Can I be forced to pay top up funds for care home ?

ladybelle

Well I know in theory I cant - as I simply cannot afford to pay ! My parents are in a nursing home, all was settled and agreed - they have now reached the point where they are under the threshold so the County Council have started paying some of the fees.

Back in February my Dad had a fall, fractured his hip, then went into kidney failure, and we nearly lost him. He recovered slowly and returned to the home in April, ever since then we have battled with Social Services to get the new care plan in place and reviewed etc. The home had said they wanted his fees to go up from previous residential rate of £390 to a whopping £632 as he was now nursing care.

Now I do not dispute the fact he is nursing at all, but I do dispute the high amount as he now is almost back to where he was before ! fully mobile, takes himself off to the toilet etc. My Mother who was the illest when they went in as she had a stroke is still totally immobile and needs nursing care and her fees have only ever been £421 a week !!

So in July their money reached the £23,000 limit (each) and the CC have been paying some of the fees.

This email from the Social Worker has said firstly that I have to top it up out of my money. I cant possibly afford that !! which the Council have always known anyway. Secondly she then says that I could use Dad's money ?? Now I have always understood that it is not possible to use their money for top up fees ?? I'm sure I read that somewhere once ?? but anyway -e ven if it were possible - if I do that now all it will achieve is deplete their money quicker and mean the Council will be fully funding them !!

But of course my biggest fear is that if the home wont budge - they could be forced out !!!

I dont know what to do ! Can a family be forced to pay if they cant afford it ? Do Care home really evict elderly frail residents !!!

stevemLS

You are mistaken and confusing top ups with NHS co-payments.

Essentially, the family can't be forced to make payments but the patient themselves can.

Ultimately, if the fees are more than the local authority are prepared to pay and no further funds are available, the local authority will find an alternative placement which has fees which are within the local authority rates.

Without putting it bluntly, you cannot stay in the Ritz amongst care homes and expect the cost to be met by the public purse.

That may be something you wish to consider.

stevemLS

Make sure you discuss the possibility of NHS Funded Nursing Care or CHC with the social worker. Your dad doesn't sound as though he is anywhere near eligible but your mum may at least qualify for FNC which is about £110pw.

ladybelle

They are already in a pretty basic home, certainly not top of the range. The only reason they are there is because I have agoraphobia and cannot travel further than my local area and this is the only nursing home in my town. If I could have travelled I would have put them in a home far nicer than this one.But we probably would have then ended up in this situation sooner as their money would have run out sooner.

The Social Worker agrees that the home are now trying to charge far too much for his care. They are both eligible and receiving the £110 Funded Nursing Care allowance - this is the charge on top of that they the home is insisting on charging.

As their money is now below the £23,250 threshold I cannot use their money to pay for it. And I cant afford to pay for it myself either.

Over the past 2 and a half years they have paid £3300 a MONTH !!! out of their funds - their savings have now been depleted and the County Council are now contributing to their care. Obviously they both received AA - but both have now stopped, so now their only income is the state pension, and Dad is eligible for £4.70 a week pension credit.

I cannot bear the thought that they may be forced to go to a home not in the local town which I could never get to. I think it quite literally would kill them.

ladybelle

And I was not mistaken - nor confused.

I have been asked to pay £39 a week TOP up to make the difference between what the Council have agreed to fund and the Funded Nursing Care allowance which he/they are already receiving.

elsien

Have a read of this summary:
http://www.caretobedifferent.co.uk/care-home-top-up-fees/


It looks like it should give you some grounds to argue your point. You can contact the charity directly for more specific advice.
http://www.independentage.org/advice/

Age Uk are also a good source of advice.

pmlindyloo

ladybelle wrote: »

Well I know in theory I cant - as I simply cannot afford to pay ! My parents are in a nursing home, all was settled and agreed - they have now reached the point where they are under the threshold so the County Council have started paying some of the fees.

Back in February my Dad had a fall, fractured his hip, then went into kidney failure, and we nearly lost him. He recovered slowly and returned to the home in April, ever since then we have battled with Social Services to get the new care plan in place and reviewed etc. The home had said they wanted his fees to go up from previous residential rate of £390 to a whopping £632 as he was now nursing care.

Now I do not dispute the fact he is nursing at all, but I do dispute the high amount as he now is almost back to where he was before ! fully mobile, takes himself off to the toilet etc. My Mother who was the illest when they went in as she had a stroke is still totally immobile and needs nursing care and her fees have only ever been £421 a week !!

So in July their money reached the £23,000 limit (each) and the CC have been paying some of the fees.

This email from the Social Worker has said firstly that I have to top it up out of my money. I cant possibly afford that !! which the Council have always known anyway. Secondly she then says that I could use Dad's money ?? Now I have always understood that it is not possible to use their money for top up fees ?? I'm sure I read that somewhere once ?? but anyway -e ven if it were possible - if I do that now all it will achieve is deplete their money quicker and mean the Council will be fully funding them !!

But of course my biggest fear is that if the home wont budge - they could be forced out !!!

I dont know what to do ! Can a family be forced to pay if they cant afford it ? Do Care home really evict elderly frail residents !!!

Something doesn't sound quite right about the fees being charged. Ask your parents' social worker to check if they are the correct amounts.

When your dad moved from residential to nursing care there should have been an assessment done as the nursing care is paid for by the NHS.

stevemLS

There is much misinformation out there and the information in the first link in post 6 is a vast over simplification.

It is also too simple to say the NHS pay for the nursing care. As I explained, the NHS will pay a fixed contribution in respect of patients who require nursing care. If the patient qualifies for CHC the NHS pay the whole cost of the placement.

Both local authorities and many CCGs set fee thresholds above which they will not pay. There will always be places available within those fee levels and they are set having regard to the area.

They cannot stay in a particular area simply to meet your needs and it may be suggested to you that perhaps you seek assistance to address your own difficulties.

SandraScarlett

I have spent the last 4 months sorting out the cost for my DH's care (he has advanced Alzheimer's), and several hours a day reading the Government's CRAG report (Care in Residential Accommodation Guidance), which extends to over 100 pages, and is available online.


This is all based on the 1948 National Assistance Act, Section 4, Subsection 2 (!!!), and there is a wealth of information therein. Basically, the Local Authority have a duty of care to provide care that meets the needs of your parents, and part of this extends to the ease of you visiting them on a regular basis.


There is no law that says the family have to pay top up fees, and unfortunately, people are at their most vulnerable, and worried sick about their relatives, when this is put to them, and offer agree, under stress.


Firstly, were your parents placed in this Care Home through the Local Authority? Was it deemed necessary for them to be placed in care, following a Council Assessment? If the answer is yes, even if they have been self funding up till now, the Council probably have a block-booking system with the Care Home.


This means that the weekly charge is the same as the maximum that the Council will pay, even though self funders will be charged more. So, for example, if the Council's ceiling is £500 a week, then that is what the Care Home will charge the Council, and someone's contribution is full SRP, half of Private Pension, if any, you forgo AA, or the care part of DLA, but can keep the mobility, and are then "given back" about £25 pocket money.


But you don't pay top up fees. And it doesn't help someone asking for help, like you are, to be told by others on here, that you can't expect for your parents to have better accommodation from the public purse, when they've paid into it for decades! I think that the trouble stems from the fact that if you're not involved in Care Home charges, you have no idea how much the most basic ones charge.


When I was told that my DH's costs would be £750 a week, they might just as well have said seven and a half thousand, because both amounts were impossible.


If your parents' individual savings are less than £23,250, but more than £14,250, then for each chunk of £250, they are assumed to be receiving £1 a week interest. Yes, I know this is ludicrous, and I did ask for the name of the Building Society that would pay £52 a year interest on £250!!


So if, say, your Dad has £15,250 in savings, he would have to pay another £4 a week (£1 for each £250 more than the lower limit). Care Home fees are a minefield to work your way through, and I wish you the best of luck.


Do look at that report, because it will save you thousands. DH's fees have been cut to under a third of what I was originally told, but it's been a battle. I see him nearly every day, and sometimes he knows who I am, but after nearly 50 years together, it breaks my heart. Even though I cared for him for 11 years, with Alzheimer's Disease, I still drown in guilt.


I wish you and your family well.


xx

[Deleted User]

^^^ excellent and well informed post

monkeyspanner

You are correct no one can be forced to pay for another persons care and this also applies to husband and wife. The SS often try to blackmail relatives into agreeing to pay third party top-up fees with the threat of a resident having to move to a home which will accept the often inadequate level of council support. It is also not permissable to pay your own top-up fees once you are under the savings limit and the social worker should not have suggested that you could use your father's savings.

Before any move is undertaken the council should undertake a risk assessment (physical and metal) regarding the potential move. Although your condition would probably not be taken into account, the fact that you would not be able to visit and the affect of that on your parents wellbeing should be considered. In addition the council are not permitted to ask for third party top-up fees if they cannot find a suitable alternative care home in the local area which has a vacant place and will accept the council level of fees for the care need required. If this alternate place cannot be found they are obliged to pay the care home fees.

You mention your mum is totally immobile following a stroke, has she had an assessment for NHS funded continuing healthcare (CHC)? I would ask for an assessment and a retrospective review. How long has she been immobile? If awarded CHC funding she would not pay any fees and would not been means tested. It is possible she should never have been expected to pay for her care. CHC funding is notoriously difficult to obtain but many people do succeed if they are persistent.

First step I think would be to insist on a case meeting to discuss what the SS are going to do about a care plan for your dad and I would also ask that they organise a CHC assessment for your mum. The CHC assessment team is now under the control of the GP commissioning groups so if the SS will not organise an assessment for you they can be approached directly. Incidentally on discharge from hospital your dad should have had a CHC funding checklist completed to see if a full assessment should be performed. If this was not done the hospital discharge team have not complied with CRAG (Charging for residential accommodation guide). If you can get this meeting set up I would suggest taking someone with you so you have a witness to the discussion and any agreement. I know it sounds paranoid but past personal experience with NHS and SS has not been positive.

If you would like me to dig out the relevant document sections regarding funding please let me know and I will try to post links.