Not Understanding Funding

[canary]

We are currently in the situation where Mum is in hospital and we have found the right care home. However, Social Services are saying that we have to use one of their 'block beds', which I believe is against the Government Statutory Guidelines.

Has your mum been offered a "Discharge to Assess" (D2A) bed?
This is usually up to a 6 week period of assessment in a care home where that persons needs can be assessed. It is paid for by the NHS, but there isnt much choice about where you go. After this, if a care/nursing home is required permanently it would be funded by self-funding/SS as per usual.

 

[SMBeach]

The problem I've got is that the care homes which meet my mum's needs don't accept the LA rate on its own - they will only do that if somebody tops up to the full private rate. I was hoping to negotiate, but no!

I think my mum is under the 23k threshold so she would essentially lose all her pensions (less £28 per week subsidence allowance), and pay the LA tariff, and I would have to pay a third party topup to keep her in the home. *

My calculation above is somewhat hypothetical but it seems to make it appear as though someone who was self funding for a while would not be worse off, given the need for topup from a family member when the 23k threshold hits them.

* The homes in question said that if you couldn't top up beyond 2 years they would then accept the LA rate (but not before).

I’m going through all this now and it is a bit mind blowing. I’m in the Scottish system so won’t go into too much detail as probably irrelevant to the English system. Dads care home is £1,680 a week. They said he’d have to pay full whack for the first 2 years before they’d accept council contract. My brain was getting in such a muddle that I ended up throwing all dad’s financial info to the home to see what they could do. They came back and said they’d drop the 2 years to 18 months and reduce the fees to £1,500. That’s do-able for dad as he has good pensions and a house to sell although we will be billed for outstanding fees on sale of house. I’m wondering have you shared the financial info with the care home as you may find they will negotiate.

 

[maisiecat]

The funding situation is an absolute minefield. LA seem to have what they will spend but my husband's needs are really complex and no homes at the level they would spend would take him. I am paying £1100 a month top up from a private legacy and he is in a really lovely home but it is £1800 a week. We never had that sort of income when we were working. They do lovely things with their residents but obviously most of the people are wealthy so money is no object so I get a monthly bill for his trips. A hospital visit cost £80 as I was unable to go due to COVID.
The Home Manager definitely does some negotiation on money although most people are self funders.

 

[canary]

LA seem to have what they will spend but my husband's needs are really complex and no homes at the level they would spend would take him.

The LA has to find at least one home that can meet his needs and accept their level of funding. If somewhere will accept him then the LA is deemed to have met their legal obligation (even if the relatives dont like the home) but if no-where will accept him, then they have to increase their funding.

 

[nitram]

@Claire Batt

Agree with @canary that it could well be a D2A placement.
The stay is not fixed it is a maximum of 6 weeks.
The outcome can be either a care home or care at home.

If you think she should move into care and have found a home you like with a vacancy and if you will be self funding you could approach the home to assess her in conjunction with the hospital discharge team to see if she can be discharged to your chosen home.

 

[AnneF]

I’m wondering have you shared the financial info with the care home as you may find they will negotiate.

I don't know anything about the Scottish system, but I'm guessing the financial assessment deemed your Dad to be a self funder for the first two years, after which local authority funding would kick in.

Private financial information is only discussed with the care home when answering the question of whether you can meet their minimum sustainability term - that is when you are self funding. If topping up a local authority allowance, you will also need to provide proof of sustainability either to the LA (if the topup goes through them, as it often does) or the care home (if they are managing the topup agreement).

And yes, I did negotiate the room rate with the care home first - I negotiate all professional fees (solicitor, financial advisers etc).

 

[Jacaranda16]

OMG, all that reading is mind boggling and I'm about to enter all that too!
I've posted these messages back to myself for future referencing. Hopefully I have a way to go yet though. What would we do without this website, I just don't know. Thank you all.

 

[nitram]

I've posted these messages back to myself for future referencing.

You can click on 'bookmark'

to store them in your account

https://forum.alzheimers.org.uk/account/bookmarks

 

[Claire Batt]

Has your mum been offered a "Discharge to Assess" (D2A) bed?
This is usually up to a 6 week period of assessment in a care home where that persons needs can be assessed. It is paid for by the NHS, but there isnt much choice about where you go. After this, if a care/nursing home is required permanently it would be funded by self-funding/SS as per usual.

(and @nitram)

No, this was for a permanent placement. They didn't want to move her temporarily and move her again. They were still talking about 'block beds' yesterday until we quoted that they were in breach and they have now contacted our chosen care home with the Referral form, so we're on the right track now.