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Funded Nursing Care ...

Discussion in 'Middle - later stages of dementia' started by Coulddobetter, Aug 12, 2017.

  1. Coulddobetter

    Coulddobetter Registered User

    Oct 19, 2016
    23
    #1 Coulddobetter, Aug 12, 2017
    Last edited by a moderator: Aug 12, 2017
    Have only just found out that Mum's nursing home treat this as a bit of a guaranteed income stream and retain it, rather than use it to offset the weekly fee. Mum is self funding and pays £675 weekly. So with the FNC this amounts to £831.25.

    I appreciate that some nursing homes will have higher weekly charges particularly in the south east.

    Am I alone in thinking that the whole sector is just 'weighted' in favour of the owners?? The charges are astronomical, the actual carers are all on minimum wage. Where Mum is they don't even get any extra for Christmas day. The good care assistants tend to get experience and NVQs then go to the NHS which pays better, and offers a pension according to one of the nurses in Mum's home.The service users are like some sort of cash cow for the owners particularly the large care groups many of which have registered offices in places like the Isle of Man presumably for tax purposes. They appear to operate like a cartel, none really publish their charges online.

    This is all so unfair. Bad enough that people get dementia in the first place. The double whammy is then having to pay for the huge cost of that care going forward.

    Why don't CQC inspect how settings charge service users and rate them for value for money, and also how the FNC is used. Our loved ones have contributed to the NHS and overall don't get their money's worth compared to others.
    I believe that following the GE the issue of social care/dementia care has been kicked into the long grass again.
    Sorry if this reads as cynical, but it's how I feel having just had a bill for over £19,000 for Mum's care for the past six months. The delay in billing not down to me but to the management at the home. I have brought this to their attention some time ago. So I'm still reeling from the shock. At this rate the proceeds of the sale of Mums home, her only asset, aren't going to last long.
     
  2. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    I got a shock this evening when I took my mum back to her care home. One of the newish careworkers told me she has to buy her uniform tunics at £50 for two) and she had to pay DBS check herself. I am sure she told me this was £90.

    I think this is truly shocking as the care home pay minimum wage yet charge residents who self fund nearly £700 a week.

    I was even more shocked when I went to collect Mums tea tray to take to her room and she had 4 triangle sandwiches and half a cup of tea! Bear in mind that she has needed no care or food all day as she has been with me since 10am. I expressed surprise that that was all she was getting and said "don't you have a piece of cake or a yoghourt". But they had neither but found her 3 of the plainest, cheapest biscuits you ever saw.

    I think more stringent checks should be made on care homes to ensure people are getting value for money.
     
  3. OldDog99

    OldDog99 Registered User

    Feb 14, 2017
    72
    The home my mother is in offer sandwiches for lunch and tea, there is a cooked meal option too, unfortunately my mom will always choose the sandwich, so her food bill isn't very high at all. She lost 5kg in weight in the first few weeks, and went down to 39kg, after voicing concern regarding her weight they have started to make an effort to encourage her to eat more and she is now 42kg.

    The home seems very friendly and the staff all seem happy but they are often short staffed so obviously people must be leaving, I don't know what the wages are but recently the admin staff have been helping to serve meals.
     
  4. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    At Mums home the lunchtime meals look good if the cook is there. She only works certain days and when she's not there the carers come up with something but it's usually something frozen - like oven chips and frozen fish. The cooks meals are what I call "proper food" cooked from scratch.

    My mum loves her food and was a cook herself so often she is not happy with what she gets. Desserts are always either ice cream, cold tinned fruit or yoghourt and she craves stuff like hot rice pudding, semolina or a fruit pie with custard. They could buy a big catering tin of creamed rice and just heat it up but they seemingly can't be bothered.

    She is supposed to have a portion of fresh fruit every day because of a health condition she has and they know this but very often she doesnt. When I queried this they said I could take in fresh fruit myself but I'm sorry but for £700 a week if they can't give her one banana a day, it's a poor effort.

    Afternoon tea is either one small sausage roll, a round of sandwiches, a small piece of cake and a cup of tea. Sometimes they don't get cake.
     
  5. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,055
    Female
    Near Southampton
    #5 Saffie, Aug 13, 2017
    Last edited: Aug 13, 2017
    So is this afternoon tea you are talking about or the evening meal? For afternoon tea my husband's home only gave a couple of biscuits around 3pm but had their evening meal around 5 - 6. On a Sunday that would be sandwiches as the cook went home at lunchtime.
    In his home there were 4 wings, each of 20 rooms so 80 in total, one residential but 3 nursing.
     
  6. Philbo

    Philbo Registered User

    Feb 28, 2017
    247
    Kent
    A good friend of ours is a manager at a local care home. She is a hands-on manager and works stupid amounts of hours (without overtime pay, as she's the manager), often having to cover when staff are either off sick or fail to turn up (she doesn't tolerate the latter so they usually don't last long). She often goes in to do the cooking and makes sure all her residents are well catered for.

    Her biggest struggle is finding and keeping good staff and given the low wages, it isn't surprising. Her own salary is pretty poor too, especially considering the hours she puts in but she is of the "old school" caring professional type.
     
  7. Mimi5

    Mimi5 Registered User

    Apr 22, 2017
    95
    Essex
    Hubby and I have been looking at and visiting CH in our region (East Anglia) Are you ready for the weekly charge....

    £950.00 per week:eek: Then you have to discuss if they will take LA funding as MIL will be self funding till her money runs out. Not all take it and some still expect a "top up fee"

    Ouch!:(
     
  8. LadyA

    LadyA Volunteer Host

    Oct 19, 2009
    11,453
    Ireland
    Golly! The food in my husband's Nursing Home was excellent, and plentiful. The lunch was always two courses followed by tea/coffee. Afternoons, a trolley was brought around with soup and/or tea/coffee and biscuits. Tea was varied. Sometimes sandwiches, sometimes something cooked. They had full time kitchen staff, and everything was cooked in their kitchens. And the cook sought me out as William's appetite declined, to ask if I could think of anything at all they could get that he might eat more of. I mentioned a particular type of ice-cream that was his favourite, but it was only available in one Supermarket. That wasn't a problem - they got it for him. They made tiny, finger sandwiches with scrambled eggs, and cut the crusts off for him, because they felt that the sight of anything larger overwhelmed him, so he didn't even try to eat it. The residents dining room was laid out like a fine restaurant, and on Sundays, those that could, had a choice of red or white wine with their meal.

    That shouldn't be out of the ordinary. Maybe the difference is that this Home is not owned by a Chain.
     
  9. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    This is the evening Meal. One cooked meal a day and that's lunchtime. Hot first course and cold dessert. Very occasionally at teatime she has had something like spaghetti hoops on toast rather than a sandwich.

    I know a woman who used to be the cook there. She says it used to annoy her because they had frozen everything delivered yet a couple of hundred yards down the road is a lovely farm stall which is very reasonable - with all local eggs, veg, salad stuff, fruit, even their own chicken and bacon.
     
  10. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    That sounds lovely and just how it should be. Last year my mum went into a council run home for a weeks respite and they had lovely food there with very generous portions.

    My Late Dad used to work for a retired Army colonel and when he went into a care home he ate like a sparrow but still knew what he fancied. He was paying a massive amount to live there and my Dad used to go and buy him what he fancied like kiwi fruit, mango and thick, creamy yoghourts. He did this because the home gave the colonel stuff like meat pie and chips which he couldn't stomach at all. They were totally inflexible.
     
  11. Saffie

    Saffie Registered User

    Mar 26, 2011
    22,055
    Female
    Near Southampton
    Nursing homes are around £1,000 a week hereabouts - or rather they were 6 years ago when I was looking for my husband so are probably a lot more now. When I asked about the Nursing allowance I was always told it was already accounted for!
     
  12. Daisy pie

    Daisy pie Registered User

    Nov 24, 2016
    19
    West Midlands
    #12 Daisy pie, Aug 13, 2017
    Last edited: Aug 13, 2017
    I worked in a residential home for 10 years as a cook, most of the food was cooked from scratch.
    Choice of cereals on the morning (Cooked breakfasts available at the weekend)

    There was always a choice of two menus for a two course hot lunch like roast lamb, chicken curry, gammon and parsley sauce but we always would cook something else for the residents if they didn't like what was on the menu.
    A choice of two puddings but one would be something hot like apple pie, steamed syrup sponge with custard

    Fresh cakes were made every day for their afternoon snack.

    Evening was a smaller meal of soup, sandwiches cheese and biscuits, a hot choice like jacket potatoes, fried egg on toast or bubble and squeak.
    Always yogurts a good choice of other snacks available as well.

    Around 13 years ago I went to work in a brand new EMI home owned by a large company, here I had to work to a very tight budget of £2.25 per resident per day, every little bit of food and drink had to be in this budget and although the residents had plenty to eat I had to order in the very cheapest of foods to keep within the budget, I didn't feel I was able to give good meals on this amount of money and I also didn't like how some of the care staff treated the residents so I left this place after just a few weeks.

    I don't know why but for some reason the cooks were paid a bit better than the domestics and care staff who were only paid the minimum wage in both of these homes but I did often wonder where all the money goes to considering how much they charged each resident :confused:
     
  13. Coulddobetter

    Coulddobetter Registered User

    Oct 19, 2016
    23
    Where Mum is there is no choice of food. It is a small nursing home, most of the residents are like Mum quite advanced dementia. There is no choice of food - most residents eat soft/pureed food. Mum eats all of it. It lacks variety, not much in the way of fresh fruit, so I take fruit in for her. Don't think it takes a huge portion of the budget.

    But as others have pointed out here it is the fees that I wanted to discuss, and the fact that nursing homes more than often take the FNC into account and use it as a guaranteed top up - surprised they don't ask for Mum's AA as well, or have they already factored this into their charges, plus the state pension.

    1. As other TPers on this thread have pointed out, minimal or no investment in their care staff who have to pay for their own DBS and uniforms. The finance manager assured me that they were having to pay the 'living wage' hence a 5% increase in their charges on April 1st this year. The nursing staff have been trained by the NHS I imagine. Their salaries obviously higher - even though their interventions with residents are minimal and mainly administering meds from my observation, at other times they are in the office.
    2. Meds and inco pads free for most residents I imagine and paid for by the NHS.
    3. Utility bills admittedly probably very high.
    4. Mum pays separately for hairdressing and chiropody.
    5. They apparently include in the fee trips out - there have been none this summer.
    6.There has to be plenty of profit - the owner often visits Head Office, on the same site as Mum's NH in his Ferrari, and other family members involved in the business, come to work in their Range Rovers with personal number plates, taking up valuable parking space, and IMO quite insensitively flaunting their affluence to their poorly paid care staff and relatives of their 'service users' - God I hate that term!! During Royal Ascot week there was spare capacity for parking - apparently the family had decamped to Ascot for the week.
    7. I don't think that we should accept that £1,000 weekly, give or take for regional variations, should be the new normal for NH fees. It isn't a 'dementia tax' it is a 'health care tax'.
    8. There is no watchdog for care fees - I think CQC should step up and scrutinise this aspect of the sector.
    9. Insult to injury - when I was looking after Mum full time, CA was about £60pw, what is the hourly rate for that 24/7.

    Wrong, wrong, wrong!! Rant over.
     
  14. stanleypj

    stanleypj Registered User

    Dec 8, 2011
    8,204
    North West
    I agree with you and many others Couldobetter that care home fees are too high.

    What I can't understand is why I read about care homes closing down/increasingly likely to close down because they are not making sufficient profit.:(
     
  15. Coulddobetter

    Coulddobetter Registered User

    Oct 19, 2016
    23
    I think the bigger groups are raking it in -economies of scale, use of tax havens as registered offices, tax avoidance??? etc etc


    Smaller, stand alone homes are going to the wall largely I think because of delays in getting their funding and because of the nature of their funding. As we all know if dependent on LAs to fund their residents then the income is smaller as they won't pay above a certain rate. LAs are cutting back on staff, less funding from central government. increase demand for social care, backlog of payments to process so cash flow problems for the smaller settings. IMO
     
  16. lemonjuice

    lemonjuice Registered User

    Jun 15, 2016
    896
    England
    Whilst I appreciate the 'Cost of Care' problem' is a big issue and it has to be funded somehow, it really gets me, that any person is effectively allowed to get themselves into debt by their living expenses exceeding their income! for a generation who didn't generally believe in the never-never.

    Anyone else 'living well beyond their means' would be prosecuted, but our relatives are allowed to do so merely because they scrimped and saved and did without for many, many years to be able to afford their own property. My mother (and father if he were still alive) would be horrified to think that my mother's 'outgoings' are 3 times her income! :eek:
    They never 'did' loans HP etc, apart from their mortagage and sacrificed much to get that property, including my mother never never getting back to her homeland for years and her father dying in the interim.

    My mother's NH owner freely admitted he couldn't continue without using self-funders to make up the shortfall. We are now paying 60% more than when my mother went into the Home 5 and a half years ago.:eek: Inflation hasn't risen by anything like that.:confused:

    My rant over.
     
  17. Coulddobetter

    Coulddobetter Registered User

    Oct 19, 2016
    23
    I take your point.

    My Mum went without to bring up five children, as well as working part time.
    She nursed my Dad through cancer, over 30 years ago. Looked after both my maternal Nan and Grandad( she was their only child) who lived with us - they didn't go into care, and also her Great Aunt, who came to live in the family home. Never went into debt, and always lived within her very modest means. She has been fortunate until AD, never to need the NHS, she had most of us delivered in a small private nursing home where she worked part time as a nurse. Was on no medication at all until AD diagnosed almost three years ago, and even now only has to take Memantine and a preventative dose of anti-biotics daily. Mum is even now 'low maintenance' compared to others in the NH, hence being turned down for CHC earlier this year.
     
  18. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    I also wish some official body would look into care home fees.

    Apart from being told to take in fruit for my Mum I was told they don't provide doorstops to prop the doors open, we would have to buy it ouselves at around £150 fitted.

    Since mum has been in there her toilet window has never opened. Mum has a colostomy and she is always very conscious about leaving smells. We already provide all our own air fresheners as they won't. I asked months ago whether they could open it but they say the key is lost and they don't want to pay out for a new window.

    I was speaking to a physio on the phone one day about returning items mum had used at home and she told me that the home should now provide any aids that Mum needs but the Zimmer frame they gave Mum looks like it came off a tip.

    Like someone else said earlier our care home owner has a top of the range brand new Range Rover and she parks it in such a way in the car park that it's difficult to get in and out.

    I realise for them it's a business and they have to make a profit but OMG they certainly cut corners. Week in week out all the residents get is budget orange squash (I've seen their Asda delivery) I gave Mum some black currant and apple on Saturday and she was like a child with a new toy!
     
  19. Coulddobetter

    Coulddobetter Registered User

    Oct 19, 2016
    23
    Frustrated at my lack of agency both with regard to AD and the care sector as it currently operates in 'Rip off Britain' decided I needed to put up or shut up. Have written to my local elected politician, and another elected politician, next stop CQC, the only watchdog we have. Could I urge that others in the same situation do the same. We should not be content to accept the status quo. Dementia is a terminal illness and not a social care issue. Sufferers are marginalised, NHS don't have to deal with it except at the margins eg falls, infections etc and whilst it remains categorised as a social care issue then the relatives have to shoulder the full burden, stress and anxiety of that care.
     
  20. SnowWhite

    SnowWhite Registered User

    Nov 18, 2016
    378
    Good for you! Well done. I have written to THe Prime Minister and had a rapid reply to say they were passing it to another dept. If I don't hear from them in the next week she will be getting another letter. I am also seeing my local MP in Sept.
     

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