Local authority eligibility criteria for care home care

[father ted]

I am hoping someone may be able to tell me where I may be able to get hold of a checklist or guidelines that the local authority would use to judge who is and who isn't eligible for financial assistance toward the cost of their care home or even if such a thing exists? I can't believe it would be so arbitary that they would look at each case on the needs of an individual- I don't think they are that advanced.

After 18 months of self funding Mum's money is running low. I have contacted the council and they have acknowledged my application but nothing since. I call/e mail every week and just get fobbed off that they are a very busy department and there are delays for more urgent cases. You never speak to an actual care manager only someone in the initial response team who have no other purpose or power than to pass on a message. Very soon her money will be gone and the bills won't be paid unless I pay them. The home have been very sympathetic but ultimately it is not their problem. They have also told of me of another case within the home( no confidentiality breached) where the lady with higher care needs than my Mum has been refused funding! I am worrying more and more, it is effecting my sleep as it is all that I can think of. My husband retires soon so our income will be reduced to around a third of what it is now. Is there anything anyone can advise me to do to push this along. Many thanks.

 

[Beate]

There are two questions here really. One, what are the eligibility criteria for a place in a residential or nursing home, and two, what are the financial criteria. The second is a lot more clear cut - under £14,250 you are LA funded, between £14,250 and ££23,250 you are part LA funded, and over that amount you are a self-funder. You can of course apply for full CHC funding, but that's rarely granted.

The first question is a lot more nebulous, because it does not only take the condition and needs of the cared for into consideration, but also the willingness of any carer. Generally SS try to keep someone at home, but if a carer refuses to continue or someone gets sectioned due to volatile behaviour, they will have no choice. Financial restraints do play a role, which is why it's important to do any needs assessment before a financial assessment.

We can't expect SS to simply start paying once someone who is already resident of a care home goes close to the threshold. They will want to know what their needs are and if a cheaper care home might fulfill their needs just as well. Basically, they pay so they want a say. I know it's deeply frustrating that this is delayed so much - other than wearing them down by calling regularly, I'm not sure what you can do though.

 

[father ted]

Thanks for your reply Beate,

I don't expect them just to pick up the tab automatically but if i am not prepared to do the caring so they have to find a placement but I am prepared to pay the top up over and above their threshold surely there should be no issue? Or am I being naive and not considering anything that might be relevant?

 

[Sirena]

That's so frustrating. I agree it is fair enough they want to do a needs assessment, but they need to do it promptly so that care is continuous. Have you asked the care home manager how SS do the assessment, and what criteria they use? (I can't see how they can refuse funding for that other resident - are they saying the person did not need to be in residential care and could live independently? Or did they just refuse to pay the fees for that particular home, and require the resident to move to a cheaper placement?)

 

[pipd]

Perhaps the 'refused funding' comment was in relation to CHC rather than Local Authority funding ? The whole process of funding seems to be quite complicated in itself but when you bring in the possible CHC issue it just seems to confuse people even more. Took me ages to get my head around the system.

 

[father ted]

The manager mentioned the local authority refusal to fund but there are many vagaries to each case and so there maybe much more to it than meets the eye. I know the home itself is on the council's approved list- this is something I made sure about before we accepted the place.

Will keep on at the council and the home manager suggested that I 'cc' him in to any future e mail contact so they can track the communication too.