Private versus Council run homes

[Saffie]

I have just read an article that states that Local authority run homes give a better standard of care than privately run ones. I had thought that the opposite was true - thinking of private schools, clubs etc. and assuming that as they are soooo expensive, they must of course be better. Does anyone know anything about this? My husband's social worker has intimated this to me - said they are inspected more often etc but I wasn't convinced. She has suggested an LA home for my husband as, although I can pay top-up fees for a time (and even those are horrific around here) - once his meagre capital is depleted, paying fully-and SS come in, I am worried that he may be moved when I am no longer able to do so. Any help would be greatly appreciated as I am at the moment having to find a home a.s.a.p. as hospital want to discharge him. I can't blame them - he has been in this one for 3 months - and the general one for another 3 before that.

 

[Helen33]

Morning Saffie,

I was very surprised to discover that a council run care home fairly local to me was excellent. I felt quite ashamed that I thought that nothing good would be provided by the council especially in the area that it was I had occasion to meet with the Manageress and staff and chose to send my husband there albeit under unsual circumstances. They allowed my husband to use one of their day rooms with his own Crossroads sitters for several hours a day. As I was responsible for picking him up at all times of the day and evening I have to admit that I was always impressed by how the staff were with the residents.

Another Talking Point member, Sadnell, also used a council run care home for respite for her husband and she always stated that it was excellent. I do believe though that she had a few issues with them towards the middle/end of last year but that may have been due to cutbacks (I am not sure about that).

Sadly, I understand these are in the process of being sold off

I will look forward to hearing what you decide and how things work out.

Love

 

[Skye]

Hi Saffie

I have no way of comparing, there are no longer ant LA run homes here, and my husband was in a private one, owned by a large chain. It was excellent, and was regularly inspected by the group management and by the LA, who had contracts with them.

Many of the residents were LA-funded, but I don't know if there were top-up fees, I suspect not, as several residents had no family.

I'd suggest you have ask you SW to put you in touch with someone from the finance department, who could clarify the situation, as this is likely to vary from area to area.

You local AS or Carers' Centre might also be able to help you.

Please let us know if you have any information, as many members are affected by cuts.

 

[BeckyJan]

an article that states that Local authority run homes give a better standard of care than privately run ones

I think this is a sweeping statement as each Home depends on the Management and level of carers. My husband is in a private one run by a large chain. Some residents there are funded by the LA and AFAIK each room is charged at the same rate. It is excellent and my husband is well cared for.

If he needed a LA place it would be out of our area and virtually impossible to get there via public transport.

 

[Saffie]

Thank you all for your comments. I hadn't thought about cuts affecting council home and yes, I guess they could close. A private nursing home very close to me, belonging to a well-known company(and charging £1000 a week), was my first choice when I was told that he had to enter a nursing home - though I didn't know cost then! But, apart from the social worker telling me there are some niggles there (and I know staff turnover is high) they only like self-funded residents so my husband wouldn't last there very long! It seems most of the nursing homes charge around that in this area. Oh what a minefield - all I want to do is the very best for my husband, I feel guilty enough about him going into a nursing home at all. I have recently been diagnosed with glaucoma too, so I need to bear in mind that I may not be driving for very long and not select a place too far away.

 

[Brucie]

Worth bearing in mind that private [charitable status] homes can be commissioned by a health authority to provide care, so there can be joint homes.

There is no generality, fortunately or unfortunately, and each home needs to be taken on its own merits.

Even within a private group of homes, one may be good, one may not. The manager of the home my wife was in - private, but commissioned by an NHS trust to provide dementia care - was regularly being called to other homes to educate them in the kind of high standards her/our home had.

She has since been promoted to oversee lots of homes in the group and hopefully that will raise standards generally. I pity her replacement at Jan's home however, because she left very big boots to fill.

 

[Sandy]

Hi Saffie,

I'm sorry that you are under so much pressure at the moment.

Forgive me if this has been covered elsewhere, but given your husband's medical history, has anyone mentioned an assessment for NHS Continuing Healthcare (NHS CC)?

I would suggest reading the factsheet on Hospital Discharge which also explains the assessment process for NHS CC and has links to more extensive documents about NHS CC (where the NHS funds the full costs of care):

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=173

It's also worth reading this one on NHS-funded nursing care:

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=104

As far as the top-up issue goes, I would suggest reading this old thread:

http://forum.alzheimers.org.uk/showthread.php?t=21161

Take care,

 

[Bastan]

Hi Saffie,

Sandy's reply was my question also. My husband has Nhs funding and is in a private purpose built 20 bed hospital.

I have replied to your post on my post. thanks

love and good luck

Bastan xx

 

[Saffie]

Thanks everyone. Yes - my husband has been assessed for Continuing Health Care under the NHS and been turned down. The hospital cannot understand it as he has numerous problems apart from the amputation and dementia,e.g. his other leg has an area of gangrene on the heel (due to weight being put on it when moving from bed to wheelchair etc by hospital staff, despite being told that he shouldn't weight-bear at all) so that he now has a hoist for every move. He also has been an insulin dependent diabetic for over 35 years and has had peripheral vascular disease for over 20(hence the amputation) - oh and kidney disease and has to have special injection for his blood every week. However, the social worker says the cuts have made the NHS raise the bar so that very few will be getting CHC.He will have the nursing component which is from the government but that £108 goes direct to the Nursing home and, apparantly, it is up to them whether they pass it on or not - which makes a complete mockery of it. Every home I've spoken to says they have already taken that into account when quoting fees but they don't seem any cheaper.

 

[Sandy]

Hi Saffie,

Well I do know that a number of TP members have been turned down on their first application and then either won on appeal or got it on a subsequent assessment.

Were you involved in the assessment process (you should have been)?

I would suggest contacting the Alzheimer's Society's volunteer group who assists with NHS CC appeals:

http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=398

I have to say that, given your other thread about the chalet home and questions about joint accounts, that it might be worth paying for an appointment with a good solicitor who deals in these matters before completing any major financial transactions or agreeing to anything like top-up fee's (NHS CC can't be topped up by the way).

The criteria is supposed to be applied consistently and there are fairly clear guidelines, but that might not stop some assessors leaning towards the less severe rating which might go through if it wasn't challenged.

Take care,

 

[FifiMo]

Hiya Saffie,

This comment is based on my experience in Scotland but I found there that the best home in the area that my mother lived in WAS a local authority home. Once difference that I had explained to me was that the home was given their allocation of funding for the year and that money was theirs to spend as was necessary. The staff there explained that they made sure every penny was spent if nothing else but to ensure that the following year the local authority didn't think they could operate on less money if they had had a surplus. They told me that last year they had spent the final few £££s on some plants for the garden! They did explain that the other homes in the area which were privately run didn't have the same freedom so far as funds were concerned and said that at the end of the day they were motivated to make a profit and to keep the shareholders happy. That is when I realised that there was a difference in approach in that regard and that might explain why you have to pay such high fees to get a similar standard of service perhaps. It is galling to think that in a private run home that local authorities can negotiate substantially less rates than are applied to self funders. There was a piece in the newspapers today that made reference to this too and also raised the old argument about whether self funders are also being used to subsidise local authority funded places in private homes.

In all of this however there is little mention of quality of care and whether that improves the higher you pay - as many on here have proved - this does not always seem to be the case either does it. So its difficult to find the right balance in the UK I think when all that anyone wants - self funders or not - is a decent standard of living for vulnerable people who need to have care provided for them. Sadly, I don't see any commonality of approach being introduced any time soon and that is why everyone struggles to find the good places in the hope that their loved one can be one of the lucky few.

There also seems to be a new type of system in place - particularly in Wales as i understand it. You are offered somewhere and if you choose somewhere else instead of what you are offered then you are charged any difference in fees and any other additional charges that might accrue. Even if you are a friend or a relative of the person you can be deemed to have entered into a contract to pay any top-up and will be expected to sign a contract to that effect. So funding is not just about the individual's ability to pay! Just another thing to be aware of because some people might find themselves unwittingly being sucked into making such commitments as austerity measures start to bite and they try to get the best care for their loved ones.

Fiona

 

[mowood]

Saffie what the SW has told you is rubbish. The NHS cannot raise the bar (though they will undoubtedly try) to make it more difficult for people to get NHS continuing care funding. The bar was set by the Coughlan case and if your husband has needs equivalent to or in excess of those that Pamela Coughlan had, he should receive the funding. I would be making an appeal against the decision. Good luck with it.

With regard to LA homes v private homes, as has already been said, it depends on the manager and staff. In my own experience I found the LA home that a relative of mine was in to be better than the private sector homes in this area.

Good luck.

 

[Saffie]

Thanks for all your posts everyone.I've been caught up with Loobyloo's home search too and have posted on that this evening that I went to see a Council home today and was amazed. It was really lovely. I went at the SW's suggestion because she has, without any prompting from me, placed his name on 3 Council homes locally. I wasn't too happy about this but I know the hospital do want my husband to be discharged so reluctantly agreed to have a look. It was certainly the pleasantest home I've seen. Light and airy, attractively decorated, bedrooms were a good size and the lounges were very pleasant. All the staff said hello and the manager showed us around - the only manager who has done so. Residents seemed happy and there was an air of calm about the place even though there awere 80 residents, in 4 wings.The downside now is that there is a long waiting list. He did say though that the other council run homes are very similar and suggested I view one perhaps a little further away. I'm not sure. However, with top-ups in this area averaging £500 a week, I doubt my savings will last overlong. I thought I was doing the best for my husband by trying for a private home but it seems I may have been misguided. I guess there are good and bad but the council homes have to more accountable I gather. Likelihood of closure is small as there are only a few nursing homes of both kinds in the area - especially that will accept dementia, though numerous care homes. My husband will have the government Nursing care contribution of £108 but as this goes direct to the home and they don't always pass it on, it appears to be of little value. Apparantly, if the CHC appliction doesn't get as far as going before the panel, one cannot appeal and my husband's didn't - why, I don't know. Thanks again for all your input.

 

[Sandy]

Hi Saffie,

Apparantly, if the CHC appliction doesn't get as far as going before the panel, one cannot appeal and my husband's didn't - why, I don't know. Thanks again for all your input.

You might want to read the Alzheimer's Society booklet called 'When does the NHS pay for care?'. It sounds as if perhaps your husband only had a screening for NHS CC and not the full assessment:

http://www.alzheimers.org.uk/site/scripts/download_info.php?fileID=75

The point is, you should have had the process explained to you and the reasons why it did not progress to panel.

Sometimes it can be hard to take all of this information on board when there is so much else going on.

The AS booklet does a very good job of explaining what can be a complicated process.

Take care,