Care Home Fees - LA Financial Assessment

weby72

I'm after some help please.

My mum (83) has quite advanced Alzheimers. My dad is 88 and, after a Herculean effort to care for her at home over several years, had to wave the white flag earlier this year. We went through the process with the local council social services and Mum entered a home, initially on a 'respite'/trial basis in May. She settled as well as could be expected and we all (me, dad, care home, council) confirmed her staying there 'permanently' in June.

I have LPA for her and control of her bank account.

She only ever worked part time and never had a private pension. She only receives a reduced state pension of £103/week. She also got £101/week Attendance Allowance. She had minimal savings (under £2k) of her own and dad still lives in the family home so that could not be taken into consideration.

The initial financial assessment stated that her contribution was £123.33 per week, which we paid monthly in arrears from her bank account.

In late September, we were notified by the council that a new financial assessment had been done, based on her receiving the State Pension and Pension Credit, so her contribution would now be £248.55/week.

I contact the LA to dispute this, saying she didn't receive Pension Credit. They informed me that she's entitled to it so they base their financial assessment calculation on that. They also informed me that, since entering the care home 'permanently', she wasn't entitled to Attendance Allowance - which nobody, until that point, had informed me of. I cancelled that at that point and applied for Pension Credit.

The Care Home then notified me that she was now £2,485 in arrears with her fees. I contacted them as I thought they'd made an error. They explained that the LA had backdated the new financial assessment to her being confirmed in the home 'permanently' on 30th June.

There was enough in her account to cover that and we paid it.

But the next lot of monthly fees wiped her out financially and the care home is now demanding further payment as she's in arrears.

My dad (who already has to subsidise the care home fees by £50/week as this amount is above the standard care home charge paid for by the LA because it charges a little more than the basic - although placing her in there was the LA's decision, not ours) cannot subsidise further, and I certainly can't. Nor are we legally bound to.

The questions I have are:

1) Is the LA allowed to include Pension Credit as income in their financial assessment even if she isn't receiving it?

2) Are they entitled to backdate that financial assessment so far, despite her not receiving Pension Credit (and unable to backdate any application to that date)

3) Is there some sort of ombudsman to complain to? Or is it just appeal to the LA?


Any help/advice would be much appreciated.


Thanks

p00hsticks

I'm sorry I can't help with your query, but I think it's probably better off asked over on the Benefits board, and I'll put in a request for it to be moved there. 

weby72

OK, thanks

tacpot12

1) Is the LA allowed to include Pension Credit as income in their financial assessment even if she isn't receiving it?

Yes, they are allowed to do this. It will be in a regulation somewhere that they are allowed to do this, and if it is allowed, then they must do it as they are entrusted to manage public finances responsibilty and that means using the powers give to them.  

2) Are they entitled to backdate that financial assessment so far, despite her not receiving Pension Credit (and unable to backdate any application to that date)

They are entitled to backdate the financial assessment that far back. There are no time limits for such actions. However, I do think that the fact that she cannot have the Pension Credit application backdated by more than three months should trigger a request that they use some discretion on how much she is left to pay (if no-one else can pay for her). I think you also have to critically examine the reason why she didn't claim Pension Credit when she was entitled to do so. If you or your father made an error, e.g. in not checking what she was entitled to, or not monitoring her circumstances as they changed, you might be as well to put your own culpability on record to the council so that you can see that you are being reasonable. It's a case of 'if you don't ask (nicely), you don't get'.  

3) Is there some sort of ombudsman to complain to? Or is it just appeal to the LA?

Local Government and Social Care Ombudsman: Home - Local Government and Social Care Ombudsman

You need to exhaust the LA's complaints process first, and clearly if you are asking them to make a discretionary payment, the Ombudsman is always going to side with them and say they have the discretion to act as they see fit where there is no obligation to cover the costs.

elsien

Also worth looking at previous ombudsman judgements as well.
I’ve not done a thorough search but this one does have some similarities and might be worth referencing. Or there might be a more relevant one if you keep searching.
https://www.localgovernmentlawyer.co.uk/adult-social-care/391-adult-care-news/56065-council-told-to-deduct-11k-from-outstanding-care-home-fees-after-delays-in-carrying-out-financial-assessment

Savvy_Sue

So they've done a financial assessment, have they also done a Continuing Healthcare Needs Assessment?
https://www.gov.uk/government/collections/nhs-continuing-healthcare-and-nhs-funded-nursing-care

Because sometimes, needs may be so great that the NHS should be paying more. It can be hard to get one carried out, and you may not agree with the outcome. 

HillStreetBlues

weby72 said:

My dad (who already has to subsidise the care home fees by £50/week as this amount is above the standard care home charge paid for by the LA because it charges a little more than the basic - although placing her in there was the LA's decision, not ours) cannot subsidise further, and I certainly can't. Nor are we legally bound to.

If it was the LA decision for your mother to be placed in that care home then there should be no top-up.