Care home funding advice?

elsien

They are correct about the third-party top up. He cannot pay this himself.

https://www.ageuk.org.uk/information-advice/care/paying-for-care/paying-for-a-care-home/

They are not correct about saying he can be safe at home with four calls a day when they haven’t even done the care act assessment. You need to show that he’s not safe at night or in between calls, if that is the case. So go back over all the help he has been given and all the issues that he’s had and make sure that the care home are properly documenting nighttime Support and any other issues.

You could decline to be the emergency contact for falls which is more likely to push things towards a care home but then he needs to consider whether he wants to try the four calls and see how it goes.

This explains the process in a bit more detail.

https://www.careadvocate.co.uk/blog/care-act-assessments-2026-uk-family-guide

But to be fair, if you haven’t tried it with the four calls a day you don’t know how workable it is.

They do have an amount that they pay, but that is not set in stone. Again they have to show any care home meets the person’s assessed needs. Their assessed needs are not only the physical support but also their well-being. Which includes maintaining contact with friends and family. But if they can show that a care home a little further away can meet us asses needs then they can use it.

The local authority will have to take over the part funding as soon as his savings go down to 23 1/2 K. Which won’t be long. Which is why they’re saying perhaps you’ve acted a little prematurely.

Are there any powers-of-attorney in place at all?

lstar337

If he has dementia this may change the outcome but even dementia patients aren't guaranteed paid for round the clock care in the care home of their choice. Many stay in their own homes. If you can't cover the costs then best to get Grandad home to his social housing before he gets more settled in the home he's in and then go through the proper channels to get him help.

The dementia diagnosis is coming soon I believe. He has had the assessment, and the woman who did it said that it is more a case of determining which type, than a yes or no. With the rapid decline, it seems like they'll say its vascular.

Cubicsrube

So sorry your wife is going through this. I can empathize from my journey with a parent who slipped step by step through all the same stages, hospitalization, discharge, falls, emergency calls, carers, respite care to ‘give it a try in a home’, dementia complicating loss of mobility, eventually becoming a danger to herself, discharged again with 4 carers a day which was totally inadequate but all that ASC would approve. We were in a different funding position as she owned a home, but we had all the same conversations.

I’m very sorry to say that there isn’t much you can do, if you aren’t able to self-fund. See how he does with 4 visits a day at home. That will take care of his basic needs, but unfortunately your wife will still be managing everything else, shopping, cleaning, etc as well as having to drop everything when the next fall happens, as it inevitably will. If this happens, your wife will need your support to take more of the load in your own home. She can also apply for carers allowance. Unfortunately, the only way we found to force ASC to step up a bit was for us to step back a bit…”no we can’t come and collect her from hospital this time, you’ll have to arrange transport”, etc. So long as they know there is a family member with a conscience in the picture, they will do as little as they can get away with.

elsien

That is not entirely accurate.

The care calls can include shopping and some cleaning.

gm0

Welcome to the care crisis. Richer self funders are charged more to subsidise the below current prices ASC max rate that the LA will pay - not raised as employment costs and energy costs have made delivering care ever more expensive.

Demand massively exceeds supply and the LA ASC budget already ate almost everything non-statutory that LA's do and that continues to worsen). This is not because they are villains. Doing what they can by the book with what they have. With significant excess demand over funding.

Care homes as providers are in a mess deeper or wider based on location in country and available self funders to balance the books via overcharing cross subsidy of other people. Care not spots are emerging where there are insufficient self funding service users to pillage. In eastern counties of england some are bad. And some parts of Wales are less in crisis. More stable. More effective ASC. It varies - a lot. Based on our experiences.

LA ASC are just people trying to make a quart out of a pint. And deflecting and delaying demand is a big part of that. The deflection feels terrible. And confusing for the individual family.

Believe me we have seen enough examples. Some good. Some terrible. Multiple police visits before ASC would accept the game was up for residential admission.

Very often visits at home with a self funding top up is what people prefer.
Which delays "admission" to the full loss of independence care home setting. Cheaper.
So the LA prefer it too. Cheaper. Capacity.

But if you are fully past that point being viable then working with the ASC team to choose a destination which they do deal with and where there are LA funded cases alongside self-funders routinely - and which your elder (or you via POA) also freely accept as self-funders. Gets them settled more likely than not for remaining life.

They will try to push you to where it is convenient for them in the moment - provided it matches care needs. e.g. a lower occupancy less desired mostly LA funded place which badly needs more patients or it will financially continue to spiral down to close - maximising bureaucratic inconvenience and causing a crisis for all those families. But the dominant factor in many places is often finding a bed at all in the appropriate nursing or secure dementia or other category.

If they are paying they get a high level of control on where this happens. Not total. But high.

You don't have to accept something awful at self funding stage and will need to be assertive.

While self-funding you still have a level of agency. But the reality here is that the LA will be paying and soon. And they likely already know that. And will be quite assertive about the rules and process albeit with a more or less human touch for a distressed family. They do this all day every day. It varies a lot how kind they are about it but it is what it is. Compassion may (sometimes) influence "how" it is done and communicated. But not "what is done". Process uber alles.

Once an elderly person is established in a care setting. And that care setting does already have LA funded residents alongside. Moving them is not something done lightly - there are rules about it. Learn what they are. You can disrupt and delay and object to a proposed move (with POA). And insist they do ALL the work required on risk assessments on moving the frail. And dispute the process (was it done properly) and the findings. Dispute. Delay. Complain. Delay. SAR. etc. etc. Become a nuisance. So they do something else with their scarce time.

If they truly must do it (care home closures etc.) there is no point. They will have to do it over your objections.

But they do not in general want to muck about with this - particularly in the face of obstruction and legalistic objection from a persistent family as it generates a load more work for them for not much of a win. And so go and do something else. Line of least resistance. Apply some incentives of your own. Work collaboratively with the friendlier faces of ASC. Be legalistic and keep scrupulous records, documenting all conversations and following up in writing with the unfriendly.

In the end you cannot expect to choose a higher end home without any/many LA cases - unaffordable for the self funder - and dump the subsequent open ended cost of that on the LA without their prior involvement. Not reasonable. Not the system. Not the process. Doesn't meet the rate card. Do not place people there.

Hence my remarks above on a "mixed economy" home choice. Getting them in somewhere harder for the LA to make a valid case to move them again. Because they pay for similar cases there already - so its part of the mix.

They will try and push you around to their convenience. In the first instance this is delaying admission and hoping the situation self resolves without the LA needing to pay for residential care at all. Later it could be a choice of homes you don't prefer. Because they are the safety net. And providing and controlling what and where it is. Expectations issue.

Some ASC workers are tasked (given budgets are blown all over the place) with demand delay and deflection dressed up as case assessment. How you apply various criteria. Some are too enthusiastic about it. And are distressing families all over the place. An ASC manager doesn't send a naive compassionate nice youngster to do that. Come back with far too many admissions. They send a bureaucratic rottweiler. Because with their targets and incentives - that's a rational choice too.

Understand the game. Learn the rules. Play.

More positively. It will get better. It will be a moment in time. And it will get settled. And hopefully they will settle into a new routine in a safe environment. That was true for our group - even for the people who had the more difficult engagements with the ASC team. This too shall pass.

Good luck navigating the mess

lstar337

https://forums.moneysavingexpert.com/discussion/comment/82133147#Comment_82133147

Thanks for your comment. Unfortunately my wife cannot claim carers allowance for him, because she already gets it for looking after our autistic daughter.

That is the only reason she has any time to look after him at all. If she didn't have to care for our daughter, she would be in full time employment because we are barely scraping by as it is!

lstar337

More positively. It will get better. It will be a moment in time. And it will get settled. And hopefully they will settle into a new routine in a safe environment. That was true for our group - even for the people who had the more difficult engagements with the ASC team. This too shall pass.

Good luck navigating the mess

Many thanks for your kind comments.

We do know ASC are already funding residents in the home, the manager has told us so, and the home is also one of the cheapest in the area, if not the cheapest. We chose it for that reason because we didn't want to push it with ASC. It may not be the cheapest in the county, but he wanted to stay in the same city, and we thought that was good because it's 30m from us and he will remember things about it. Moving to a strange area would only be worse for his mental state.

RAS

https://forums.moneysavingexpert.com/discussion/comment/82133150#Comment_82133150

Can you organise shopping delivered to home and ask that the carers stuff in the fridge and freezer? Even if it's just bunged in.

lstar337

https://forums.moneysavingexpert.com/discussion/comment/82133147#Comment_82133147

It's a difficult situation as it is (sorry you had to go through it), and their zero empathy approach doesn't help.

We have already been through dementia once, with his wife. He nursed her day and night at home until the day she passed, and his reward for that is getting it himself and having nobody to look after him. Such a shame.

Brie

When we had to deal with social services for my MiL they were insisting that I should quit working so that both my husband and I could be there 24/7 for her. There was the offer of 1 person coming 3 or 4 times a day to assist with using the toilet and hygiene but we refused that as we deemed it insufficient for her needs. She was basically bedridden and had dementia (albeit in a jolly way which was a relief, not everyone is so lucky) and so could not be left alone at all. Given the demand this would put on us we refused to let her return to her/our home from hospital. Fortunately the staff at the hospital agreed with us that it was neither practical nor in MiL's best interest to be sent home. I'm sure the social services person we were dealing with thought we were proper pains in the posterior but it's only by standing our ground that we were able to get them to agree to funding a space in a care home for when her money ran out.

It's a difficult situation but you have to be tough to get the right solution. Best of luck, try to stay strong.