can't keep up with top up fees

[nellen]

Hi has anyone any experience of moving your relative to another care home and being told you have to give 28 days notice?

i got my mum into one of two care homes in our area that cater for dementia with 24 hour nursing care. I needed to get her discharged from hospital and into somewhere that would give her some care and tlc so i took a chance on the more expensive one as the other home wasn't taking anyone as they were undergoing refurbishment. She is funded by social services and continuing nursing care and i pay the top up of £400 pw -from a small amount of money saved up, i was hoping to get CHC and have requested an assessment for it but I've been told theres a waiting list of two months. We can't keep paying £400 per week for more than about 10 weeks and mum has been in the home a month, so, bearing this in mind and the time it may take to apply for CHC (even though she may not get it), i enquired at the other home if they had any vacancies and they said they can take mum. When i spoke to the home that she's in to tell them i can't continue paying their top up fees and was looking to move mum this is when they told me that theres a 28 day notice period Having looked at their contract it does say 28 day notice and also that theres a trial period on all placements of six weeks - so I'm thinking that after the six weeks i can move her What do people think? Can anyone advise me?

 

[marionq]

You would assume that the trial is on both sides. They can turn you down or you can turn them down. Make sure the other place will be available at the end of six weeks and then approach SS for further advice.

 

[JLSW]

Speak to social services

Hi,

I would advise you to speak to social services as soon as possible about the situation, and specifically the social worker who helped place your mum in the home about the top up fees being unmanageable. The SW should be carrying out a review of the placement at the end of the 6 week trial period anyhow. The SW will also need to secure funding for your mum's new care home and that care home will need to carry out a pre-admission assessment before she moves too.

A 28 day notice period is pretty standard procedure from care homes but I don't think it applies to the 6 week trial period. However, check with the SW involved.

Hope this helps and good luck

JLSW

 

[nitram]

The contract is with the LA.
Do you pay the top up to the LA or the care home?
Did you sign any agreement with the care home?

Whatever the answers I suggest you contact the LA and say you (or more precisely your Mum, depending on anything you may have inadvertently signed) cannot afford the top up and ask them to terminate the contract within the 6 week's trial period.

It is up to the LA to find a suitable placement but there is nothing to stop you doing research so you can suggest the other home.

Have a read through
http://forum.alzheimers.org.uk/show...es-ombudsman&p=1168890&viewfull=1#post1168890

 

[nellen]

Thanks for your replies. As regards the social worker arranging this placement it was the hospital social work team and they were pretty useless at helping me negotiate the minefield of care homes and funding. Also the hospital was in the city 15 miles from mums home town and they didn't seem to know much about provision in our town. They put me in touch with an organisation who help you find care homes and I found them to be pressuring and trying to push me into accepting homes which weren't suitable for mum, so in the end I tried to do it myself - contacting the homes and visiting them and getting mum assessed and then telling the social worker what I'd done and liaising with the hospital and home to get her discharged into a home.

I hadn't thought about getting help from Soc serv but I think that now mum is back in her home town she should be allocated to a Soc worker so I'll contact them and find this out and get them to help me
As regards payment, ive not yet had a bill or anything as mum has reached her first month at the home, I'd better find out what's happening about payment as I'd assumed I'd get a bill soon.

 

[Beate]

I'm sorry but I am confused - is she funded through social services or not? Where does this huge top up fee come from? I was always under the impression that they have to find a suitable care home for people and if the only suitable one is more expensive than their rate, then they simply have to up it. Top up fees should only be payable if you want cosmetic upgrades like a bigger room or a better view. Have you signed a contract? It might have been better to involve SS in your decision because now they might say there are other cheaper homes that would have been suitable. Why agree a top up fee you can't afford?

 

[nellen]

As far as I understand it Beate, care homes charge a rate that they decide is suitable, then if it is more than what you are allocated by social services and health then this is called top up and it is up to you to decide what you can afford to pay.

In my mums case as I said in my initial post, there are two homes in our home town that fit the criteria of dementia care and 24 nursing care which my mum needed as she'd been very ill in hospital and was recovering from shingles. One home of the suitable homes was closed for refurbishment and the other is the one that charges £900 a week which was 400 top up I made the decision that I would take a chance and pay the top up just to get my mum out of the hospital and into a caring environment where she'd be looked after and then either apply for and hopefully get chc funding (full) or not get it. Bythat time the other home which is cheaper would have finished their refurb and would be taking new residents.

We cant afford to keep paying the £400 top for long and I was always up front about this to the home and that I'd be applying for full funding but the waiting list for assessments round here is 2 months, hence my wanting to move my mum sooner rather than later when the money runs out
This is what I know. Others might come along with more.
Also the hospital social work team were useless - conspicuous by the their absence!

 

[Pickles53]

As far as I understand it Beate, care homes charge a rate that they decide is suitable, then if it is more than what you are allocated by social services and health then this is called top up and it is up to you to decide what you can afford to pay.

I think top up payment only applies if there is a home that can meet your mum's assessed needs but for some reason you prefer a more expensive home. If there is no suitable place at the LA usual rate, they have to fund the difference.

Others more expert than me will be able to quote the relevant sections of the 2014 Care Act.

 

[Beate]

That's what I was getting at. I think this top up fee is wrong.

 

[Pete R]

Also the hospital social work team were useless - conspicuous by the their absence!

Nellen, have you been able to get social services involved at all or did you make the decision to move your Mum out of hospital without their involvement?

The 28 day notice period is normal.

 

[nitram]

From first post

"...She is funded by social services and continuing nursing care and i pay the top up of £400 pw..."

it would appear that the LA is involved and paying some of the fee.

This takes me back to my earlier post
http://forum.alzheimers.org.uk/show...-top-up-fees&p=1174996&viewfull=1#post1174996

 

[nellen]

Pete once the doctor decided my mum was fit for discharge then I got the home and the hospital to liaise with each other to decide on a date to discharge her. The social workers then emailed me a care plan and forms to sign about my mums funding - this was literally the first time I spoke to the social worker and Ive certainly never met her

I've been on the phone this morning to the local social services office to find out who my mum is allocated to - after being out of hospital a month they said she's NOT yet allocated! But I told them I need help and advice with this minefield of funding and carehomes and they are getting the duty officer to give me an urgent call - I laid it on thick about the lack of support that I'd got from the hospital social work team. So, I'll await their call......zzzzzz

 

[Pete R]

Pete once the doctor decided my mum was fit for discharge then I got the home and the hospital to liaise with each other to decide on a date to discharge her. The social workers then emailed me a care plan and forms to sign about my mums funding - this was literally the first time I spoke to the social worker and Ive certainly never met her

I've been on the phone this morning to the local social services office to find out who my mum is allocated to - after being out of hospital a month they said she's NOT yet allocated! But I told them I need help and advice with this minefield of funding and carehomes and they are getting the duty officer to give me an urgent call - I laid it on thick about the lack of support that I'd got from the hospital social work team. So, I'll await their call......zzzzzz

If you do not get a call back today then do the same again tomorrow.

Good Luck

 

[JLSW]

Top up fees

Top up fees are paid directly to the care home and are a private arrangement between the person / person's family and the care home. They do not involve the local authority.

The local authority have a usual rate they will pay care homes depending on which type of care they provide, i.e. a different rate for residential, nursing, EMI nursing, EMI residential. Most care homes will have rooms available at the local authority rate but will also have rooms for privately funded residents costing more. Some care homes will not accept the local authority rate, which is where top up arrangements come in.

In this case I'm guessing the funding is made up of:
Local Authority funding +
Assessed financial contribution of Nellen's mum +
3rd Party Top up (private arrangement with the care home)

As the local authority are part funding this placement, they have a duty by law to follow up on the placement and the hospital social worker should be carrying out the 6 week review as a follow up to the discharge.

The social work team should also have realised that such an enormous top up fee would be unsustainable mid term (let alone long term!)

Keep pestering the hospital social work team and the older adults social work team for your local authority!

Good luck
JLSW

 

[jenniferpa]

Top up fees are paid directly to the care home and are a private arrangement between the person / person's family and the care home. They do not involve the local authority.

That's not always the case. In fact CRAG stated the LA must contract with the home to pay the full amount of the accommodation including the top-up, with the third party paying the LA the top-up. I know it's not always done that way, but it should be.

 

[nitram]

Extract from the post I linked in post 4 above.

Dr Jane Martin, Local Government Ombudsman, said:

“I know from the many complaints that we receive that this is not an isolated case. The law is clear: it says that the actions of the care provider in carrying out these arrangements shall be treated as actions of or on behalf of the council.

“Therefore I hold the council responsible for the actions taken by the care home provider in seeking to extract extra funding from the family.

http://www.lgo.org.uk/news/2013/sep...-care-home-fees-following-ombudsman-s-report/

 

[nellen]

I got a call about 4pm from the duty social worker and he was good!! The first sw in the whole 4 month long saga who has read mums notes and knew what he was talking about and understood and sympathised with what mum has been through. He gave me a plan of action and said he'd email me some info about the new care act etc. He said if I don't hear back from social services tomorrow from mums newly allocated Soc Wkr to ring them up.
I feel like I'm back in the system again rather than battling away by myself.

I'm fairly articulate and determined - it makes you wonder how people less confident with these agencies cope with the system. It's a minefield.

I just hope it all works out and goes smoothly

 

[Pete R]

That's not always the case. In fact CRAG stated the LA must contract with the home to pay the full amount of the accommodation including the top-up, with the third party paying the LA the top-up. I know it's not always done that way, but it should be.

The New care Act states the same and covers top ups in great details in Annexe A and stresses that the LA should pay all the fees direct to the CH.

"Where a local authority is meeting needs by arranging a care home, it is responsible
for contracting with the provider. It is also responsible for paying the full amount, including where a ‘top-up’ fee is being paid. However, where all parties are agreed it may choose to allow the person to pay the provider directly for the ‘top-up’ where this is permitted."

A benefit of the LA paying is that should for whatever reason the top up ceases to be paid the LA are responsible for it continuing till other arrangements are put in place.

I would imagine CH's may not like this arrangement as the LA can also restrict the yearly increases in the contract.