Care home following stroke

HillStreetBlues

Trying to find out some info for a friend whose father enter a care home after being in hospital.
The financial form has been submitted to the council and are waiting to hear back.
There are certain things I understand but do have gaps in my knowledge.

When is the needs assessment made? would that have been decided before admitted to care home? As the family are worried that the council will turn around and say they aren't going to fund the care. Can they do that? 

Brie

I thought that the needs assessment was made before someone was transferred from the hospital to the care home.  It certainly was with MiL although the council rep (horrid person) kept saying we should allow MiL to come home first just "to see how she got on".  We knew we couldn't cope with the situation, in part as it would require me to quit working as 2 people were needed AND the council couldn't guarantee what help they could provide within the home.  So we had to be mean and refuse to accept her home.  

Presumably they have agreed, since he's in the care home, to cover the costs at least initially.  It took them about a month to determine that MiL would need to self fund but nothing had to be paid until we were invoiced.  Frankly that took about 3 months and she had died before then. 

Yes the council can say they will not fund but that's dependent on the individual's circumstances.  If father was broke, no savings and no assets then the council will fund.  It doesn't matter if the rest of the family is filthy rich or has just won the lottery they are not obliged to pay for his care.   

If father has some money (like MiL did) then it's self funding until the saving are down to under £24k.  Then it's on a sliding scale depending on what income he has and as the saving reduce it becomes full funding by the council. 

If father's assets include a home he owns that needs to be taken into consideration for the funding.  But if his spouse/partner lives there it's excluded as it's that other person's home.  If there are adult children living with him different questions will be asked - they dependency on him, their age etc as to whether they need to move out so the house can be sold for his benefit.  Likewise any income he has (like pensions) may be needed to support the spouse/partner/child and therefore are not all available for father's funding.  

HillStreetBlues

I do mostly understand about the funding (sorry should have said)  if there is an agreement he should be in a care home. It's if or not the council think he should be in one.

Nobody knows if he will return home (hopefully he will)  and know there are different rules if he is expected to return. I have made it clear that it's in the best interest to say he will return home, as council need to factor in upkeep of his home. His home is discounted as his wife still lives there. and he is below the capital threshold. so just based on income. 

With income it's a State pension and a small private pension. I believe that with the private pension 50% of that can be disregarded if passed to  wife  (open to correction if wrong about that). 

elsien

How the needs assessment side of things works tends to vary in different areas.
Where I am if someone has been in hospital and can’t return home straight away, maybe because they need more assessment, they are often sent to a care home on a short time health discharge to assess bed.  That allows time for the health funding assessment be carried out and then the local authority care act assessment if his needs are not primarily health-related. 

That period of time (which should be completed within four weeks) it’s not charged to the person. It’s only when a full term place has been agreed that the disregard ends. Or if he’s fully health funded, which appears not to be the case here, because if it was you wouldn’t need to be submitting financial information.

Otherwise, the hospital social worker may have completed a basic care needs assessment which would be updated once out in the community

 The financial assessment shouldn’t happen until the care needs assessment has taken place.

HillStreetBlues

He was admitted to hospital in June and entered care home start of October, so taking their time.
I thought the fact the council were doing a financial assessment they they would be funding (pointless if they wasn't)  but wanted to check before relaying info.

elsien

They should know if he’s had the care act assessment, surely, because either he or they would have been involved? And he is entitled to a written copy of it once complete. Although to be honest, they take a lot longer to be sent out than they should do.
if they’re unsure they really need to be phoning up the local authority social services duty team if there’s no allocated social worker to find out what is going on. 

Keep_pedalling

HillStreetBlues said:

He was admitted to hospital in June and entered care home start of October, so taking their time.
I thought the fact the council were doing a financial assessment they they would be funding (pointless if they wasn't)  but wanted to check before relaying info.

Whether they would be funding him would depend on the result of that financial assessment. If he has no substantial assets then they will find his care.

elsien

Make sure as well that your friend is aware that it is a local authority are funding any third-party top of requested from family is completely voluntary with no obligation on them to pay it. This could potentially mean the father having to move somewhere cheaper but they shouldn’t put their name to something they’re  not able to keep up with to their own financial detriment.
Who chose the care home?

HillStreetBlues

Sorry if being dense, but want to be certain to pass on correct info.

So the council can't now say  he should have gone home instead of a care home and refuse to cover costs? (I know if they agree that most of costs would be covered)
If they will be funding who decides if he is able to return home if he feels unable to? As I expect the council rather not be funding a care home.

elsien

That’s why I was asking who arranged the care home - if the hospital arranged it and neither he nor the family signed anything to agree to pay then it’s not their responsibility up to this point. 

What happens next depends on his capacity, but if he is assessed not to need residential care at any point then they won’t continue to pay for him to stay there long term even if he doesn’t want to go home. If he is self funding of course, that’s entirely his choice while he can afford to pay for it. If he lacks capacity, it would be a best interest decision.

That would then be a case of looking at what his concerns were and how they can be addressed; looking at care calls, doing an OT assessment at home to see what aids and adaptations are needed or putting telecare alarm systems in; if there is a different option such as housing with care which can meet his needs and give him more security etc. 

Which is why they need to check with the local authority about the care act assessment. But as per the earlier comments, if he’s at the financial assessment stage that would seem to imply that the assessments have been done.

HillStreetBlues

elsien said:

That’s why I was asking who arranged the care home - if the hospital arranged it and neither he nor the family signed anything to agree to pay then it’s not their responsibility up to this point. 

I will try to find out, it's a bit hard atm as he doesn't want to talk about anything like that as he gets very upset. I know the hospital wanted to get him out ASAP  and was given a choice of two care homes.
One issue is that his wife has extreme OCD and couldn't deal with carers in the house, I don't know if that would have any bearing on a decision.