HELP! care home business model and how FNC accounted for in fee structure -

urbanproserpine

Anyone have any experience or views on the legitimacy or best practice here on how NHS-funded nursing care payments accounted for in the fee structure of care homes?

Context:

Looking for care home for my self-funded dad with Parkinson's and Dementia and very rapid decline over past few weeks. We can't cope (my Mum is here with him in our home since Covid but we are ALL reaching breaking point now and we are urgently seeking a care home). I have identified three suitable homes with places nearby that all seem to tick the boxes for dealing well with my dad and providing a good environment. One even has such a tight testing regime they don't require two weeks isolation before allowing him out of the room - which nearly all seem to require, and which would be horrific for Dad.

Two separate homes quoted me yesterday as per the following: We charge £1,250 per week fro care. If we get you FNC (£183 pw currently) - which we will apply for on your behalf, we will take that money. The fee will be the same though, because 'we take the risk' that we will get the FNC - and if we don't we still charge the same fee.

I was very 'excuse me you do *what*?' and they went through this again. Apparently this 'takes the risk of not getting the FCN away from you as we cover the FCN if you don't get it'

Two separate care companies said this to me.

I want to know if its usual/reasonable/a swizz

I'm in extremis and the home I really liked said this. In the absence of being able to visit its so difficult to tell.

JGB1955

I have heard of that scenario before and I find it amazing/abhorrent/greedy/call it what you will.

My father spent his final 20 months in a care home.  He also had Parkinson's and dementia.  Initially (after a hospital admission) his stay was covered by NHS Continuing Healthcare Funding but at review it became apparent that his needs no longer met their criteria.  He was then awarded Funded Nursing Care.  His care home counted that as a discount on the full cost, leaving us to pay the (lower) balance.  He then also qualified for Attendance Allowance, so our/his cost was a 'mere' £800 'ish' per week.  We felt that the care home were very fair and clear about the funding.  I would feel far from happy about the examples you quote.

Linton

I have no specialist knowledge of how it all works but as a disinterested outsider...

It sounds odd at first but on further thought the net effect is that those who get FNC subsidise those who dont.  If the home didnt operate like this the quoted charge would have to be higher on the assumption that FNC would be refused and presumably only some time after your father has moved in would you know how much the costs would be. 

It would be wrong to look at it as some kind of swizz - it would be much easier just to raise the prices.  Rather the home has to cover its costs in some way, and the way they have chosen could be preferable to the alternative where it would be a % call as to whether your father gained or lost. 

So does it matter given the situation? Can you father afford £1250/week? 

Bobziz

What Linton said. If you like the home then what it costs will be irrelevant to you in years to come as long as it doesn't put your family in financial difficulty. Good care is worth paying for however the fees are structured. £1250 is not unreasonable. My mother pays £500 more than that.

urbanproserpine

Thanks all, interesting to see both views there.

I think ultimately you aren't going to want to be in a nursing home unless you need it or are nearly at that point, so its a little bit academic - I can see why they do it. Just not the clearest policy.

Sharktail

urbanproserpine said:

Anyone have any experience or views on the legitimacy or best practice here on how NHS-funded nursing care payments accounted for in the fee structure of care homes?

Context:

Looking for care home for my self-funded dad with Parkinson's and Dementia and very rapid decline over past few weeks. We can't cope (my Mum is here with him in our home since Covid but we are ALL reaching breaking point now and we are urgently seeking a care home). I have identified three suitable homes with places nearby that all seem to tick the boxes for dealing well with my dad and providing a good environment. One even has such a tight testing regime they don't require two weeks isolation before allowing him out of the room - which nearly all seem to require, and which would be horrific for Dad.

Two separate homes quoted me yesterday as per the following: We charge £1,250 per week fro care. If we get you FNC (£183 pw currently) - which we will apply for on your behalf, we will take that money. The fee will be the same though, because 'we take the risk' that we will get the FNC - and if we don't we still charge the same fee.

I was very 'excuse me you do *what*?' and they went through this again. Apparently this 'takes the risk of not getting the FCN away from you as we cover the FCN if you don't get it'

Two separate care companies said this to me.

I want to know if its usual/reasonable/a swizz

I'm in extremis and the home I really liked said this. In the absence of being able to visit its so difficult to tell.

Hi
 my wife is a manager in a care home and states it’s standard practice across the care sector re FNC aswell as the care charges