Top Ups

[Lizzie K]

Hi, sorry I haven't been back as I promised to let you know about Dad, but life has just taken over I am afraid. Some of you may recall Dad was sent home by hospital as he refused to go into nursing care despite having great difficulty coping at home, even with carers. He managed to stay at home for about 10 days then collapsed behind his bedroom door and no one could get at him. Paramedics had to be called and thankfully he was physically okay. However, we felt we could not cope any more and with the assistance of Social Services got him into emergency respite care. Dad has been there nearly 6 weeks and has finally realised that he cannot cope at home. At nearly 81 with late stage dementia, double incontinence; poor visability; hearing and great difficulty walking he has finally given in. That is not to say that he isn't settled in the home. We are lucky in that he has settled in well and the nursing staff are very good.

One of my reasons for coming on line today is to ask advice about these so called "top ups" requested by nursing homes. Dad has had all the physical and financial assessments and we as his powers of attorney we are beginning to sort out his finances/clearing his bungalow for sale. The nursing home then stated that, as well as dads payments, they wanted us to pay an extra £40.00 per week top up. We refused. After a bit of twoing and froing and us threatening to take dad elsewhere this request has miraculously vanished. We are however awaiting the final costings to make sure it has not been added on elsewhere.

The thing is can anyone enlighten me. What is the purpose of these top ups? Are they legal? There is enough money in the pot at present for dad to fund himself so why do they want our money as well? We have a son at Uni who we are assisting financially and any spare cash is needed for our own purposes. What rights do these people have to do this? I am very cross about it and am considering taking some action. I would be grateful to hear of others experiences.

Just to finish off, my hubbie and I had our first weeks holiday in 4 years at the end of October in Cornwall. It was wonderful. Never underestimate the value of a break, you owe it to yourself. Take care everyone. Lizzie K

 

[jenniferpa]

I can honestly say that I've never heard of family being asked to contribute a top up when the person is already self-funding. Now I have seen requests for an additional amount over and above the fees for incidentals (outings, haridressing, and the like), but those are also normally paid (indirectly) by the person who is in care. Sometimes those are out of line with what you would expect, but the basic principle seems reasonable. What you have experienced does not.

This is beyond strange, if you ask me.

Edited to add - something that may or may not be relevent. As he was placed as an emergency is he there under a social services contract? Not that that "should" make a difference but it might. Have you looked at CRAG (charging for residential accomodation guidelines).?

 

[Skye]

Dear Lizzie,

I can't understand this demand for top-ups either, if your dad is self-funding.

Usually, top-ups are demanded when an LA-funded paqtient goes into a NH whose fees are higher than the LA maximum.

Surely if your dad is self-funded, the fees will have been agreed in advance, so I don't see how they can ask for more.

Unless the £40 is for 'incidentals', such as newspapers, hairdressing, chiropody, etc. But it does seem rather a lot for that. I think you should definitely ask for an explanation, before agreeing to pay it.

It's good that your dad has settled so well, I hope you won't have to move him.

 

[Lizzie K]

Thanks you for your responses. I too have not heard of this before hence my concern. We had already paid £20.00 to the home for Dad's incidentals so that certainly wasn't what was being said.

We had already agreed that Dad should pay a top up of £40.00 for his six weeks respite care as the fee was over and above the LA's contribution. This extra £40.00 was requested from us to be added to his fee once he became a permanent resident.

We are still awaiting confirmation of a final amount for his permanent care. Things have gone a bit quiet on that front. We also would like dad to stay there if possible. I will keep you posted of any developments.

Thank you, as always for your advice and support. Take care everyone. Lizzie K

 

[jenniferpa]

You do know it's not at all unsusual to be expected to pay more as a self-funder than social services would pay? As an example we paid £600 per week when social services would have paid £450 (and there would have been no top up). What is strange about your situation is the way that it has been presented. In other words, I wouldn't have been surprised if the contract had been written with the extra £40 in it, but I am surprised that they seem to be saying that you (i.e the family) are being expected to pay that. Very odd. Are you in England? Because Scotland is potentially different. Also, you do know that you (or rather your father) is entitled to a 12 week diregard of his property when it comes to paying fees? I am, in fact, wondering if this has any bearing on this additional ¢40. It does sound like a) you haven't got the whole story or b) the home has inadvertantly signed a contract with social services that they didn't intend to.

 

[Lizzie K]

Hi Jennifer, we live in Nottinghamshire. We have today received confirmation from the local authority that Dad has to pay £148.00 per week towards his six week respite care and the family is to pay £40.00 pw for that 6 weeks. We are happy to do that. However, all has gone quiet as to how much Dad is to pay once his respite care is over. We are aware that he is now going to get the 12 free weeks and then the actual costs step in. We were quite surprised how quick they caved in when we refused to pay this top up. I also wonder if they have agreed to something somewhere they shouldn't have done as you suggest.

I have spoken to a work colleague who tells me she had a similar problem when her mother went into a nursing home in Yorkshire. She and her brother were also asked to pay a top up. They also refused and it was withdrawn.

I will let you you know what happens as and when we get any further communication. Thankfully, Dad is totally unaware about what is going on. He told us the other day that although he is enjoying it in the home he will be ready to go home soon. We just have to try and be positive. We know whilst he is there he is safe; clean; well fed and has 24 hour care. At home we were on constant tenderhooks as to when the phone would ring telling us he had fallen again or that he was refusing to let carers/meals on wheels in.
Why or why is this living hell sent to good people. It makes you feel so desolate at times doesn't it. Take care. Lizzie K