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Care & carers

Breaking down the cost of care

(19 Posts)
LiltingLyrics Fri 06-Jul-18 17:51:50

Apologies as I am sure this will have been discussed before but I am new here and wondering if anyone can help with breaking down how care costs are calculated. I found this on GN saying:

“On average you can expect to pay more than £27,200 a year for a residential care home, rising to over £37,500 a year if nursing is required.”

A friend is checking care homes for her husband. He has rapidly deteriorating dementia and she is finding it increasingly difficult to look after him. Initially she needs respite care but as she knows things aren’t going to get better it would also be a trial to see if the home would be suitable for him in the longer term.

Weekly charges are being quoted around the £1300 mark so almost double that upper sum quoted in the article. She hasn’t asked how these charges are calculated but I am assuming that one factor is the staff to resident ratio.

I’m also aware of a Radio 4 You & Yours feature, some time ago now, where they discussed the standard business model for care home investors citing 12% as the expected ROI.

Can anyone provide some insight into this? Are care homes obliged to explain how their charges are calculated? I'm assuming a new build would be charging substantially more as they are having to cover substantial capital expenditure as well as running costs.

BlueBelle Fri 06-Jul-18 17:59:39

I think my friends mum pays about that and it’s not a new built but a home with a good reputation

Lazigirl Fri 06-Jul-18 18:17:59

As far as I know most Nursing Homes (not Care Homes) are private businesses and can basically charge what they like. All of the Homes that I investigated for my mother last year charged in excess of £1,000 a week, and this did not seem to reflect quality or buildings, but they do need to employ a certain number of qualified nurses, depending on size. You can usually gauge the best ones by the length of their waiting list! Care is means tested and the local council will part fund if a person has less than £16,000 (including value of house, investments etc). The fees do not cover many extras either. In some cases you can apply for Continuing NHS Care to fund, but this is extremely difficult to apply for and get, and in my experience a person has to need total 24 hour medical care to meet the criteria.

Luckygirl Fri 06-Jul-18 18:37:35

There are many many cases where continuing care funding applies, but the whole system works to put people off doing this. And it is important to remember that continuing care funding can be paid for care WHEREVER it is given: own home, residential home, nursing home.

Many of those telling folk that they do not qualify simply do not know the rules and get it completely wrong.

I would strongly advise anyone looking into this to google for a specialist solicitor, or do what I did and buy the book that is available online and follow its advice to the letter. The cost of these is a drop in the bucket compared with what can be saved.

When the assessment meeting was held I had it all at my fingertips; and I had filled in the assessment form (which I had downloaded) myself already so my reasoning was clear. They could see that I was not about to fobbed off.

The essence of continuing care findong is that in law the NHS is obliged to provide nursing care to all those who need it.

Now.....the other side of this coin is of course that if everyone who qualified for CCF got it, the NHS would collapse instantly through lack of funds!

Please also do not be bamboozled into paying family top-ups.

Luckygirl Fri 06-Jul-18 18:38:43

PS - the one thing you can bet your bottom dollar on is that the carers are being paid a pittance.

Eglantine21 Fri 06-Jul-18 18:39:49

They are not obliged to show a breakdown of costs unless they are a charity, where general costs must be shown in the annual audit.

A good care home will be happy to show you a general breakdown though. You will see that it is good because of the quality and number of staff employed. The two go hand in hand.

Eglantine21 Fri 06-Jul-18 18:41:21

Not always Luckygirl. Check out the Methodist Care Homes!

kittylester Fri 06-Jul-18 18:48:37

The cost is what it is! Check out Ageuk website to see what might apply in your friends case

Not all homes are registered for dementia care.

Dolcelatte Fri 06-Jul-18 18:52:08

Lucky, can you provide a link to the book please or tell me the name of it, as we are facing this situation at the moment.

M0nica Fri 06-Jul-18 19:42:56

Dementia patients do require an extra level of care and supervision, beyond the care provided for those in the early stages of dementia. This requires extra staffing and more qualified staff.

LiltingLyrics Fri 06-Jul-18 19:44:43

Thank you Dolcelatte. I was going to ask the same question.

Funding sounds complicated and is not making a lot of sense to me. For example, on ... it explains that if you have capital of more than £23250 you have to fund your care but says that private and state pensions may count towards that sum. How does pension income suddenly become capital?

Luckygirl Fri 06-Jul-18 19:51:58

Here's the link - go down the page and you can download the book digitally. It really helped me.

The assessment forms are in the book so you can look at the criteria in detail and fill them in yourself so you are ready to challenge any mistakes that are made - and believe me they are made!!

The website is called "Care to be Different."

annsixty Fri 06-Jul-18 19:53:31

You need to download Age UK fact sheet 39 (I hope) to understand how pensions are used.
I understand the whole of the state pension is included but in the case of a man with an occupational pension, in spite of what the SW will tell you, only half can be taken for care while the wife is alive and she can't be made to leave/sell the house.
I rang AGE UK and good this info 2 weeks ago.

LiltingLyrics Fri 06-Jul-18 19:59:00

Thank you Luckygirl.

Luckygirl Fri 06-Jul-18 20:34:18

By the way, if you receive continuing care funding it is completely independent of what you earn/your pension/your assets. It is essentially the same situation as if you were in an NHS hospital.

Dolcelatte Sat 07-Jul-18 05:41:13

Yes, thanks Lucky, much appreciated!

Lazigirl Sat 07-Jul-18 10:12:34

You are right about the funding for Continuing Health Care Luckygirl in that the money is not there to support it. I applied for Checklist for my mother earlier this year. She lives alone. Has LA carers four times a day. Cannot walk, after a fall last year, and needs help with all her needs. She is on controlled drugs for severe pain, and all medication administered by carers, she is in incontinent pads, and has been diagnosed with early dementia (but not challenging behaviour) She is receiving ongoing care for skin cancers. In addition to organised Care which she pays towards, she has considerable input from family. She was assessed, but in order to qualify for CHC she would have needed to have challenging behaviour and more nursing needs, and was turned down. I haven't the energy to fight it.

winterwhite Sat 07-Jul-18 12:13:54

The situation is preposterous. No justification for dementia care not being as fully funded as, say, cancer care. If we ‘can’t have everything’ i would rather have properly funded care for the old than, e.g., Trident.

Lazigirl Sat 07-Jul-18 12:24:59

There is no clear divide between "social" and "nursing", surely they are co-dependant? My mum couldn't stay alive without being washed, fed, toiletted, medicated etc. She would only be suitable for a Nursing Home, not Care Home if she went into care.