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Three Critical Things You Should Know About Paying For Care Home Fees

Paying for care home fees is often misunderstood and care and support services have never been free for the elderly. The misunderstanding is because people often think care home fees come under  healthcare from the NHS which is free. However care home costs are considered social care. Everyone has to contribute something towards care home fees and many have to pay the full cost.

The difference between Health and Social Care funding

Social care includes personal care such as washing, bathing, dressing, toileting and managing continence, assistance with daily living (shopping, administering medication, social stimulation etc.) and maintaining independence (assistance with mobility and equipment etc.) Social care does not require trained health professionals and care homes do not employ nursing staff.

Health care includes the treatment of disease, and illness, which needs to be administered or supervised by a trained health professional. Nursing homes have to employ a registered nurse 24 hours a day.

Local Authority social care funding criteria

Many people don’t realise there are two interdependent criteria for social care funding. You need to meet both to be eligible.

Care home costs being enjoyed by residents

Care home costs being enjoyed by residents

1. Needs criteria

The local authority will identify your care needs and check they meet a nationally agreed set of criteria. Basically you must have a significant or critical level of needs. This usually means that you need a high level of supervision and support for personal care and things like drug administration and/or food preparation every day, to qualify for social care funding. BUT even if you do have a significant or critical level of need, you must also meet the local authority’s financial criteria.

2. Financial criteria

You will have to fully fund your care home costs if you have more than £23,250 savings and capital. This includes property no longer occupied by you, unless it is occupied by the following as their main and only home, which they have occupied continuously prior to your move into a care home:

  • Your partner, spouse or civil partner (except where you were estranged)
  • A lone parent who is your estranged or divorced partner
  • A close relative or member of the family who is:
  • Aged 60 or over or
  • is a child under 18 or
  • Is incapacitated

If you have between £14,250 and £23,250 you will have to make a contribution from your savings/ capital as a tariff income of £1 for every £250. A contribution from income will also be required.

If your savings and capital are below £14,250 you will not need to make a contribution from capital. However, a contribution from your income will need to be made.

NHS funding criteria

The assessment process begins with a National screening tool called the Continuing Healthcare Checklist, and must be carried out by a trained health or social care professional. If you are assessed as eligible for funded nursing care, you will receive a standard rate of £110.89 a week from the NHS to pay towards your nursing care (amount correct at April 1st 2015)) This is paid directly to the care home and will be deducted from the local authority’s contribution. It will therefore not reduce the amount you have to pay yourself.

If you are paying for your own care home fees, the funded nursing care contribution is deducted directly from the cost of the care home fees before you pay and therefore reduces your care home costs.

The Continuing Healthcare Checklist will indicate whether a full assessment is indicated. If you disagree with a decision not to proceed to full assessment for NHS continuing healthcare following completion of the checklist, you can ask for the decision to be reconsidered.

To be eligible for NHS continuing healthcare, you must be assessed by a multi- disciplinary team of health and social care professionals as having a “primary health need”.

Whether or not you have a primary health need is assessed by looking at all of your care needs and relating them to:

  • what help is needed
  • how complex these needs are
  • how intense or severe these needs can be
  • how unpredictable they are, including any risks to the person’s health if the right care isn’t provided at the right time

Eligibility for NHS continuing healthcare depends on your assessed needs, and not on any particular diagnosis or condition.

You should be fully involved in the assessment process, kept informed, and have views about your needs and support taken into account. Your family should also be consulted where appropriate.

If you are considered eligible for full NHS continuing healthcare funding, it can be used to fund a package of care and support to meet all your assessed needs including personal care, mental health and physical needs. NHS continuing healthcare can be provided in a hospital, nursing home, residential care home or in your own home.

Paying for care home fees is a complex subject. Further information can be found below

Paying For Care

Age UK

Alzheimer’s Society

What does The 2014 Care Act mean for older people?

With 96% of people over the age of 65 in the UK having not made any financial provision for potentially needing future care in a residential or nursing home, it is clear that more information is needed in the public sphere that will allow them to take an informed course of action and begin to plan for the future.

In addition, The 2014 Care Act has introduced major changes to the way that the government will assist certain people financially, as care and nursing home costs are not covered free of charge by the NHS – this means that anyone who moves into a home has to pay for it themselves. While the cost of residential care differs wildly from county to county across the UK, people need all the information they can get to ensure that they aren’t paying more than they need to wherever they are.

A new downloadable guide from Caring Homes explains these changes and lays out what people with different levels of capital can expect in terms of financial assistance if they require it for a move into a residential or nursing home. Given that the process is difficult enough to get to grips with as it is, it’s important that elderly people discover how to give themselves the best quality of life at the lowest price possible.

Untitled

State-funded or self-funded?

One of the most significant questions that the guide answers is the way that funding for residential care works.
Your local authority will determine whether you or your loved one need residential or nursing home care and then assess you financially. Whether you are state-funded, self-funded or a mixture of the two will be determined by their assessment of your assets and capital.
That financial assessment is based on the state of your income and assets, including interest on savings, bonds, investments, pension and assets such as your house. It does not include the value of personal possessions, nor does it include the income of a spouse, partner or family members.

• Ultimately, if your total capital is below £14,250 you will be completely financially assisted and you will not have to pay anything towards care bills.

• However, if your total capital is greater than £23,250, no financial support will be offered. This tends to be the case with most people who own their own homes. This however is set to be addressed in 2016 and is likely to change again.

• If you require a high level of care, which would mean that you struggle to perform simple tasks, you may be eligible for the £72k care fee cap which will be introduced in April 2016.

The guide explains the situation and the different options in more detail. Download it today to see what you or your loved one should be doing in preparation for potential residential care over the next couple of years.

The Growing Cost of Health and Social Care

The aging population is having a considerable effect on public services. According to the government, the majority of public spending is spent on older people.

There are over 10.5 million older people in the UK. It’s estimated that there will be 5½ million more elderly people in 20 years’ time and the figure will almost double by 2050.

The fact of the matter is that we are living longer. Nowadays we have better healthcare, we have much more knowledge when it comes to healthy eating, exercise and habits like alcohol and smoking; and we take better care of ourselves.

However, this comes at a price. The number of older people needing care is growing at an alarming rate. There are three million people over the age of 80-years-old in the UK alone.

What does all this mean though?

  • Rise in State Pension age

The age at which British people receive the State Pension has recently changed. For years it was 65 for men and 60 for women but the pension age will rise to 66 for men and women by 2020. What’s more, it will start to increase again in 2026 to 67. The women’s state pension age will move to 65 by 2018 and then hike to 66 two years’ later.

  • Public spending

According to the Department for Work and Pensions, 65% of benefit expenditure goes to people over working age. This is equivalent to one seventh of public spending and an additional spending of £10 billion a year for every additional one million people over working age.

However, spending cuts mean that there will be less money for things like hospital beds and help towards care home fees.

  • Impact on the NHS

The Department of Health estimates that the average cost of providing hospital and community health services for a person aged over 85 years is three times greater than a person aged 65-74 years. The supply of state services has failed to keep up with the demand for care and support. Spending on the NHS has risen by £25 billion since 2004 but spending on social care has only risen by 0.1% per year in real terms.

Resources cannot be stretched even further. The result is that costs are rising and the eligibility criterion is getting tighter.

  • Care

By 2050, it is predicted that there will be three times more people of working age looking after two billion ageing family members. Caring for a family member can have a big impact on the economy with adults juggling work with care. The cost to individuals as well as the economy is huge as a 2011 survey revealed that 31% of working age carers gave up work or reduced their hours to care for a loved one.

So what does the future hold? Authorities have given their expectations as to what consequences our aging population will have but only time will tell.

What matters is that we have a solid framework to plan a fruitful future that cares for our elderly loved ones. Failures in social care will only lead to stifled economic productivity and we can turn the challenges it brings into a driver for economic growth.

How do we go about doing it? Perhaps we look to other countries to see how they look after their elderly; alternatively, a new system should be put in place that offers more financial support. Mr Dilnot, Head of an independent commission into social care, has previously recommended a cap on how much people should pay for their own care of £25,000-£50,000.

Only one thing matters- older people should always be viewed as a blessing, not a burden!

This article is provided by Cheselden, the UK’s leading independent authority on NHS Continuing Healthcare.

Paying For Care- Why Care For Mum Has To Be Paid For

People continue to be confused and surprised  when they learn that they have to pay for the care of their elderly mother, partner, or relative. The reason for this is that people get social care confused with the NHS, so let me explain the difference.

The difference between NHS and Social Care Funding

With a few exceptions, such as the contribution towards prescription charges, NHS services are free whereas social care services are means tested.To satisfy the criteria for social care support, an individual has to have a significant or critical level of need, minimal savings and assets of less than £23,500 (including their home if they own it) for residential care and £14,250 for support in their own home.

Paying for residential and home care

At best people have to pay a contribution towards the cost of residential care and at worst, they have to pay the total cost. For home care only people on the lowest income with minimal saving, receive fully funded care, most have to contribute towards the cost of care at home.

Alzheimer’s Disease

People often think that Alzheimer’s disease and other types of dementia come under the NHS and are therefore free. Unfortunately this is not the case unless the person has a ‘health’ need, in which case they may be eligible for NHS Continuing Healthcare. This will depend on strict criteria laid down by the Department of Health.

Eligibility for NHS Continuing Healthcare Funding

Support and funding for NHS Continuing Healthcare is determined on the basis that someone’s primary care need is a health need. A primary health need is determined by:

  • The nature or type of condition or treatment.
  • The complexity – symptoms that are difficult to manage or control, or by their intensity – one or more needs which are so severe that they require frequent and skilled treatment.
  • The unpredictability – unexpected variable needs that are difficult to manage and present a risk to the individual or othI hope by now you can see that other than in exceptional cases, people at best have to contribute towards the cost of their care and many have to find the full cost of their care. You can find more information on my other blog posts at Costs, Planning and Specialist AdviceThe Two Best Kept Secrets, Choice and Help with Care Home Fees, Demystifying Social Care Costs, As I have said before, my advice is to seek advice from a financial advisor that specialises in funding long term care fees and is registered by the Society of Later Life Advisors (SOLLA) who ensure that all advisers registered by them have fully satisfied all criteria to become an accredited adviser. This means peace of mind and assurance that the advice you are given is from financial advisers who have proved they have specialist knowledge of the sector. You can find a SOLLA registered financial adviser here

 

Paying For Care – New Policy But Don't hold Your Breath

An announcement today is expected to say that the cap for long term social care will mean that no one in England will have to pay more than £75,000 after 2017 for their care in old-age. Big deal! The amount was most likely decided by people who have no clue what life is like to have less than £75,000! The cap will be so high it will only help a few and many will still have to sell their homes to pay for care under £75,000.bigstock-House--2632885

Only actual care costs will be included

The cap will only cover personal care (help with washing and dressing) at the rate Social Services will pay, meaning the lowest rate possible and will not include the cost of accommodation or food. The figure is much higher than that recommended by the Dilnot report, which said that the cap should be set at £35,000.

The Current Situation

At present people with savings and capital of more than 23,250 have to pay for care costs. Those with assets of between £14,250 and £23,250 have these taken into account when their contribution is assessed. If they have less than £14,250 only a person’s Income is taken into account.

Means tested support will increase

It is likely that those with up to around £120,000 savings and capital costs, including property, will qualify for means tested support after 2017.

What will the cap actually mean?

According to financial expert, Paul Lewis, if the cap is set at £75,000 and doesn’t start until 2017, 214 weeks of care will have to be paid for. So if a person who has to fund their own care pays £500 a week for their care, they will have to spend £107,000 before the cap kicks in. They will also have been paying food and accommodation costs of £10,000 a year for more than four years, so around £150,000 will have been spent before the cap would apply. Most residents will have died before they benefit from the new arrangement!

A drop in the ocean

Although a step in the right direction a cap of £75,000 is nothing more than a drop in the ocean and most older people will still have to sell their home to pay for long term care fees. How long do we have to wait for a Government to seriously prioritise elderly care and realise that most older people have worked hard all their life and paid more into the system than the younger generation ever will?

Time to put our money where our mouth is

The cap of £75,000 for long-term care fees will do nothing to help the huge underfunding of the elderly care system which is a separate matter. Whichever political party is compassionate and brave enough to balance affordability in the current economic climate with a better way of adequately funding the care system for older people, will certainly get my vote. Will it get yours?

Relative Matters are independent specialists in care management for older people and we can often help people access funding (so long as they are eligible) save money and negotiate care fees with care providers on behalf of our clients. Why not give us a call and see if we can help you 0845 319 4870

Paying For Care – New Policy But Don't hold Your Breath

An announcement today is expected to say that the cap for long term social care will mean that no one in England will have to pay more than £75,000 after 2017 for their care in old-age. Big deal! The amount was most likely decided by people who have no clue what life is like to have less than £75,000! The cap will be so high it will only help a few and many will still have to sell their homes to pay for care under  £75,000.bigstock-House--2632885

Only actual care costs will be included

The cap will only cover personal care (help with washing and dressing) at the rate Social Services will pay, meaning the lowest rate possible and will not include the cost of accommodation or food. The figure is much higher than that recommended by the Dilnot report, which said that the cap should be set at £35,000.

The Current Situation

At present people with savings and capital of more than 23,250 have to pay for care costs. Those with assets of between £14,250 and £23,250 have these taken into account when their contribution is assessed. If they have less than £14,250 only a person’s Income is taken into account.

Means tested support will increase

It is likely that those with up to around £120,000 savings and capital costs, including property, will qualify for means tested support after 2017.

What will the cap actually mean?

According to financial expert, Paul Lewis, if the cap is set at £75,000 and doesn’t start until 2017, 214 weeks of care will have to be paid for. So if a person who has to fund their own care pays £500 a week for their care, they will have to spend £107,000 before the cap kicks in. They will also have been paying food and accommodation costs of £10,000 a year for more than four years, so around £150,000 will have been spent before the cap would apply. Most residents will have died before they benefit from the new arrangement!

A drop in the ocean

Although a step in the right direction a cap of £75,000 is nothing more than a drop in the ocean and most older people will still have to sell their home to pay for long term care fees. How long do we have to wait for a Government to seriously prioritise elderly care and realise that most older people have worked hard all their life and paid more into the system than the younger generation ever will?

Time to put our money where our mouth is

The cap of £75,000 for long-term care fees will do nothing to help the huge underfunding of the elderly care system which is a separate matter. Whichever political party is compassionate and brave enough to balance affordability in the current economic climate with a better way of adequately funding the care system for older people, will certainly get my vote. Will it get yours?

Relative Matters are independent specialists in care management for older people and we can often help people access funding (so long as they are eligible) save money and  negotiate care fees with care providers on behalf of our clients. Why not give us a call and see if we can help you 0845 319 4870

Paying for Care – De-mystifying Social Care Costs

There is a great deal of confusion around our complicated care system for older people. In my experience, most people don’t fully appreciate that adult social care is a means tested benefit and over 50% of people requiring care will need to part or fully fund it themselves. 

Adult social care funding has become a significant issue over recent years. An independent care commission was set up to consider the amount people pay towards their own care and have made proposals to the government. There is currently much political debate about this and how the extra money needed will be paid for.

In order to simplify things I have identified the key points that currently apply to make things easier to understand.

Community Care Funding for Residential care

  • If you need Residential or Nursing Home care and have savings (capital) of less than £23,000 it is likely that you will be eligible for financial help towards the cost of your care so long as you have been assessed to need it.
  • Anyone who has capital of their own above £23,000 will be assessed as being able to pay the full cost of their care home fees.
  • Those whose capital is between £14,000 and £23,000 will be expected to make some contribution from their capital as well as income (state pension, Attendance Allowance, fifty per-cent of any private pension or other income)
  • Your relative should not have to make any contribution from their capital below £14,000, but will still be expected to contribute from their income (state pension, Attendance Allowance and fifty per-cent of any private pension or other income)
  • Different financial rules apply for couples and single people.
  • Care in a residential home can be free for up to six weeks if it is arranged as part of “intermediate care” after hospital treatment.
  • All local authority Social Services have their own systems, allowances and procedures, although every person funded by Social Services is entitled to a personal allowance. You can check out current rates at www.turn2us.org.uk.
  • A personal allowance cannot be used to pay top-up for fees or for services that should be included by the home as part of the care service.
  • For the first twelve weeks after Social Services have made an assessment, the value of your relative’s property will be disregarded in their calculations. The purpose of the twelve-week disregard is to give your relative time to sell, let or raise money on their property to fund care costs.
  • If your relative claims Attendance Allowance and Social Services are making an increased contribution to their care fees, the allowance is withdrawn after the fourth week and reinstated at the end of the disregard period.

Community Care Funding for Home Care

  •  The situation for Community Care funding for home care  is even more complicated and varies between each local authority. This is the infamous postcode lottery that the government has pledged to reform. Until then eligibility is determined as much by what each Local Authority has a policy of  paying for, as by their need
  • If you have more than £23,250 in capital (not including the value of your home) you will be charged the full cost of your care.
  • If your capital is less than £23,250, your income will be assessed but you must be left with at least the basic amount of Pension Credit plus 25%.
  • Some councils are more generous and increase the capital threshold or set a maximum amount they expect anyone to pay for their care.

Paying for Care – The Two Best Kept Secrets

Your elderly relative may need care and support because of serious illness, physical disability, sensory impairment, mental health problems or loss of independence due to old age.

So how do you go about finding out if they are eligible for support from Social Services? (now often called Adult Services) First of all you need to contact Adult Services in their area who will undertake an initial assessment over the phone.

Everyone has the right to request an assessment, called a Section 47 assessment, to discuss their needs, including people who are not eligible for social care services. 

1. With increasing pressure on Social  Service departments, if your relative does not meet the Local Authority’s financial criteria, which is usually determined as part of the initial screening call, they will often have their needs assessed over the phone without having realised they have been assessed! Make sure you ask for a Section 47 Assessment during your initial call, and unless its considered urgent, be prepared to wait for it.

2.The Adult Services assessment process consists of two elements. Firstly they look at the issue of need and are obliged to undertake an assessment to determine how best the care needs of an individual can be met.There is a second element to the assessment, which is financial. If your relative’s level of need indicates that they may be eligible for social care funding, Social Services will carry out a means test.

 In order to be considered for social care funding your relative must satisfy both the level of needs AND financial criteria.

The Needs Assessment for social care will determine:

  • If a person is eligible for health and/or social care funding and services
  • What level of help and support the person needs
  • What kinds of services are needed, from aids and adaptations in the person’s home, to home care workers or residential care.

A needs assessment will form part of the basis on which to make decisions about your relative’s eligibility to receive support from Social Services. It also provides valuable information if your relative is to fund and arrange their own services at home or in a care or nursing home.

Most councils’ have now set their threshold at the substantial and critical levels. This means your elderly relative must have a high level of personal care needs and require support with personal care every day.

Try to be present with your elderly relative when they are being assessed. Sometimes older people find it difficult to express how difficult certain tasks have become and most older people underestimate the amount of care they need. If you are there with them you can provide moral support as well as offering gentle reminders about the problems they face.

If you are unhappy with the assessment of your relative’s needs for any reason, you can request a reassessment. If this is refused or you remain dissatisfied, you could consider making a complaint.

Once your relative’s eligibility has been established with regard to their level of need, they must also pass a means test in order for Social Services to provide funding and support.

Financial Assessment for Funding and Support

At the present time, anyone with more than £23,250 savings will not be eligible for funding and support from Social Services.

 If Adult Services might be funding part or all of your relative’s care, you will need to provide financial information, including:

  • Their pension details.
  • Bank and building society statements.
  • Details of any property they own and its current value.
  • Details of any stocks and shares they may hold or other financial products they own.

Paying for Care – Choice and Help with Care Home Fees

Social Services have a maximum fee they are willing to pay for a care home, including a person’s assessed contribution, based on their level of need and the type of home.

If you or your elderly relative want to go into a more expensive care home, this may be possible if you or another third party, such as a relative, friend or charity, pay the additional amount for as long as your relative is in the home. 

Third party payments

Under the arrangement the third party pays the difference between Social Services’ usual maximum rate and the amount the care home charges (often called a “top-up” or third party contribution). However, it is illegal for your relative to “top-up” his or her own fees.

Before you or any other third party agrees to make a contribution towards the cost of a care home, you need to be aware that the amount could increase at any time. You therefore need to be sure that you are able to maintain the payments for as long as required.

If someone is willing and able to fund the payments they will be asked to sign an agreement with Social Services who then collects the additional money to pay the home. If the additional payments are going to stop for any reason, advice should be sought from Social Services.

Financial help from social services

If your relative needs residential or nursing care and Social Services have agreed to give them financial help, they can still choose where they want to live. The home may be provided by Social Services or be run independently, but it must be a home that:

  • Has been approved by Social Services.
  • Is suitable for your relative’s assessed needs.
  • Will enter into a contract with Social Services.
  • Has a vacancy.
  • Is within their financial limit of support for your relative’s assessed level of need.

Paying for Care – Costs, Planning & Specialist Advice

The care system is confusing and people thinking that care is free and funded by the NHS get a shock when they realise that it isn’t. Even when someone has dementia, which is after all an illness, other than for severe and exceptional cases, when care is paid for by the NHS (Continuing Healthcare) most people will have to pay for some or all of their care fees. Hence the recent headlines about older people having to sell their home to pay for their care.

Funding long-term care is the second largest expenditure people have to make in their life, after buying a property and we are often in the position of being first-time buyers when it comes to choosing the right care home and long-term care services. I therefore find it surprising that while many older people make wills and ensure that their funerals are already paid for, they have rarely thought about whether they might need care and support and, if so, what they would want to happen and how it will be funded. 

Cost of care home fees

Alarmingly, people who fund care themselves; spend on average, around four years in a residential care home and one in eight stay eight years or more. With weekly care home fees costing between £500- £1200 (depending on where the older person lives and whether they need a care home with nursing) you can see how the cost soon mounts up.  Using an example of a weekly fee of £700, the cost over four years would be over £145,000, the cost of a small flat.

Unfortunately people who fund their own care make major decisions with consequences for large amounts of personal expenditure, on the basis of little or no independent financial advice. Few people are even aware that specialist financial advice exists in this field. Similarly, few are aware of the support available to carers. I always advise my family, friends and clients to seek specialist financial help when planning long-term care.

Paying for Long Term Care

Planning for long-term care is crucial to ensure that all options are explored, your relative’s financial assets and if relevant any proceeds from their property are invested wisely and any remaining inheritance protected. If your relative is considering long term care at home or in a residential or nursing home, it is in everyone’s best interest to seek accredited specialist financial advice before making important life-changing decisions.

To find a specialist financial advisor near you, contact the Society of Later Life Advisors (SOLLA) You will also find the ‘not for profit’ organisation PayingForCare  really helpful to find out more about paying for long term care fees.

In addition, the service we offer at Relative Matters includes helping people make their money go further. We also make sure our clients are getting the funding and benefits they may be entitled to and negotiate care fees on their behalf