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Care home fees ss and top up

deepetshopboy

Registered User
Jul 7, 2008
249
hi if your loved one was to go
Into a private home say for instance costing £2000 a week and there self funding dropped would the council pay afterwards or would they move the person to a cheaper home
Or could you top up the rest but then would they still move the person when the savings were all gone ?
Thanks
 

Kevinl

Registered User
Aug 24, 2013
4,771
Salford
Well if the home was £2k per week then you're talking 3 or 4 times the average LA rate so it's unlikely a home like that would ever take the LA rate, some home will say that if you self fund for X years then they'll let you stay on after that at the LA rate the price differential would be too much, you can't expect them to go from £2k pw to £500 pw, maybe if the home was £700 and the LA rate was £500 they might be able to do something but they are a business.
The LA step in and assist with funding as about £23k and fully fund when the assets fall below £14k, but the top ups must be made by a third party you can't use the persons own money to pay the top up (except when Section 117 funding which is a special case) so as soon as the LA start to fund the top up have to come from a third party not the resident's own money.
If there is no third party able or willing to pay the top up then the LA can move someone to a home that's within their budget and that can meet the person's needs and basically your choice would be accept that or pay a top up so "move the person when the savings were all gone" isn't an issue the move would be when their savings hit the level at which the LA start funding after that their savings are safe.
K
 

Jaded'n'faded

Registered User
Jan 23, 2019
684
High Peak
The council wouldn't pay anything like that amount, I'm afraid and would move the person with dementia. Once savings drop below £23,500 the council start part-funding but the PWD still pays an amount (on a sliding scale) until their savings drop to about £14,500. At that point the council pay all the CH fees but do take the PWD's pension, etc.

Regarding top ups - top ups can be paid by family but cannot come out of the PWD's money.
 

deepetshopboy

Registered User
Jul 7, 2008
249
The council wouldn't pay anything like that amount, I'm afraid and would move the person with dementia. Once savings drop below £23,500 the council start part-funding but the PWD still pays an amount (on a sliding scale) until their savings drop to about £14,500. At that point the council pay all the CH fees but do take the PWD's pension, etc.

Regarding top ups - top ups can be paid by family but cannot come out of the PWD's money.
Right ok .. so if the pwd had 14k and had a person in the family with poa that wanted their relatives to go to a ‘better home’ or one that was more expensive there not allowed to dip in to their savings to allow them to stay ? Doesn’t make sense in a way to me if the pwd has savings and the relative wanted to use them
Savings on them ie keeping in a home why arent they allowed sorry hope i make sense
 

Kevinl

Registered User
Aug 24, 2013
4,771
Salford
Right ok .. so if the pwd had 14k and had a person in the family with poa that wanted their relatives to go to a ‘better home’ or one that was more expensive there not allowed to dip in to their savings to allow them to stay ? Doesn’t make sense in a way to me if the pwd has savings and the relative wanted to use them
Savings on them ie keeping in a home why arent they allowed sorry hope i make sense
The pwd is not allowed to make a "first party top up" it has to be made by a "third party" family, friends or a charity but it can't come from the pwd's money no matter who wants what, the law doesn't allow it (other than S117).
The logic is that if someone's assets go down to a certain level and the government no longer feels it reasonable to keep taking their money then no one else should be taking it either.
No one should die broke and the level of broke is £14k after that the government will put a roof over your head, feed you and make sure your taken care of free of charge, if they do all that for free no one should be dipping into the funds to buy something better.
Does it make sense...maybe not but you have to draw a line where someone dies with enough in the bank to pay for a funeral and settle their estate and that figure it has been decided is £14k for whatever reason.
If they tried to change this and take everything then the papers would have even more "death tax", "dementia tax" stories to run and there's enough of those already.
K
 

Louise7

Registered User
Mar 25, 2016
2,007
I know the LA will takeover his pension. But Is the LA contribution to fees then made In addition to his pension contribution? Or is his pension taken to pay for the LA contribution?
I'm not sure what you mean by the LA 'taking over his pension' - they don't 'take over' pensions, they take them into account during a financial assessment. The difference between what they are prepared to pay for care fees and your OH's income will be the amount that they pay to the care home, minus approx. £25 per week allowed for 'personal expenses'. My Mum continues to get her occupational & state pensions paid into her bank account and is sent an invoice separately by the care home in respect of her personal contribution towards her care. Edit: not sure if this varies from LA to LA. They may pay the full amount to the home and then collect the personal contribution from your OH.
 
Last edited:

Louise7

Registered User
Mar 25, 2016
2,007
I think the simpler way to look at it - rather than who pays what to who - is if your OH was in a home that cost £6,000 a month, and the funds available to pay for his care totalled £3,500 (from all sources). There would be a £2,500 shortfall each month and as you have you have stated, this would need to be paid via a third party 'top up' or a move to a cheaper home. (Don't forget that your OH may be entitled to attendance allowance so that could also go towards paying for his care).

Unfortunately the maximum care home rates paid by LA's tend to fall substantially short of what care homes charge and few homes will now accept this rate. If they do, the rates for self-funders may be increased so that they are effectively contributing to those who do not have the funds to pay for their care. It's worth speaking to your OH's care home to see whether they would be prepared to keep him there on the LA rate, as some do.
 

Louise7

Registered User
Mar 25, 2016
2,007
The local authority have to provide at least one home which can meet your OH's needs and is within their budget. However in the case of complex needs they may be limited with regards to finding a suitable placement, plus will have to raise their budget if they can't find anything within their rates. If the home he is currently in was the only one you could find which would take him it may be that he wouldn't be moved. CHC can be difficult to get but it's worth applying for it if you haven't already. So many things can change - usually suddenly when you're least expecting it - and so many of us are having to let fate take its course, but best of luck to you and your lovely OH.
 

nitram

Registered User
Apr 6, 2011
20,047
North Manchester
the top ups must be made by a third party you can't use the persons own money to pay the top up (except when Section 117 funding which is a special case) so as soon as the LA start to fund the top up have to come from a third party not the resident's own money.
To clarify.
First party top ups are also allowed during the 12 week disregard or when the person is on a deferred payment scheme
 

Baker17

Registered User
Mar 9, 2016
479
When the LA are contributing to anyone’s care attendance allowance stops, it is only paid when the PWD is fully self funding
 

Cazzita

Registered User
May 12, 2018
546
When the LA are contributing to anyone’s care attendance allowance stops, it is only paid when the PWD is fully self funding
Really? I am surprised at this as SS are contributing to mum's care at home and say the AA can be used to top up fees...?
 

Baker17

Registered User
Mar 9, 2016
479
Really? I am surprised at this as SS are contributing to mum's care at home and say the AA can be used to top up fees...?
That’s right I’m afraid when my PWD was self funding their attendance allowance was still paid to them but as soon as they reached the £23500 and the SS part funded you have to tell the attendance allowance people and it stops, my PWD was in a home though so maybe it’s different if they are receiving care at home
 

Cazzita

Registered User
May 12, 2018
546
Okay, thanks for clarifying that @Kevinl , I think you are right, the AA is swallowed up if you are in a care home. Definitely want to keep mum at home though :)
 

Cazzita

Registered User
May 12, 2018
546
That’s right I’m afraid when my PWD was self funding their attendance allowance was still paid to them but as soon as they reached the £23500 and the SS part funded you have to tell the attendance allowance people and it stops, my PWD was in a home though so maybe it’s different if they are receiving care at home
Yes, I think it must be x
 

DesperateofDevon

Registered User
Jul 7, 2019
2,660
Really? I am surprised at this as SS are contributing to mum's care at home and say the AA can be used to top up fees...?
So at home care is domiciliary care & the you get to fill in another financial assessment for residential care.
It’s unduly complicated & time consuming filling in forms sending bank statements etc.
When does it move from SS to CHC ? What’s the criteria please?
 

Cazzita

Registered User
May 12, 2018
546
I
So at home care is domiciliary care & the you get to fill in another financial assessment for residential care.
It’s unduly complicated & time consuming filling in forms sending bank statements etc.
When does it move from SS to CHC ? What’s the criteria please?
I have no idea, sorry. Agree that it is all complicated though - I am worried about all the form-filling myself - don't know where to start and hate the thought of sending them bank statements - such an invasion of privacy!
I am still determined to keep mum at home as long as possible. Someone will answer your question soon, I'm sure x
 

canary

Registered User
Feb 25, 2014
12,138
South coast
When does it move from SS to CHC ? What’s the criteria please?
CHC is Continuing Health Care and, unfortunately, most people with dementias problems are things like - memory loss, getting confused, needing help with washing/dressing/eating, incontinence and loss of mobility. These things are all considered to be social needs, not health, and the bar is set incredibly high anyway, so most people with dementia never qualify for it (my mum never did). You dont apply for it - medical staff, SWs etc are the ones to fill in the initial checklist form and if you reach the criteria they will put that person through to a panel of professional assessors who will make the decision using the decision support tool. If you are interested you can find it all here
https://www.gov.uk/government/publi...inuing-healthcare-and-nhs-funded-nursing-care

Realistically, for someone with dementia to qualify there needs to be either some other health need, extreme and unpredictable violent/aggressive behaviour or a very high risk of falls. A good rule of thumb is :- does this person require a qualified nurse on duty 24/7? - and even then you may only qualify for the nursing component. CHC can also be removed at any times and often is if eg the CHC was awarded because of high risk of falls and that person then becomes bed-bound - being bed-bound is considered a social need and as they are no longer falling (because they are bed bound) they no longer qualify for the CHC

There is also the point that you cannot get CHC if you are in a care home (as there isnt a qualified nurse on duty 24/7), so in order to get CHC, or the Funded Nursing Care component, you have to move to a nursing home, which is more expensive. So some people have been in the bizarre position of applying for CHC, getting only the FNC and then having to pay more for their care!

Its a total mine-field.
 

DesperateofDevon

Registered User
Jul 7, 2019
2,660
CHC is Continuing Health Care and, unfortunately, most people with dementias problems are things like - memory loss, getting confused, needing help with washing/dressing/eating, incontinence and loss of mobility. These things are all considered to be social needs, not health, and the bar is set incredibly high anyway, so most people with dementia never qualify for it (my mum never did). You dont apply for it - medical staff, SWs etc are the ones to fill in the initial checklist form and if you reach the criteria they will put that person through to a panel of professional assessors who will make the decision using the decision support tool. If you are interested you can find it all here
https://www.gov.uk/government/publi...inuing-healthcare-and-nhs-funded-nursing-care

Realistically, for someone with dementia to qualify there needs to be either some other health need, extreme and unpredictable violent/aggressive behaviour or a very high risk of falls. A good rule of thumb is :- does this person require a qualified nurse on duty 24/7? - and even then you may only qualify for the nursing component. CHC can also be removed at any times and often is if eg the CHC was awarded because of high risk of falls and that person then becomes bed-bound - being bed-bound is considered a social need and as they are no longer falling (because they are bed bound) they no longer qualify for the CHC

There is also the point that you cannot get CHC if you are in a care home (as there isnt a qualified nurse on duty 24/7), so in order to get CHC, or the Funded Nursing Care component, you have to move to a nursing home, which is more expensive. So some people have been in the bizarre position of applying for CHC, getting only the FNC and then having to pay more for their care!

Its a total mine-field.
Brilliant explanation, thank you.
That’s another thing ticked off the list of “what the heck..,,?”
Much appreciated
 

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