Care Home Top up Fees

[Not so Rosy]

I am hoping to point a friend in the right direction with regards to care home fees.

I think I understand the rules but after hours and hours of going round and round on the net I can't find it officially in writing.

A person will be initially self funding.

When they drop below the £14k savings, what happens ?

Care Home £950 a week

Persons income £300 a week

Local Authority rate £450 a week.

Would the family need to top up £200 a week or £500 a week

Many thanks

 

[jenniferpa]

Let me try and clarify for you: there is an upper threshold of £23250 and a lower one of £14250. A person is only truly self-funding if they have assets of over the upper threshold: they would be expected to pay their entire care bill from their income and savings (but they would also retain attendance allowance to help offset this a bit). Once savings drop below this upper level, the the LA will start to contribute. If the assessed LA rate is £450 but the home costs £950, the LA would pay £450, but the person in care would be paying the LA their whole income (minus the PEA of £24.90) plus a payment of £1 per £250 of savings per week (this is called tariff income) also to the LA. All these payments do is partially reimburse the LA for what they are paying out. However, there is still a shortfall of £500 every week that someone else (a relative or charity) will have to pay. The only thing that changes when the person in care reaches the £14250 level is that the tariff income ceases.

So basically, once the person drops below the upper threshold family would be expected to pay £500 a week. And do bear in mind that is likely to rise. The only slight wrinkle is that sometimes a care home will be prepared to accept a rather lower rate from an LA client than from a self-funding one, but there is no guarantee. Also, if your friend does decide to do this the LA should contract with the care home at the full rate with the family paying the LA the top-up. It offers a small measure of protection.

 

[Pickles53]

Jennifer has set it out very clearly but this is based on the assumption that there is no suitable home which can meet all the person's assessed needs which costs no more than £450 per week (or the equivalent LA rate in your area). In other words, it is the family's choice of a more expensive home or larger room or sea view or whatever which results in the extra cost.

If the LA cannot offer a suitable place at their 'usual' rate then top-ups should not apply and the LA must meet the full cost.

See sections 8 and 9 of the guidance, specifically paragraph 8.37, and Annex A. 8.37 specifically states that the LA must offer at least one option which is within the person's personal budget and should ensure that there is more than one. (Personal budget is the amount allocated by the LA to meet the individual's needs.). Paragraph 12 of Annex A says clearly that the LA must adjust the budget if there is no suitable accommodation available.

You should not agree to pay a top-up of any amount if no suitable home has been offered where top-ups would not be needed.

https://www.gov.uk/government/uploa.../file/366104/43380_23902777_Care_Act_Book.pdf

 

[Not so Rosy]

Thank you both so much for your replies. It is all clear for me now.

 

[margaret2]

Lower threshold

Hello Jennifer,

Re:The only thing that changes when the person in care reaches the £14250 level is that the tariff income ceases.

My husband is below this level....what position does that place him in regarding LC funding?

Thank you,

Margaret2

Let me try and clarify for you: there is an upper threshold of £23250 and a lower one of £14250. A person is only truly self-funding if they have assets of over the upper threshold: they would be expected to pay their entire care bill from their income and savings (but they would also retain attendance allowance to help offset this a bit). Once savings drop below this upper level, the the LA will start to contribute. If the assessed LA rate is £450 but the home costs £950, the LA would pay £450, but the person in care would be paying the LA their whole income (minus the PEA of £24.90) plus a payment of £1 per £250 of savings per week (this is called tariff income) also to the LA. All these payments do is partially reimburse the LA for what they are paying out. However, there is still a shortfall of £500 every week that someone else (a relative or charity) will have to pay. The only thing that changes when the person in care reaches the £14250 level is that the tariff income ceases.

So basically, once the person drops below the upper threshold family would be expected to pay £500 a week. And do bear in mind that is likely to rise. The only slight wrinkle is that sometimes a care home will be prepared to accept a rather lower rate from an LA client than from a self-funding one, but there is no guarantee. Also, if your friend does decide to do this the LA should contract with the care home at the full rate with the family paying the LA the top-up. It offers a small measure of protection.

 

[jenniferpa]

Margaret: he won't be paying that £1 per £250 of savings. But he will be paying over the majority of his state pensions plus 50% of any occupational pensions (assuming he passes the other 50% back to you). Everything else stays the same.