From LA funded home care to Self Funding and back again?

[Ohso]

I am hoping for someone with experience of this.

Mum was admitated to hospital last year (June) diagnosed with Alzheimers and discharged home ( she lives alone) with carers coming in 3 times a day ( each visit 30 minutes) to mainly administer medication.
This has slightly increased in what they do, still 30 minutes but now they warm food for her/fill empty dishwasher and leave kitchen tidy.
This care is put in for 6 weeks following discharge and is then reassessed, it was decided to keep it for mum and going forwards perhaps increase it, all good so far.
I have also made arrangements for a friend to call in daily ( weekdays) to sit with mum so she isnt feeling so alone. I work full time and visit every evening and during the day at weekends too.
Mum recently was send financial assessment forms that I completed to the best of my knowledge, mum at that time was over the £23,500 limit but with plans to install a stair lift and possibly a walk in shower this would have fallen under, so mum has been assessed to now fully fund the carers,( back dated to October)
I just presumed that once the alterations had been made and she fell under the £23.500 limit the LA would begin paying and wondered how it would work as some months she would be over and some under and couldn't see how that would all work...I needn't have worried....
In the last month I have registered LPA for both Welfare and Finance and so have access to accounts I was not aware of the balances, it now appears mum will be over the £23.500 level for some time to come so my questions are
As she is now in fact going to be self funding for some time.
1) Can I remove LA carers and select a better/cheaper one and so be able to increase the 3 x 30 minute visits to 3 x 60 minutes?

2) If I do this, what happens eventually when mum falls below the £23,500 threshold, will LA pick up the tab and continue care that is already in place, and indeed increase it, if that is required at that time?

3) How does it work if you go in and out of the threshold every couple of months?

It is also mums wish that she doesn't go into a care home, she has always been terrified of them, now while I realise that this might eventually become necessary I would like to at least try to keep her at home for as long as possible,
4) If she stays in her own home, is there a limit to the care that the LA will pay for ( by then she will be well under the £23.500 threshold I am sure) so could she, for example have live in carer 24/7?
If she moved into my home with me, would they still fund to the same level?

Sorry for all the questions, I have tried looking online and here and have found some great information but cant seem to find the answers here, I would rather have an idea of whats ahead before I try to ask advice from the financial assessment team. I plan on speaking to them anyway as from information on TP I believe that prepaying a funeral plan is a good idea and allowable without being considered deprivation of assets

 

[Prudencecat]

My mum is self funding and is at home. To answer your first question if she is paying for it she can have who ever you want. We chose the carers hours and agency for mum as she is paying we have the hours we think she needs. If Social Services have to pay towards her care they will only pay the County rate and assess what hours they think she needs which may not be as many hours as you think she needs. If her savings are likely to go below £23250 get a financial assessment they look at all of her income and savings so won't be paying the full bill and there is a sliding scale down to the lower savings threshold of £14250. My dad's was done over the phone and they told us how much they would pay towards the care bill.

My mum has over the savings limit and a decent monthly income from occupational pension, state pension and attendance allowance. It might be best to get a care assessment by Social Services so you know how much care they think she needs. A Social Worker said to me that 24/7 care is best delivered in a care home and they look at the costs involved. If it gets to the stage where you think she needs 24/7 care then get a CHC assessment.

We are in the situation where mum really needs 24/7 care we can't get CHC funding so when she goes in to a care home and her savings are exhausted we will have to sell her house. It's very sad we are just taking it one day at a time.

 

[Chrissie B]

I am hoping for someone with experience of this.

Mum was admitated to hospital last year (June) diagnosed with Alzheimers and discharged home ( she lives alone) with carers coming in 3 times a day ( each visit 30 minutes) to mainly administer medication.
This has slightly increased in what they do, still 30 minutes but now they warm food for her/fill empty dishwasher and leave kitchen tidy.
This care is put in for 6 weeks following discharge and is then reassessed, it was decided to keep it for mum and going forwards perhaps increase it, all good so far.
I have also made arrangements for a friend to call in daily ( weekdays) to sit with mum so she isnt feeling so alone. I work full time and visit every evening and during the day at weekends too.
Mum recently was send financial assessment forms that I completed to the best of my knowledge, mum at that time was over the £23,500 limit but with plans to install a stair lift and possibly a walk in shower this would have fallen under, so mum has been assessed to now fully fund the carers,( back dated to October)
I just presumed that once the alterations had been made and she fell under the £23.500 limit the LA would begin paying and wondered how it would work as some months she would be over and some under and couldn't see how that would all work...I needn't have worried....
In the last month I have registered LPA for both Welfare and Finance and so have access to accounts I was not aware of the balances, it now appears mum will be over the £23.500 level for some time to come so my questions are
As she is now in fact going to be self funding for some time.
1) Can I remove LA carers and select a better/cheaper one and so be able to increase the 3 x 30 minute visits to 3 x 60 minutes?

2) If I do this, what happens eventually when mum falls below the £23,500 threshold, will LA pick up the tab and continue care that is already in place, and indeed increase it, if that is required at that time?

3) How does it work if you go in and out of the threshold every couple of months?

It is also mums wish that she doesn't go into a care home, she has always been terrified of them, now while I realise that this might eventually become necessary I would like to at least try to keep her at home for as long as possible,
4) If she stays in her own home, is there a limit to the care that the LA will pay for ( by then she will be well under the £23.500 threshold I am sure) so could she, for example have live in carer 24/7?
If she moved into my home with me, would they still fund to the same level?

Sorry for all the questions, I have tried looking online and here and have found some great information but cant seem to find the answers here, I would rather have an idea of whats ahead before I try to ask advice from the financial assessment team. I plan on speaking to them anyway as from information on TP I believe that prepaying a funeral plan is a good idea and allowable without being considered deprivation of assets

I'm nearly at that stage now. My mum is over the capital threshold, but has some in tied savings I can't get out of until 3rd week in June. I thought that she may be entitled to some help because we can't access the extra money meaning she will appararently have nothing to live on for 3 weeks, but apparently they don't want to give an answer until she is actually on the capital threshold, but I have a little idea on how it works now.

When your mum gets down to the capital threshold the Social Services will probably suggest she goes into a home if she can't manage on their recommended 3 times or so a visit etc.

The capital threshold doesn't mean they take over the payments, they will pay a small proportion of their recommended level of care and your mum is expected to put the rest towards it. If your mum's savings continue to go down, their proportion towards it goes up slightly. When your mum's savings goes down to £10,000 the idea is that they pay what they consider to be reasonable for all the care needed.

If she moves into your house with you, I think that you would eventually be entitled to a carer's allowance if you can't work full time because she is at your home, it comes to somewhat below what you will be able to live on because there is a possibility that you may get some help but it's means tested. You may need to work out if your mum will be comfortable moving to your house, and bear in mind that any adaptation you have made in her house, will then have to be done to your house. Social Services will probably supply small equipment needed even in your house such as rails and a toilet stand to help with her getting up and off the loo for free. I would think very carefully on this move. It sounds lovely, but being close to your mum makes it a lot harder to deal with her when her condition gets worse.

My suggestion at the moment for you would be to legally employ your friend to sit in with your mum if that seems to be working out well, bear in mind one of you will need to pay tax and insurance. Perhaps your friend could administer tablets if she builds up a trust with your mum, warm up food and provide drinking water, none of these things are highly skilled jobs, and you could always pay the council to do the job when your friend is away on holidays and wants time off. You may wish to employ someone to wash and shower your mum, but if your friend is there, it would only need to be for the time it takes to do these things. I've had professional people in from an agency to provide my mum with tablets, and some of them have been unable to persuade her to take them, and some of them couldn't get her into a shower or even wash her down, so just because you employ someone who is professional, it doesn't mean your mum will trust them.
Employ a cleaner if you know one you can trust, again bear in mind that this may involve tax and insurance, it would be easier for you if they are willing to be self-employed and pay their own tax and insurance.

Apply for Attendance Allowance because it is not means tested. If you can persuade them to give you higher rate Attendance Allowance you should then be able to get a full allowance for your mum's council tax on the grounds that she has a mental disability, something that Social Services failed to explain to me last year until they were close to thinking they would have to pay towards my mum's care this year. . Again this is not means tested, but one of the criteria to make it possible was to be on Full Attendance Allowance. You get the council tax benefits form from your local council, bring it to your doctor's to sign that she has been diagnosed with mental incapacity. When I bought mine into the doctor's, the receptionist told me his signature would cost £25, read the form, it clearly states that no money should be charged for this service. The receptionist backed down as soon as I showed her this.

As already pointed out, if your mum is self-funding, you can choose the care-plan, the tricky bit at the moment is to apply for everything you are entitled to, and then work out the finances to see how long it will take to go down to the capital threshold level.

The needs assessment isn't a bad move at all, and they can give you some help towards ideas of where you can get local help from, but they won't help you with your financial assessment, and you need be very careful that they don't sell you something you don't need. As a self-funder, you are under no obligation to follow their advice, and their job is only to give you suggestions.

As I am approaching the battle you may have one day, I will know some of the other answers to your questions, but this is where I have got to so far because even at this stage they don't like to give any answers.

 

[Sirena]

As others have said, if she is self-funding you can choose whatever care agency you like and however many hours you like. My mother was paying for 6 hours of daily care in the end (she's now in a care home). I don't quite understand why your mother would dip over and under the £23k so regularly?

As far as I know, the most SS will fund is 4 x 30 minute care visits a day. I have not heard of anyone having LA funded live-in care, the LA aim to move the person to a care home as it's far cheaper.

My mother wanted to stay at home to the end of her days but there came a point when she was no longer safe, or even happy, in her flat. She was fine when the carers were there, but the other 18 hours a day she was anxious and lonely - and unsafe. She moved to a (self funded) care home a year ago and she loves it.

And yes, buying a funeral plan is a good idea.

 

[Rosettastone57]

I am hoping for someone with experience of this.

Mum was admitated to hospital last year (June) diagnosed with Alzheimers and discharged home ( she lives alone) with carers coming in 3 times a day ( each visit 30 minutes) to mainly administer medication.
This has slightly increased in what they do, still 30 minutes but now they warm food for her/fill empty dishwasher and leave kitchen tidy.
This care is put in for 6 weeks following discharge and is then reassessed, it was decided to keep it for mum and going forwards perhaps increase it, all good so far.
I have also made arrangements for a friend to call in daily ( weekdays) to sit with mum so she isnt feeling so alone. I work full time and visit every evening and during the day at weekends too.
Mum recently was send financial assessment forms that I completed to the best of my knowledge, mum at that time was over the £23,500 limit but with plans to install a stair lift and possibly a walk in shower this would have fallen under, so mum has been assessed to now fully fund the carers,( back dated to October)
I just presumed that once the alterations had been made and she fell under the £23.500 limit the LA would begin paying and wondered how it would work as some months she would be over and some under and couldn't see how that would all work...I needn't have worried....
In the last month I have registered LPA for both Welfare and Finance and so have access to accounts I was not aware of the balances, it now appears mum will be over the £23.500 level for some time to come so my questions are
As she is now in fact going to be self funding for some time.
1) Can I remove LA carers and select a better/cheaper one and so be able to increase the 3 x 30 minute visits to 3 x 60 minutes?

2) If I do this, what happens eventually when mum falls below the £23,500 threshold, will LA pick up the tab and continue care that is already in place, and indeed increase it, if that is required at that time?

3) How does it work if you go in and out of the threshold every couple of months?

It is also mums wish that she doesn't go into a care home, she has always been terrified of them, now while I realise that this might eventually become necessary I would like to at least try to keep her at home for as long as possible,
4) If she stays in her own home, is there a limit to the care that the LA will pay for ( by then she will be well under the £23.500 threshold I am sure) so could she, for example have live in carer 24/7?
If she moved into my home with me, would they still fund to the same level?

Sorry for all the questions, I have tried looking online and here and have found some great information but cant seem to find the answers here, I would rather have an idea of whats ahead before I try to ask advice from the financial assessment team. I plan on speaking to them anyway as from information on TP I believe that prepaying a funeral plan is a good idea and allowable without being considered deprivation of assets

In my mother-in-law area,social services will not fund live in carers. It's just too expensive. Council tax is exempt even with the lower rate of attendance allowance, as my mother-in-law lived on her own and was classed as severe mental impairment. My mother-in-law was self funding but even with 3 carer visits, to be frank, she just wasn't safe when the carers weren't there. After she went into hospital, after a crisis we moved into a care home. It got to the point where my husband and I were just managing one crisis after another. The care home move was the best thing for all of us

 

[Beate]

I'm nearly at that stage now. My mum is over the capital threshold, but has some in tied savings I can't get out of until 3rd week in June. I thought that she may be entitled to some help because we can't access the extra money meaning she will appararently have nothing to live on for 3 weeks, but apparently they don't want to give an answer until she is actually on the capital threshold, but I have a little idea on how it works now.

When your mum gets down to the capital threshold the Social Services will probably suggest she goes into a home if she can't manage on their recommended 3 times or so a visit etc.

The capital threshold doesn't mean they take over the payments, they will pay a small proportion of their recommended level of care and your mum is expected to put the rest towards it. If your mum's savings continue to go down, their proportion towards it goes up slightly. When your mum's savings goes down to £10,000 the idea is that they pay what they consider to be reasonable for all the care needed.

If she moves into your house with you, I think that you would eventually be entitled to a carer's allowance if you can't work full time because she is at your home, it comes to somewhat below what you will be able to live on because there is a possibility that you may get some help but it's means tested. You may need to work out if your mum will be comfortable moving to your house, and bear in mind that any adaptation you have made in her house, will then have to be done to your house. Social Services will probably supply small equipment needed even in your house such as rails and a toilet stand to help with her getting up and off the loo for free. I would think very carefully on this move. It sounds lovely, but being close to your mum makes it a lot harder to deal with her when her condition gets worse.

My suggestion at the moment for you would be to legally employ your friend to sit in with your mum if that seems to be working out well, bear in mind one of you will need to pay tax and insurance. Perhaps your friend could administer tablets if she builds up a trust with your mum, warm up food and provide drinking water, none of these things are highly skilled jobs, and you could always pay the council to do the job when your friend is away on holidays and wants time off. You may wish to employ someone to wash and shower your mum, but if your friend is there, it would only need to be for the time it takes to do these things. I've had professional people in from an agency to provide my mum with tablets, and some of them have been unable to persuade her to take them, and some of them couldn't get her into a shower or even wash her down, so just because you employ someone who is professional, it doesn't mean your mum will trust them.
Employ a cleaner if you know one you can trust, again bear in mind that this may involve tax and insurance, it would be easier for you if they are willing to be self-employed and pay their own tax and insurance.

Apply for Attendance Allowance because it is not means tested. If you can persuade them to give you higher rate Attendance Allowance you should then be able to get a full allowance for your mum's council tax on the grounds that she has a mental disability, something that Social Services failed to explain to me last year until they were close to thinking they would have to pay towards my mum's care this year. . Again this is not means tested, but one of the criteria to make it possible was to be on Full Attendance Allowance. You get the council tax benefits form from your local council, bring it to your doctor's to sign that she has been diagnosed with mental incapacity. When I bought mine into the doctor's, the receptionist told me his signature would cost £25, read the form, it clearly states that no money should be charged for this service. The receptionist backed down as soon as I showed her this.

As already pointed out, if your mum is self-funding, you can choose the care-plan, the tricky bit at the moment is to apply for everything you are entitled to, and then work out the finances to see how long it will take to go down to the capital threshold level.

The needs assessment isn't a bad move at all, and they can give you some help towards ideas of where you can get local help from, but they won't help you with your financial assessment, and you need be very careful that they don't sell you something you don't need. As a self-funder, you are under no obligation to follow their advice, and their job is only to give you suggestions.

As I am approaching the battle you may have one day, I will know some of the other answers to your questions, but this is where I have got to so far because even at this stage they don't like to give any answers.

The info about Attendance Allowance is slightly incorrect in that it really doesn't matter which rate you are on - you get the SMI disregard on both of them.

 

[charlie10]

sorry just tagging onto this conversation....am I right thinking that Attendance Allowance does not require an official dementia diagnosis, but the Rates disregard needs AA AND the diagnosis? Thank you.....every time I think I've got I start to doubt myself!

 

[Louise7]

Attendance Allowance does not require a dementia diagnosis. When you say 'rates disregard' do you mean council tax exemption/reduction due to severe mental impairment? If so, here is the criteria:

Who is eligible for the severe mental impairment discount?
Both of the following must apply for someone to qualify for a severe mental impairment (SMI) council tax discount:

• They've been medically certified as being severely mentally impaired. For example, this may be the case if they have dementia, Parkinson's, severe learning difficulties or have had a stroke. It will depend on each individual’s case though and simply having been diagnosed doesn’t automatically mean they qualify - a doctor must also certify they are severely mentally impaired.
  
  
• They're eligible for (but NOT necessarily actually receiving) at least one of the following benefits:
  
  • Incapacity benefit
  • Attendance allowance
  • Severe disablement allowance
  • Disability living allowance (higher or middle-rate care component)
  • Increase in disablement pension (due to constant attendance being needed)
  • Unemployment supplement or allowance
  • Constant attendance allowance
  • Income support (which includes a disability premium)
  • Personal independence payment (standard or enhanced daily living component)
  • Armed forces independence payment
    
    In England and Wales you can also be eligible for:
    
  • Disability working allowance (based on getting income support including disability premium)
  • Universal credit (including an element for limited capability for work or limited capability for work and work-related activity)
    
    In Scotland you can also be eligible for:
    
  • Tax credits (including disability element)
  • Employment and support allowance
  • Universal credit

 

[charlie10]

Louise....thank you for the info, FiL is resistant to applying for any allowance he may be eligible for but we will keep trying and if we can get him to agree to LPA it will make things a lot easier to claim on his behalf. Looks like the rates exemption may have a long wait tho....can't get him to see GP for anything at all, let alone a referral for memory testing, so that will be on the back burner I shall tuck it away on my 'to do' list for the future

 

[Ohso]

Thank you all for the information. I will certainly look into it further, I feel like I am always playing catchup and just when I think it is going to run smoothly for a while things change, ever so slightly, but just enough to send me right back here reading everyone else experiences, so thank you to all who share x