My mother-in-law was diagnosed with Alzheimer’s at the end 2021 whilst renting a flat independently from a local charity. As her condition worsened through 2022, it became clear it wasn’t safe for her to continue living independently despite her local adult social services arranging 4 carer visits per day. This was confirmed after she spent about a month in hospital over last Christmas and again in March this year. The occupational health team in the second hospital made it clear to social services that it wasn’t safe for her to return home and that she needed a permanent care home. The charity my mother-in-law rented from also had its own highly rated care home catering for dementia sufferers but in a neighbouring local authority area. We organised a place there which she moved into at the beginning of April, which her local social services reluctantly agreed to (because of costs) , but on a temporary basis whilst they assessed her. Social Services have told us how much they will provide to fund her care, without explaining how they arrived at the figure. However, we believe that my mother-in-law‘s pension will be sufficient to meet the shortfall between the monthly care charges and the local authority contribution. In the 2 months she has been in the home she has settled well and developed a close relationship with the staff. The local authority has yet to carry out a financial assessment of my mother-in-law, but despite this is asking my wife and I to guarantee In writing any shortfall, otherwise they will not confirm the placement is permanent and they will move her to another, cheaper, care home. We are perplexed and worried.
Local Authority Finance
- Thread starter Sirhowy
- Start date
Hi @Sirhowy and welcome to Dementia Talking Point our supportive and friendly community. I am sorry to hear about your situation, which I have not come across before. However, my understanding is that you are not liable in any way for the cost of care for your mother-in-law. If she has assets of more than £23,250 she will be considered to be self-funding. If below this threshold level then she will be required to make a contribution, with the Local Authority picking up the rest. This contribution will be calculated as part of a financial assessment.
As an illustration, my wife's full time residential care costs require a weekly contribution equivalent to her state pension plus half of her occupational pension, less a statutory personal expenses amount.
The link and attachment below give more details on paying for care.
www.alzheimers.org.uk
As an illustration, my wife's full time residential care costs require a weekly contribution equivalent to her state pension plus half of her occupational pension, less a statutory personal expenses amount.
The link and attachment below give more details on paying for care.
Paying for dementia care in England
Dementia care isn't free, and you may need to pay for some of the care you or someone you know needs. We help you understand the different ways to pay for care, and the amount you might be expected to pay.
www.alzheimers.org.uk
Hi @Sirhowy
For what its worth my views/thoughts are as follows.
Each local authority make their own decision as to how much they will/can pay for a residential care home place and for a nursing home care place. The figure they choose may or may not be at the level the care home / nursing home wants and in fact is usually well below.
So, for example, if the LA says they'll pay at the rate of £575 per week, they then see if they can get the home in question to accept this. If the home accepts this, then all is OK. (The home just charge any shortfall to those that are self funded residents. Thus if the home really want £775 per week, then they divide the £200 "shortfall" between those residents that are self funded, which means the self funders might be charged £825 per week and not £775 per week)
If however the home in question won't accept the £575 per week the LA offer, then the home tries to get the extra from the resident's family. The family are under no obligation to pay, unless they actually agree. If the family don't agree or can't agree, because they don't have the money, and the patient doesn't have the money and the LA won't pay what the home want, then sooner than later the home will say to the LA, sorry we can't keep this resident here and they give notice to the LA to move the patient. The LA then, if they can't get family to pay extra, have to find a care home / nursing home that is prepared to accept what the LA will pay. This usually means a home provided a lesser standard of amenities (it can't or shouldn't be a lesser standard of care/nursing.).
The LA are more likely to find a home that will accept what the LA will/can pay in their own area because the homes in that area know what the LA will/can pay; and in your case, you're dealing with a home out of area and the LA for the area in which the home is geographically situated may have set a different level of payment they can make.
Sorry for length of reply. I hope it makes sense to you.
So you need to find out (i) what LA will pay or are paying, (ii) what home would like to charge (to see the difference)(you'll need to speak to home), (iii) what LA in area of home would pay (the care home may be able to tell you) (iv) what the homes are like that are in the original LA area that would accept the LA payment.
Don't agree to anything or any payment that you don't want to pay, whatever pressure / "blackmail" they try to put you under. It's a horrible position to be put in.
Best wishes, and good luck.
Hello @Sirhowy and welcome from me too. Sorry to hear about the issues you are having with regards to your mother-in-laws care - does anyone hold Health & Welfare / Financial lasting power of attorney (LPA) for her? It sounds as though the local authority have now conducted a care needs assessment, which will have identified the level of care that your mother-in-law needs, and that will result in a figure that equates to the maximum amount that they will pay to meet these care needs. If your mother-in-law is not able to fund her care herself they will then conduct a financial assessment which will determine how much your mother-in-law will be required to pay towards her care. Most of her income (including pensions) will be taken into account and she would be left with approx £28 weekly as a personal expenses amount to pay for things like clothes, toiletries, hairdressing etc. If there is a shortfall between what the local authority will pay and what the care home will accept then this will have to be paid by a third party, not your mother-in-law (known as a 'top-up' payment).
The local authority have a legal obligation to offer at least one care home placement that meets your mother-in-laws needs and is within the amount they will pay but as they have already been reluctant to pay the care home fees during the temporary assessment period due to the cost, and are asking you to agree to a 'top up' payment to meet the shortfall, it's likely that they are already aware that the maximum amount of fees that they will pay will be less than what the care home will accept. Is it in a more expensive area than where your mother-in- law previously lived? As already mentioned, unfortunately if the care home will not accept the local authority rates (and many won't as this is often several hundreds of pounds less than the care homes are charging) your mother-in-law will most likely need to move somewhere cheaper unless a third party is happy to pay the 'top up' payment.
If there is someone who holds LPA they can request a copy of the care needs assessment which will show the level of care that the local authority has assessed your mother-in law as needing and the cost of that care. They will also be able to request a copy of the financial assessment when it has been completed. As mentioned above, the care home will be able to confirm what their fees are and whether they are happy to accept local authority rates, but don't agree to paying a 'top up' unless you are willing and able to do so as the amount is likely to increase yearly when care home fees go up. The social care system can be difficult to navigate but I hope this helps.
The local authority have a legal obligation to offer at least one care home placement that meets your mother-in-laws needs and is within the amount they will pay but as they have already been reluctant to pay the care home fees during the temporary assessment period due to the cost, and are asking you to agree to a 'top up' payment to meet the shortfall, it's likely that they are already aware that the maximum amount of fees that they will pay will be less than what the care home will accept. Is it in a more expensive area than where your mother-in- law previously lived? As already mentioned, unfortunately if the care home will not accept the local authority rates (and many won't as this is often several hundreds of pounds less than the care homes are charging) your mother-in-law will most likely need to move somewhere cheaper unless a third party is happy to pay the 'top up' payment.
If there is someone who holds LPA they can request a copy of the care needs assessment which will show the level of care that the local authority has assessed your mother-in law as needing and the cost of that care. They will also be able to request a copy of the financial assessment when it has been completed. As mentioned above, the care home will be able to confirm what their fees are and whether they are happy to accept local authority rates, but don't agree to paying a 'top up' unless you are willing and able to do so as the amount is likely to increase yearly when care home fees go up. The social care system can be difficult to navigate but I hope this helps.
All Local Authorities have an amount that they will pay, which is probably based on the lowest amount that a care/nursing home is willing to pay.
Unfortunately, your mums pensions will be included in this amount so will not be available to pay for any extra if the care home you want will not accept the LA rate. This short-fall between what the care home will accept and what the LA will pay is known as the "top-up" fee and has to be paid by someone else.
No-one has to pay a top up fee, but if it is not paid then the home has the right to refuse to accept them
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