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The cost of being self funding

Discussion in 'Legal and financial issues' started by Avenger, Apr 24, 2015.

  1. Avenger

    Avenger Registered User

    Oct 25, 2012
    10
    Whilst one does not want to raise the subject of money while talking about care, the enormous cost of being self funding makes it unavoidable. According to the manager of the care home where my parent is residing, if the care home is short of staff at night and they have to call a supply carer from elsewhere, usually from a private care company, the cost can be £400 per night. However, the pay that goes to the carer herself is only about £60.00. Therefore, on what is the other £340.00 spent on? The fee from the care home itself goes up every year to the tune of £40.00 per week. In a year that is an increase of £2080. Whilst the company is very good at defending itself to justify these hike in prices - stating their increase in heating costs, insurance, training, meeting the increase in minimum wage of staff, etc. - I only have their word for it. In other words, they can say anything to try and pull the wool over my eyes. At the end of their letter giving notice of increase in fees, which comes before every April, they plead for our understanding and patience and end with the rhetorical question 'I trust these increases are acceptable to you? I've never challenged them because I know they are not offering any choice. My challenge is pointless. I know what their answer would be, something like, "If you are not going to pay our charges, then your parent will know where the door is. He can go. There are plenty of other homes you can move into. If you can find a cheaper one offering the same services as ourselves, then good luck to you. We don't mind kicking you out of one of our care homes, because we know there are plenty of others waiting to come in and take your place."
    My summary is this: care homes and caring should not be for profit. There should not be owners and shareholders making a living out of them. They are living well off the backs of people who have had to go to care homes. Going to a care home is not a choice but rather something which is forced upon people when circumstances and events of old age and health have taken over. Counter me if I'm wrong, but I suspect there are people who see running care homes as easy pickings. The people who work in the care home where my parent is are very hard working and caring for their patients. My argument is not with them, but rather with the remote managers and owners who are not local and know little or nothing about the patients and their next of kin. If there are any slip-ups or delays with payment they, without seeking what is the reason, and there could be a bona fide reason for it, like illness with the relative sending the cheques, they come down on me like a ton of bricks. In that way, they show they are not in the business for the caring, but rather for the money. I have no doubt that there are genuine, honest nice people who run care homes. But the ones who run the care home where my dad is are rampant capitalists. I think all care homes should be state run. They should not be running for a loss, but run well and efficiently, and in a loving and homely way. In order to cut out the enormous fees we are having to pay to this private enterprise, I would be willing to increase paying 10 per cent more in taxation. If everybody contributed an increase in what they pay in tax, and look at it as an investment for their old age, I think the state could well afford to run all care homes, or at least most of them. That is how it used to be before, as has the government done in many other fields, sold off sections of the state to the grasping of the private sector. Those are sections of the state which generations of people have paid good money for in their taxes only to see it sold off to the gains of the few. Also think of this: the news has exposed, often years or decades later, bad people running children's homes. In a different sort of bad way, might some care homes for the elderly be run by bad people, who's chief motivation is making huge profits?
     
  2. AlsoConfused

    AlsoConfused Registered User

    Sep 17, 2010
    1,958
    Wholeheartedly agree that good state-funded care would be more affordable, better monitored and probably a generally better deal for the cared for person and their relatives BUT sadly I can't see it happening.
     
  3. Angela T

    Angela T Registered User

    Jul 13, 2014
    187
    France
    £400 per night seems very high for an extra carer.

    When my mother needed one-on-one care for a few weeks, the cost to us was £10 an hour, so £120 per night.
     
  4. Kon Dealer

    Kon Dealer Account Closed

    Apr 25, 2015
    18
    Find out what the Local authority are paying the Care Home for state-funded residents. If you are paying more and are not receiving any extra benefits and facilities (e.g. better room, extra, personalised care, better food), they cannot legally charge you extra, without your agreement. Tell them this and say you are willing to pay exactly what the local authority pay, but you are not paying any supplement, unless they can demonstrate your parent is getting additional care and/or facilities that the state-funded residents are not. I did this and the care home simply accepted it.
     
  5. katek

    katek Registered User

    Jan 19, 2015
    191
    #5 katek, Apr 25, 2015
    Last edited: Apr 25, 2015
    Avenger

    You make some very good points

    If you haven't already read it, there is a recent thread called 'continuing care fees and costs' on which there has been a lively discussion about the pros and cons of self-funding. There are those who see there is an advantage in terms of freedom of choice, but your post shows the other side of the coin when they 'have you over a barrel' as it were. Like you, I hate the way people turn caring into a business in this way. Care Homes also use self-funders to subsidise the LA funded patients quite substantially(LA's budgets are limited but Care Homes wouldn't survive financially without them) so, as Kon Dealer suggests, you should challenge the manager over this. There may well not be someone waiting to fill your father's place, and the CH would therefore be losing out without him there.

    Has your father been assessed for Continuing Health Care? Depending on his condition he may qualify for this NHS funding, although as you might know, it is extremely hard to get even if your needs are at the required level. Self-funding is legal to a certain point (laid down in the 1948 Act) but beyond this, it is NHS responsibility. However, because the NHS are so reluctant to award this, thousands of self-funders are doing so unlawfully.
     
  6. mancmum

    mancmum Registered User

    Feb 6, 2012
    384
    What is the legal basis for this?

    I am interested in this. What is the legal basis for saying that they cannot charge private individuals more than local authorities....

    I am thinking: walk up train fares vs. advance bookings, members discounts, preferred customers etc.

    We are not into care homes yet but to me it does seem like an abuse of monopoly power but how legally can you challenge it.
     
  7. Liz57

    Liz57 Registered User

    Dec 22, 2013
    184
    I'm not sure if this is actually going to work in practice, but my local authority - not known for being particularly responsive - are offering to "commission" my mum's care and then bill me (she's self funding) which they claim will be cheaper for me/her in the long run.

    Worth asking?
     
  8. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419
    I'm of the opinion that if we are talking about legalities, it's perfectly legal for a care home to have one price for self-funders and another for LA clients if the LA is buying a "block" of beds, and paying for them if they are occupied or not.

    The legality issue is: can a self-funder force an LA to provide them with an LA funded bed and thus incur the lower fees? I don't think this would work in practice but it is an interesting question. It definitely is legally a requirement if a top-up is required, but other than that, I haven't seen anything that addresses this as legal requirement.
     
  9. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,666
    Salford
    I have no connection with the care industry, just so you know.
    Currently business inflation is nothing like the 0% the RPI says the consumer is experiencing. Care is a very labour intensive industry and all the government's new initiatives like; workplace pensions, paternity leave, more and more health and safety and all the rest whilst very laudable come at a cost and businesses can't keep absorbing the costs forever, they pass them on to the customer in this case you.
    While supermarket prices are falling wholesalers are putting up the price of catering products as unlike the supermarkets and their massive mark ups the C&C trade has to pass on the upward pricing that is skimming away their small margins.
    We live in a free market economy and a home can charge what it likes as can; a supermarket, an airline or any other business, if you don't like the price then go somewhere else, as care homes are businesses not charities. Is that wrong? Hell Yes. will it change Hell no, or at any rate not 'til hell freezes over.
    If the home you're referring to is a limited company or a PLC then you can look up their accounts and see how they're doing, if it turns out to be a huge profit then the shareholders will be benefiting, that's the way it works now.
    Controversially I will say that the reason it's being privatised is the government when they employ people do it on such favourable terms it became unsustainable, however, when privatised you can let some big company employ staff on much less favourable terms and "keep its hand clean" as they're not the ones exploiting them.
    I don't think you have a case for asking for the LA rate as they will say (quite reasonably) they "bulk buy" so get it at the trade rate which is less than the general public pay, favourable terms for being a good customer are everywhere from air miles to Tesco loyality cards and a co-op divi.
    Great post though Avenger, you've summed up so much of what is wrong but I fear nothing will get better, only worse as the cost of the Baby Boomers feeds through the system.
    K
     
  10. katek

    katek Registered User

    Jan 19, 2015
    191
    And it doesn't even bear thinking about what will happen by the time our children each old age. The current generation of '20/30 somethings' unable to afford property now, will not have assets to enable them to self-fund, and hence there will also be fewer people able to subsidise LAs (assuming they still exist by then!) to provide support.
     
  11. Chemmy

    Chemmy Registered User

    Nov 7, 2011
    7,593
    Yorkshire
    I'd like to think there will be a cure or at least treatment available by then. Dementia research needs to try and get to the same levels of funding which cancer research has enjoyed these last few decades.
     
  12. katek

    katek Registered User

    Jan 19, 2015
    191
    I agree that the two-rate system is legal, but is is certainly questionable (morally at least) whether self-funders should be subsidising others as well as paying for themselves. Self-funders are essentially people who are ill - these places are not hotels!

    Also, because this also happens in nursing homes (not just residential), a sizeable proportion of the patients are likely to be people who have been wrongly refused CHC, so shouldn't even be paying in the first place, by law!
     
  13. katek

    katek Registered User

    Jan 19, 2015
    191
    So do I! And I agree more funding should be available for research (although that won't necessarily guarantee a cure). I'm sure people will continue to need some sort of care for this and other illnesses (and people will probably be living longer), so as a society we need to think about future provision for ourselves and our children/grandchildren.
     
  14. PeggySmith

    PeggySmith Registered User

    Apr 16, 2012
    1,685
    BANES
    Just to say that where I live neither of the LAs have "block booking", they just ring round to see who has a place available.
     
  15. katek

    katek Registered User

    Jan 19, 2015
    191
    Even if they don't 'block-book', they will certainly pay substantially less than the self-funders. LAs have fixed budgets. Care Homes cannot afford to have a room empty for any length of time, so have to accept this lower rate if they cannot fill it with a self-funder. The LA rate is better than nothing, and the self-funders pay more to make up the difference.
     
  16. Kon Dealer

    Kon Dealer Account Closed

    Apr 25, 2015
    18
    I wrote to the care home saying that they could not charge my mother extra than state-funded residents because she was not receiving any "benefit" over and above that which the state-funded had. Got no reply, so told them that I would amend the standing order to reflect the Local Authority rate. Still no answer so I went ahead. Now paying out almost £400/week less and still no reply after 4 months.

    Just do it!
     
  17. jenniferpa

    jenniferpa Volunteer Moderator

    Jun 27, 2006
    39,419

    I feel I should point out that 4 months is nothing in terms of them coming after you for payment, and I do feel it's massively unwise to encourage others to take this action. For a start, it will all depend on what was signed. If one signed a contract agreeing to pay X then the care home would be well within their rights to sue one for payment and I doubt they would have much problem getting a judgment. Even without a written contract I feel you are on very shaky ground legally speaking. Now obviously if you are comfortable with that, that's your call. A lot of people would not be.
     
  18. Kon Dealer

    Kon Dealer Account Closed

    Apr 25, 2015
    18
    Thanks jenniferpa- but I'm sure if they believed they were on solid legal ground they would have come down on me like a ton of bricks.
     
  19. fr0d0

    fr0d0 Registered User

    Dec 23, 2009
    186
    Mid Wales
    My Local Authority area has a massive elderly population and the care homes can easily fill with self funders. The LA themselves are forced to find places out of county/in neighbouring counties at, as you'd imagine, great inconvenience to relatives. Our LA don't block book either. I'm aware roughly of the LA rate. How do you find out exactly what that is?
     
  20. Kevinl

    Kevinl Registered User

    Aug 24, 2013
    4,666
    Salford
    I think if you dig hard enough you can find out what your LA pays although the shield of "commercially sensitive information" may come into play. One at least is quite open about it (see link below) but really it's not in their best interest to let you know either from the council's or the home's points of view.
    K
    https://www.sheffield.gov.uk/caresupport/adult/support-available/resnursing/paying.html
     

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