Whatever happened to "saving for a rainy day"?

In my experience the really excellent homes are full of self funders, they can provide the best care as everybody pays more than the LAs can afford. The LAs block book beds in some homes, and in some it’s a fight for beds depending on who gets in first. Preference is given to self funders because they pay more. It’s not a fair system, but that is how it works in practice. So the homes which accept clients who are both LA funded and self funders and are good are sought after like gold dust.

volver

It was you who used the phrase people who haven’t made provision for themselves. Which to me suggests that you think there are people who haven't behaved as you would like them to.

Maybe somebody can explain this to me....

Apparently the nice homes accommodate people funded by the LA who didn't make provision for themselves. But people who can't pay for themselves get moved to other, not-so-nice homes.

It doesn't add up, does it? Both can't be true.

Yes, I can explain it to you. It’s down to the personal budget that the council allocates to the person in care. If a person goes into a care home as a self funder from savings or the sale of a property, the choice of care home is chosen depending on budget and life expectancy.

Once savings drop below the £23,250 threshold a financial assessment is carried out and the person will become eligible for partial funding from the LA until savings drop below the minimum threshold of £14,250, then another financial assessment will determine the personal budget for the LA to start fully funding the persons’ care.

The personal budget offered by the council may not cover the fees the elderly person has been paying in their existing care home, so there is a shortfall between what the council is prepared to pay and what the care home is prepared to accept. The LA will provide a list of available care homes that will be affordable with that person’s personal budget and if the existing facility is not on it they will have to move.

If the person wants to stay put they may be expected to pay a top up fee to cover the shortfall - usually dependent on other income, or if this is not sufficient, on other family members agreeing to pay a top up fee. If there is no facility to cover the top up fees it will then depend on the contract the resident has with the care facility - some homes will accept council contributions as payment in full when the person runs out of money. Others will offer a grace period while residents make other arrangements or renegotiate to move to a smaller or shared room in the same facility, to cover the shortfall.

In other cases, there will be no alternative other than moving to a cheaper facility. Just because you are resident in a care home which also has LA funded residents, doesn’t mean you can automatically stay on when your funding runs out. It depends on the personal budget set by the council and if there are no available facilities within the existing home which are affordable then you have to move. It’s not rocket science, and it’s also not hard to figure out how this could all be avoided with targeted taxation to make sure everyone can access affordable later life care.

volver

^is obviously going to penalise some of the more frugal.^

If any of us live to be 100, we will have to pay to live; heating, food, TV licence, whatever. Whether we are in our own homes or in a residential facility, we will have to pay. I think my perspective is about whether those who have a bit of money behind them should be expected to spend it or not. And they should be expected to spend it. Sorry for being blunt, but what is the point of dying with thousands in the bank just so that your children can have it, but expecting the state to support your living expenses?

I am not talking about medical care, which I believe should be free at point of need for all. But I'm not going to get all would up about spending my/our money to support ourselves just because I think someone else doesn't deserve it.

I agree - but living in your own home until your 100 will be considerably cheaper than the present rates of full time care. And this is what I have a problem with. If care was still run directly by LA’s there would be less overheads so care would be cheaper for all. As it is, it’s run mostly by private providers who have all kinds of overheads, including an obligation to shareholders, so the resident ends up paying huge amounts. As an example our LA provides at home care at a rate of approximately £26 an hour, which self funders have to pay in full, of which approximately £12.50 is paid to the LA carers who do the work. It’s becoming unsustainable.

Doodledog

volver

I'm not suggesting you were moaning Doodledog. But when I see posts that are wondering why people bother to save when the feckless irresponsible poor get something for nothing, that does sting a bit (my words, not said by anyone here).

I agree that the tax system should be fairer and that those with more should pay more.

Ok, so can you explain how my hypothetical example above is fair?

You are right that there is an unpleasant amount of judgement and gloating on here - people buying coffee on the train are judged as though they are asking for a life of poverty - but there is no judgement implied in believing that everyone should spend their own money as they wish (and if they wish to save it, that is their right too). If anything it is quite the reverse, yet every time this conversation comes up (or any other mention of means-testing) the assumptions come think and fast.

Means testing (or 'targeting' as politicians prefer to call it) is not caring. It is not designed to give more to those with less. It is cruel and is designed to limit the number of beneficiaries from a scheme to which we all contribute (and, as a percentage of disposable income, it is the 'squeezed middle' who contribute the most). The rich are not impacted to any great extent and the very poor will get full means-tested benefits. It is the largest contributors (as a group) who get hit - people like nurses, teachers, office workers and others on PAYE, who don't have accountants to massage their earnings, and don't get paid in cash and decide how much to declare, but earn an average or only slightly above average income. If they buy a modest house, or squirrel money away in an ISA they are treated as though that money is not theirs, but must be spent on things that could be provided on the basis of need (as they are for the poor) if the tax system were fairer and if everybody paid in.

You said it much better than I could have done.

I’m not sure I follow you Pammiel. Although it’s what most people want given a choice, it’s more expensive to provide care at home per hour of carer time used because of travel between clients, travel expenses etc. Care at home is only provided by LAs up to a certain level of dependency and to a limited number of hours per week, so most clients with little or no family support end up in care homes as their needs increase.

You said it much better than I could have done.

Not at all. You are making your point very clear.

You are wasting your time though, as there is always an underlying assumption on here that people arguing for equality of provision are castigating others for not saving, or arguing from self-interest rather than principle. It happens every time, no matter how carefully the case for higher taxation and fair pay is made, and it's wearisome.

Doodledog

You said it much better than I could have done.

Not at all. You are making your point very clear.

You are wasting your time though, as there is always an underlying assumption on here that people arguing for equality of provision are castigating others for not saving, or arguing from self-interest rather than principle. It happens every time, no matter how carefully the case for higher taxation and fair pay is made, and it's wearisome.

I can’t help thinking that’s not necessarily what the issue is for the majority of posters Doodledog, I think unless you’ve been directly involved you just don’t understand how complex and inherently unfair the care system funding arrangements actually are at present.

Gabrielle56

Not wanting to sound flippant but- more fool you. I was advised by my father never to divulge any savings to anyone! What I'd saved out of already taxed money was my business alone! And he was a senior civil servant in a very sensitive department! So I never did, not that I ever had loads but they don't allow you hardly ANY savings.so be warned ,if you don't tell they can't find out and they also assume that majority of decent types tell the honest truth....

Who are ‘they’ ? To claim means tested benefits you have to provide proof of income and savings. Since when did DWP assume anyone is decent and telling the honest truth ?!!

You're right that I haven't been directly involved, so there could easily be something I'm not 'getting', but I do feel that the system is inherently unfair for the reasons I have given.

Yes, I think that 'they' can easily find out how much you have in savings, unless you keep it under the mattress,

Casdon

I’m not sure I follow you Pammiel. Although it’s what most people want given a choice, it’s more expensive to provide care at home per hour of carer time used because of travel between clients, travel expenses etc. Care at home is only provided by LAs up to a certain level of dependency and to a limited number of hours per week, so most clients with little or no family support end up in care homes as their needs increase.

My point was - and looking back on my post I didn’t make it clear enough - that our LA uses a large private care concern and of the £26 an hour charged, only £12.50 goes to the actual care workers. The rest is overheads. It just doesn’t seem right that care in the community is being left to profit making organisations beholden to shareholders.

Doodledog

You're right that I haven't been directly involved, so there could easily be something I'm not 'getting', but I do feel that the system is inherently unfair for the reasons I have given.

It is unfair, you’re right there, I don’t think that it’s something people know about, or even think about generally until they are caught up in the system themselves, or their parents are, by which time the decisions and choices they have to make are stark.

Pammie1

Casdon

I’m not sure I follow you Pammiel. Although it’s what most people want given a choice, it’s more expensive to provide care at home per hour of carer time used because of travel between clients, travel expenses etc. Care at home is only provided by LAs up to a certain level of dependency and to a limited number of hours per week, so most clients with little or no family support end up in care homes as their needs increase.

My point was - and looking back on my post I didn’t make it clear enough - that our LA uses a large private care concern and of the £26 an hour charged, only £12.50 goes to the actual care workers. The rest is overheads. It just doesn’t seem right that care in the community is being left to profit making organisations beholden to shareholders.

I’m with you now. Local Authorities have been forced to use care agencies because the Local Authorities care budgets are so tight, and it was cheaper for them than employing in house staff. The care staff individually have all suffered the consequences, with worse terms of service, zero hour contracts, etc. etc.

Casdon

Doodledog

You're right that I haven't been directly involved, so there could easily be something I'm not 'getting', but I do feel that the system is inherently unfair for the reasons I have given.

It is unfair, you’re right there, I don’t think that it’s something people know about, or even think about generally until they are caught up in the system themselves, or their parents are, by which time the decisions and choices they have to make are stark.

I don't know, Casdon. When we made our wills a few years ago the solicitor talked us through how to avoid fees by the first to die leaving the house to the children, with the surviving spouse having the right to stay there for life (or sell and move house if they chose). This would mean that if either or both of us needed care there would be no house to take into account. She pointed out that many people in circumstances like ours ended up paying everything for care (particularly if one person needed care while the other was alive) as we don't have a massive cushion in the bank, but have enough to lift us out of getting free care. There was another option of making the house ownership tenants in common, so that only half of the house belonged to each of us, and the other half would be protected if only one of us went into care. As it stood we were joint tenants which would mean that despite us having both paid for the house if one person needed care the other would lose his or her stake in it to pay the fees.

We didn't go for either option, so some of the detail might be wrong, but that was the gist. I think that a lot of people do think about the implications as they get older.

Doodledog

Casdon

Doodledog

You're right that I haven't been directly involved, so there could easily be something I'm not 'getting', but I do feel that the system is inherently unfair for the reasons I have given.

It is unfair, you’re right there, I don’t think that it’s something people know about, or even think about generally until they are caught up in the system themselves, or their parents are, by which time the decisions and choices they have to make are stark.

I don't know, Casdon. When we made our wills a few years ago the solicitor talked us through how to avoid fees by the first to die leaving the house to the children, with the surviving spouse having the right to stay there for life (or sell and move house if they chose). This would mean that if either or both of us needed care there would be no house to take into account. She pointed out that many people in circumstances like ours ended up paying everything for care (particularly if one person needed care while the other was alive) as we don't have a massive cushion in the bank, but have enough to lift us out of getting free care. There was another option of making the house ownership tenants in common, so that only half of the house belonged to each of us, and the other half would be protected if only one of us went into care. As it stood we were joint tenants which would mean that despite us having both paid for the house if one person needed care the other would lose his or her stake in it to pay the fees.

We didn't go for either option, so some of the detail might be wrong, but that was the gist. I think that a lot of people do think about the implications as they get older.

I only got involved in cases when I was working with more complex discharges from hospital, and and many were those cases where there were loads of issues around finance, so I saw only one end of the issue - if funding was all sorted out in advance the decisions were taken quickly and easily, and we never heard any more about them, so perhaps I have a jaded view!

There is no doubt that the Care System needs a complete overhaul, and it is a complete lottery just now. If you are “lucky” enough to drop dead, no care costs are incurred, but if you have dementia say, it’s a different story. No government will grasp the nettle because it will cost billions and it is a time bomb because of the increasing age demographic who will need care.

I think that Home Care and Care Homes should be returned to LA responsibility, with responsibility for training of staff with living wage as a minimum and standards of care monitored.

I believe those who can afford it should pay towards care but there should be a cut off point, after which care should be free. Of course this will mean higher taxes, but I think as a society we should share responsibility for our elderly, infirm and disabled.

I have personal experience of the care system because my mother receives full time care at home, and believe me, I have to produce accounts, with bank statements, with expenditure down to every last penny, every 3 months for the LA.

Exactly what are overheads? They are the necessary costs of recruiting staff, undertaking all the checks needed for it to be safe to hire them, assessing anybody who needs care , preparing rosters, coping with crises that arise when carers are ill, preparing pay checks, ensuring standards are met, providing PPE and other materialspaying those doing all the 'overhead' experiences. It is not surprising that doing all these tasks account for half the hourly cost of a carer. What tasks should they leave out? Running all the safety checks? coping with crises? providing ppe?

I very much doubt whether an LA can do it any less expensively than a commercial care provider, the majority of which are not part of huge chains but local agencies run by one or two people, who generally earn not a lot more than their staff.

M0nica

Exactly what are overheads? They are the necessary costs of recruiting staff, undertaking all the checks needed for it to be safe to hire them, assessing anybody who needs care , preparing rosters, coping with crises that arise when carers are ill, preparing pay checks, ensuring standards are met, providing PPE and other materialspaying those doing all the 'overhead' experiences. It is not surprising that doing all these tasks account for half the hourly cost of a carer. What tasks should they leave out? Running all the safety checks? coping with crises? providing ppe?

I very much doubt whether an LA can do it any less expensively than a commercial care provider, the majority of which are not part of huge chains but local agencies run by one or two people, who generally earn not a lot more than their staff.

That Was why Local Authorities stopped running in house care services Monica. One of the unintended consequences has been the consequent reduction in status and pay rates for carers, left isolated and undervalued.

If it is just one or two people doing all these things, how does it cost £1600 a week for each resident when care staff are so abysmally paid, though? Even with on-costs care staff don't cost much, and the running of the home itself (heating, lighting etc) can't possibly add up to that sort of money.

A figure of £1600 a week comes to £83,200 per resident per year. What are the staff/resident ratios? If we assume a generous £30,000 a year for one carer after on-costs, even if the ratios were 1:1 that leaves £53,200pa per resident after staff costs, and I'm guessing that the ratios are far higher than that. Do the residents really cost that much to keep? Older people eat less than younger ones, it is cheaper to cook for larger numbers, and their personal effects are not included in the fees, so the home is not paying for shampoo or toothpaste etc.

I may be jumping to the wrong conclusions, but I don't see how that can be right. I agree with Farzanah that they should go back into LA hands and be properly regulated.

It doesn’t cost that much. I just looked it up, according to Care UK the average weekly cost of living in a residential care home is £704, while the average nursing home cost is £888 per week across the UK.

Is that the cost to the resident or the cost of keeping them there?

Farzanah

There is no doubt that the Care System needs a complete overhaul, and it is a complete lottery just now. If you are “lucky” enough to drop dead, no care costs are incurred, but if you have dementia say, it’s a different story. No government will grasp the nettle because it will cost billions and it is a time bomb because of the increasing age demographic who will need care.

I believe the overhaul should be a cross-party project. It's so important that leaving it as a political football to be kicked around by one party (any party) just causes more problems than are solved.

The laissez-faire free-market approach has resulted in a lottery, with many losers. I cannot believe that privatising a care service for very vulnerable people in order to make a profit is really the best way of dealing with it. Others of course will disagree. I'm not against 'the market', nor Capitalism, but believe that some things should just not be in private hands, or should I say Corporate hands - essentials like water, energy, health and social care. They are so basic, so essential to the wellbeing of the whole nation. And in our current society with such a divide between the wealthy elite and the impoverished it is, IMO, bordering on 'criminal' that these basics are left to 'the market'. Health / social care is not a 'product', it is not a commodity. As one - Richard M. Titmuss (a British social researcher and teacher) - said back in the 70s... unlike when we buy shoes, as patients we have little idea of what treatments we will need. Finally, we are not in a position to return them, least of all from the grave.

Casdon

It doesn’t cost that much. I just looked it up, according to Care UK the average weekly cost of living in a residential care home is £704, while the average nursing home cost is £888 per week across the UK.

I don't know where they get their figures from but everybody I have spoken to from different areas has said that Nursing Care is much higher than that. We pay £6200 at the moment but that is because Mum has a very small room. It will go up considerable if she goes into one where she can swing a cat.

The last home I worked in is one of a chain, owned by someone purported to be on the "richest" list.

icanhandthemback

Casdon

It doesn’t cost that much. I just looked it up, according to Care UK the average weekly cost of living in a residential care home is £704, while the average nursing home cost is £888 per week across the UK.

I don't know where they get their figures from but everybody I have spoken to from different areas has said that Nursing Care is much higher than that. We pay £6200 at the moment but that is because Mum has a very small room. It will go up considerable if she goes into one where she can swing a cat.

If somebody meets the threshold for nursing care for 24 hours they are classified as an NHS patient, and paid for through Continuing Healthcare funding, so I’m guessing your mum doesn’t qualify for that, which is free for eligible people.
This seems a reliable source regarding care home fees.
www.carehome.co.uk/advice/care-home-fees-and-costs-how-much-do-you-pay