Care home fees and what they want.’

[peter smith 5Participant @petersmith5]

The time has come for my 98 year old mother to go into a care/nursing home following a succession of falls, urine infections leading to a diagnosis of delirium and dementia.

Having run a boarding cattery for more than 40 years she has sufficient finances for a few more years of care.

The care home business seems to be able to ignore the laws appertaining to data protection, fraud and identity fraud. This is what they tell me to provide.

Original Copies of bank, building society post office savings accounts and ISA’s.Investment bonds ( dates and amounts ), shares and unit trusts, pension statements showing what has been received, all other income and a full list of outgoings. NHS and NI numbers.

Recent property valuation, pension credit. Etc etc etc.

As you can imagine, as I will be paying, they will get a heavily redacted bank statement showing that I can pay fees of £ 1,300 per WEEK.

Any thoughts or comments?

Pete

[peter smith 5Participant @petersmith5]

[SteviegtrParticipant @steviegtr]

Many years ago when Mum was ill. We looked at this. At that time the way we read it was they take everything. If you have nothing fair enough, but Mum was quite well off. Luckily it never came to that.

I hope you get the result you want.

Steve.

[Stuart Smith 5Participant @stuartsmith5]

Who is asking for this information? Is it the local authority? As I understand it, local authority will do a needs and financial assessment, but if the person who needs care has over £23500 the LA will not contribute. So I presume if you know you are in this position and intend to self fund there would be no need to divulge the info you mention.

The other issue is whether your mother has arranged a lasting power of attorney giving someone (for example yourself) the power to make decisions on her behalf. If not , it may be necessary to apply to the Court of Protection to be appointed as Deputy. If you need to do this, they will need all the financial info, it takes quite a while to be sorted out, they charge a annual fee and require you to pay an insurance premium. Plus provide annual updates .

If your mothers medical conditions and care needs meet the requirements, there is also NHS Continuing Healthcare. If assessed as being eligible, the NHS will pay the fees.

I am not a professional in this, just info obtained from experience.

Stuart

ps I would suggest getting professional advice.

Edited By Stuart Smith 5 on 28/04/2021 00:26:06

[Bill PhinnParticipant @billphinn90025]

It's intrusive, yes, but presumably designed to reassure the care home that a potential resident will have the means to fund their care for the whole duration of their projected stay.

If, some time after admission, the self-funder's savings dry up, am I right in thinking the local authority will generally pay the care home less money per week than it was getting under the previous self-funding arrangement? If so, I should imagine it's a situation most care homes will want to avoid, and it's presumably why not all care homes will accept local authority-funded residents.

Are you definitely no longer in a position to continue providing care for your mother in her own home, Peter?

[pgk pgkParticipant @pgkpgk17461]

Wow, that does seem intrusive.
I went through similar with my mum at the same age.
We were fortunate that she had support from neighbours and friends in her village but as things deteriorated we moved on to local authority assistance twice a day with getting in and out of bed… a poor service that rocks up for a max of 15 mins twice a day. Luckily we had the additional support of a long term friend who happened to be a senior nurse in the local hospital and would pop in regularly to help out (she had been employed as part time help with general chores for a few years).
Inevitably matters deteriorated further and the next stage was to employ a live-in carer via a company that provides such but i was only happy with that because nurse friend was able to pop in regularly to supervise. I had trustworthy oral agreement with the only other beneficiary that I could reclaim my costs from the estate afterwards.
Again matters progressed to the point tthat a single carer wasn't enough and some ocassions when i had to make the 4 hrs journey to help out on days off etc. The two carer phase only lasted a few weeks before the inevitable end.

edit addtional:

You might also wish to look ahead at the unavoidable matter of probate etc. My wife had been through that with her mother (who had very little estate) and discovered the punitive fees solicitors want to charge – so she had done the simple estate herself. Forewarned by that I had had the pragmatic cheek to get my mum to help fill in all the forms while she still had full faculties (she thought it was amusing too). It was just as well since both my parents were post war refugees and original state records were impossible and they had outlived siblings and relatives. Again my mums record keeping was excellent so apart from a major plod I was able to deal with probate myself as the only surviving executor. For the very few stumbling blocks I found the probate office very helpful via phone. The biggest issue to resolve was that mum's solicitors had lost her house deeds – the firm had been taken over  a few times – and then tried to claim they had never had them until i produced letters from mum's files confirming their 'safe' storage…

pgk

Edited By pgk pgk on 28/04/2021 04:03:08

[Anthony KnightsParticipant @anthonyknights16741]

+1 for doing the Probate yourself. I did it for both my mother and my wife. For my wife I was quoted in excess of £2000 by a local Solicitor. The really sneaky bit was at the time, the probate office fees were reduced for solicitors, but in the quote they charged the full rate. I believe the probate fees have changed since then.

[HOWARDTParticipant @howardt]

I think the request for information depends on the route taken for the person going into a home. When my father went into one he went in from hospital and I sourced the home and signed documents for his care. No financial information was passed either for him or me, he only lived just over a week after going in. When a friend of mine’s mother had to be taken into care due to dementia her husband refused all attempts to reveal his financial position only gave his wife’s. He never paid anything out of his pocket and she lived for some years in care. Read the rules and you follow them, even get legal help, the alternative employ people to give her the care. Our local care system charges £18per hour for in home assistance.

[Lee RogersParticipant @leerogers95060]

There are a number of benefits that may or may not be available for your mother. Attendance allowance ,and continuing nursing care may be possible. My advice is to contact one of the help organisations for dementia or altzheimers. They will be able to guide you through what is your right and what may be available in the near future. Particularly if she has a combination of chronic conditions . Chronic arthritis combined with diabetes , makes for a complex care regimen and this should be NHS funded ( I use those 2 conditions just as an example ,you need proffessional advice) Do not rely on local government or social services to advise you ,they will avoid pointing you towards costly (to them) options.

[Ian MellorsParticipant @ianmellors72388]

Posted by Stuart Smith 5 on 28/04/2021 00:24:35:

Who is asking for this information? Is it the local authority? As I understand it, local authority will do a needs and financial assessment, but if the person who needs care has over £23500 the LA will not contribute. So I presume if you know you are in this position and intend to self fund there would be no need to divulge the info you mention.

The other issue is whether your mother has arranged a lasting power of attorney giving someone (for example yourself) the power to make decisions on her behalf. If not , it may be necessary to apply to the Court of Protection to be appointed as Deputy. If you need to do this, they will need all the financial info, it takes quite a while to be sorted out, they charge a annual fee and require you to pay an insurance premium. Plus provide annual updates .

If your mothers medical conditions and care needs meet the requirements, there is also NHS Continuing Healthcare. If assessed as being eligible, the NHS will pay the fees.

I am not a professional in this, just info obtained from experience.

Stuart

ps I would suggest getting professional advice.

Edited By Stuart Smith 5 on 28/04/2021 00:26:06

Agreed

Mum went into a care home last year when Dad was getting ready for a big cancer op, she has dementia and Dad was her main carer (at 86). whilst Dad was in Hospital she contracted COVID and ended up in the same hospital as Dad. After recovering she was discharged on a "Fast Track" agreement – end of life care, as the hospital did not expect Mum to last much longer on discharge. The upshot of this was that the full cost of Mum's care was met by the LA.

A year later the LA decided that they had had enough funding her care (always been a fighter has Mum) and did an assessment. Care element of £180 ish only leaving Dad with a bill of approx £1000 per week to find as her savings were in excess of the £23500 threshold.

We shopped round and found a private care home that would take her for just over £700 per week, which meant that once below the £23500 her remaining savings would last approx 18 months before Dad's money started to be spent. It was important to us to ensure that Dad's money was protected in case he ended up needing care in future.

Just before the transfer her current care home contacted Dad to see why she was moving, when they found out it was just cost they promptly reduced her fees to the same level as the alternative home!

Shop around, play one home off the other, they have a lot of room for negotiation

[Andy CarruthersParticipant @andycarruthers33275]

Fee increase this year is an outrageous 7% on top of previous excessive fee increases

Once in the system, the recipient only comes out one way, captive audience until then

The system is a disgrace and in urgent need of reform, private healthcare provider fees should be tightly regulated and capped

[HopperParticipant @hopper]

Posted by peter smith 5 on 27/04/2021 22:18:01:

The care home business seems to be able to ignore the laws appertaining to data protection, fraud and identity fraud. This is what they tell me to provide.

Original Copies of bank, building society post office savings accounts and ISA’s.Investment bonds ( dates and amounts ), shares and unit trusts, pension statements showing what has been received, all other income and a full list of outgoings. NHS and NI numbers.

Recent property valuation, pension credit. Etc etc etc.

Seems like the same type of thing a bank would demand to see if you were asking for a mortgage, loan etc. to ensure you can meet your end of the financial obligations. Seems reasonable for a care home to exercise the same sort of due diligence before taking on the responsibility of mum's longterm and expensive care? If it turns out you can't pay, it can cost them a lot of money. Sadly, they are run as a business, not as a public service these days.

[SillyOldDufferModerator @sillyoldduffer]

Posted by Stuart Smith 5 on 28/04/2021 00:24:35:

… So I presume if you know you are in this position and intend to self fund there would be no need to divulge the info you mention.

…

I ran into intrusive requests for financial detail last year when helping my son buy a house, and have since discovered it's a recent feature of the modern world.

• UK Privacy Law doesn't forbid anyone collecting private data: it only effects how the data is used and requires the holder protect it, method unspecified. In my view, a serious flaw is that the Information Commissioner doesn't set security standards and only imposes fines after Slack Alice has leaked millions of customer details to the Mafia. Privacy protection is retroactive with no recompense for victims. I would prefer the Commissioner to set standards, require data holders to confirm standards are met, and to do regular spot checks and occasional full audits.
• Clients who cannot pay are a serious problem to Care Homes because they cannot dump people into the street. As people often lie about their finances, or have unstable incomes, many institutions demand high levels of proof.
• Worse, following multiple scandals involving money laundering and changes to the banking system aimed at making it hard to disguise the proceeds of crime, many institutions are legally required to check new arrangements carefully. Pete's intention to provide heavily redacted bank statements is unlikely to be acceptable, not least because that's what a Drug Dealer would do! I didn't redact anything and still got follow up questions and requests for more detail. I was blissfully unaware the regulations had been tightened because it affects new transactions, and not all of them! For example, Granny sent my son a cheque for £200 that appeared on the bank statement given to his mortgage provider: she was required to produce proof of identity. Due to gifting a larger sum to bump up his deposit, I was required to present myself to a solicitor with documentation proving I really was the source of the money. On the other hand, I paid for my daughter's second-hand car with a no questions asked debit card transaction.

As said by others I'd recommend anyone worrying about how to fund care to find out what the 'client' is entitled to before assuming the worst. If mum in good health is put into private luxury supported accommodation, then there will be no support at all. But if care has to be provided for a medical reason a proportion of the bill will be picked by the state: depending on the problem, the state contribution is likely to be generous.

Pete has my sympathy. It's a horrible problem.

Dave

[Alan DonovanParticipant @alandonovan54394]

Good morning Peter.

Their information request seems exceptionally intrusive. The suggestion to seek some legal advice with respect to this issue is probably very good advice.

One issue that sprang immediately to mind is – has your mother left any money/possessions to you, siblings and/or grandchildren ‘In Trust’ or in her Will. It may be worth taking legal advice to ensure your mother’s wishes are adequately protected.

When seeking a placement for my father-in-law (diagnosed with dementia) we found social services very unhelpful. So to do ‘the best’ for my father-in-law, my wife and I had to become experts in the care system. This occurred in 2012 so my comments and experiences may not be quite so relevant now.

We found organisations such as Age.uk quite useful, one of these organisations offers (or offered at the time) free legal advice. You have a limited time (30 minutes) to talk to the solicitor so be well prepared with your questions.

One ‘gem of information’ that came out of my conversation with that solicitor was that Care Home ‘Top-up fees’ (which are usually paid by relatives) are NOT compulsory. The phrase ‘emotional blackmail’ comes to mind here.

We didn’t pay any top-up fees (although they tried a second time to force the issue after my father-in-law was resident in the home), but we have had sight of a ‘Top-up fee’ agreement. If you choose to pay top-up fees, read the document very carefully, and make sure you understand the T&Cs – our experience is there is NO escaping the payments once you have signed – regardless of how your personal situation may change.

Lastly, if your mother is self-funding, may I suggest you keep control of when payments are made. My (ex)neighbour put her trust in her father’s care home to manage the self-funding payments as required and then later found that the payments made were in excess of the contracted amount. The excess fees were returned ……… eventually.

I accept that good care has a significant price tag attached to it, but the Care Home business is exactly that – a business, so unfortunately, in some organisations the ‘quality care/profit’ balance has become far too ‘profit orientated’.

I hope this has been helpful to you.

All the best to you at this difficult time.

Alan.

Edited By Alan Donovan on 28/04/2021 11:17:25

[HOWARDTParticipant @howardt]

Talking of carrying out Probate, I did my fathers back in 2009 and it was completed within six weeks for just the fee. My sister in-law died the same year, she was single and had HSBC as her executor total cost £12,000 and it took them six months with less to do than I had done as there was only a house, cash in HSBC accounts and a will with two recipients.

[Author]

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