Care Costs - How Much???!!!

theoretica

Minimum wage applies even if you are employing someone to live in and there are stringent limitations on charges for accommodation.

Keep_pedalling

Being cared for in your home is a great option for those who have sufficient liquid assets to afford it, and it can be cheaper the residential care, as their are no accommodation costs involved. If I need any level of care, under no circumstances do I want to burden any of my family with doing it, and if I can possibly avoid it I don’t want to go into residential care, so a certain amount of savings have been ring-fenced in case home care is required.

If never needed it might result in some IHT that could have been avoided, but that is a price worth paying for piece of mind.

tooldle

My mum lives in a home, care rather than nursing. It is excellent value at just over £3.80 per hour. Around £34K a year. As others have said, the actual care is not the only cost. The heating bill alone must be huge. Add on the constant hot water, the gardeners, the maintenance person and associated costs, specialist equipment etc etc. To give some context mum did have care at home for a short while, some years ago. That cost £15 per hour and she still had the costs of running her own home on top of those charges. 
There are also the things that you cannot put a price on. She has company, as much or as little as she likes. She has people looking out for her, and other visiting families to engage with. It is truly her home and the staff are extended family to us. Don’t under estimate how lonely and isolating it is to deal with the needs of a person with dementia, when doing it on your own,

Morglin

Mickey666 said:

A friend's mother has recently had to move into a care home.  very sad but all too common etc etc.  But what has astounded me is that it is costing £1200/week!.  I don't know the full details but that's not really relevant to my question . . . which is, has anyone here any experience of home care alternatives, because it seems to me that at if care homes are charging 40, 50, 60k per year it must surely be cheaper to employ a full-time home carer.  Indeed, many retired people have spare bedrooms in their homes so why not even a live-in carer?  Perhaps this is what we used to call a 'housekeeper' in the good old days?  They get somewhere to live, rent-free, plus a 'living allowance' and they run the household for the elderly owner.  OK, maybe not so appropriate if there are serious medical conditions, but for basic old-age frailty it must surely be an option.  After all, I don't think there was the prevalence of care homes in the 'good old days' - or perhaps 'extended families' were more the norm back then?  - but they certainly seem to be raking in the profits these days.  Is there really no alternative?

My dad has complex needs and his home charges £1800 per week. (London prices!)

Employing a carer wouldn’t have worked, because he needs two carers at a time for lifting etc., and obviously, you also have to allow for time off, holidays etc.

One carer couldn’t work night and day - although this would depend on level of need.

i sold the house to pay for this, but, luckily, they have assessed him as being eligible for NHS Continuous Care funding, so we're not having to pay at the moment.

its an expensive nightmare.

(Sorry - not very sure how to quote and post on this new forum )

JGB1955

My father had live-in carers for over a year.  He is now in a nursing home, where his expenses are far less and he has 24 hour company/care.

The live in care cost £940 a week.  In reality, the carer was only 'on duty' for 8 hours a day, so there was a substantial amount of time when my father was left alone in the house.  One of the carers used to put my father to bed, then go clubbing until the early hours.  That was quite within their rights, but not quite what we had envisaged when signing up to the package!  In addition to the £940 he had to pay £60 weekly to the carer, to cover their food/expenses.  He still had to pay for his own food, gardener, cleaner, window cleaning, council tax, insurance, water, telephone, Sky and electricity bills etc etc.  The carers would work on a two-weeks on, two-weeks off rota.  Most were really professional, but it's hard for a 20 something year old carer to engage with an 88 year old on a solo one-to-one basis.  There was a lot of time companionably watching TV, but nothing much else.

Circumstances meant that my father ended up in a Nursing Home, following a hospital admission.  He is self-funding but receives higher rate  Attendance Allowance (£87.65 p.w.) and Funded Nursing Care (£165.56 p.w.), leaving him a net bill of £641.79 p.w.  This is covered by his various pensions.  Financially he is far better off than being at home.  Emotionally he would be in a 'dark place' whatever his physical situation.  As a family we are happy that he is being well looked after, with a team of dedicated staff who have access to everything that my father needs, both socially and medically.

 

I don't believe there is any 'right' answer - it's all down to individual circumstances but thought an insight to our own situation might be of interest to others out there.....

thepurplepixie

Mickey666 said:

Interesting points.  I guess I'm thinking of someone who is mainly just frail rather than needing specialist medical care.  Interesting comment about agency home care being equally as expensive.  I guess I'm just struggling to understand where £100k/year actually goes when all the media reports seem to suggest that carers are very low paid workers, probably minimum wage.

As for needing total care such as "toileting, washing, dressing, feeding", I reckon I'd rather top myself before I got to that stage, but I guess that's a whole other topic!

Where does the money go?  Well there is buying and equipping the home, maybe a mixture of capital and mortgage payments,  They are generally bigger than the normal domestic home and the cost will depend on where they are in the country but kitting them out with the necessary equipment isn't cheap.  I think to get registration now you need en suite facilities.
Staffing isn't highly paid but it mounts up, you need enough staff on shift for safety reasons e.g. so assistance available when needed, meals cooked and served, washing done, general cleaning, emergency evacuation if there was a fire.  You need a registered manager to run it all, they aren't minimum wage.  Staff need training, recruiting and on top of their pay the employers NI needs to be paid, pensions.  Insurance can be expensive, registration with CQC also costs.  Maintenance can add up, the frail elderly can take a toll on a house, wheelchairs knocking into things, things being spilt, dropped etc.  Do you think the owner should get a return on their investment, I mean if you invest in something I assume you expect a return.  Heating costs, lighting and water don't come free, council tax needs paying, clinical waste has to be taken care of.  I'm sure there is stuff I've forgotten.

3stones

Care / nursing homes were actually closing at the rate of one a week a few years back despite an increase in demand, Increasing costs and the cutting of government subsidies were cited as reasons why It become a business to get out of rather  than get into.

thepurplepixie

3stones said:

Care / nursing homes were actually closing at the rate of one a week a few years back despite an increase in demand, Increasing costs and the cutting of government subsidies were cited as reasons why It become a business to get out of rather  than get into.

Yes you are right, people think it is a licence to print money but there are so many costs they've never even thought of.

onwards&upwards

Mickey666 said:

onwards&upwards said:

Mickey666 said:

 I guess I'm just struggling to understand where £100k/year actually goes when all the media reports seem to suggest that carers are very low paid workers, probably minimum wage.

Yep, carers get paid peanuts, they aren’t the only costs though.  Care homes also have to pay for the fabric of the building (rent maybe, repairs, upkeep), utilities, food, laundry, specialist equipment like hoists and chairs, consumables like soap/toilet paper/cleaning products, social and enrichment activities.  Probably loads more that I haven’t thought of too, and then on top they have to make a profit because our society has decided for some reason that caring for vulnerable people is a business opportunity rather than a collective responsibility. 

Yes, care homes have loads of overheads as you rightly say, plus commercial/liability insurances, management overheads and other things . . . whereas a person requiring care presumably already has a home so it’s not really all those overheads they need, only the incremental actual care.  Perhaps it’s a cultural thing together with the demise of the extended family?  Once we had multi-generational homes or at least families all living close together so care needs were more shared within the family.  I know that times change but sometimes wonder if there’s a hidden price to pay for our progress.

A lot of the time the home is no longer suitable without major adaptations, and sometimes the home can’t be adapted at all (upstairs flat with no lift, lots of steps to front door, tiny bathroom that can’t be made accessible, doors too narrow for chair/bed/hoist to fit through etc etc.)

thepurplepixie

3stones said:

Going back a few decades I think people died younger of more natural causes, suet puddings and the like did for a lot of people. I'm sure a much lower percentage of people  ever got to the age of needing specialist nursing care.

And lots ended up in the workhouse.