Cross border placement....No written confirmation

[Exning]

Hi. My saga of moving MIL continues. Been a linear approach with each step having to be concluded before they start the next.
Have been asking from start of process for a list of the steps involved without success. Last week told we could arrange move and that file from SW passed to contracts.
Have no written confirmation of anything. The trail is really my e mails asking questions,giving information etc.
The home are waiting for MIL but have confirmed that apart from telephone contact with SW and hospital they have no better information.
I am told that contracts will be told on Wednesday that MIL moved and that the personal care payment will be set off cost.( Scottish resident going to English home)
MIL Will be self funding but wanted arrangements done by Nhs Sotland to ensure backstop when money runs out and to benefit from Personal Care payment
Just having to take all.on trust.
Becoming a bit anxious that it's all going to go pear shape. Or is the way all transfers take place?

 

[Grannie G]

Sorry I cannot help but I do wish agencies would make procedures clear.

The Helpline may have something better to offer.

National Dementia Helpline

0300 222 11 22


Helpline opening hours:

Monday to Wednesday

9am – 8pm

Thursday and Friday

9am – 5pm

Saturday and Sunday

10am – 4pm

 

[Exning]

The saga continues. MIL been resident now for 4 weeks and we still have nothing in writing confirming the arrangements for payment.
Home has now asked me, as Attorney, to sign contract.
I have now started an official complaint as can not get any answers to 3 simple questions.
Is the contract between NHS Scotland and the care home?
Has the payment of the Personal Care allowance been confirmed to offset part of the fees?
Is the payment by my MIL to be paid to NHS Scotland?
I know that the payment of the Personal Care allowance is dependent on the arrangements being made by Social Workers of NHS Scotland. But....Home demanding me to sign contract, for full amount makes me concerned something has gone very wrong.
I simply can't get answers from the people involved hence the formal complaint being made.
Have horrid feeling I know more about this than the people who should ha e been helping,advising and facilitating the move.
I know the bill is now £7000, not an inconsiderable amount, and is going up £866 per week.
I despair at the lack of transparency in explaining what is going on.

 

[Kevinl]

I don't know how it works but the English equivalent of the Personal Care Allowance (PCA) used in Scotland is Funded Nursing Care (FNC) and it's not offset against the care home fees.
FNC is used to pay for nursing care over and above what any normal care home would provide and is only available to people in a designated nursing home not just a care home.
My wife gets FNC (which is £155 in England, Scottish PCA is £174) but if she didn't I'd have to make up the difference. In England FNC is awarded on medical needs so a self funder can get FNC you don't have to wait for the LA to start funding, if you pass the criteria then you can get FNC from day one, so it might be the same in Scotland or it might not but if PCA is means tested then you might be better off applying for FNC right now as it's not means tested.
In short keeping her as a Scottish resident in an English home and funded via Scottish rules may not be the best move, if, as I say PCA is means tested and you have to wait to pass a means test when you could be getting non means tested FNC from the start.
K

 

[Katrine]

Whoa! Hold your horses! I don't think the PCA is at all equivalent. See below:
"Free personal care is available for everyone aged 65 and over in Scotland who have been assessed by the local authority as needing it. Free nursing care is available for people of any age who have been assessed as requiring nursing care services."
https://www2.gov.scot/Topics/Health.../Adult-Social-Care/Free-Personal-Nursing-Care

I think the OP is right to be holding out for clarity on who is paying what, and to whom, and not signing anything that might let the Scottish authorities claim that MIL has been transferred off their books so they are no longer required to fund her personal care element of the CH's fees.

 

[jugglingmum]

I agree with Katrine, PCA and FNC are different.

My understanding is that PCA is not means tested and can move with the person if they move from Scotland to England.

It is worrying that there are these issues as at some stage I anticipate we might have to transfer MIL to England, but not anywhere near it at the moment. She is 91 and at that age things can change very rapidly.

 

[Kevinl]

Whoa! Hold your horses! I don't think the PCA is at all equivalent.

So what's the difference? People in England don't get PCA people in Scotland don't get FNC, the rules in both countries do differ but basically they are a benefit which may be paid in the circumstances Exing describes, in other circumstances they may not be the same but in these circumstances I think they are.
Possibly you could suggest a closer benefit to PCA in England...,or maybe just there isn't one.
My point is that staying under the Scottish system and waiting to see if a benefit is given in the future as opposed to claiming an English benefit not might want looking into. I don't know which is the best idea, I'm just putting the question out there for the OP to consider.
K

 

[jugglingmum]

My understanding is there isn't the equivalent in England, all personal care in Scotland whether at home, or in a care home (of whatever sort). So much of the home care that is provided in England is free in Scotland.

My understanding is if you are awarded personal care in Scotland and subsequently move to England that moves with you, but it does need to have been awarded before the move.

 

[Katrine]

In Scotland a person may be assessed as being eligible for a nursing care payment in addition to their funded personal care. They will, however, lose their eligibility for Attendance Allowance if they move into residential care. The Care Information Scotland website gives a summary of personal and nursing care in care homes: http://careinfoscotland.scot/topics...fees/personal-and-nursing-care-in-care-homes/

I think the OP knows all this already. MIL is currently entitled to the more generous Scottish state benefits but can't move to England until the contractual obligations have been agreed in writing.
As we know, a verbal agreement is not worth the paper it's written on.

 

[Exning]

By badgering the home to give me any information they receive it now appears that NHS Scotland have just today sent a Route 2 contract to the home in order to pay £174 per week. This means that I have to enter into a separate contract for the balance.
This is different to what I was led to believe and means I have no safeguard of a backstop when money runs out and have a totally different relationship with home.
I imagine at some point I will be told what the responsibilities are. Do the Social Workers in Scotland still supervise,as I was told, or do the local SW step in as the main contract is made in England.
I always knew the fees would be a fortune but always believed, clearly naively, that by utilising the guidance of NHS Scotland I would be get an arrangement as good as it could be.
It will be interesting how they deal with complaint.
My wife is convinced they will in effect blame me for being too helpful. By providing all the information they needed quickly and by sorting out the problems that existed they didn't think they needed to engage.
The fact that I asked specific questions and sought advice being irrelevant if the process was ticking along the Route they expected.
If I had insisted on the answers before I provided the information/help then no doubt they would have been more forthcoming. But it would inevitably have resulted in significant delays in getting MIL out of hospital to home.
We will see.

 

[Kevinl]

It's difficult to get any straight answers as Scotland and England use different laws and some like the English 2014 Care Act (which came into force in April 2015) are relatively new and social workers don't always know what the official line is, some still quote the old regulations to me. The principle is that when someone goes into care they are, and remain the responsibility of the authority where they were normally resident when they went into care.
But the The Statutory Guidance Notes to the 2014 Care Act (in England) seem to contradict that and say:
"People who arrange and fund their own care
19.74 People who self-fund and arrange their own care (self funders) and who choose to move to another area and then find that their funds have depleted can apply to the local authority area that they have moved to in order to have their needs assessed. If it is decided that they have eligible needs for care and support, the person’s ordinary residence will be in the place where they moved to and not the first authority (for further information on self-funders, see annex H4, paras. 21-23"
(link below) And down there in Annex H
it goes on to say@
"People who have sufficient funds to pay for their own care and accommodation
21) When a person moves into permanent accommodation in a new local authority area under private arrangements, and is paying for their own care, they usually acquire an ordinary residence in this new area"
This is the law within England how the relationship between England and Scotland works I don't know but it appears to me from the notes that if you move as a self funder then you can become s resident of that area by virtue of having funded your care there, conversely you could say that the PCA is funding, in England FNC is an NHS funding not an LA funding.
Is PCA a Scottish government funding or an LA funding, it's a minefield of who could try to pass the book to someone else not helped that it's covered by 2 different countries using different laws and different funding methods.
It may be worth having a read through the links (with a big drink in your hand) and see what you think.
K

https://www.gov.uk/government/publi...inter-local-authority-and-cross-border-issues

https://www.gov.uk/government/publi...ce/care-and-support-statutory-guidance#AnnexH

 

[Exning]

Thanks. Have already seen this and realise there is a lack of awareness. I queried whether the process for cross country placements had been carried out in a accordance with schedule 1 of the 2014 Care Act to be asked what it was. Great for building confidence.
Real problem is you think you know what is going on and the reality turns out to be different.
We will see how it pans out. Being realistic and pragmatic the important thing was always to get MIL into care home. Other things really annoying but not as important. We will see

 

[Kevinl]

Thanks. Have already seen this and realise there is a lack of awareness. I queried whether the process for cross country placements had been carried out in a accordance with schedule 1 of the 2014 Care Act to be asked what it was. Great for building confidence

But the 2014 Care Act doesn't apply in Scotland so there's no need for social workers in Scotland to be aware or know about the laws in a different country albeit we're (currently) still part of the UK and for now part of the EC.
Scotland and England are different countries legally and I might as well ask a social worker about the laws in France (that being the next country down from England), could I expect social services to know about the French Civil Code laws that make children responsible for the care of both their parents and their antecedents under article 205 of the French Civil Code and expect a straight answer?
Under the French legal code, as a daughter in law you can be held legally liable for the care costs for you late (should you become a widow) husband's parents and if it come to it grandparents as well as your own and that liability will pass onto your own children.
Scotland and England share a land border, France is 22 miles away over some water, but all legally they can be miles apart and who knows before your MIL applies for state funding Scotland may have become independent, what happens then?
Something inside makes me think that keeping the Scottish connection for the extra £20pw that PCA gets you rather than English FNC would bring in might some round and bite you on the bum in the future when/if the two countries dispute who's paying the bills and if you do sign the contract then it's all down to you if you do sign you're the guarantor.
K

 

[Exning]

2014 Act does apply in Scotland in relation to cross border placements. Schedule 1 specfically has applicability.
MIL should retain residency in Scotland for purposes of care and NHS Scotland retain responsibility.
Personal Care Payment is non means tested and has 2 levels £174 lower level and £79 extra if you need nursing care. Not really the same as FNC