Money worries

[Marsupial15]

Hi there,

I was just wondering if anyone had any stories/tips/anything they could share about social services and continuing healthcare financial assessments?

Mum was moved in to a residential home at the end of last year (privately funding) but things have deteriorated very rapidly and a few weeks ago the home said they could no longer cope with her behaviour and moved her to their sister nursing home, which is great and specialises in dementia. Fees are, however, more expensive and it won't be long before Mum's savings are gone and we'll be at the threshold for the local authority to start contributing to care costs.

We are still awaiting the results of the formal financial assessment but her social worker has told us that because of a combination of Mum's income and the cap the local authority will pay, we are likely going to be looking at an enormous shortfall. A monthly shortfall of around £4,000!!!!!!!!!!!!!!!!!!!!

The justification for this cap is apparently that there are other homes in the area that have 'social beds'. I've not fully got to the bottom of what this means/how this works, but we've looked at a lot of the local homes and some of them have been heartbreakingly dreadful.

I really don't want mum to have to go through the upheaval of moving for a second time, especially to somewhere awful. I don't think I could do it.

We are also progressing an application for continuing healthcare funding but I know this can take ages and be very difficult to get (the social worker believes we have a decent case but I don't want to hold out too many hopes on this).

I guess I just wondered if anyone had been through similar or had any words of wisdom. There's just no way Dad and I can afford to make up that kind of difference in the long run.

Thanks in advance.

 

[70smand]

I can’t offer too much help as my dad was not successful in obtaining chc funding but there needs to be very thorough documentation from the care home regarding specific incidents to support your case and I would also make sure you have dates etc carefully documented yourself.
I may be wrong and hope someone can clarify this but I thought that even if funding was granted it would only be up to a certain limit depending on the area and if a home was more expensive then it would still need topping up by family? Not sure if I misunderstood that bit.
Also, are you sure it’s a shortfall of £4,000 a month as that is more than my dad’s nursing home costs in a whole month and sounds ridiculously expensive. I do know that sometimes nursing homes lower their fees to the local authority rate once the person is no longer self funding- that’s what my dad’s care home did.
Sorry I can’t be of more help. It’s horrible to think of having to keep moving the person you love, when you just want them to be settled and well cared for. Best wishes x

 

[Baz22]

Firstly remember that the NHS CHC team are not like the nurses, paramedics etc they are not there to help you but to find any way possible to deny you funding. There is lots of information on the Alzheimers and the Age UK websites. Familiarise yourself with the Coughlan case, Grogan case, Pointon case and Garside case as you will get an understanding of how the NHS use their Decision Support Tool illegally. Record everything. You will need perseverance and a strong will. Most people get refused but the NHS have had to pay out in over 750 cases where they refused funding.

Re the £4000 gap that is more than we pay in fees for my Mother who has mixed dementia. We are in the middle of the CHC Appeal process and are also getting close to exhausting private funds to pay for my Mother's care. The CHC people just add more stress to an already stressful situation. Feel for you and hope you can get funding.

 

[sah]

Remember that SS are obliged to provide care according to your mother's needs-not according to their finances-plus there is not really a 'legal' cap to what they will pay-if the only home that suits her is more than they say, they have to finance it although we're all aware that there is not a bottomless pot.

Homes generally charge SS residents less than those paying privately as well so the short fall may not be anywhere near that much. For example-when my husband move from private to social funding, the fees dropped from 1300 per week to 900......

If they have a cheaper home that will suit her, then you may have to accept a move-but it would seem that it should be a dementia specialist. Maybe try her GP/consultant for support? Maybe ask for a statement from her first care home as to why she need the more specialist care? Good luck!

 

[canary]

I think that it is extremely unlikely that you will be able to persuade the Local Authority to finance that much over their limit. They only have to provide one home that will meet her needs that they will fully finance in order to meet their obligations - the care/nursing homes set their own fees and if their fees are higher than the LA cap then they are looking for a top-up fee from a third party (usually the family).

I really wouldnt place too much hope in Continuing Health Care. If you cannot afford the top-up fees (and they are, indeed, eye-wateringly steep), then I think, honestly, that you should bite the bullet and look at cheaper homes. The most expensive place are not necessarily the best and the cheaper places are not necessarily the worst. Dont look at the superficial stuff like decor, coffee shops, on-site hairdressers etc - look at the carers and how they interact with the residents. My mum was in a cheap care home (a dedicated dementia unit) which was a bit worn and scruffy round the edges, but the care was wonderful. Aim for a place with a homely atmosphere, clean and welcoming, visible caring staff and dont worry about the rest.

 

[Marsupial15]

Thanks everyone for taking the time to respond.

I've started looking around at other local homes, but none of them appear to be that much cheaper - if they offer nursing care (which Mum needs) they seem to be eye wateringly expensive. I'm going to try to speak to the social worker again this week to see if she can show me which home she believes would offer the level of care mum needs for the price they would pay (or close to - we are very aware will may need to top up, but were expecting a more reasonable figure!).

Also interesting that homes sometimes lower fees for ss funded residents, I'll look in to this.

I've been documenting Mum's decline sporadically but also sounds like I need to get much hotter on this and keep more detailed notes to inform the chc funding assessment. I'm not holding out hope but will pursue it as much as humanely possible!!

Thanks again and good luck to you all with your own battles - it really does add stress to an already horribly stressful time!