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Nursing home fees (no assets)

15 replies 1.3K views
Looking for some advice,

My mother in law has vascular dementia and is in the late stages of this. She was in hospital for about 4 months getting out at back end of December last year.

There was a care package put in place for her to return home however the person charged with sorting this out has tried for months while she was in hospital that the best place for her would be a nursing home. She is coming upto 80 and he is 77 and not in the best health himself.
They have been together for over 40 years and he decided as stubborn as he is that he could deal with it at home.

He phoned my wife last night (an only child) and said to her he just can't cope anymore the last 6 weeks or so have been so hard for him he said that he didn't really take into account how hard it would be from the advice given from the care lady in the hospital. As a family we have chipped in where we can to help him but she is an only child and works full time and I also work fulltime myself and we have a 6 year old that is special needs herself and a hand full.

He decided after she had a long chat with him last night that a nursing home would be best. I have contacted the women that has helped him through this but they are away till mid next week and he knows there will be a waiting list.

They live in social housing and don't have much savings. He said his wife has 9k put away in savings but didn't say what he had probably not much more. they have no other assets.

How does this work with regards to costs and would they take the small savings into account and take them off him towards costs or are you allowed to have some savings?

Thanks
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Replies

  • Keep_pedallingKeep_pedalling Forumite
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    As far as finances are concerned residential care would be fully funded by the LA with the level of savings she has.

    It is good that your FIL has finally accepted that he can no longer cope, as that was a big hurdle for her getting the care she really needs. Don’t wait until Wednesday, contact social services first thing Monday morning.
  • RambosmumRambosmum Forumite
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    Those with less than £14500 in savings (in their own name and half of any joint savings) and with no assets would be funded by the local authority. HOWEVER - the local authority have a rate which they will pay, they will happily tell you this rate. Depending on the area the person lives in, there may or may no be any homes which accept this rate.  If there are no homes that accept this rate then a "third party top up" would be payable. This cannot be taken from the person's savings and so would have to be paid by either the 77yo or the family. The other alternative would be moving the person to care home in another area where the fee is the same as the rate paid by the LA, how feasible this is will depend on where you are. 
    Please reassure your wife and FIL (or whoever it is) that more expensive doesn't mean better. In the LA I work in, some of the most expensive homes are the worst. 

  • RambosmumRambosmum Forumite
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    Also something to note is the difference between a nursing home and a residential care home. A nursing home has a registered nurse on staff at all times. This element of the care is funded by the NHS and the decision as to whether a person needs nursing care is made by an NHS assessment (usually a senior district or hospital nurse). If NHS says no nursing needs, then the person cannot be placed in a nursing home. The social worker should tell you whether nursing care is a possibility or not and should provide you with a list of homes you can choose from. Some will have waiting lists, others may not have. 
  • Gavin83Gavin83 Forumite
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    Rambosmum said:
    Depending on the area the person lives in, there may or may no be any homes which accept this rate.  If there are no homes that accept this rate then a "third party top up" would be payable. This cannot be taken from the person's savings and so would have to be paid by either the 77yo or the family. The other alternative would be moving the person to care home in another area where the fee is the same as the rate paid by the LA, how feasible this is will depend on where you are. 
    Please reassure your wife and FIL (or whoever it is) that more expensive doesn't mean better. In the LA I work in, some of the most expensive homes are the worst. 
    That's not quite accurate. The LA have an obligation to place her within her own authority and if no suitable homes can be found that accept the council rate the LA will pay the top up. However this is extremely unlikely, the LA will base their rate on the local homes and they'll be a number of homes that will accept council rates.

    OP the greatest barrier is generally getting the LA to agree with the placement. As it appears you have this in place you need to speak to them to get the ball rolling. She won't be required to spend her savings but the majority of her income will be taken into account, pensions, etc. She will however be left with some spending money.
  • RambosmumRambosmum Forumite
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    Gavin83 said:
    Rambosmum said:
    Depending on the area the person lives in, there may or may no be any homes which accept this rate.  If there are no homes that accept this rate then a "third party top up" would be payable. This cannot be taken from the person's savings and so would have to be paid by either the 77yo or the family. The other alternative would be moving the person to care home in another area where the fee is the same as the rate paid by the LA, how feasible this is will depend on where you are. 
    Please reassure your wife and FIL (or whoever it is) that more expensive doesn't mean better. In the LA I work in, some of the most expensive homes are the worst. 
    That's not quite accurate. The LA have an obligation to place her within her own authority and if no suitable homes can be found that accept the council rate the LA will pay the top up. However this is extremely unlikely, the LA will base their rate on the local homes and they'll be a number of homes that will accept council rates.

    OP the greatest barrier is generally getting the LA to agree with the placement. As it appears you have this in place you need to speak to them to get the ball rolling. She won't be required to spend her savings but the majority of her income will be taken into account, pensions, etc. She will however be left with some spending money.
    This doesn't happen in my authority. We have a number of homes which accept the LA rate, but occasionally they are all full or there are restrictions on placements on the ones with spaces. I do not know of an instance in which we have paid the top up. This may be because we have a number of homes that are just over the border, often closer than the in authority home due to geography. 

    OP do not let the carer play down the carer stress, this is the number one reason we place people in care, especially where if they lived alone they could be supported to remain at home. 
  • edited 17 February at 1:08PM
    Gavin78Gavin78 Forumite
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    edited 17 February at 1:08PM
    Thanks getting back to me.

    She went into hospital over the weekend with a water infection. I've not spoken to him this morning yet but he is going to try and get hold of the social worker that deals with her care in the community. I've advised him to inform the hospital that he can't accept her back home because he can't cope with look after her and it's a safe guarding issue.
    They can't discharge if it's not safe to do so.
    He has said at 77 he's got his own medical issues and thought he could handle her being home despite the hospital social worker and the leeds care force advising him that a care home would be best. However he said he wanted her home and the care woman said to me it might be that he just has to go through the emotion of having her at home because she always said to him I don't want to go into a home. However there isn't much choice now he can't even get the strength to get her to the tiolet because she's too heavy for him and she has limited mobility.
    The only savings he has is around 18k plus his and her pensions and the DLA part of the care package they have.
    It wouldn't be a private home it would have to be a council one as me or the wife don't have the money to support a home and other than his few savings and a pension he has nothing.

    So how does it work if there is no money to pay for a home? surley they can't force a home discharge with nobody to care for her?
  • Keep_pedallingKeep_pedalling Forumite
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    Being in hospital is going to make things far easier. If the discharge team do not believe she can safely sent home they will be looking at sending her to a residential care home. In the end this is how I finally got my mother a place in care, as the LA panel did deem her condition serious enough to fund residential care. It was the hospital discharge team who made the final decision.

    The danger is that her husband might go back to insisting he can cope again, so you should try and be present at her assessment. 

    Nearly all care homes are privately run these days. Some of them except LA funded residents others don’t, so she will be offered a place at the former only. The LA will fully fund the care, with a contribution coming from your mother’s income only.
  • RambosmumRambosmum Forumite
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    Gavin78 said:
    Thanks getting back to me.

    They can't discharge if it's not safe to do so. 

    However he said he wanted her home and the care woman said to me it might be that he just has to go through the emotion of having her at home because she always said to him I don't want to go into a home. 

    The only savings he has is around 18k plus his and her pensions and the DLA part of the care package they have.
    It wouldn't be a private home it would have to be a council one as me or the wife don't have the money to support a home and other than his few savings and a pension he has nothing.

    So how does it work if there is no money to pay for a home? surley they can't force a home discharge with nobody to care for her?
    They can't discharge home if THEY don't believe it is safe, if it is her home, and they feel she can be safely managed at home then they can. Which is why I said earlier that you FIL (I'll call him this for ease) needs to ensure that he focuses on the carer stress element. 

    Are the savings in his name alone? Or joint? Either way they won't matter, but if they are in her name, then £4kish of it will.

    As for discharge, it sounds as though they've already said before that she meets residential criteria, in which case it'll be fairly easy to get them to agree again. I don't know Leeds homes but if I were you I'd call up a number of homes and ask "do you accept the Local Authority rate" It's a yes or no question. Do NOT ask "what's your weekly rate" or "how much do you charge". I'd then encourage you and FIL to look at the homes which accept the LA rate and choose from those. Obviously taking in to consideration whether they have availability. As far as I am aware Leeds do not have any Local Authority owned homes, they are all private (as is the case in most Local Authorities these days).
  • RambosmumRambosmum Forumite
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    When placed in a home,your MILs pensions, Attendance Allowance (DLA) etc will all be stopped and she will be left with a small stipend for buying toiletries, new clothes etc. Your FIL needs to be prepared for the loss of household income. 
  • lisyloolisyloo Forumite
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    He should not accept her home if she turns up in an ambulance. Sounds harsh but he should lock the door and refuse.
    being in hospital is a much better position. The LA will get fined for bed blocking so there will be pressure to get them into a home which may work in your favour.
    they dont have to pay (beyond single income minus £25) but could be offered a terrible home or one not so close.
    find out the LA rate, ring up the homes and start vistiting them and checking care quality commission reports (CQC) - these should be taken with a pinch a salt e.g. management can change.
    you should refuse any home you really aren’t happy with. 
    We went to “panel” and got a fully funded home outside LA rate so it can be done but you have to make visits and you have to fight.
    they are more likely to give in if they are being fined for bed blocking.
    so get phoning and get visiting, maybe one of you has to do this whilst one of you does the childcare? Yes it’s hard, we did it between 3 of us and it was still difficult.
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