Care Home Assesment - How much will council contribute to Care Home fees?

puddy

so in these homes, say one of the clients wants a hair do, or a pedicure or some nail varnish or a book or cd, who pays for that, that cant come out of 22 quid a week, its not enough?

Darlyd

I know aunty pays for her hair to be done. Another lady in there who I used to care for in her residential flat, has her nails done and she pays for that as well as her hair. Again I think her estate funds all her care. BUT when we cared for her, she paid via direct payments, so I guess SS paid towards her home care, and paid that money direct to her to pay us.

It's complicated isn't it?

lessonlearned

Thank you so much Pollycat.

My husband is currently in respite care this week and it's one of the few homes I feel comfortable about.

He will need to go into permanent care sooner rather than later and I really want him to go into this particular home. Trouble is the cost.

Tomorrow he is having a "nursing" assessment - arranged by this SS care manager. I assume this is a Continuing Care Assessment.

Do you know offhand if he this is deemed necessary do the PCT then pick up the tab for his care. If so is it likely to be fully funded or will I be expected to top it up.

Sorry to be a nuisance but I'm going loopy trying to sort it all out.

Anyway - have a really busy day but will definitely look at that info you've directed me to tonight.

Thank you so much for your help - I really appreciate it.

His care manager is very nice but has a very pronounced Cameroon accent and I struggle to understand him sometimes.

Thanks again - will keep you posted with how I get on tomorrow.

Gavin83

puddy wrote: »

thats a good point, although i suppose they're not removing it because its a benefit (although i agree with you that its not), they're removing it because it pays for care. what would happen if the fees were £500 a week and the local authority agreed to pay £500 what happens to the persons pension then?

Well that's what happens at the moment. The care home will ask for an amount (£500 in this case) and the care home will agree to pay a certain amount towards it, which we'll assume is £500. Then the resident will pay all their income, including state and private pensions to the council to cover some the costs. AA in this situation isn't paid as the council are covering part of the costs and if it was paid the council would collect it towards the contribution anyway. If you pay the full costs yourself, either via cash or the value of the property you will still be entitled to collect AA as normal.

If in the above situation the home requires £500 but the council is only willing to pay £450 then the £50 will have to be found elsewhere, normally through a relative that's willing to pay. If there is no one the the council will find a home which will accept their payment. Each council has a different maximum they're willing to pay and the costs of the homes can vary wildly between boroughs.

I do think the amount a resident is left with a week should be increased slightly, I think nearer £30 is more reasonable. I'm probably in the minority who thinks the current care home charging system is reasonable though.

For the OP before you even worry about the finances you need to confirm if she qualifies for care so contact social services and get her a care manager. If they don't feel she requires care they will be unwilling to fund it at all.

Gavin83

puddy wrote: »

i know im being really dim, by why does the LA do a financial assessment if you are self funding?

surely the result of looking at fees minus income will always result in the same amount, ie if income is £200 a week, care home fees ar £700 a week, leaving £500, that is what the person pays out of their 'pot', so they are still paying £700 a week??

im talking here about people with more than 23k, so what does the assesment ever achieve

The council generally like to know when the resident is likely to approach them for funding again in the future. There is no requirement for it though, if the resident is self funding they can refuse the assessment or declare their capital over the amount.

Gavin83

puddy wrote: »

so in these homes, say one of the clients wants a hair do, or a pedicure or some nail varnish or a book or cd, who pays for that, that cant come out of 22 quid a week, its not enough?

In some situations essentials including hairdressers and having the toe nails clipped is covered. Any luxury items will always come out of their personal allowance though.

Pollycat

puddy wrote: »

i know im being really dim, by why does the LA do a financial assessment if you are self funding?

surely the result of looking at fees minus income will always result in the same amount, ie if income is £200 a week, care home fees ar £700 a week, leaving £500, that is what the person pays out of their 'pot', so they are still paying £700 a week??

im talking here about people with more than 23k, so what does the assesment ever achieve

I guess the financial assessment is to see if you should be self-funding or not.
It's not (AFAIK) obligatory to have a financial assessment.

And for people who are pretty close to the £23,250 ceiling, it helps to make the council aware that they will soon need to share the care home fees.

Pollycat

puddy wrote: »

so in these homes, say one of the clients wants a hair do, or a pedicure or some nail varnish or a book or cd, who pays for that, that cant come out of 22 quid a week, its not enough?

Unfortunately, it will have to either come out of the £22.60 weekly personal expenses allowance or be funded by family.

From what I've read (extract from Counsel and Care Guide 16, page 13):

You will be allowed to keep a Personal Expenses Allowance of £22.60 per week from your income which you can spend as you wish. The council has the discretion to allow you to keep more than £22.60. This could be because you have to pay ground rent or standing charges for a house that you are trying to sell. You can also ask to have your Personal Expenses Allowance increased to help support your partner who remains at home, for instance, if they need to complete repairs to the house, if you have left them with debts, or if they are living on a low income.

monkeyspanner

Sorry if this has already been covered in the posts above.
If the care home resident has savings of less than the savings limit of £23250 the social services in the area will support care home fees up to financial limits which each area set each year.

The level of support will be determined by assessing the persons care need. Because of budget pressure the councils try to keep this support level as low as they can and in at least one area have been taken to court by care homes in order to have the levels reviewed.

The maximum support is set at one of 4 care levels and you should be able to find out what actual levels they are from social services in your area. The actual level of care needs is determined by a social services assessment (see below). This is important when you look at care homes as many will not accept the council supported rates and you may then have to consider making a third paty top up to get a place in a home you want. Relatives should be careful in this situation because the 3rd party top-up will change as the care home fees and support levels change. However the council cannot demand a 3rd party top up if there is no care home in their area which will accept their support level and has a vacancy, in that situation the social services have to make up the shortfall. If forced into this situation social services may then attempt to move the resident to a cheaper home at a later date but will have to demonstrate this would not put the resident at risk either physically or mentally.

In Devon the support levels 2010/11 were:
Band 1 £295
Band 2 £309
Band 3 £330
Band 4 £391

Which were frozen from 2009/10 levels.
In my MIL's case she was initially assessed as band 2 which was subsequently raised to band 3 when the care home complained about the original assessment. The standard care home fees were £429 per week so immediately there was about £100 per week shortfall. Of course there were care homes that would accept the standard rates but we decided that they were not the place for MIL.

Here is the link to explain what each band means.
http://www.devon.gov.uk/index/socialcarehealth/social_services/charges-benefits/res-and--nurs-care-cb/bandings.htm

The support levels should reflect local conditions so London for instance will be more expensive because of housing and wages being more expensive.

Here is a link to the government financial assessment guidance for residential accommodation. (CRAG)
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_115533.pdf

In addition the local PCT may provide a nursing supplement of about £108/week to the care home but this is normally in addition to the normal weekly care fees.

As previous posters have mentioned the care home resident will have to contribute the majority of their income including any state or private pensions towards the fees. Attendance allowance will cease 4 weeks after going in a care home if social services supported but will continue to be paid if self-funding. There are certain other benefits which will be disregarded from the financial assessment.
A very good guide to paying care home fees is here.
http://www.counselandcare.org.uk/category/advice/pdf/care-home-fees---paying-them-in-england-guide-16

Pollycat

lessonlearned wrote: »

Thank you so much Pollycat.

My husband is currently in respite care this week and it's one of the few homes I feel comfortable about.

He will need to go into permanent care sooner rather than later and I really want him to go into this particular home. Trouble is the cost.

Tomorrow he is having a "nursing" assessment - arranged by this SS care manager. I assume this is a Continuing Care Assessment.

Do you know offhand if he this is deemed necessary do the PCT then pick up the tab for his care. If so is it likely to be fully funded or will I be expected to top it up.

Sorry to be a nuisance but I'm going loopy trying to sort it all out.

Anyway - have a really busy day but will definitely look at that info you've directed me to tonight.

Thank you so much for your help - I really appreciate it.

His care manager is very nice but has a very pronounced Cameroon accent and I struggle to understand him sometimes.

Thanks again - will keep you posted with how I get on tomorrow.

Hi
Sorry, I can't advise about CHC as I've not had to swot up on that (bad enough to go through the Care home stuff), it was just something I noticed as I was googling and thought it worth bookmarking as Dad is in a care home specialising in Dementia but was hospitalised for a few days and I was worried that the Care Home might not accept him back as they don't do nursing care.

However, I think if you look at Guide #27 page 25 that may help:

7 What happens after my assessment takes place?


[FONT=StoneSans,Stone Sans][FONT=StoneSans,Stone Sans]If you are assessed as meeting the criteria for NHS continuing healthcare, it is normally the PCT responsible for your GP who will pay for the care. This care can be provided in a variety of settings, including:

• In a nursing or residential care home setting: you should be given a choice about the location of this that takes into account your needs and circumstances.
• In a hospice: this would apply to someone who is in the final stages of a terminal illness.
• In your own home: this will depend on the type and level of care needed and whether your home is suitable or can be adapted but should be available as an option wherever appropriate. PCTs can take the cost of support into account but this should be based on a comparison with the actual cost of other options such as care home places and should take also into account specific reasons why you wish to remain in your own home.

[/FONT][/FONT]

I don't know if I've taken that section out of context but it does sound like the guide will answer most of your questions.
There's what looks like an incredibly complicated flow chart on page 24. :eek:

Good luck.