Third Party Top Up

[gemini]

Hi Everyone

I haven't posted for well over a year but I wanted to let off a bit of steam.

Mum in Law was admitted to a care home in January. She's self funding and we are in the process of selling her home to pay for her care which is bad enough. But then we found that we are expected to contribute £10 per week out of our own pocket towards the cost!!!

The first we heard the phrase 'Third Party Top Up' was last week when the care home phoned to say that they weren't being paid by Social Services as a form needed filling in! Turned out it was a contract between my husband and Nottinghamshire County Council, which would legally obligate him to pay £10 every week.

We knew absolutley nothing about this. It had never been discussed with us or agreed to by us. I phoned the Social Worker dealing with Mum's case and was told that if my husband did not sign the form then she would have no choice but to contact the court of protection to get our power of attourney revoked on the grounds that we are not acting in Mum's best interests.!

I'm utterly disgusted! How can they bully people like this? We are simply not in a finacial position to agree to this. Even if we were it's the principle of the issue. She's paid her NI contibutions all her life and has still got to sell her home. But Notts CC still want £10 from us! Mum can afford to pay this herself with no problems what so ever. She is very well provided for! It doesn't make sense!

The Welfare Rights consultant I spoke to told me that she hears a lot of people complaining that they felt bullied into signing these contracts. DONT BE ONE OF THEM!!! DON'T SIGN ANYTHING YOUR UNSURE ABOUT! DONT GET CAUGHT OUT!!

Best Regards
Gemini

 

[JPG1]

Hi Gemini

You are being given a lot of nonsense to deal with.

My first step would always be to ask SW or whoever to put it in writing to you ASAP, with full reasons.

Chances are they will suddenly "sort the problem" by magic.

 

[DianeB]

Well to be honest anything to do with Nottm ( thats our area too) you don't surprise me what so ever. My Mum got awarded the nursing care componet £103 a week to be funded when she went into a nursing home, only for them to loose all paper work, we have appealed but they would only back date it to mid Dec not beginning of Sept when Mum first went into a home, so Dad had to fork out a fortune for what she was entilted to and can't even claim those 15 weeks back at £103.

 

[Canadian Joanne]

only for them to loose all paper work, we have appealed but they would only back date it to mid Dec not beginning of Sept when Mum first went into a home, so Dad had to fork out a fortune for what she was entilted to

Which goes to show we should always get copies of all paperwork. I have had to send my mother's insurance company copies of my PoA 4 times in 8 years. I have now refused to send any more copies. One division of the insurance company has the PoA on file, it's the other division now that needs it. I put on my cranky voice, read out what my fax from March 2008 said (I tediously detailed everything from the previous 7 years) and told them to call the other division & get a copy, as the fact they kept losing the PoA was inefficient and didn't inspire me with any confidence.

People should be sacked for incompetence. Or at the very least, drawn and quartered .

 

[jenniferpa]

Gemini - that's more than a little bizarre. Is she in that 12 week disregard stage? I assume she must be as you say social services are supposed to be paying for her at the moment even though she's "self-funded".

CRAG says

6.006A When a resident who is subject to the 12-weeks property disregard tops-up from capital
resources between the lower and upper capital limits, the level of tariff income that applies during
those 12 weeks of topping-up is the same as it would be if the person were not using capital to
top-up. (See 8.019B)


8.019A Except in circumstances set out in 8.019B, a resident cannot use their own resources to pay for
more expensive accommodation, ie act as their own third party.

8.019B From 1 October 2001, a resident may top-up from his own resources as listed below only if they
and the LA have made a deferred payments agreement or the resident is subject to the 12-
weeks property disregard.

Residents subject to the 12-weeks property disregard may top-up from :
• Earnings disregarded by CRAG.
• Income disregarded by CRAG.
• Capital disregarded by CRAG (with the exception of the value of the resident’s home
that is subject to the 12-weeks property disregard).
• Other capital resources, excluding their home, with the provisos that :
• people can only top-up to the value of the lower capital limit;
• where these resources are used to top-up by residents who have resources above the
lower capital limit, the level of tariff income that applies during those 12 weeks of
topping-up is the same as it would be if the person were not using capital to top-up.

Residents who have a deferred payments agreement may top-up from :
• Earnings disregarded by CRAG.
• Income disregarded by CRAG.
• Capital disregarded by CRAG.
• Other capital resources, including the value of the property that is subject to the
deferred payments agreement, with the proviso that the resident must be left with total
capital resources under the means-test to the value of the lower capital limit. (When the
value of the property is used as “collateral” for top-ups. the amount of the top-up is
added to the resident’s deferred contributions, and is eventually repaid when the home
is sold.)


This is the example they give

A resident who has accessed the 12-weeks property disregard has a house valued at £50,000,
other capital resources worth £14,000, and income of £150. He chooses to enter a residential
care home where the actual cost is £600, while the council’s usual cost for someone with his
assessed need is £300. The council agrees to the placement, and the resident contributes
income of £150 minus the personal expenses allowance, plus a tariff income of £6 per week to
the costs of care. The council makes up the difference between its usual cost and the income
contributed by the resident. The resident agrees to make a top-up of £300 (the difference
between the actual cost and the council’s usual cost). This reduces the resident’s capital
resources (excluding the value of the home) by £3,600 over the 12 weeks. Despite the fact that
the resident’s capital resources fall because of the topping-up, the tariff income remains at the
level of £6 per week.


How was she placed? By you or by social services? I feel very strongly that if you haven't agreed to this contract then you are not a party to it. Incidentally - I very much doubt that this "we'll get your Power of Attorney revoked" is anything other than an empty threat from someone who, I suspect, has dropped the ball (she was probably supposed to get this signed in advance). I would definitely complain to your LA about being threatened in the way - their website should outline the formal procedures.

 

[Sandy]

Hi gemini,

I am a bit confused by the sequence of events in your post. Usually the term "third party top-up" is only used when social services is funding, but you say your MIL is self-funding. Does this just relate to the 12-week property disregard period and/or until your MIL's house is sold?

By the way, the £10 in question would be paid to the care home not to social services. Could you negotiate with the care home to drop the fee by £10 a week until your MIL is self-funding?

I agree that you shouldn't sign anything until you are happy that all avenues have been explored. Threatening COP seems very extreme and not even relevant really - since the top-up they are asking for relates to your personal funds not the assets that you are managing for your MIL.

Take care,

Sandy

 

[gemini]

Thank you for all your responses!

To ellaborate further. Mum is currently in the 12 week disregard period. As we understand it, Social Services pay the care home fees outright during this period, afterwhich Mum's 'Estate' is expected to re-emburse them. If her house is sold then we use the cash in the bank (so to speak) other wise the fees are acruing until such time when her house does sell and we then 'Settle up'.

According to the Welfare Rights Rep whom I spoke to this morning, Mum can be her own third party and pay the additional £10 only for the 12 week disregard period. After this the additional cost would fall to another 'third party' - us it would seem! The contract is in force for the entire duration of Mum's care home stay and can go up in the future.

I agree that the Social worker has messed up. According to Notts CC own guidelines, this should have been agreed at the time of her admission.... and it wasn't! So the SW has been very under hand in sending the contract direct to the care home to get them to do her dirty work! Presumably she was hoping my husband would feel put on the spot and sign without reading it through! The care home are baffled as to why they have been asked to sort this out. The SW told them 2 copies have already been signed but have gotten lost (NOT TRUE - NONE HAVE EVER BEEN SIGNED!) so could they get this third one signed when hubby visits!!!

The whole issue seems bizarre because of the small amount in question. But we made a point of asking the SW which homes had fees in line with Social Services payments in case her funding runs out. We didn't want to have to move her to a cheaper home in the later stages of her illness as we couldn't afford to offer any financial assistance.

Regards Gemini

 

[MarkEdge]

NHC Continuing Care

Hi gemini

Was your Mum admitted to the nursing home from hospital? Did the NHS carry out a Continuing Care assessment on her?

Mark

 

[MarkEdge]

... sorry - title should be NHS Continuing Care (oops)

 

[Softy]

Hi Gemini

I cant help with the rights and wrongs here as my Dad was fully funded under continious care. I just felt that I had to write and say that you are being treated disgustingly as if moving a parent into care isnt hard enough now you are being bullied and made to feel guilty because you carnt pay a contribition. When did children become responsible for their parents fees in this country. I would stick to my guns and call their bluff, if you think the SW is not being truthfull refer to her superior. Good luck xx

 

[jenniferpa]

According to the Welfare Rights Rep whom I spoke to this morning, Mum can be her own third party and pay the additional £10 only for the 12 week disregard period. After this the additional cost would fall to another 'third party' - us it would seem! The contract is in force for the entire duration of Mum's care home stay and can go up in the future.

I think that's half right but half wrong: yes she can be her own 3rd party for that 12 week disregard period (as per CRAG), but I have seen noting to suggest that she can't continue being her 3rd party while the deferred payment scheme is going on. In fact the bit I copied above says that. After that, of course, she's self-funded so in that sense, 3rd party tops-ups don't apply.

I've just read what I copied from CRAG above and provided she has adequate liquid funds so that payment of this £10 would not reduce her to the lower capital limit then she can pay this herself.

Don't be bullied (not that I think you're about to be). More and more is sounds like an inept social worker trying to cover her own tracks, and threatening you into the bargain. Makes my blood boil.

 

[gemini]

Hi again

Mum was taken to a special unit in the QMC hospital just before Xmas as she became so agressive that the homecare group that were calling 3 times a day, understandibly refused to continue. She was there for about 6 weeks. During this time we didn't see a single doctor or consultant, we were given no information about her condition what so ever. Eventually the hospital appointed SW, called my husband to a meeting where she stated that mum could not return home and insisted that my husband put her in a care home!

She sent him away with a brochure of carehomes, and a booklet of guidelines. (Is was at this meeting that my husband told her to only point him in the direction of carehomes compatible with SS Funding!) That was the last time he saw the SW. He phoned her the next day and instructed her that he found a suitable home and the SW made all the arrangements and that was that. Mum moved in 3 days later!

It may sound ludricous but we dont know what the NHS did! We simply weren't told anything which in itself has been very upsetting. This whole procedure has been taken completley out of our hands. We felt as if we were on a runaway train driven by madmen, and yet, when the issue of finances are raised..... suddenly they want us in the driving seat!

Gemini

 

[ella24]

Hi Gemini

we're currenlty in a 12 week disregard with my gran, and then she will be on deferred payments until the house is sold, when she will self fund.

For gran to be placed in the CH a number of contracts had to be signed between the Local Authority(LA) as follows

LA with care home to pay full amount
LA with service user (gran) for her payment from her state pension (done via POA)
LA with top-up payer for top-up figure

I know it vaires from region as to how it is administered but if you or your husband havent entered into any contracts then I don't beleive you will be liable, even if you agreed to a home, as the finances and contracts have to be set up.

Hope this helps a bit

e

 

[Snip]

I'm watching this thread with interest.

As well as dealing with my mum and her AD I am the only family member willing to help get my 93 year old auntie into care. The SW keeps making odd references about a third party top up to me. The figure she is quoting is.....£60 a week!!!!!

I love my auntie, but sorry - I've got enough on my plate with my own mum. I am not having anything to do with being a third party topper upper!! (They already see me as the relative with 'sucker' written on her forehead )

Snip (feeling very ) LOL

 

[jenniferpa]

Good grief Snip no wonder you feel . Fruit and nut chocolate can only take the edge off so much. If the LA can't find a suitable residential placement for your aunt at the rate that they normally pay, then they'll have to pay more, because those are the rules. I think this is going to come up more and more: with everyone belt-tightening (particularly LAs) they are going to try and hold down the amount they "normally" pay even if it becomes completely unrealistic. Call me mrs cynical but it wouldn't shock me if in some circumstances they have an unspoken agreement that they will cave on this (because they can always say "oh this person needs more care") if pushed, knowing that a lot of people will hand over the cash without arguing.

 

[Skye]

Snip, that is absolutely ridiculous!

You have your mum to care for, no way can you fund a £60 p/w top up for your aunt, and there is absolutely no reason why you should.

It's emotional blackmail even to ask you.

Stand firm, it is SS responsibility to find and fund a suitable placement -- and not necessarily the cheapest!

 

[Jase]

Hi Gemini

I feel so frustrated and angry for you!!
I work in hopsital based social work and there should have been more involvement than your obviously had. We all work differently but within similar limits. Generally the medics are the people who indicate that 24 hr care may be required, the SW will then look at the risks and request a nursing report to be completed which includes the continuing care checklist. Family at this point should be made aware by the consultant that it is felt that their relative is not safe to be maintained at home and why. The SW should then meet with family to gather information and explain the assessment process. Once this info is all put together it goes to a panel (joint SS and NHS) to determine where someone should be placed (their status). Family then get a list of suitable homes to look at.
Re funding issues SS have to advise re top up fees. If someone is self funding they should still be made aware that they ought to check the home does LA rates and whether or not a top up is charged. This is so if money runs out family are aware that they would have to pick up the top up or move their relative to somewhere without a top up.
Top up fees can be negotiable with some homes- it is worth a try.
Sorry if I've told you what should have happened rather than helped with what did. Hopefully it will open others eyes to the process though.

Continue as you are but if you have no luck I would ask for access to your mum's records. These would show when the other copies were apparently sent out and signed???? When documents are sent out there should be a record kept- independent from the SW's documentation, to prove this. Conversations with yourself and the care home should also be recorded, it might shed a little light or prove things either way.

Good Luck
K x

 

[gemini]

Thank you so much for all your comments, as always your input has been a great help.

I said from the start that I only wanted to let off steam..... but I also REALLY wanted to alert anyone that is in this early stage of finding a Care Home that they need to be aware of the implications of 'third party top ups'. I don't REALLY know how they work! It's never been discussed or explained to us! .... and thats my point .... thats why I'm so angry with Social Services. All we've got is a booklet that doesn't answer all the questions.

The council are forever patting themselves on the back and telling us how politically correct and fair they are, equal opportunities and all that... We were requested in a recent letter not to smoke in our own home for at least an hour before one of the finance officers visits in order to protect their workers.. fair enough i dont smoke myself BUT this paints a very misleading picture of the council's attitude to 'fairness'. Who is protecting us? Who is watching out for us? What redress would there be for us if my husband had signed the form (ACM/23) and later found out that he was mislead or mis-informed. It is after all a legal and binding document. What if he lost his job a few weeks later, broke a leg, couldn't work etc etc.. The opportunity to ask these very real questions was never given to us!

I think Snip has just proved a case in point. His SW has made references to Third party payments, but has it been explained thouroughly? At what point would he have been made aware of his legal obligations? Before or after he'd signed?

During my phone call with 'Our' SW this morning, she actually told me that I was mistaken! She told me that my husband would be able to 'sort of' claim the top up's back from his mother... sort of!!! I then pointed out that according to the Notts CC's own guidelines, this is not correct. I told her the page number I was reading from.... it went very quiet her end of the phone!

I would be really interested if Ella could advise how the subject was raised by her SW. Is it just our incompetant SW or is this a bigger issue?

Best Regards
Gemini

 

[JPG1]

Hi again, Gemini

This is a link that I've posted before somewhere, and I think Jennifer has posted it too a couple of times:

http://www.thisismoney.co.uk/retirement/article.html?in_article_id=419136&in_page_id=6

It may be dated 2007, but the basic principle still applies, because the law has not changed. Merely the way it is being misinterpreted and misunderstood and wrongly applied in many instances, as I know from personal experience. It's not easy to argue the toss with SW and CH managers, but ... it is possible.

Important bit is:

"Care fees expert Philip Spiers says: 'At the traumatic time of placing a relative in a care home, families find they are coerced into paying top-ups to obtain the care that's needed. Care homes do not always make clear that although the contract is with the local authority, they still require a top-up payment which in many cases may not be legal. Many local authorities routinely expect families to make top-ups. This clearly contravenes the guidance under which local authorities should operate.'"

There's more to it all than just the demands placed onto the shoulders of family and relatives, but it is not something that anyone should accept or be asked to accept.

I'll try to find the other relevant links tomorrow, unless someone else has come up with them by then.

Good luck,

 

[ChrisH]

I'm reading this thread with interest too as I moved my mum to a CH near me nearly 3 weeks ago. I'm having to pay the top up for the difference between Worcs. contract rate and Devon's. But I'm also going to have to pay an additional £20 per week when the home put their fees up next month. It's going to be a real struggle as I'm on Tax Credits myself because of a low income and my eldest son is due to go to uni this year. I was told I'll be able to claim this back from mum's capital, so long as it doesn't exceed the £22,250 savings limit, once her home has been sold as she will then become self-funding. However, I don't think I'm going to be in any rush to sell her place (not that it will sell quickly anyway) as they haven't been able to put a legal charge on it to claw back their funding once it is sold as it's a mobile home and doesn't count as 'property' because she doesn't own the land it stands on.

I hope you get your situation sorted Gemini. Don't let the b.....s bully you. Maybe your MP or the local press would be interested in the case, especially as you seem to have been so misled. Mum's SW did explain the top-up thing to me but to be honest I'm not sure I fully understood everything at the time, and still don't, but was simply so relieved that they were going to allow her to move. I could have been given 2 options within the contract price in Devon but they could have been anywhere in the county and I'd have been no better off with all the travelling. Now she's a 10 min walk away.

Chris