Choice of care homes

[Taximan]

My Mum who is 90,has finally agreed that she might be better off in a care home.Her health has deteriorated over the last couple of years.She has a pacemaker,and was on warfarin,which they have now stopped.She has to have blood transfusions because her blood count is low.She has difficulty in walking,and has had 4 falls which resulted in her being hospitalised,in one case for three weeks,because they couldn't arrange caring when she returned home.She has now been diagnosed with Alzheimers,and obviously at her age this is progressing fast.She has an infection in her leg which is being treated(but wasn't at first).I've tried to get her continuing health care,but as many of you will realise,this is nigh on impossible,they can,and do,put every obstacle in your way.Her council has agreed that a care home is the best place for her,the problem is how much they are prepared to contribute.She has some savings,maybe £15,000 or so,and i have no problem with her having to contribute every penny if need be.However,we have been told that this money cannot be used as the council say this is her assets that they need to draw on,and it is the family who will have to make up any shortfall(not sure i completely understand this).The question i'd like to ask is,my Mum lives in an area that is miles away from the rest of the family,and it would be far more suitable if she were in a home near to either myself and two brothers in Herts,or two sisters in Dorset.The council say that they will only pay a set amount,and that were we to put her in a home that went beyond their budget,we would have to pay.They also want us to sign a contract saying that we will make up the shortfall.Of course i want to see mum end her days in the most comfortable place possible,but i am myself a pensioner looking after my wife who also has Alzheimers.It's possible that i would have to find £200+ per month as my contribution,What do i do.

 

[Pete R]

What do i do.

If that £15,000 is your Mum's only asset then the Local Authority have to be able to supply you with at least one Nursing Home (I say that as her needs certainly suggest it) in their area that they will fund that does not need any top up at all. If you do not like this NH or want to move her elsewhere that is more expensive then there really is no alternative apart from someone paying a top up.

However no one can forced to pay for someone else's care.

Your Mum is allowed to keep and spend £14,250 of her saving but unfortunately not on her care.

Have a read of this fact sheet.....
http://www.ageuk.org.uk/Documents/E..._permanent_residential_care_fcs.pdf?dtrk=true

If you have more questions it is often better to start your own thread so the answers can be tailored to your circumstances.

Good Luck.

 

[Shedrech]

hi taximan
as Pete R says, the LA must offer one placement in their own area which they fully fund - so do not sign anything that says you yourself, or any other family member, agree to pay a 'top-up'
however, this does mean that the home they suggest may not be the one you would hope for and I think it may be tricky having your mum's current LA fund a care home in another locality - they may agree to whatever is their current rate of funding but if that doesn't fully meet the fees of the care home you choose, I think you are stuck
maybe have achat with one of the AS Helpline operators on 03002221122
best wishes

 

[Kevinl]

As has been said the LA will be doing the funding and will have to offer at least one place without a top up. My wife is in a home that takes people who are I know LA funded as well as self funded and it's great, no one is treated differently in fact I doubt the staff know or care how someone is funded so don't listen to all the stories where LA funded homes are rubbish, they aren't.
The important thing is to match the person to the home, people who still have capability don't (to me) seem to get on too well with people who no longer have capacity. Your mum seem to have other medical issues so I'd say you should be looking for a nursing home (where there has to be a qualified nurse there at all times) as a "Care Home" can mean anything and most don't have a nursing service.
Sad to say you have to consider that the place you chose will need to deal with her condition as it gets worse and can do end of life care if it comes to it otherwise you may have to move her in the future.
Don't let the social services have you looking at every home in town, ask for the names of the places they will fully fund first, say you're unable to pay a top up and make them give you the fully funded options first.
A top up is an open ended commitment in that if care cost (for example) £1,000pw and the LA fund £800pw and you pay a £200pw top up, then the care home fees go up by 10% but the LA only agree to a 3% increase, then the fees go up to £1.100pw.
The LA will only pay £824 and the top up will be £276 so where possible a top up is best avoided. The LA are also obliged to ensure that before you are asked to pay a top up that you're able to commit to an on going financial commitment like that and if you're not they should not let you sign one.
If you look up "third party top ups" you'll see a lot of stories about how some LA's are not always being entirely fair in the way they deal with this.
K

 

[Taximan]

As has been said the LA will be doing the funding and will have to offer at least one place without a top up. My wife is in a home that takes people who are I know LA funded as well as self funded and it's great, no one is treated differently in fact I doubt the staff know or care how someone is funded so don't listen to all the stories where LA funded homes are rubbish, they aren't.
The important thing is to match the person to the home, people who still have capability don't (to me) seem to get on too well with people who no longer have capacity. Your mum seem to have other medical issues so I'd say you should be looking for a nursing home (where there has to be a qualified nurse there at all times) as a "Care Home" can mean anything and most don't have a nursing service.
Sad to say you have to consider that the place you chose will need to deal with her condition as it gets worse and can do end of life care if it comes to it otherwise you may have to move her in the future.
Don't let the social services have you looking at every home in town, ask for the names of the places they will fully fund first, say you're unable to pay a top up and make them give you the fully funded options first.
A top up is an open ended commitment in that if care cost (for example) £1,000pw and the LA fund £800pw and you pay a £200pw top up, then the care home fees go up by 10% but the LA only agree to a 3% increase, then the fees go up to £1.100pw.
The LA will only pay £824 and the top up will be £276 so where possible a top up is best avoided. The LA are also obliged to ensure that before you are asked to pay a top up that you're able to commit to an on going financial commitment like that and if you're not they should not let you sign one.
If you look up "third party top ups" you'll see a lot of stories about how some LA's are not always being entirely fair in the way they deal with this.
K

Thanks for the advice everyone.Another thing i'd like to ask,why will they not allow Mum to pay top up fees out of her savings?I've since found out she has approx £20k.I accept that as she is over the lower end limit that she will have to self fund to an extent,but why can she not use her savings in order to secure a better home that is nearer to her children.As it is she knows nobody in her "home" town,and we'd like her to be near either myself and brothers in Herts,or near my two sisters in Dorset.Also what happens if her medical needs are such,that she becomes eligible for Continuing healthcare,and what if the top up fees end up putting me in a dire financial situation?

 

[Pete R]

Another thing i'd like to ask,why will they not allow Mum to pay top up fees out of her savings?I've since found out she has approx £20k.I accept that as she is over the lower end limit that she will have to self fund to an extent,but why can she not use her savings in order to secure a better home that is nearer to her children.

As your Mum has £20,000 the LA will take £1/week for every £250 over the lower threshold of £14,250 to go towards their contribution of her care costs so she cannot use it to pay any top up.

Your Mum is entitled to live wherever she wants, even outside of her current Local Authority as long as they agree that it meets her needs and it is within their budget.

Also what happens if her medical needs are such,that she becomes eligible for Continuing healthcare

It can happen but it is very hard to get CHC. If she did qualify you are in similar situation in so much as the State has to be able to provide you with one Home that can meet her needs and that they will fully fund. Again this may be somewhere that you do not like or is not near any of you. If you originally choose a Home that has a Top Up it does not necessarily mean that CHC will fully pay that amount.

and what if the top up fees end up putting me in a dire financial situation?

The LA have to be satisfied that you are able to pay any top up for the duration of your Mums care so should not allow you to get into that situation however it can easily happen and it is something you will have to think about very carefully as their will be no State help for you.

 

[jenniferpa]

You ask why can't your mother use her savings to upgrade her care and the bald answer is : that's the way the law is written. I'm broadly in agreement with it, because if it wasn't that way, the LA would most definitely expect people to spend their last penny on care, but I can see how that would seems unfair under the circumstances you describe. But it is one of those things that neither you or the LA have any control over so don't think that it is possible to get them to change their mind: their hands are tied as much as yours over this issue. I'm sorry.