Whatever happened to "saving for a rainy day"?

icanhandthemback

The "unfairness" of the care system is much murkier than people with subsidising people without. If you need to be in a home with medical needs and you can jump through the hoops that the CHC system puts you through (with each local authority interpreting the rules differently) you can get all your care free regardless of savings. CHC has almost become impossible to get but in her area, the few people who have successfully applied are people who have professional qualifications and the ability to fight the system up to the Ombudsman.
I don't mind my mother having to pay for her care which is due to her medical needs if everybody has to if they have money. I do object to only those who have the wherewithal to fight to get their care fees paid despite their wealth. I also object to people who have had the same income/inheritance/lifetime earnings as her getting their care fees paid because they lived the life of Riley whilst she was taking care to provide for old age. I just don't think that is equitable but I don't know how you allow for it unless you tax for care at source so the money can't be frittered away.

Yes, the sharp-elbowed, those with clued-up solicitors, those who somehow hide their savings (no idea how, but still), and those who spend as they go all get free care, as well as the poor. The rich will often not need it, as they can pay for in-house care, or have enough of a cushion to spend without missing it, so it's Mr and Mrs Ordinary who lose out.

I think taxing at source (and not just PAYE, but any source of income) is a fair way of doing it. It's too late for we older lot, but an additional ring-fenced tax proportionate to income would mean that nobody had to worry about getting old and in need of care. I think only one in four of us need care, so as the cost would be borne by everyone it needn't be ruinous, and anyway it would be a progressive tax, meaning that higher earners would pay more.

Casdon

Pammie1

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.

But that doesn’t include specialist care. Our relative is in a care home which specialises in dementia care. It costs well over £1000 a week and when funding runs out a cheaper facility will be necessary, which won’t meet her needs. She is contributing over £1000 a month to LA funded residents, which reduces her funding pot by £60,000 if she lives five years, which reduces her funding for the care she needs by almost two years. Do you really think this is fair when the introduction of targeted taxation at rates that are affordable according to circumstances could provide proper care for all ?

I’m not saying it’s fair Pammiel, I’ve already said that it isn’t. A major review of the care system is needed.

I agree - but it won’t happen under the Tories. Too busy feathering their own nests !

Pammie1

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.

But that doesn’t include specialist care. Our relative is in a care home which specialises in dementia care. It costs well over £1000 a week and when funding runs out a cheaper facility will be necessary, which won’t meet her needs. She is contributing over £1000 a month to LA funded residents, which reduces her funding pot by £60,000 if she lives five years, which reduces her funding for the care she needs by almost two years. Do you really think this is fair when the introduction of targeted taxation at rates that are affordable according to circumstances could provide proper care for all ?

I’m not saying it’s fair Pammiel, I’ve already said that it isn’t. A major review of the care system is needed.

icanhandthemback

Witzend

Pammie1, care home fees often don’t seem so excessive when you compare them to the cost of B&B in (say) a reasonable 3 star hotel or B&B locally.

Instead of just B&B, you have all meals and drinks, all laundry (often a lot, esp. if incontinence is involved), help with washing, dressing, and possibly ‘toileting’, as they like to call it, maybe with eating and drinking, not to mention often a higher than normal level of heating, and someone on hand 24 hours a day. And often sundry activities, too.

So next time you are on holiday at a hotel, perhaps you could subsidise somebody in the hotel who can't really afford it.

???

icanhandthemback

Casdon

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

If you believe that to be the case, you are mistaken. The thresholds are moveable goal posts and eligibility is not clearly defined so it is difficult to fight your corner. Assessors break the rules all the time and I am sure they must be paid a bonus for turning down claims. The Nursing Home where my mother is now have people with full blown dementia who are unable to do anything for themselves and they are continually being turned down for CHC even though they should be entitled to it. They asked the assessor at what point they would pay it and basically they said within weeks of dying. It is an absolute travesty.

This. I was told mum had to have a terminal diagnosis before she would qualify for CHC. She now has one and they continue to find excuses not to fund it. It’s typical of the shit attitude in this country to the sick, the disabled and the elderly. There seems to be a never ending line of people ready to rip them off and no one cares. Shame on us.

Witzend

*Pammie1*, care home fees often don’t seem so excessive when you compare them to the cost of B&B in (say) a reasonable 3 star hotel or B&B locally.

Instead of just B&B, you have all meals and drinks, all laundry (often a lot, esp. if incontinence is involved), help with washing, dressing, and possibly ‘toileting’, as they like to call it, maybe with eating and drinking, not to mention often a higher than normal level of heating, and someone on hand 24 hours a day. And often sundry activities, too.

So next time you are on holiday at a hotel, perhaps you could subsidise somebody in the hotel who can't really afford it.

Casdon

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

If you believe that to be the case, you are mistaken. The thresholds are moveable goal posts and eligibility is not clearly defined so it is difficult to fight your corner. Assessors break the rules all the time and I am sure they must be paid a bonus for turning down claims. The Nursing Home where my mother is now have people with full blown dementia who are unable to do anything for themselves and they are continually being turned down for CHC even though they should be entitled to it. They asked the assessor at what point they would pay it and basically they said within weeks of dying. It is an absolute travesty.

Witzend

*Pammie1*, care home fees often don’t seem so excessive when you compare them to the cost of B&B in (say) a reasonable 3 star hotel or B&B locally.

Instead of just B&B, you have all meals and drinks, all laundry (often a lot, esp. if incontinence is involved), help with washing, dressing, and possibly ‘toileting’, as they like to call it, maybe with eating and drinking, not to mention often a higher than normal level of heating, and someone on hand 24 hours a day. And often sundry activities, too.

I agree. But that still doesn’t excuse the fact that those who have the means to pay are subsidising those who can’t, when a simple targeted tax could ensure that the care is there for all when they need it.

Pammie1, care home fees often don’t seem so excessive when you compare them to the cost of B&B in (say) a reasonable 3 star hotel or B&B locally.

Instead of just B&B, you have all meals and drinks, all laundry (often a lot, esp. if incontinence is involved), help with washing, dressing, and possibly ‘toileting’, as they like to call it, maybe with eating and drinking, not to mention often a higher than normal level of heating, and someone on hand 24 hours a day. And often sundry activities, too.

Casdon

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

My mum is 91 and has vascular dementia, and now has a terminal diagnosis for advanced breast cancer. She needs 24 hour care but the NHS will not pay for continuing health care funding - they have lots of reasons for denying it and it’s an ongoing battle. It was only through MacMillan services that I discovered that she was eligible for free hospice care - all other sources said she had to pay for care. The information is out there but not easily accessed, which IMO is disgusting.

The "unfairness" of the care system is much murkier than people with subsidising people without. If you need to be in a home with medical needs and you can jump through the hoops that the CHC system puts you through (with each local authority interpreting the rules differently) you can get all your care free regardless of savings. CHC has almost become impossible to get but in her area, the few people who have successfully applied are people who have professional qualifications and the ability to fight the system up to the Ombudsman.
I don't mind my mother having to pay for her care which is due to her medical needs if everybody has to if they have money. I do object to only those who have the wherewithal to fight to get their care fees paid despite their wealth. I also object to people who have had the same income/inheritance/lifetime earnings as her getting their care fees paid because they lived the life of Riley whilst she was taking care to provide for old age. I just don't think that is equitable but I don't know how you allow for it unless you tax for care at source so the money can't be frittered away.

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.

But that doesn’t include specialist care. Our relative is in a care home which specialises in dementia care. It costs well over £1000 a week and when funding runs out a cheaper facility will be necessary, which won’t meet her needs. She is contributing over £1000 a month to LA funded residents, which reduces her funding pot by £60,000 if she lives five years, which reduces her funding for the care she needs by almost two years. Do you really think this is fair when the introduction of targeted taxation at rates that are affordable according to circumstances could provide proper care for all ?

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.

Then how does it cost well over £1000 a week for the average care home resident ? If the La provided direct care they wouldn’t have to worry about satisfying shareholders or other unnecessary overheads. Elderly and disabled people are routinely ripped off because they are not a priority - until there’s a squeeze on the economy as there is now, and then they are the first in line for cuts.

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

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

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.

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.

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

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.

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.

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.

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.

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.

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!

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.