Respite costs and financial assessment

[SusanH]

Three weeks ago my Dad (who is carer to my Mum who has mixed dementia) was admitted to hospital for an emergency operation and we had to find emergency respite care for my Mum. Dad is now out of hospital, but very weak and unable to cope with looking after Mum - in the short and the longer term. Stress was a factor in his admission and Mum has become increasingly violent and difficult to care for (refusing to wash, change clothes, wandering, doubly incontinent). Dad cannot cope any more and as a family we have decided to investigate the possibility of Mum staying in the Care Home as she seems to have adapted well to the change in environment and although unwilling to accept care from the staff she will, at least, accept it in the end, which she wouldn't do from us. I have arranged for the Social Worker to do an assessment of both Mum and Dad (as a carer) on Friday.

In the meantime Dad has received a form from the Social Worker asking if he is prepared to pay £102 per week for the respite care. Neither Mum nor Dad have much money and are well below the limits over which contributions must be made for permanent residential care. Does anyone know whether, if he signs the form saying that he is willing to pay this contribution for the period she has received respite care that will count against him in the financial needs assessment? Clearly, if Mum were in permanent care her pension, attendance allowance etc would form a contribution to her costs and it seems only right and proper that this money should be paid for the period she has been in respite care - so we feel morally it should be paid. BUT, in saying that he is willing to make £102 contribution is Dad commiting himself to anything in the long term do you think? Without Mum's pension and allowances he will find it hard enough to cope financially without having to find £400 a month in addition.

Has anyone else been presented with such a request and are there any consequences of agreeing to it that have caused later problems?

Thanks for any advice or experiences you can share.

Sue

 

[jenniferpa]

I don't know Susan. I would definitely suggest contacting the Alzheimer's Society helpline, because they have people who could probably advise you about the legal specifics - 0845 300 0336.

 

[Margarita]

was admitted to hospital for an emergency operation and we had to find emergency respite care for my Mum. Dad is now out of hospital, but very weak and unable to cope with looking after Mum

Seeing it was all done in an emergency ( respite )I presume they never done a financial assessment on your mother income before she went into respite care home ?

If that is right .

If I was you I would not sigh or pay anything till SS have done the financial assessment on your mother .

My mother had a financial assessment done by social services before she went into respite , so does not pay for the respite care home.

 

[Prague09]

paying for care.

Hi Susan H, my understanding of the sysytem for paying for care is that if the person needing care has savings of less than £30.000 then they are entilled to a finicial assessment, and the person should not be paying any more than they can afford.
The finicial assessment should be from a quilfied member of the local council(FABA).
My understanding is that anyone who is on Pension Credit they shouldnt be paying anything at all.
Did Social services organise the respite care. regards Prague09

 

[Skye]

In the meantime Dad has received a form from the Social Worker asking if he is prepared to pay £102 per week for the respite care.

I'd say that if they are asking if your dad is prepared to pay, they have no right to ask for the money. If they had, they would be making a demand!

I don't think your dad should agree to anything. Maggie's right, your parents should have a full assessement and until that is done they shouldn't pay anything.

 

[Tender Face]

Not sure this is worth anything, Susan ... but when my mum was admitted to an NH for 'emergency' respite because of nursing needs when she herself was first ill recently, the NHS agreed to cover the first six weeks of NH care ...... that she 'used' only 10 days before she was then admitted to hospital ... but on her subsequent discharge from hospital there was no mention of any 'funded' period and the 4 weeks or more she hadn't 'used' previously were obviously 'wiped out' ........ becoming a 'self-funder' from Day 1 after her discharge from hospital .....

Perhaps there is a difference between respite/emergency respite and longer term arrangements? I have given in trying to understand the 'rules', I'm afraid ......

What doesn't surprise me is that social services see fit to present your dad with a dilemma like this at a time he needs to be recuperating himself ......sorry if that is unnecessarily cynical .... but the needs of SSD to see all things financial as paramount is driving me to distraction! Surely your parents' welfare comes first and the money and the paperwork can be sorted out later?

I do hope your dad has the opportunity to 'convalesce' as he needs to after his own experience, and no-one puts any pressure on you all as a family to agree to anything until some equilibrium is restored,

Love, Karen, x

 

[SusanH]

Thank you for all your valued advice. My Mum has not previously had a financial assessment and is receiving pension credits, so I am sure nothing would be payable for full-time care (allowing that pension and allowances will go toward this). I was surprised that my Dad had received this bill - there was no mention of payment when Social Services arranged the place at short notice. I will suggest to my Dad that he does nothing until after the assessment, although he is worrying abou it and wants to get it "sorted". I will also take your advice Jennifer to phone the legal helpline.

I have been reading as much as I can about funding, but it is so complicated and difficult to follow, and I am a qualified accountant saying that!!

Thank you for your kind thoughts for my Dad's recovery. This worry is not helping - Mum is only booked in until July 31st, so Dad is in a bit of a panic. Just what he doesn't need when he is recovering from a major abdominal operation at the age of 73!

Thanks again. I hope Friday's assessment goes ok and is not too upsetting for Dad.

Sue

 

[jenniferpa]

While I don't disagree with what has been said (particularly the "don't pay it" advice and the "if they thought they could get it they'd be demanding it not just asking") I have a recollection that there is something in CRAG (Charging for Residential Accommodation) that allows an LA to make a standard charge for respite if provided to someone who it not supposed to be permanent. I do vaguely remember that there was one poster who had discovered that in their particular London Borough this was done routinely since it meant they didn't have to provide that financial assessment for several months (and my cynical side says that they probably go more money than they would have done otherwise). I'll see if I can find the relevant bit.

 

[jenniferpa]

Right this is the link for CRAG http://www.dh.gov.uk/en/Publication...tions/PublicationsPolicyAndGuidance/DH_073650 (they haven't published the 2008 one yet).

It's section 3 - temporary residents. Essential, it says that for the first 8 weeks of the LA may charge what seems reasonable. (3.005)

 

[SusanH]

Thanks for that link Jennifer. The same document also says that there is a flat allowance for "nursing care" of £101 per week and that double incontinence is classified as requiring nursing care. As my Mum is doubly incontinent then I would have thought that she should qualify for this, so maybe that would help my Dad in this instance.

He has received her pension and Attendance Allowance whilst she has been in respite care, so we don't think it is unreasonable for this to be paid to cover the costs of respite care. We just don't want my Dad to be committed to any payments he couldn't continue in the future.

It's a minefiled! I will speak with the Helpline as you suggest and just see how the discussion falls tomorrow.

Thanks again,

Sue

 

[Margarita]

Thank you for all your valued advice. My Mum has not previously had a financial assessment and is receiving pension credits,

Like Prague09 said , I am sure also as your mother on pension credits, she won't have to pay for her respite. Am sure that help line will clear that up for you .

Also tell your father not to panic , your mother can stay in the respite care home she in as long as they a vacancies, If not social services will have to look for a place where they a vacances .

As that what happen with my mother , I wanted her to stay in a respite care home she was in for good, but there was not a vacancies so SS where going to look for one that had a vacancies.

But I change my mind brought mum back home


Do it now ring SS tell them how your father can't cope & why. because they need warning as if that bed is book up after the July 31st, they won't be a bed for your mother in that care home. so SS have to look around for another place .

Mum is only booked in until July 31st, so Dad is in a bit of a panic.

Hopefully you never know if you don't ask NOW if the bed vacant after the 31st July .

also seeing that your mother on pension credit, all her pension go toward the care fees home she be living in full time, SS top in it with what they legally allowed to.

your mother only keep back £20 a week .

PS



Also other time in 07 mum was in respite care home , while I’ve been abroad, lost my passport .I've rang my SS from abroad and they organized for mum to stay in the respite care home for a week longer as an emergency respite

In 06 they keep my mother in emergency respite for 12 weeks, as I had an emergency at home, my mother did not have to pay any money towards it’s as they class it as emergency respite.

I also did not care if they taken all mum money while in 12 weeks emergency respite, but they said that they would not do that as its an emergency & mum would be coming home .

Then I found out after they told me , that I was still entitled to my 8 weeks respite in that year of 06 , even thought I had taken 12 weeks emergency respite in that year of 06

Then in 07 they allocated me 8 weeks respite a year, also 4 weeks emergency respite , but if they thought I needed more emergancey they do it for me .

 

[SusanH]

Well, our meeting with the Social Worker went very well this morning. She'd been to meet Mum and spoken with the staff at the care home. Her opening gambit was that she would be quite worried if we proposed that Mum should come home, as she clearly required 24 hour professional care. We agreed with her wholeheartedly! This made it easier for my Dad, who didn't need to make a case as to why he couldn't cope - it was evident why not.

To cut a long story short, Mum can stay at the care home, where she seems to be happy and is well-cared for. Her place will be (almost) fully funded, with a small "third-party contribution" to be made directly to the care home. The Social Worker told us to negotiate on this, and the care home staff have been very good and said they would make a case to their accountant for a reduction.

The respite fees are completely separate and have been judged to be covered by Mum's pension and Attendance Allowance, as we suspected. Paying them will not compromise the financial assessment in any way.

So, we all feel mightily relieved that Mum will be allowed to stay where she is, and that they are happy to have her. The Social Worker said everyone thinks it is amazing that my Dad was able to cope for so long (this helped him feel less guilty, I'm sure).

We popped in to see Mum afterwards and shared a nice cup of tea with her. I must say I have been very impressed with the Social Worker since my first panicked call as my Dad was being taken off in the ambulance. So far they have been brilliant and very compassionate. Long may it continue! I told the Social Worker that we were very lucky that a place was available in such a good home that was appropriate to Mum's level of care and she said that actually, she didn't think we were lucky at all in what we had to deal with and that she felt good that she could help. Bless her.

My Dad received a call from the lady who runs the local Alzheimer's support group because she "hadn't seen him around for a while and was worried" and she confirmed that the home is a good one. Wasn't that nice? Dad will pop along to their next meeting to maintain contact.

Thank you for all your help and good advice.

Sue

 

[gigi]

Phew!!!!

Hello Sue,

It's great news....

So good to hear a positive outcome....

Glad that mum is well cared for....

And dad is recovering...

Things do work out....

Keep in touch..

Love gigi xx

 

[Skye]

Hi Sue, that's really good news.

Actually, I've found SS to be very good in an emergency, they seem to pull out all the stops to get things sorted. It's when you're trying to sort out a care package, and asking for ongoing support that there can be difficulties.

I hope you can all have a period of calm now.

Love,

 

[Margarita]

Mum can stay at the care home, where she seems to be happy and is well-cared for.

Now that is Good news , am pleased for you .