Care Home Fees Conundrum

billy2shots

I have been at meetings where directors from local social services have been open and said they are not seeking to place people in care homes.

The alternative sounds lovely 'care in the community ' with people staying in their own homes.

The reality often results in one or two 15 minute visits a day by a domiciliary agency. In place of the sometimes needed 24h support. Often the care workers that visit are complete strangers to the person requiring support. I'm sure everyone can imagine being washed, toileted etc by a complete stranger and how that would make you feel.

In many cases there isn't time for the care worker to read the persons care plan so the person centred level of care can be lacking.

This is acceptable to the government as it's cheaper, in some cases it's also acceptable to the family of the person for the same reason (careful with my inheritance). The agencies can charge a pretty penny and the level of scrutiny on these providers is far less than a nursing or care home.

But hey, as long as those mean nasty care homes don't make a profit, it's all good.

peterbaker

billy2shots wrote: »

This is acceptable to the government as it's cheaper, in some cases it's also acceptable to the family of the person for the same reason (careful with my inheritance). The agencies can charge a pretty penny and the level of scrutiny on these providers is far less than a nursing or care home.

But hey, as long as those mean nasty care homes don't make a profit, it's all good.

Yep its all good billy2shots, and it is clearly acceptable to the British public, because no-one is up in arms over it, so job done, eh?

Nevertheless, your country thanks you for the daily service you and your staff manage to do (mostly unthanked and understaffed) bumbling along on low wages which support the very limited tax budget which in itself of course is a very difficult task to fairly administer.

Malthusian

peterbaker wrote: »

There has continually been money to pay for the enormous costs of treating smoking related disease, alcohol related disease and obesity related disease.

Smokers, drunks and fat people save the NHS and the wider State billions of pounds a year and perform a heroic financial sacrifice to the nation.

We cannot afford for people to live longer.

One solution to the care crisis would be simple: immediately abolish all taxes on cigarettes, alcohol and sugar, legalise all other narcotics. Anyone over State Pension Age could be provided with all the vices they want for free, or at least at a heavy discount, like bus travel.

Obviously this is not going to happen as the State and the medical lobby is obsessed with extending life at all costs.

Keep_pedalling

Cross subsidy is not simply a one way thing, if a home decided that it was no longer going to accept LA funded residents they would very likely struggle to fill the rooms as there are not enough self funders to go round. This could mean fees would rise to the home go out of business.

Those homes who currently only take self funders, tend to be in more affluent areas and their fees tend to be higher than homes with a mix of residence.

lisyloo

I have been at meetings where directors from local social services have been open and said they are not seeking to place people in care homes.

This is surely quite correct.
Just because someone with say arthritis needs help with dressing once a day doesn't mean they need a care home 24/7.

Often the care workers that visit are complete strangers to the person requiring support. I'm sure everyone can imagine being washed, toileted etc by a complete stranger and how that would make you feel.

They are not a complete stranger for long, plus what do you suggest.
Unless family can be on hand 24/7 (and sometimes 2 people) then there isn't really an alternative to professional help.

This is acceptable to the government as it's cheaper, in some cases it's also acceptable to the family of the person for the same reason (careful with my inheritance).

Sometimes it's absolutely the right thing, for example a man with cellulitis who cannot lift his legs into bed or a woman who can't put on a cardigan due to arthritis (both real examples).

The reality often results in one or two 15 minute visits a day by a domiciliary agency.

And sometimes it can be an hour (you can't shower someone frail within 15 mins). My FIL also got taken out for coffe and cake and my MIL went to a day centre with transport provided to give him respite.
Yes probably the economically cheapest option but also the best for their wellbeing and beyond the minimum to sustain life.

The agencies can charge a pretty penny

Ours was £15 per hour which I think is pretty good given they also have to travel.


Not quite sure what your point is but sometimes what's best for people (staying in their own homes) does co-incide with being economical AND people's wishes.


But if it's not acceptable then people should PAY for themselves as they do with education, health etc.
The state is a safety net not neccessarily to sustain people'e lifestyle to a level they have been accustomed.


BTW - We are all quite happy for our "inheritance" to be spent (not that it is ours it's HERS).

billy2shots

lisyloo wrote: »

This is surely quite correct.
Just because someone with say arthritis needs help with dressing once a day doesn't mean they need a care home 24/7.


I should have perhaps made it clear I was talking about people that required a higher level of care than someone with arthiritis.

They are not a complete stranger for long, plus what do you suggest.
Unless family can be on hand 24/7 (and sometimes 2 people) then there isn't really an alternative to professional help.

Having different people let themselves into your home can be very daunting. You could argue that in a care home staff are strangers at first but at least there are others around you.

Sometimes it's absolutely the right thing, for example a man with cellulitis who cannot lift his legs into bed or a woman who can't put on a cardigan due to arthritis (both real examples).

Again I perhaps should have clarified my comments were regarding people with greater care needs. I'm not suggesting for a second that someone with a mobility issue automatically needs 24h care. My points were aimed at people that required 24h support but were getting 2 visits a day instead.

And sometimes it can be an hour (you can't shower someone frail within 15 mins). My FIL also got taken out for coffe and cake and my MIL went to a day centre with transport provided to give him respite.

Unfortunately I have seen personal care such as bathing and showering carried out in the timescale I said. 1 hour visits are a fantastic service but a service I'm not sure the government provide. Happy to be corrected.

Yes probably the economically cheapest option but also the best for their wellbeing and beyond the minimum to sustain life.

Wellbeing is subjective. I'm not sure someone having to eat at the time of a care visit is best. If they can't prepare food and drink they have to wait until the scheduled visit. I'm also not sure many people like being put to bed at 5pm but the sheer logistics mean some people will be put to bed/helped up later in the morning than others.


Ours was £15 per hour which I think is pretty good given they also have to travel.


Not quite sure what your point is but sometimes what's best for people (staying in their own homes) does co-incide with being economical AND people's wishes.

[B]You are correct. Sometimes is the key word. That is not where my issue lies. My problem is when 2 short visits aren't enough but that's all their getting because the LA have decided that they are not placing in care homes this 1/4. This is not a person centred approach but a blanket decision. [/B]

But if it's not acceptable then people should PAY for themselves as they do with education, health etc.
The state is a safety net not neccessarily to sustain people'e lifestyle to a level they have been accustomed.


BTW - We are all quite happy for our "inheritance" to be spent (not that it is ours it's HERS).

Apologies if you took that personally, it wasn't aimed at an individual. The majority of relatives are great. Unfortunately in 20 years I have also experienced many that have no problem with financially abusing a loved one or denying them care as it will chip away at possible inheritance.

I'm happy that your loved one is receiving appropriate good quality care. Many aren't that lucky.

lisyloo

My points were aimed at people that required 24h support but were getting 2 visits a day instead.

We were strrong advocates for our parents.
For example we refused the LA to split up MIL & FIL when a place was available in the same home.
I agree that those without good advocates don't get the best. It's the same with hospitals, GPs, dentists and even schools.

1 hour visits are a fantastic service but a service I'm not sure the government provide. Happy to be corrected.

I can confirm that it was provided to our parents and all-day care for MIL (free with transport and wheelchair assistant) and a trip out (coffe and cake) with FIL which probably took a little more than 1 hour.

Wellbeing is subjective.

Oh totally, but I was impressed that LA would pay for a trip out FIL as it's not necessary merely for survival.

If they can't prepare food and drink they have to wait until the scheduled visit. I'm also not sure many people like being put to bed at 5pm but the sheer logistics mean some people will be put to bed/helped up later in the morning than others.

Yep you have to wait your turn.
Getting meals at 12:00 didn't suit FIL, but playng devils advoocate what do people expect from taxpayers?
If you want things done on your own terms do your own planing and get a care fees annuity and PAY FOR IT yourself.
You cannot expect to have this done as suits your preferences on the taxpayer.

Apologies if you took that personally,

Not at all, just sharing my personal experience as it's real.

I'm happy that your loved one is receiving appropriate good quality care. Many aren't that lucky.

I agree, but there are going to be limits when people leave themselves to the mercy of the state isn't there, the same as NHS dentistry, schools, NHS hospitals - none of it is as good as going private?

I'm not arguing just debating but there's a conflict between fantastic care on the state and taxpayers having to pay for it for those who cannot afford to some of whom chose not to plan for it.

I personally have no issue with MILs home being used to pay for care but LA wouldn't take it (disregarded) until FIL died.

Terron

The NHS was originally intended to shrink after the major infectious diseaes had been dealt with and their would be less need for it. It didn't work out as intended.


Both my parents received care towards the end of the life, paid for by the NHS though my dad's pension - he had been a doctor for 39 years. He started by getting 2 visits a day to help him dress and undress as he had Parkinson's. eventually it increased to 4 visits a day, plus meals on wheels each weekday lunchtime and a once a week visit to bathe him. Then he got worse and had to go into residential care (£477pw in 2011). One of the carer's had been a patient of his when she was a child.

elsien

There are also many people who would much prefer to stay in their own home, even with the downsides of different carers and having to go to bed at a time not if their choice.
It's not just about saving money, it's also about wishes, preferences and emotional/psychological wellbeing. Finances obviously come into it, but I do think Billy is giving only part of the picture.

billy2shots

Not my intention to give one side of the picture and dirty the other.

To be crystal clear, I'm very much pro people staying in their home if possible. There is great care out there (despite much negative press).

My gripe is when people are no longer able to receive the required level of care they need within their home because their care needs have deteriorated over time. It's at these times when the process can fall down due to many factors but the greatest one is local authorities health and social care budget.