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Nursing home top up demand

Judge80

Registered User
Nov 23, 2016
6
Hello all, my first post as a relative of a vascular dementia sufferer. We have just moved her from a nursing home with no mental stimulation to another local one which suits her needs better. Our council have agreed to fund it as her spouse lives in their house and her savings are low now. However the new manager rang us the day before admission asking for a top up to full private rate but told us not to tell council or they will withdraw funding. Council now demanding to know if we are paying a top up . We took legal advice and were told to get home to get top up via council and we then pay council extra rate but we are afraid of losing her place. She is not settled and agitated so we don't want to give home any excuse to not take her permanently! She cannot live at home as spouse also affected to a lesser degree and she was not happy in herself there either. Does anyone else have similar experience of top up demands please?
 

PeggySmith

Registered User
Apr 16, 2012
1,683
BANES
Don't. Once you start it goes up every year. Can you absolutely guarantee that you'll always be in a position to pay?
 

nitram

Registered User
Apr 6, 2011
19,934
North Manchester
The LA (Council) have placed the relative in this home.

They will be paying less than the self funding rate.

They have duty to find an appropriate place, if they can't find one at what they are prepared to pay, hard luck they have to stump up.

If the person is placed in a home demanding a top up they do not have to pay this, this refusal may lead to a less preferable placement, maybe some distance away.

The preferred method of paying any top up is that it is paid to the LA although paying to the home is possible with the agreement of the LA, home, and resident.

Approach the LA and say that the home are asking for a top up that you can't afford and see what they say, the worst they can say is 'if you can't afford it they will have to move', it's most unlikely that they will take any actio until they have your response.
 

jenniferpa

Registered User
Jun 27, 2006
39,448
I hesitate to throw around terms such as fraudulent, but that's what this sounds like : attempted fraud on the part of the home. Pretty damn barefaced as well. I understand that you don't want to jeopardize her placement but I do rather wonder if the home can actually be trusted.
 

Kevinl

Registered User
Aug 24, 2013
4,771
Salford
However the new manager rang us the day before admission asking for a top up to full private rate but told us not to tell council or they will withdraw funding
Hi Judge, welcome to TP
The bit I've underlined of itself sounds well dodgy, what else are they hiding from the authorities? If the LA are funding then they have to find somewhere that meets her needs without a top up, whether you find the place acceptable is a secondary concern.
This shouldn't be happening and I smell a rat.
K
 

nitram

Registered User
Apr 6, 2011
19,934
North Manchester
Jenniferpa

I was more hesitant than you.
The bits I did not like were:-

but told us not to tell council or they will withdraw funding

and

Council now demanding to know if we are paying a top up

It would be interesting to see the contract with the LA.
 

Judge80

Registered User
Nov 23, 2016
6
Thanks

I agree it sounds dodgy but after asking people at work this seems commonplace with councils turning a blind eye. At the moment we have a short term agreement with them so have avoided issue and have no intention of just paying up. This practise was also deployed to a lesser extent in her previous home and we naively thought my FIL just had to pay. He also has dementia and it really angers me that he could have been pressured by guilt into paying anything they asked without question. There needs to be a cap on what care homes can charge and clear guide lines from Government on top up charges. Age Concern have advised us not to enter into a private agreement as this can be increased at will. Our problem is that we are having to talk hypothetically to the Council who seem to want to investigate the matter aggressively. We need this place desperately as ,apart from the financial department ,it is a lovely, convenient place for her husband to see her daily. We have power of attorney now so can intervene and ask them to keep to one Council contract and keep our fingers crossed. I hate this cruel disease and how businesses and individuals are so quick to take advantage. Thanks for all replies.
 

jenniferpa

Registered User
Jun 27, 2006
39,448
You're in a difficult position, I do understand that and it's easy for someone on the outside ( I.e. me) to be outraged but you are the people having to deal with it. But I am outraged: because it's clear that they have a contract with the LA that precludes them asking for a top- up. And the LA is sending them placements on that basis.

You say people you work with have told you this isn't uncommon but from what you have said your LA isn't inclined to turn a blind eye, and in my view, rightly so. Realistically, I suppose, the La rate should be higher to reflect the real cost if care. If people are essentially forced to pay an under the table top- up, the LA have no incentive to raise their rates.

On the practical level, I have to say I completely agree with age concern about entering into a private agreement, although only you know how much you can afford to pay and for how long.

The difficult thing here is that you have to balance what us right in a general sense and what is right for your mother. I can be all about: don't do it, it's not right but in your position you may well feel it's the lesser of two evils. And perhaps decide that when you no longer need the placement, shop them to the LA. I'm really sorry you have been put in this position. Although I feel I should point out that in this situation it's not about the government not being clear about top- up charges but the willingness of this home to break their contractual agreement with the LA.
 

Kevinl

Registered User
Aug 24, 2013
4,771
Salford
There needs to be a cap on what care homes can charge and clear guide lines from Government on top up charges.
Care homes are a private business how can you cap what they can ask people to pay?
If one home has twice as many staff as another and a whole load more activities, better rooms and food why should they only get the same as some run down hole of a place? It would be a race to the bottom and the worse homes would win.
The second part on top ups the rules are clear, no one LA funded has to pay a top up.
I found a place with an £800pw top up over and above the LA rate but you could see why, it was like a 5 star hotel, if people can afford it then they should have it.
The home are deceiving the LA but on the one hands you say " the Council who seem to want to investigate the matter aggressively" but earlier say "asking people at work this seems commonplace with councils turning a blind eye" the 2 comments seem to contradict each other!
Personally I'd work with the LA if they find out you've been paying a "backhander" to the home they could refuse to deal with them, that wouldn't be "withdrawing your funding" they would just be telling you it can't be spent at that home but if you don't tell the LA the truth there may be implications too.
K
 

Judge80

Registered User
Nov 23, 2016
6
Thanks

Sorry my comments did sound contradictory! I should explain that I work with people from different London Boroughs and it was interesting hearing their experiences with relatives and friends in various nursing homes. The Council we deal with seems to be anti top up but we are a bit wary of putting all our cards on the table although I think my husbands family will have to trust them. I quite agree that it is right to pay for extra facilities and nicer homes if you want more than the Council is offering but in this case she seems to have a pleasant standard room with no extra frills so an extra £300 a week (£12000) annually is not a reasonable request! Anyway, enough from me and all the best to all of you clearly dealing with the many issues that dementia brings to families.
 

jenniferpa

Registered User
Jun 27, 2006
39,448
I've been thinking (for that read simmering) about this today.

The new (I wonder if that's relevant and if that person is actually clueless?) manager has basically said that if you don't pay them funding will be withdrawn. Well it won't be withdrawn from your mother but it's entirely possible that the home will no longer be under contract with the LA. Now I can see two scenarios here: that the home doesn't actually want to have LA funded clients and are trying to get the LA to break the contract (although I would imagine if the LA did this because the home was extorting the clients to pay top-ups that there might be ramifications) or that the new manager has been brought in to improve the financial situation of the home and is basically trying it on.

If the LA has, independently, contacted you to ask if you have been asked to pay top-ups, then it seems to me that you aren't the only people to have had this proposition put to you, and if that's the case: well TBH - whatever you do, it seems likely that any placement here will be temporary at best (unless the manager is truly rogue, in which case the home will back pedal). Because if you don't tell them someone will.

And do bear in mind I'm assuming they have already assessed your mother (or is it your MIL?) If they ask for money now, you refuse it, and then they say "Oh no, she's not suitable" then as Beate says: that sounds an awful lot like blackmail.
 

Babymare01

Registered User
Apr 22, 2015
309
I just don't understand top ups - we recently had to look for a nursing home given mum is now bed ridden and in late stages of Dementia. We were offered 2 rooms - 1 en suite(top up) I not (no top up). Given mums situation we choose non top up. Mums care is beyond excellent. The home itself is not the most glitzy place(big old house with only 18 residents) but clean and homely. The staff are focused on mums care and dignity and when ever I walk in I feel like there are arms going round me to hug me - so an en suite means top up ?
 

Toddleo

Registered User
Oct 7, 2015
411
The staff are focused on mums care and dignity and when ever I walk in I feel like there are arms going round me to hug me
Just lovely to read this! isn't that just what we all want for our loved ones?
 

jenniferpa

Registered User
Jun 27, 2006
39,448
I just don't understand top ups - we recently had to look for a nursing home given mum is now bed ridden and in late stages of Dementia. We were offered 2 rooms - 1 en suite(top up) I not (no top up). Given mums situation we choose non top up. Mums care is beyond excellent. The home itself is not the most glitzy place(big old house with only 18 residents) but clean and homely. The staff are focused on mums care and dignity and when ever I walk in I feel like there are arms going round me to hug me - so an en suite means top up ?

I'm really pleased you feel this way about the home: I think everyone would wish to feel that way. And no, en suite doesn't by definition mean top-up. In your case - yes because the home had both en suite and not rooms. And so you would be paying for extra facilities. But in many homes all rooms or en suite (or none are). The truth is: in my opinion the OP is being shaken down by the manager of the care home. I think this really is an anomaly.
 

Judge80

Registered User
Nov 23, 2016
6
Update on top up demand

In the end my husband copied his siblings and the home manager into an email to the council asking how top up requests should be paid. He immediately received a reply from the social services department saying that NO extra money should be paid directly to the home and only one contract should be in operation between the care home and the council. This isn't to say we won't have to pay any extra but the financial assessment requested a small extra amount initially anyway and my in laws financial circumstances haven't changed since then. The care home is owned by a large corporation and we feel were clearly trying it on to get the full rate. It angers us that probably many relatives have paid up and are unaware or frightened to enquire about their rights. My father in law also has dementia and is very trusting and full of guilt that he can't look after his spouse of 60 years at home. He would have paid up with no questions had we not had power of attorney. The care home have fallen silent for now and I really hope my MIL's place isn't jepordised but we will fight it if so . I will post further updates as this situation needs to be clarified and I hope to help others in these stressful dilemmas.
 

pamann

Registered User
Oct 28, 2013
2,635
Kent
Hello Judge, l have to pay top-up fee's to the council, they then pay the Care Home, l thought it would go up when a re-assessment was made in April, but l paid £10 less. My husband does have an ensuite room, that was the only room available when he went into the CH, l was told they may move him to another room but they never have. Hopefully it will go down next year.
 

nitram

Registered User
Apr 6, 2011
19,934
North Manchester
" l thought it would go up when a re-assessment was made in April, but l paid £10 less"

This may not be anything to do with the top up, it could be your husband's reducing capital.

With capital between the lower and upper limits the resident has to pay £1/wk for every £250 (or part thereof) their capital exceeds the lower limit.