the costs of her care.
I am really, really confused what costs she will need to pay towards (I have lasting power of attorney)? The costs that I know need to be paid include the costs of carers coming in to see her three times every day, a Day Centre she attends twice a week (owned and run by a national charity) and the costs of transport to and from the Day Centre.
The local authority is really, really slow...but she had care for probably two years, they assessed her finances only last October and still have not told me what she needs to pay towards (I know she will end up being charged up to £235 a week).
Am I right in assuming that the carers that visit daily (home care and dementia support), the day centre charges, the meal in the day centre, the community alarm and the travel to and from the day centre would all be included? The travel is quite expensive and I discovered last week that the transport company have not been paid since October even though social services arranged for them and agreed the costs...any experiences or knowledge in this area are welcomed!

monkeyspanner

Payment arrangements for at home care vary from council to council dependant on their decision on how much they will support this type of care arrangement. When my MIL was receiving similar care the care package was assessed separately from the day care arrangements. The separate day care cost (at council run centre) did I think include transport and lunch. assessment for at home care should not include the value of your Aunt's home but will include any income, benefits and savings.

It is not unusual for the council to be a very slow payer but I would not get involved unless the transport company refuse to continue providing the service until payment is made, they should be used to the council being slow payers.

If you want more control of the services provided then some councils offer a direct payment arrangement where they give the finance they would provide in support direct to the client (or clients representative) for them to arrange the care services. From our experience there are serveral downsides to this arrangement.
- Organisation of care and any employment technicalities is the client's responsibility..
- It is unlikely that the client will get quoted the same rate as a council can arrange so you will get less care for the same money.
- The council in my MIL's case required regular accounts to prove we were spending the money provided in the right way. This included needing an entirely separate bank account to run the finances.
- Terms with the care service provider were less advantageous e.g. bank holidys charged at double hourly rate.

Dependant on your Aunt's medical condition there is an outside chance she might be elibable for NHS funded continuing healthcare this can be provided in any setting but the persons health care needs have to be pretty severe. This funding is not means tseted and any assessment would be done by the CHC team in your Aunt's local PCT. There is more information on ths in a couple of MSE threads which you can find using a forum search for "CHC".

Hope this helps.

cookie54

i am a homecareer and some of our clients have to pay for there lunch ands some get it free so it may be worth ringinh up and checking if you have there number .

also we had a lady who like your aunt had paid for thing for a few yr and when she got the bill and paid them it brought her under the limit and she was free form then onwards

Cook_County

My aunt has savings well over the capital limit (aside from her flat). It is her life's savings for her "rainy day" and the only place I can spend it right now is on her and her care in future. Some of her savings will probably outlive her and I know some of it now needs to be spent on her care.

The government policy today is that she needs to contribute ... I don't suppose anyone likes this, but there is a rule and she is not ill enough to get free NHS treatment.

The transport firm to and from the day centre are currently owed about £1,500 - this is a lot of money and obviously it would be simpler if these costs were included in her capped contribution.

I am a novice at the language of direct payments and community care.

monkeyspanner - very helpful indeed. I have been offered to choose carers myself and manage it but I don't really have the time or knowledge and reading your experience does not sound wonderful. The care home is part of a well funded religious charity which is why I chose it, it has great reports so I want it to continue.

It sounds like some authorities will pay for some things (eg transport) and others won't.

Incidentally the transport is a minicab that picks her up at her flat and drops her home afterwards because the social worker at the time called several ambulance and other specialist companies and there charges were two or three times as much. She can hardly get to the door these days so can't walk or get a bus to the day centre so I know it is good for her to go there. I'd just like to know what she needs to be paying for and it all sounds jolly unclear to simple me!

monkeyspanner

I afraid elderly/infirm care is a minefield. All I can suggest is that you try to clarify the position with social services. However, in our experience they seem to regard providing information as outside their remit, and we were told by a senior manager in social services that they expect clients to search out information for themselves. How exactly someone who is ill and has no internet access can achieve that I am not sure. On one occasion I did spend some time explaining the direct payment sysytem to a social worker who was considering it for a relative.

On second thoughts I think I would query the minicab charges as just because SS arranged them it doesn't necessarily mean they have agreed to pay them. I woud say the day care provision is of more benefit all round than the at home care visits and my MIL was very upset when SS decided to take her day care away from her when at home care was provided.

Katykat

Cook-County, I take it when you say your aunt is not ill enough to get free NHS treatment, you have not really researched Moneyspanners advice. How ill do you have to be to get NHS treatment? If you have a wart on your finger, you get free NHS treatment. Your aunt has dementia ( an illness) and she obviously has some condition that causes mobility problems ( ? arthritis). Maybe you dont have time to research the VERY complicated world of "FREE" NHS care, but believe me, all your aunts money will very quickly disappear because she will only deteriorate in time. Do a bit of googling like Monkeyspanner suggests.