Third Party Top Up Fee - what if you can't pay?

Mojisola

pmlindyloo wrote: »

Sounds right to me as regards the finances.

Even though the OP's mother is not self funding her pensions will be taken towards the fees leaving her with a personal allowance of about £20 a week. Usually the LA's contribution and the resident's contribution is sufficient to meet the care home fees. In this case there is a shortfall and they are asking for a third party top up from the family. This top up cannot be paid by the resident.

Maybe it's the way lilyboo has described this - the LA gets all of Dad's income apart from the £20+ a week and makes up the difference but he doesn't get a bill to pay. I read it that lilyboo's mother was getting a bill on top of that.

pmlindyloo

Mojisola wrote: »

Maybe it's the way lilyboo has described this - the LA gets all of Dad's income apart from the £20+ a week and makes up the difference but he doesn't get a bill to pay. I read it that lilyboo's mother was getting a bill on top of that.

In my mum's case she also gets a bill from the care home.

I think this is sorted out during the financial assessment. The LA usually has a set rate which they pay to the care home (in our case this was negotiated with the home.) then the resident is billed separately . Certainly when mum was recently reassessed as needing nursing care, the LA paid one amount, the NHS paid another (for the nursing part ) and mum paid the same amount as when she was in the residential care home.

As far as I am aware the LA does not collect the resident's contribution- it is paid directly to the care home.

Perhaps it works differently in different authorities.

wishiwasinliverpool

My mother doesn't have dementia, either, although the social worker kept saying she had. She has schizophrenia, and is in an EMI care home up in Liverpool mainly for patients with dementia. She's 86 and can't look after herself at home now. She can't go into a general residential home because she's very aggressive when her meds are due.

We don't pay a top-up fee for this particular home, it wasn't required, but my sister, a third party signatory on mum's accounts, was paying for her care from her money while I applied for Lasting Power of Attorney. I live in Bristol and I'm estranged from my sister thanks to other issues over her grievances with me and Mum I won't bore you with here.

Anyway I went up to visit Mum on Saturday just gone and found out her phone bill hadn't been paid. It's only for the rental as I don't use the phone when I stay there but I got to wondering what else hadn't been paid. Mum is obsessed with bills. When I told Mum she insisted I take her to my sister's to get her bank books back, which I did. My sister hasn't been to see Mum or phoned the home to find out how she is since she was admitted in July. My sister told Mum she didn't pay the bill because Mum had no money left (she has four accounts plus three ponds and there's her flat). She also gave her the pack the home sent her and I briefly looked at a bill for December 2012 for the home for £4135. Unfortunately because Mum was on one she refused to give me the books so I could get them updated for her to ascertain how much she DID have left (it looked like my sister had been paying for the home from the Abbey National account which was down to £993 and was the most recent book updated) Mum's pension is in limbo because without the LPA I can't have it paid to me so I can put it towards her care. Mum wouldn't give up the care home bills either so I haven't been able to look at them properly.

The manager of this home doesn't work at the weekend when I go up (I have to work). I contacted her last Monday and told her what my sister had told Mum. She said she would ask the finance manager to contact me. I asked how much the weekly bill was for the home. It's £520 a week and the bill was sent to my sister monthly. I said hang on, the December 2012 bill was £4135 - how does £520 a week equate to that?? She said it's because your Mum is self-funding (which I don't get, which is why I'm taking next Friday off work to go up and see her so she can explain it to my face!)

I wouldn't mind, but although the carers are lovely the place could do with a lick of paint! It's never worth a thousand quid a week!

I needed to contact the social worker to let her know the situation and I find out she doesn't deal with Mum any more - basically Mum doesn't have a social worker, so I'm waiting for someone from her council to get back to me so I can have one allocated to her. The solicitor goes to the home yesterday to get Mum to sign the LPA agreement and she refuses, and I get told that even after I'm registered I have to wait yet another three to four months before I can exercise my attorney status. If Mum keeps refusing I may have to go down the route of Court of Protection. I've told her it's cost me money already but she doesn't give a monkey's.

Meanwhile the home aren't getting their money. They won't get it off me, I haven't got it to give them!

troubleinparadise

Katykat wrote: »

Lillyboo, you say your mother was moved to a dementia unit without the knowledge of SS. Does your mother have dementia? Regardless of the quality of care which you say was lacking in the original home, there is a point to be made here. If your mother has dementia, she should not be paying anything for her care, and neither should you be paying any top up fees. The NHS should be paying through the Continuing health care scheme. Dementia is an illness, not a social care problem and as such is the responsibility of the NHS. There is a very good thread on the over 50's forum on MSE which gives some very good links. Its complicated, but why should she pay when she's ill.

Whilst the points you make here are totally valid and reasonable, it isn't the way it works sadly.

Being approved for CHC funding appears to be virtually impossible except for a few, and even if approved it will be reviewed regularly and withdrawn if the patient is regarded as no longer meeting the criteria - which can be as quickly as three months later from first approval.

It also takes a very committed and tenacious family member (usually) to pursue the application.

MissMoneypenny

pmlindyloo wrote: »

When my mother first went into a care home we had to pay a top up. Fortunately we got some help from a forces charity. When the charity
Stopped contributing after a few years we were asked to make up the difference. We could not afford to do so. The local authority came up with the money. This was about ten years ago. There has been quite a lot of arguments about top up fees and as I said before local authorities have considerable negotiating powers.

Was that because she had been a long term resident when the charity stopped paying?

I know that in my mother's private residential home, we sold her house to pay for the fees. We calculated that this money and her pensions, would pay the fees for about 10 years. Her pensions alone were not enough to cover the fees.

We were worried about the cost of fees after 10 years and the home said that although they never accepted state funded residents; with their long term residents, they reduced the fees if the money ran out. They then allowed pensions and state funding money and waived the rest of the fees. TBH, many residents are fairly old/poorly when they go in a home and don't last many years.

Sorry to be blunt, but if their mind goes, they don't know where they are anyway and wouldn't know if they changed homes as they forget 2 minutes later. In the homes I visited with my PAT dog every week; not only did some residents not remember me and my dog from week to week, but if I went out of their lounge for a couple of minutes and then went back in again, they had forgotten again. They were asking the staff for food (again) to "feed the little dog"; despite the fact they had fed him just moments before I left their lounge and I got the same "What's your name" "What's the dog's name" "Where do you live" questions that they had asked me just minutes before!

Interestingly, their long term memory (back to their childhood) remained, but anything else was forgotten and some even didn't remember they had their own children.

Katykat

troubleinparadise wrote: »

Whilst the points you make here are totally valid and reasonable, it isn't the way it works sadly.

Being approved for CHC funding appears to be virtually impossible except for a few, and even if approved it will be reviewed regularly and withdrawn if the patient is regarded as no longer meeting the criteria - which can be as quickly as three months later from first approval.

It also takes a very committed and tenacious family member (usually) to pursue the application.

Yes, I know, I was trying to just pass on some information. I was a commited and tenacious family member. I got funding for my mother after a 3yr hard fight. I had to sell her house at a loss and I will readily admit that there were times when it completely overwhelmed me. But I had determination. She had dementia, she was ill and she would not have been in the home if she had any choice, so I believed the Nhs had a resonsibility for her. It is possible to get funding.

troubleinparadise

Katykat wrote: »

Yes, I know, I was trying to just pass on some information. I was a commited and tenacious family member. I got funding for my mother after a 3yr hard fight. I had to sell her house at a loss and I will readily admit that there were times when it completely overwhelmed me. But I had determination. She had dementia, she was ill and she would not have been in the home if she had any choice, so I believed the Nhs had a resonsibility for her. It is possible to get funding.

No criticism of you intended, Katykat, you are absolutely right to pass on that information, and well done to you for actually achieving CHC funding.

And anyone reading these threads who may not know about CHC funding should be made aware of its availability - but also that achieving it is not an easy path.

Your experience - 3 years of blood sweat and tears - should not be the way it is, sadly it is all too common, but equally your story shows that it is possible.

Katykat

troubleinparadise wrote: »

No criticism of you intended, Katykat, you are absolutely right to pass on that information, and well done to you for actually achieving CHC funding.

And anyone reading these threads who may not know about CHC funding should be made aware of its availability - but also that achieving it is not an easy path.

Your experience - 3 years of blood sweat and tears - should not be the way it is, sadly it is all too common, but equally your story shows that it is possible.

Thanks for that, But I didn't take offence. Yes, more should be known about CHC. Unfortunately both the NHS and Social Services do very little to put this information out there. So its up to people like me and forums like this to do it.

monkeyspanner

Late contribution I know, but having skim read this thread there are a couple of points that may be relevant. First I think the OP's sister should make it clear in writing that she signed the 3rd party top-up under duress without being fully informed of the implication and that she is unable to pay. It is in fact an open ended financial agreement.

The OP stated in one of their posts that the council have said her mother must move to a cheaper home. This is often used as a threat to get the family to pay the 3rd party top up. The council have to demonstarte that there actually is an alternative suitable home in the same locality which is prepared to provide care at the councils support band funding amount. Even if there is a home which will provide care at that funding the SS should carry out a risk assessment that the residents physical and mental well being will not be detrimentally affected by the move. The assessment should take into account domestic factors such as the ability of family members to continue visiting. Another issue is the care needs assessment, the council assess needs and alocate a band and funding is provided up to the councils funding level for that band. It is possible that if the needs are reassessed and the band increased this will reduce the top-up fee required. The council has a financial interest in underestimating needs to reduce their funding level.

SuziQ

I haven't read the rest of the thread as I am just off out, I just wanted to tell you where my dad found help when he was having similar problems with my mum'splacement.

He was advised to contact a local Admiral nurse. They are fantastic because they know all the rules re care homes etc, will help people put together cases and be a source of huge support. Google them in your area.

Hope this sorts out in your favour, OP.