Care home / nursing home fees

When I was looking for care homes the SW told me that 'the family' would probably have to pay a top of fee. I said 'you mean me?' and she backed off. Another SW was much more helpful and my Mum was happy in the home we found and which took LA rates when Mum's money ran out. I couldn't afford to pay a top up fee and still have money left for my own future care.

The whole care system is broken .....care homes now saying they will not be able to keep running when the new 'cap' on money you are allowed to keep comes in ......I had to put my late husband into one in his later stages of life ...cost me Euro 4,000 a month in France which I was able luckily to pay through an inheritance, or I have no idea what would have happened ! ONE really good thing about France is that throughout your working life you pay a lot of deductions per week/month from salary ...including an amount for your possible long term care, your pension (currently over E2,000 a month for retirees) your health care and taxes ....they moan about this but I really think it is time the UK had a similar scheme ...i e my neighbour had a mother in the same care home paying only 1,000 Euro a month .......I know the idea of paying for health care extra, as well as long term old age care, is anathema to most of my friends in the UK ...but you get what you pay for ! My late father was in a residential (not care) flat ...complained bitterly that because he had sold his house, he had to pay for everything ...taxis to the lunch club, a cleaner, decorator, etc etc when 'him upstairs gets it all for nothing cos he spent all his money;...............how fair is that ! I have written to MP's etc etc but all they say is Social care is being reviewed ! oh yes...............exactly when ? I guess the review will include a one off payment of £15,000 to enable the aged to go to Dignitas .......... and as you say, WHEN all the money you have has gone, how are you supposed to pay for your own care if you need it !

What happens when the first spouse is in need of care? I know they will be assessed as individuals, but what happens if a top up is needed? If the other spouse pays it there may be no money left if and when they need care themselves. How is that right?

If and when the new cap comes in at least people will know where they stand, just remember the cap does not cover expenses you woul occur at homelike food. It is solely care charges which count against the cap.
Never agree to pay top up fees, it is a huge commitment as prices can rise without you having a say,
You can often argue your case successfully why the loved one should not be moved. Reasons like ease of visiting, lack of transport, and the condition of the loved one. The worst situation at the ,omens is that they are discharged from hospital for assessment in a care home knowing that home probably can keep them, then moved on when they find a to 5hem not necessarily you, suitable place. You have to do your own groundwork at all times use the CQC list, which are not perfect but better than not searching before placement

leeds22
I had a similar experience. My mother was discharged into a lovely and very expensive care home after she broke her shoulder. She spent two weeks in hospital and then was sent to this care home at the expense of the NHS. After three months she was told she could go home or self fund. She was at this stage totally unable to go home to live, even with carers. When I spoke to the admittance manager I told her mum could probably afford to self fund for about eighteen months and I was then told that ‘the family’ could guarantee and pay after that! At £1325 a week! I gave her very short shrift about that. I said what if I or my husband need care later in life? Who would pay if we spent whatever money we had on mum’s care? Was I supposed to remortgage my house to pay for it?
We found another lovely home for mum where the LA will hopefully pick up the cost when mum’s money is gone. What a cheek to suggest we pay.

My mum is 91 and has dementia. She’s lives with myself and partner in our home for some years and it’s been hard work but very rewarding, and I’m hoping that she will end her days here with us. Her condition has deteriorated and the Dementia has affected her appetite - I’m advised that this is a sign of the condition advancing and she may only have months left. Our GP has put us in touch with the Local Authority to discuss options for home care if we’re finding it difficult to cope nearer the end, but something I found out the other day, quite by chance, is that Dementia qualifies for hospice care in the final months of life, at no cost to the patient or their family. To qualify, the patient has to have a terminal diagnosis and in the last few months of life - their time can be split between hospice care and home as needed. Not once has this option ever been mentioned in any of our enquiries about respite and home care. The other thing I didn’t realise is that care homes routinely charge 20% more to self funding residents to cover the cost of those who rely on council funding. A relative was charged £4000 in a care home who charged LA residents £3000 for the same facility - this was the reason they gave. So in the course of 12 months, self funders who may have to sell a property to fund their care, are stumping up £12000 a year in some cases, effectively to subsidise community care. Not sure how I feel about this TBH.

maddyone

leeds22
I had a similar experience. My mother was discharged into a lovely and very expensive care home after she broke her shoulder. She spent two weeks in hospital and then was sent to this care home at the expense of the NHS. After three months she was told she could go home or self fund. She was at this stage totally unable to go home to live, even with carers. When I spoke to the admittance manager I told her mum could probably afford to self fund for about eighteen months and I was then told that ‘the family’ could guarantee and pay after that! At £1325 a week! I gave her very short shrift about that. I said what if I or my husband need care later in life? Who would pay if we spent whatever money we had on mum’s care? Was I supposed to remortgage my house to pay for it?
We found another lovely home for mum where the LA will hopefully pick up the cost when mum’s money is gone. What a cheek to suggest we pay.

This very subject was discussed on a recent thread. There is no legal obligation for someone’s relatives to fund their care, and yet there are more and more people being asked by care homes if they would like to act as guarantors for their relative when self funding runs out and top up is required for LA funding. What most people don’t realise is that there is no legal way out of a guarantor agreement - once you’ve done it, you’re stuck with it and it’s a recipe for financial ruin.

win

If and when the new cap comes in at least people will know where they stand, just remember the cap does not cover expenses you woul occur at homelike food. It is solely care charges which count against the cap.
Never agree to pay top up fees, it is a huge commitment as prices can rise without you having a say,
You can often argue your case successfully why the loved one should not be moved. Reasons like ease of visiting, lack of transport, and the condition of the loved one. The worst situation at the ,omens is that they are discharged from hospital for assessment in a care home knowing that home probably can keep them, then moved on when they find a to 5hem not necessarily you, suitable place. You have to do your own groundwork at all times use the CQC list, which are not perfect but better than not searching before placement

The cap covers personal care and what are described as ‘hotel fees’ which cover accommodation and food. Nursing care should be free, but you need to establish this as there’s a lot of confusion about what is NHS ongoing care and what is not. And crucially, I believe the cap will not include any state benefits paid to help with care, such as disability living allowance or attendance allowance - it’s purely on the persons’ personal income and assets.

The spouse who doesn't require care isn't under any legal responsibility to make top up payments Cabbie, just as it is with any other family member.

Had same experience with elderly relative here in Scotland...At the time you had to exhaust your savings till you only had 16k lef as that was the amount you are allowed to keep...In Scotland personal card for the elderly is free so council paid that part to the retirement home...Unfortunately or fortunately for her daughter her mum died before her house would have had to be sold to continuepaying for her care package....So glad the home she was in was amazing because it cost her a lit to stay there..

Thank you Pammie yes it was me who put a contribution in the other thread about being a guarantor and you gave me a very nice reply there too. It is outrageous that relatives are asked to be guarantors, where would it end? You could end up losing your own house to pay your parents care fees. I was astonished when this was out to me as an option.

put to me…

Didn’t a certain someone promise to sort out social care? I went through all this with my mum who had dementia 20 years ago. Every member of the family had to pay up to top up her care. Now my sister has dementia and it’s been months trying to get her into the nursing home she so badly needs. It’s actually got worse in the last 20 years, probably due to pressure on places. I’m dreading when it’s my turn….

My FIL has been in a care home for over a year now and is self funding. At the moment, his house is on the market to ensure that he has enough funds to keep him there for the foreseeable future, which could be quite a while. As I understand it, there is no current law that demands that the family pay for the care when the funding is diminished. I believe that the funding situation will change in September 2023 when there will be a cap on how much you self fund, after which, the Govt. will pay for the care element, but not the accommodation and meal provision, which will still be self funded, but hopefully to a more manageable level. This is my understanding of the proposal. If I am wrong, I am sure someone will put me right.

Cabbi 21 ….. I totally agree with your statement …. I wish we didn’t live so long.
Medicine seems all about keeping people alive as long as possible! For what: so those on the outside of these zoo’s can go gape at relatives who don’t want to be there….. don’t want us to be there…. where has the quality of life gone , once you’re incarcerated into these places. Not for me . My house is for my children ….I earnt it….I’ve upkept it. When my husband finially Goes into one of these places ….they can have his £1000 per month pensions….they’ll get nothing of mine . I am determined to stay in my home so they can’t take it to pay for his care. The upshot is…. my husband is deemed not to need one of these homes…. I had my third stroke last year….I have 4 prolapsed discs …I am in constant pain. I have to lift him ( 12.5 stone) of the floor at least three times a week. He won’t allow me to sleep as he constantly wanders the house with light and tv blazing! I’m shattered. His mind is going! But apparently he does not need care while I’m standing upright. I’ve been laid up with Covid 6 weeks now….still no help!! I’m on my knees! Which of course is what they want. If I need a care home and he needs a care home …. they can sell our house to pay for it! The system is shut ! I wish to hod my stroke would’ve killed me last year.

‘The system is shit’

DON'T, whatever you do, when you are looking for a home indicate to them that your relative is a self funder - they whack the fee up by as much as £400-£500 a week - I work in the Social Care sector and have seen it time after time

The home where my mother is won’t accept people unless they are self funders to begin with, although they accept LA funding later if the resident’s money runs out.
I agree with you Saggi in that medicine seems to be used to keep people alive as long as possible with little regard to their quality of life. Having said that illnesses have to be treated because it would be unethical to leave people untreated.

My Mum died on the 19th September 2019 in a nursing home, she entered her care home with dementia in July 2010. She spent her last years as an inanimate, non responsive, prone ‘person’.
My Mum died to us many years before her heart stopped beating, I agree Saggi

Pammiel, these are the guidelines at the moment
Will the cap really fix the social care system?, the government confirmed the accommodation-related costs of care - those associated with daily living, such as; food, energy bills and the physical building - would not count towards the cap.

The government has not confirmed how much people are likely to pay for the accommodation costs, but previous reference of the cap following the 2014 Care Act suggested people's contribution to these accommodation costs should be fixed at £12,000 a year. This is now likely to be higher.

The other point of consideration must be the reference to the local authority arranging the care to find ‘better value care’.

In the 2014 Care Act, which was later abandoned, the cap was due to be £72,000. However, this was not as it first seemed.

It did not mean that once an individual had spent £72,000 on care home fees that the local authority would completely fund their care thereafter. Rather, when the cap was reached depended upon the rate of care fees that a local authority was prepared to pay. For example, if a local council was willing to pay £500 a week for care then, for individuals falling within that local authority’s responsibility, the £72,000 cap would not be reached until 144 weeks of care had been paid for. This was true even if, in reality, an individual was paying £720 a week for their care.

Further, the cap would not even be reached in this instance (after 144 weeks) if the care fee included the accommodation costs. This is because the cap on care costs in the Care Act (as it now appears to be with the new cost cap) was just that; it placed a cap on care costs only and the cost of accommodation and living expenses were therefore still needed to be met by the individual receiving the care or, their family.

This is obviously in stark contrast to NHS continuing healthcare: What makes someone eligible, where the NHS is responsible for all costs including accommodation costs for individuals who received care primarily because of their health needs.

The vast majority of people have their home as their only real asset. The new system will continue to ensure local authorities offer deferred payment agreements, which is an accruing charge on the property, which will need to be settled on the sale of the property or death of the individual. Therefore, it remains that no one should be forced to sell a home during the care recipients lifetime.

It will remain to be seen as more details emerge from the UK government. However, as more information is coming to light, the cap contained within the paper may prove to be somewhat disappointing for the majority of those in care homes who pay more than the rate that the local authority is willing to pay and also for those who will still be required to fund the accommodation element of their care which is likely to run into hundreds of pounds a week.

For advice on the topics discussed in this post, visit our Nursing Care Fee Recovery team page.

Author bio

Lisa Morgan
Lisa Morgan
Partner, Head of Nursing Care
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Lisa Morgan is a Partner and Head of the Nursing Care department. She is regarded as an experienced and specialist solicitor leading in the niche area of continuing healthcare.

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When the cap is introduced I'd lay an odds on bet that people who have been self funding for years, will not have the the many thousands of pounds already paid taken into consideration.
No doubt the cap date will be the start date for payments to counted towards the cap.

The care costs will be deemed to be small no doubt, so that the individual (and iniquitously, their family) will still finish up paying the bulk of the bill.

The new guidelines have added nothing to clearing up the anomalies as regards funding from the health authority for those who are deemed to have predominantly health needs. This Continuing Health Care Funding system fails to pay up for the many who either know nothing about it and therefore do not apply, or are wrongly refused. If all those who qualified for this received it then only a minority of people would fall under these new care rules. It is in the government's interest to keep people in ignorance. As some on here will know my OH was turned down twice, but I won our case on appeal - sadly posthumously. The government relies on people not having the knowledge that I did, nor the ability to deal with the appeal process nor the tenacity that I am lucky to have. If I had not worked in the field I would not have known his rights.

Quite right Lucky girl, it's an absolute minefield. CHC is difficult to comprehend. People assume that the person who is more dependant and very ill will qualify for funding. This is not so. It seems to be how much of the staff time a person requires.

I wish we did not all live so long

Never a truer word. Very old people, existing, not living. Being kept alive on drugs.

So glad my mother died at 92 before ever getting to that stage.

Just so hope I do too.

The home my mother was in (primarily private) said that if residents run out of money they are not moved and the home accepted the council contribution. Residents there have homes for life. Not all homes are like this though.