Care Home Fees Conundrum

Fermion

Think you were given poor advice by your Solicitor doing the conveyancing. What they should have advised you to do is to register both your name and your Mothers on the Land Registry title deeds as Tenants in Common with a separate Declaration of trust (Deed of Trust) stating that the percentage ownership on any sale of the apartment should be in proportion to the nett proceeds of park home sale and your contribution.
The Land Registry would then include a note of the Deed of Trust on the Official register.
The deed of Trust would then have explained the full circumstances and financial logistics.
That would also avoid any Capital Gains Tax liability on your part on future sale of the Apartment

Terry_Towelling

Well how strange this CHC issue is. If a person is unable to wash themselves at all and needs to be hoisted to do anything and who may also be incontinent and unable to feed on their own etc then they are going to die quite quickly if no one is there to do it for them. I'd say that was a fairly compelling case for someone to be classed as having a primary health need. Perhaps if they are able to communicate their needs, this makes a difference.

Let me quote (almost) from our local Commissioning Support Group literature:-

If [big 'if'] you are found to be eligible for NHS CHC in your own home...the NHS will pay for healthcare (e.g. nursing...specialist therapist) and associated social care needs...(e.g. personal care...bathing, dressing, food prep and shopping). In a care home, NHS also pays for your care home fees, including board and accommodation.

Some of those tasks are clearly not nursing-related and are openly stated to be social - like cooking and shopping. The literature goes on to talk about having just the nursing element paid for if CHC is declined.

For my part we qualified for CHC funding 2 years ago (for mental health reasons - probably linked to aggressive behaviour). We got nothing during that 2 year period apart from one visit from an agency to assess our needs and they said they couldn't meet them anyway.

We were signed off by the Community Psychiatric Unit when the aggressive behaviour lessened and CHC funding was cancelled at the same time - although nobody told us. We are now going through the application process again. Both applications were started by, and on the advice of, medical professionals, not by us, so there must be a reasonable reason to believe it should be in place and we are by no means in the kind of dire straits as others who have seemingly not qualified.

elsien

Aggressive behaviour is one of the factors that would count towards CHC funding. But there is an annual review and if the need has decreased then health funding can be withdrawn. Which is likely to mean the person having to move if the LA aren't able to agree the extra.
So someone's whose behaviour has settled because of the care they are receiving has to move to a less skilled setting with things then deteiriating again.
We really do not have a joined up system.

Terry_Towelling

elsien wrote: »

So someone's whose behaviour has settled because of the care they are receiving has to move to a less skilled setting with things then deteriorating again.
We really do not have a joined up system.

It all comes back to the money issue again. There is no incentive for an LA to employ joined-up thinking when that will lead to them having to pay out. They should be looking at 'cause and effect' not taking an isolated snapshot.

elsien

Nursing home near me who takes people no other setting wants due to the challenges which charges £1500 a week. (It's not the best run place but pretty much has a monopoly.) The local authority rate is under £400 a week. Hard to see how the two can be affordable reconciled if someone then loses the health funding.

But the government backtracked on its plans to review health and social care, so that's what we're stuck with for the foreseeable.

Terron

My mother had a form of dementia for about 5 years before she died. It could be treated by her using an oxygen concentrator for 15 hours a day. We got her two, one for upstairs and one for downstairs so she could live at home. With prepartion she was even able to take a few hoolidays to helpful hotels in the UK.


She spent several weeks in hospital shortly before she died. The hospital said they couldn't do anything for her but wouldn't let her come home until a care plan was in place, despite it being Christmas so everyone was home and could look after her. We set up a bed for her downstairs and used a wireless doorbell so she could signal for help. She came home on Christmas Eve and died early in January when her one working lung finally failed.


When my Dad needed a care home later than year my sister and I visited several. Only a couple seemed suitable for someone who did not have dementia. and we left the final choice to him. He wanted to go home eventually but when first admitted he was too weak to even sit up in bed. He got stronger and regained the ability to walk short distances.

lisyloo

Terry_Towelling wrote: »

Am I wrong in thinking that where an individual has a primary health need in order to survive, they should be in receipt of Continuing Health Care (CHC) funding from the NHS. There is an application process to go through but it doesn't have any means test attached to it.

If it is deemed necessary for that primary health need to be met in a nursing/care home, the LA will pay for the healthcare and board and accommodation too - again no means test and no 'asset stripping'.

One would have thought that anyone in end-stage dementia or requiring 24 hour care, hoisting etc would qualify for this funding.

Or have I missed something?

Yes when their primary need is medical I.e. they need drip/medication.

If they need dressing, washing, feeding, making sure they don’t wander off, set fire to things etc. That all counts as personal care.

lisyloo

xylophone wrote: »

Which doesn't go far against fees of £60,000+ a year......

This are very expensive fees, so won’t apply to most people I. Most of the country.

As an example (yes I know not everyone has the same circs) my MILs fees aren’t £825, so her £440 weekly income (no private income just benefits) goes a long way towards that.

Where is the £60k home?
Yes some people will need expensive care and have to be in the SE and London but most people won’t. Some homes are £400 per week (not very nice I might add - actually my SIL said over my dead body, but it’s worth point our that most poeople won’t be paying £60k.

lisyloo

xylophone wrote: »

I am coming round to thinking that for those who require twenty four hour care in a nursing home, the fees should be tax deductible.

I don’t claim to understand all the issues, but it won’t help people who are don’t pay tax e.g. assset rich, cash poor.
So helps the wealthier not the poorer people.

(I dont expect to pay tax when I sell my MILs £170k flat).

lisyloo

Terry_Towelling wrote: »

It all comes back to the money issue again. There is no incentive for an LA to employ joined-up thinking when that will lead to them having to pay out. They should be looking at 'cause and effect' not taking an isolated snapshot.

Agree, but then need to fund them properly and not put them under massive financial pressure and there you hit the nub of the problem which is is that tax payers don’t want to pay for an excellent standard for other people (as with hospitals, gps, Dentists, education). You’ve heard first hand some of the resentment on here. If you go too far with tax then talented and wealthy people and companies will leave the country so it’s not a simple thing at all to raise taxes.

Ultimately this all comes down to money (and I include the training and pay of social workers and hospital staff in that).

Plan financially, get an LPA and look out for your relatives.