Care home top up fees - worried about the cost

Lovelyjoolz

I've posted this in the marriage and families board, but it was suggested I might get more of a response over here.

Anyhow, here's the situation: Elderly Granny has been deemed by Social Workers unfit to return to her home and must go into Residential Care. My Parents have been told that they must pay the top up fees, which is OK as long as the paperwork for the home we've found is done quickly because the top up is only £20 p/week. However, there is only one room left and it's first come first served and, if the paperwork isn't done in time the only other home that will take Granny has top up fees of £350 p/week!!

My parents are pensioners themselves and only have their pension as income so I'm worried about how they will afford these top up fees. What help can they get? Will they have to take out loans? Can the council put a charge on their house to cover the top up?

Can anyone here advise us? I'm so worried.

Trebor16

Your parents have no liability whatsoever to pay top up fees!!

I presume social workers have told them this and it is something they do a lot and it is misleading and inaccurate.

You need to take a look at the Charging for Residential Accommodation Guide (CRAG) 2013 and here is a link. It explains when top ups have to be paid.

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/264477/CRAG_33A_December_2013.pdf

In essence, local authorities try and tell people that they will only pay up to a certain level and that above that top ups have to be paid. The truth is that their maximum levels are arbitrary and if a person has certain needs which can only be met in certain nursing homes then the local authority are obliged to pay the additional cost above their upper limits.

The only way they can insist on top ups is if a home is available that meets a persons needs but someone insists on going into a more expensive home. Or if a home charges extra for a better standard room and a person wants that room.

If the council are trying to rush you into getting this done tell them to stop and that you need time to do this properly. They rely on this being an emotional time for families and take advantage of that.

Is your gran currently in hospital?

Mojisola

Trebor16 is right. Read the links and also talk to AgeUk if your parents need convincing.

Your parents do not have to pay anything!

Lovelyjoolz

Yes, Gran is currently in hospital. Has been for a couple of months now and they are desperate to get rid of her!

We have spoken to AgeUK and they told us that we do indeed have to pay top up fees.

We are restricted in finding a home because physically, she's fit as a fiddle, not a thing medically wrong with her. So she doesn't need nursing care, just residential care at a home licenced to deal with dementia. Problem is, most homes that deal with dementia are nursing homes and they will not take her! Which is why we are restricted to just two in our area. I think the council are using this as a way to increase the pressure on us to commit to paying fees.

cavework

Ask Social Services for a list of suitable homes that are within the budget avaliable plus Grannys contribution and that do not need a top up.
I bet there is not one or this one is already on the list
Then advise them that as this is the only suitable home in the area, they are responsible for the extra £20 per week and also any further increases in the future.
If you lose this room then they will have to pay for the even more expensive alternative.
Absolutely refuse point blank to pay a top up. Tell them your Granny is going nowhere until they agree to fund the extra.

Trebor16

Lovelyjoolz wrote: »

Yes, Gran is currently in hospital. Has been for a couple of months now and they are desperate to get rid of her!

Joolz, have they completed a continuing care checklist and invited the family to participate in the assessment prior to handing your nan over to social services?

Lovelyjoolz wrote:

We have spoken to AgeUK and they told us that we do indeed have to pay top up fees.

Whoever you spoke to at AgeUK got this totally wrong. Your nans care home fees are her responsibility to pay and no family member can be compelled in law to pay the top up fees.

Lovelyjoolz wrote:

We are restricted in finding a home because physically, she's fit as a fiddle, not a thing medically wrong with her. So she doesn't need nursing care, just residential care at a home licenced to deal with dementia. Problem is, most homes that deal with dementia are nursing homes and they will not take her! Which is why we are restricted to just two in our area. I think the council are using this as a way to increase the pressure on us to commit to paying fees.

If your nan needs a nursing home placement then it is possible her needs are primary health needs so a continuing care checklist should have been completed. Social services will apply pressure but resist it because legally you or your parents have no obligation to arrange for your nans discharge from hospital.

Tell social services that you will not be pressured and state categorically that you are not legally obliged to meet any top up fees and you refuse to do so.

Trebor16

cavework wrote: »

Ask Social Services for a list of suitable homes that are within the budget avaliable plus Grannys contribution and that do not need a top up.
I bet there is not one or this one is already on the list
Then advise them that as this is the only suitable home in the area, they are responsible for the extra £20 per week and also any further increases in the future.
If you lose this room then they will have to pay for the even more expensive alternative.
Absolutely refuse point blank to pay a top up. Tell them your Granny is going nowhere until they agree to fund the extra.

Spot on Cavework.

Mojisola

Lovelyjoolz wrote: »

Yes, Gran is currently in hospital. Has been for a couple of months now and they are desperate to get rid of her!

Has Gran had a multi-disciplinary assessment? Do the professionals agree that she needs a care home?

We are restricted in finding a home because physically, she's fit as a fiddle, not a thing medically wrong with her. So she doesn't need nursing care, just residential care at a home licenced to deal with dementia. Problem is, most homes that deal with dementia are nursing homes and they will not take her! Which is why we are restricted to just two in our area. I think the council are using this as a way to increase the pressure on us to commit to paying fees.

You're very unlucky with that - we've got quite a few homes in our area that take reasonably fit dementia patients. Nursing homes are much more expensive than the ones that provide old age care plus dementia.

Have you researched the homes yourself or has the council told you about the homes?

converted

I think everyone should read the guidance which was linked carefully - as it does not say that the council should pay the top up regardless, nor that the 3rd party is not responsible for the payment.

The council can make a contract for the full amount including the top up, but they recover this from the 3rd party - the person agreeing to the 3rd party must show that they are able to pay that amount - the council is still responsible for the whole payment if the 3rd party does not pay, but they can (and will) move the person to a home which accepts the local authorities rates.

I would take the left arm off the home who only has the small top up - as most try and get as much as they can (not that I blame them) The advise from age concern is correct.

Mojisola

converted wrote: »

I think everyone should read the guidance which was linked carefully - as it does not say that the council should pay the top up regardless, nor that the 3rd party is not responsible for the payment.

The council can make a contract for the full amount including the top up, but they recover this from the 3rd party - the person agreeing to the 3rd party must show that they are able to pay that amount - the council is still responsible for the whole payment if the 3rd party does not pay, but they can (and will) move the person to a home which accepts the local authorities rates.

Only if that home is suitable for the person's needs. If a resident needs a higher level of care (and dementia patients usually do), the council has to fund the higher cost.

Trebor16

converted wrote: »

I think everyone should read the guidance which was linked carefully - as it does not say that the council should pay the top up regardless, nor that the 3rd party is not responsible for the payment.

The guidance in CRAG is very clear on a local authorities responsibilities. LA's try and wriggle out of their responsibilities by imposing an upper limit but the fact remains if a home is found that is above their limit and it is the only home that can care for a person then the LA have to pay.

converted wrote:

The council can make a contract for the full amount including the top up, but they recover this from the 3rd party - the person agreeing to the 3rd party must show that they are able to pay that amount - the council is still responsible for the whole payment if the 3rd party does not pay, but they can (and will) move the person to a home which accepts the local authorities rates.

LA's rarely pay the full amount that are advertised to self funders by care homes and usually contract at a much lower rate.

converted wrote:

I would take the left arm off the home who only has the small top up - as most try and get as much as they can (not that I blame them) The advise from age concern is correct.

The advise from AgeUK (as it was) is most certainly not correct. No third party has any liability whatsoever to pay a top up on behalf of another person.