Best Way To Pay Care Home Top-Up?

[Lizziebeetle]

The posts about top ups have been helpful. Just had a 'best interests meeting' today for my Mum, with the outcome that she needs to be placed in a care home in the next week or so for her safety. I was told that we would need to pay a top up as the council's rate was unlikely to cover all the costs. The social worker also told me that we could use some of Mum's money, even though she is entitled to have the full cost paid, as her funds are low.

 

[Saffie]

Top-ups cannot be paid by the resident. They have to be paid by somebody else.
Also, the LA will not pay all her fees. She will have to contribute her state pension and any occupational pension of she receives one. She will be allowed to keep around £23 as a weekly allowance.
I assume she does not have a house to sell.


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[jenniferpa]

The posts about top ups have been helpful. Just had a 'best interests meeting' today for my Mum, with the outcome that she needs to be placed in a care home in the next week or so for her safety. I was told that we would need to pay a top up as the council's rate was unlikely to cover all the costs. The social worker also told me that we could use some of Mum's money, even though she is entitled to have the full cost paid, as her funds are low.

The social worker doesn't know what (s)he is talking about with regard to paying the top-up from your mother's funds (as Saffie said, this isn't permitted). And as you've realized having read this thread, the top-up thing isn't on either. If the only homes available and suitable for your mother are more expensive than the council rate, then they have to up the council rate. It's not optional on their part, while paying a top-up is entirely optional.

The difficulty arises when the homes that will accept your mother and will accept the council payment are ones that you don't find acceptable. Bear in mind, though, that price doesn't necessarily correlate to quality of care. There are some pretty fancy homes out there that have issues with care, while there are some shabbier ones with dedicated carers.

I would start to make a list of possibles and start visiting then you can get an idea of what's on offer.

 

[Sally May]

Top Up Fees

Hello, I am new to the forum. In July 2012 I was persuaded to sign a document to pay £35 per week for my mum's top up fees when she moved from residential care to a nursing home. As PoA (and because my mum was left a very good income by my late father) I used her income to pay me to pay the top up fees. When I was told by Social Services that I couldn't do that I refused to pay any more. I have been subject to an 'investigation' which went as far as the Court of Protection but the judge found in my favour and now (12 months later) I am wondering where I stand as Social Services have been paying the top up fees for the nursing home. What would you advise me to do? I am still indignant at the outrageous financial system that my mother has been subject to since her diagnosis in 2007 (almost all the capital from her property has gone) so why should I have to pay anything at all (sorry if I sound bitter).

 

[Saffie]

Hello and welcome to TP.
I have to say that I am really surprised that the CoP approved the top-up fees being repaid to you from your mother's capital as it is a fact that only someone other than the resident can pay these.

That is of course, unless there was no home that costs less which would satisfy your mother's needs. That would then make the top-ups not applicable and may be why you have heard no more about them from the LA. That seems likely to me because, if this is the case, then the LA had no right to charge for top-ups in the first place.

Otherwise, using your mother's capital to repay you for the top-ups would be wrong, no matter whatever your mother's income is as it is depriving her of her assets. That is how the LA would be viewing it. As the LA are now involved with part-paying the fees, it would affect how much your mother's contribution is which of course, in turn, affects how much they have to contribute too.

I have to say that the amounts for top-ups I was quoted hereabouts were nearer the £300 per week. Is your mother receiving the nursing care element of £108 per week?

I would be inclined to let sleeping dogs lie.

 

[birdblack]

Hello, I am new to the forum. In July 2012 I was persuaded to sign a document to pay £35 per week for my mum's top up fees when she moved from residential care to a nursing home. As PoA (and because my mum was left a very good income by my late father) I used her income to pay me to pay the top up fees. When I was told by Social Services that I couldn't do that I refused to pay any more. I have been subject to an 'investigation' which went as far as the Court of Protection but the judge found in my favour and now (12 months later) I am wondering where I stand as Social Services have been paying the top up fees for the nursing home. What would you advise me to do? I am still indignant at the outrageous financial system that my mother has been subject to since her diagnosis in 2007 (almost all the capital from her property has gone) so why should I have to pay anything at all (sorry if I sound bitter).

I don't see what right the ss have to investigate your handling of your mothers finances. How did they become involved with that?

 

[birdblack]

Home won't give me copy of care plan or falls risk.

Crikey thank goodness common sense prevails in Pete's CH. If I had to listen to a load of regulations and talk of DPA sections and DAP sections this and that I think my eyes would glaze over

I don't even know if they realise that I have LPA (financial) As I'm not going to report them to the PC Police I guess it doesn't matter

Poor you Birdblack. Life is hard enough without the red tape

Take care

Lyn T

I asked the home for a copy of the falls risk and also care plan but they won't give me a copy and say I can only read it in the nursing home. What is the situation on this? My father had a very bad fall in the lounge area this week and is back in hospital now with a broken hip. This is shocking. He had several falls in the lounge and I called for more supervision in the lounge at all times. That was weeks ago. He was in there this week after supper. They knew he tries to get up and they should have had someone close by watching him. The manager says that staff were in the area but could not get to him in time. They say they can't give one to one attention! Surely,their duty is to protect him from falls if they know he is a big risk. Where were the staff? She is vague about that. Where am I legally about this? Does anyone know? He would have been safer in his home. Why pay a for a place which is careless and not vigilant. One night I stopped a blind and deaf lady falling on the electric fire!

 

[Saffie]

I don't know why you would need have a copy of the falls risk and care plan as they should be available to view in the nursing home at all times. Is this not enough? I make notes from my husband's careplan.

Without knowing the size and ratio of carers in your father's home, it is difficult to judge the amount of supervision available for somebody to be continuously watching one person. This usually applies with CHC funding I believe. I know there isn't always someone in my husband's lounge as so many are in bed or their rooms and immobile that carer's are busy.
However, one lady who used to get up from her chair a lot and was likely to fall, had an alarm which sounded when she raised herself from the chair. This then alerted the staff. I have to say though that on occasions I had to go to her as they couldn't reach her quickly enough if they were hoisting people in or out of beds or toilets.

Having said that, people do fall everywhere. I'm not trying to minimise your concern but just trying to think how it can be addressed.

I have to say that I think having an elecric fire in a position where someone can fall on it, never mind a blind person in the room too, does sound like a risk in itself.

I hope your father makes a speedy and full recovery.

 

[birdblack]

Falls

I don't know why you would need have a copy of the falls risk and care plan as they should be available to view in the nursing home at all times. Is this not enough? I make notes from my husband's careplan.

Without knowing the size and ratio of carers in your father's home, it is difficult to judge the amount of supervision available for somebody to be continuously watching one person. This usually applies with CHC funding I believe. I know there isn't always someone in my husband's lounge as so many are in bed or their rooms and immobile that carer's are busy.
However, one lady who used to get up from her chair a lot and was likely to fall, had an alarm which sounded when she raised herself from the chair. This then alerted the staff. I have to say though that on occasions I had to go to her as they couldn't reach her quickly enough if they were hoisting people in or out of beds or toilets.

Having said that, people do fall everywhere. I'm not trying to minimise your concern but just trying to think how it can be addressed.

I have to say that I think having an electric fire in a position where someone can fall on it, never mind a blind person in the room too, does sound like a risk in itself.

I hope your father makes a speedy and full recovery.

I thought the care commission stated that lounges had to be supervised the whole time. It seems to make sense that they should have someone keep an eye on them at all times if they are a high risk of falling. What is the connection with chc funding? Is that one of the criteria in getting the funding?ie danger of falls and needs supervision? My father is doing ok at the moment and chatty this afternoon. Very lucid in fact. I think he is glad to be out of that dreary home, plonked in front to the tv and no outings or garden.

 

[Saffie]

CHC funding applies when a person requires one to one care.
Of course, it applies to other criteria too and these do include a likelihood of falling.
However, it is only one of many.

The CQC may state that and will make judgements in their reports but if you have 20 residents on a wing, with the majority of them being unable to do much, if anything, for themselves, needing to be returned to bed, taken to the toilet etc. and all being hoisted or pushed in wheelchairs, also fed and helped with drinks in their rooms, there are bound to be times that, with the best will in the world, the lounge might not be supervised.

As I said earlier, I can only speak about my husband's nursing home and your father's may be completely different with most of the residents in the lounge for most of the time. In which case, I would imagine it is easier for a carer to be available to supervise it which makes your grievance very valid.

If you are really unhappy, could you perhaps arrange for your father to be moved to a different home when he is discharged from hospital. It doesn't sound as though you, nor your father. like it very much.

Good luck with whatever you decide to do.

 

[birdblack]

CHC funding applies when a person requires one to one care.
Of course, it applies to other criteria too and these do include a likelihood of falling.
However, it is only one of many.

The CQC may state that and will make judgements in their reports but if you have 20 residents on a wing, with the majority of them being unable to do much, if anything, for themselves, needing to be returned to bed, taken to the toilet etc. and all being hoisted or pushed in wheelchairs, also fed and helped with drinks in their rooms, there are bound to be times that, with the best will in the world, the lounge might not be supervised.

As I said earlier, I can only speak about my husband's nursing home and your father's may be completely different with most of the residents in the lounge for most of the time. In which case, I would imagine it is easier for a carer to be available to supervise it which makes your grievance very valid.

If you are really unhappy, could you perhaps arrange for your father to be moved to a different home when he is discharged from hospital. It doesn't sound as though you, nor your father. like it very much.

Good luck with whatever you decide to do.

Saffie thanks for your reply.
Most of the residents are put in the lounge after a meal in front of the tv. There are three who are high risk fallers. My dad is one and had four falls in the lounge before when a visitor found him. Where were the carers? I have often been in there with my dad and have stopped him getting up and also an old blind and deaf resident who is high risk too and had a very bad fall weeks ago with a very bruised face. Three weeks ago she got up and nearly fell on the fire place. I rushed to get a nurse and when we got back another resident in a wheelchair had managed to move forward and try and catch her. I wrote to the manager and said they needed a loung supervisior 24 hours and a rota. I did not get a reply! However, someone told me they had out in someone to supervise the lounge. Chair alarms may help. They do not have these. If there are only three high risk fallers they should provide one to one care. I will try and transfer my dad but there is not much choice where he is and I don't feel happy about any of them apart from one which is residential only and another which has a waiting list and just more nursing. I asked social s about chc funding and was brushed off. I asked the care home and the same attitude. I understood the chc is very difficult to get.

 

[birdblack]

Care home wants more money after hip fracture! Money spinners incorporated!

My father broke his hip in his care home last week. He fell when trying to mobilize on his own from his chair and no one spotted him. He has already fallen four times in that lounge so something is not quite right is it? I have asked for chair alarms since there are none and also more supervision in the lounge. We already pay over the top in fees for the room rate for the area and now the manager says if we want one to one monitoring of him we have to pay more money! Surely this is part of the fee that we already pay. It is just a case of looking after my dad and part of the standard care share hours. Why should we pay more? If they think he needs one to one then this is really to do with nhs continuous funding isn't it? Which they are avoiding discussing.

 

[Raggedrobin]

i am currently paying extra for one to one care for my mum at times when she is sundowning and causing difficulties. I don't resent it, I don't like paying out as the fees are already over £1000 pcm but As Saffie says, with the best will in the world they can't do one to one all the time, the only option is to pay in the short term, unless he can get full funding. Mum's funding situation is being looked at.cThe home at least provides some of its own staff for me at a reasonable rate, whereas if they outsourced to agencies this would cost me double because of the agency fees.

 

[birdblack]

My father is quiet but tends to get up sometimes and thinks he can walk and there is never anyone around to keep an eye on him. Then he falls. This has happened in the lounge several times. There is a very old lady blind and deaf and she had a big fall and bruised her face badly. She almost fell again in April but I managed to stop her. No staff about. I think I have a valid point that they should have someone from the staff and included in the fee, to watch the residents in the lounge areas.

 

[Raggedrobin]

Ooos sorry I meant £1000 a week.