I suppose the LAs think in averages, four years or whatever it is.
In August my mother will have been at her CH for 8 years. During that time I have seen so many other residents go, or both come and go.
Protecting mums finances
- Thread starter Martin099
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I suppose the LAs think in averages, four years or whatever it is.
In August my mother will have been at her CH for 8 years. During that time I have seen so many other residents go, or both come and go.
I read somewhere that the average stay in a CH was 2 years which is why they think this is affordable.
I can only guess, like everyone else including LA's, as I have read no guidance on how it will happen in practice.
LA's will probably have to err on the side of safety of many, many years of care and it would be determined by your total capital being high. I doubt very much it will have anything to do with lower threshold being increased (mentioned above) as that kind of money isn't going to buy you much at all.
Again with those on deferred payments I cannot see first party top up's being offered to anyone without a very substantial property.
They don't know the duration of the stay but post April 2016 a person moving from self funding to LA assisted funding will have capital of £17000.
Assuming a top up of £100/Wk is required for them to not change accommodation their funds to pay top up would not run out for just over 3¼ years (maybe less because of fee increases). This would mean that the LA did not have to worry about 'you can't move Mr. Smith because it's not in his best interests' until that time and not have to pay the top up themselves if the argument went against them.
Also during that 3¼ years Mr. Smith may have died or have had to be moved from residential to nursing care effectively resetting the whole care assessment, the LA can't loose.
Assuming a top up of £100/Wk is required for them to not change accommodation their funds to pay top up would not run out for just over 3¼ years (maybe less because of fee increases). This would mean that the LA did not have to worry about 'you can't move Mr. Smith because it's not in his best interests' until that time and not have to pay the top up themselves if the argument went against them.
Also during that 3¼ years Mr. Smith may have died or have had to be moved from residential to nursing care effectively resetting the whole care assessment, the LA can't loose.
In the Nursing Home where my sister was, the longest someone had been there was 16 years.
And, of course, Pamela Coughlan, who won her case to get CHC in 1999, has been in care since the '70's, following the accident that paralysed her. That is why the NHS are so reluctant to award it!
For people unlucky enough to need care for that long, the Care Act will at least reduce their expenditure to mere tens of thousands, rather than hundreds of thousands. I'm sure LAs are praying there won't be too many like that once the cap comes into effect!
"... the Care Act will at least reduce their expenditure to mere tens of thousands, rather than hundreds of thousands. I'm sure LAs are praying there won't be too many like that once the cap comes into effect!..."
That assumes that CHC is not awarded thus moving the cost from the LA to the NHS.
However >>>DEVO MANC<<< is about to change this where I live.
That assumes that CHC is not awarded thus moving the cost from the LA to the NHS.
However >>>DEVO MANC<<< is about to change this where I live.
In the New Care Act Guidance it says...........
"Given an average length of stay in residential care of 19.7 months (source: BUPA 2010, cited in Laing and Buisson 2012/13)"
The LA could loose out as they will be responsible to pay the full cost till the person gets moved which could take some time.
From the new Guidance.......
"When entering into a contract to provide care in a setting that is more expensive than the amount identified in the personal budget, the local authority is responsible for the total cost of that placement. This means that if there is a break down in the arrangement of a ‘top-up’, for instance if the person making the ‘top-up’ ceases to make the agreed payments, then the local authority would be liable for the fees and must either recover the additional costs it incurs or make alternative arrangements to meet the cared for person’s needs."
Post 68
OK.
My point was that the LA know the resident's funds and the amount of top up. They can sit back for a calculated time whilst the top ups are being paid during which time it is likely that the resident may have died or their needs changed significantly.
Only when, and if, the funds are running low do they have to start negotiations about the resident's continuing ability to pay top ups.
OK.
My point was that the LA know the resident's funds and the amount of top up. They can sit back for a calculated time whilst the top ups are being paid during which time it is likely that the resident may have died or their needs changed significantly.
Only when, and if, the funds are running low do they have to start negotiations about the resident's continuing ability to pay top ups.
I think the guidance says the LA have to be sure that top ups can be paid for the "duration" so no renegotiation should take place except in extraordinary circumstances.
Post 67
It would be interesting to know more about this statistic, I would assume that temporary stays are excluded, but what defines a temporary stay? Is it just respite?
In the home my wife was in they took people from the local hospice. As the home did not have a permanent doctor on duty they could not administer IV medication, some people currently in the hospice (where IV was possible) who did not require IV were transferred to the home for end of life care.
I spent 10 to 12 hours a day at the home for 3 months (I was almost accepted as a member of staff and was put 'on the menu' for residents' meals FOC! ) and saw that hospice transfers typically stayed for days bordering onto weeks, I believe they were classed as permanent residents.
It would be interesting to know more about this statistic, I would assume that temporary stays are excluded, but what defines a temporary stay? Is it just respite?
In the home my wife was in they took people from the local hospice. As the home did not have a permanent doctor on duty they could not administer IV medication, some people currently in the hospice (where IV was possible) who did not require IV were transferred to the home for end of life care.
I spent 10 to 12 hours a day at the home for 3 months (I was almost accepted as a member of staff and was put 'on the menu' for residents' meals FOC! ) and saw that hospice transfers typically stayed for days bordering onto weeks, I believe they were classed as permanent residents.
That Manchester initiative looks very interesting. I hadn't heard of it so thanks for sharing. I wonder if other areas will follow suit.
Re the other point in your comment, - yes, I'm assuming CHC is not awarded, as we're talking about self-funders who reach the care cap and then have to be funded by LAs. If they had not been awarded CHC already, they would be no more likely to qualify when they happen to reach the cap, as that would not have any relation with their health - just their finances!
"I think the guidance says the LA have to be sure that top ups can be paid for the "duration" so no renegotiation should take place except in extraordinary circumstances."
The whole thing is going to end up in a shambles.
Are top up a fixed amount, a % of the LA assessment, or subject to some kind of increment?
Presumably the LA has a contract for £x which is the sum of the LA assessed value and the agreed top up, one could also expect an annual review.
The whole thing is going to end up in a shambles.
Are top up a fixed amount, a % of the LA assessment, or subject to some kind of increment?
Presumably the LA has a contract for £x which is the sum of the LA assessed value and the agreed top up, one could also expect an annual review.
Even if the person has to move to nursing care, the LA will still have to fund them -minus the Funded Nursing Allowance - once they fall below the threshold. And if the person does live for a number of years longer, the costs to LAs could be substantial.
"Even if the person has to move to nursing care, the LA will still have to fund them -minus the Funded Nursing Allowance - once they fall below the threshold. And if the person does live for a number of years longer, the costs to LAs could be substantial."
The person will already be below the threshold otherwise top up would not be involved.
A change from residential to nursing care will involve a new contract between the LA and the home. The LA may not agree to a top up on this new contract.
The person will already be below the threshold otherwise top up would not be involved.
A change from residential to nursing care will involve a new contract between the LA and the home. The LA may not agree to a top up on this new contract.
There are two issues which I think need to be considered.
- The result of the referendum on Europe.
- The present government's aim to reduce immigration.
Regardless of who is paying for the potential resident's care, there has to be a residential or nursing home which has vacancies, and more importantly staff.
Without the staff, who is going to look after the potential residents?
It seems to be a case of putting one's name on a waiting list, literally years or even decades before care might be needed. And fingers crossed the home will still exist when the need for care is required.
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Sorry - I think I got confused somewhere along the thread and did not realise you were talking about top ups - which I don't fully understand the ins and outs of anyway!
I am just looking at the whole picture once the care cap comes into effect. LAs may have done their sums based on the average stay in a care home, and think they are relatively 'safe', but the fact remains that there will still be a number of self-funders who live considerably beyond the average, and the new law will mean the LA having to contribute towards such people, unlike at present. It is going to cost LAs more, and I wonder where this money will come from.
You may find this >>>BBC CARE COST CALCULATOR<<< useful to estimate your spend before the cap is reached and the time to reach the cap.
That is a good point. Even now there are waiting lists. My father, who happened to be self-funding when he first went into care, had to wait some time before a place became available. Also, as the current baby boomer generation start needing care on a large scale, supply may not be able to keep up with demand. Working in a care home is not a job that many people either want or are able to do, yet it is essential to get the right kind of staff.
There are also young adults with congenital disabilities who don't have adequate care nor have had the chance to build up resources to pay for their care.
Who cares for them?
Who cares when people without assets and capital have profound needs?
Who pays?
The taxpayer.
Nowt but right.
Who cares for them?
Who cares when people without assets and capital have profound needs?
Who pays?
The taxpayer.
Nowt but right.
