Funding Care - Options

Funding Care - Options

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Discussion

winshent

Original Poster:

1,170 posts

194 months

Friday 21st April 2017
quotequote all
My dad went in the hospital recently with a hip problem but the doctors have now determined that his dementia is so bad that you most likely needs to go into a home. He is most likely going to be discharged from hospital within the next few days.

Bit confused and stressed so a few questions.


My dad is 83 and 8 years ago he decided to split the deeds of the house between himself myself and my uncle who is 78. So we all own an equal share. The house is worth around 350k.


So now I'm wondering what the options are. Social Services have explained that his share of the house will be used the fund care. 


I'm concerned about the quality of care that he would receive from a local authourity care home with the options we will be presented.


Options....


1. Could we sell the property and use his share of the proceeds to fund I care home but we have chosen privately. Is it too late to even consider this and also happens when the money runs out.


2. Could I take out a mortgage on his share of the property and buy him out or is it also too late to consider this. 


With either of these options how can the care be funded it in the interim? Can the costs be deferred?

3. If we just go along with social services arrangements for and his share of the property is signed over. If he pops his clogs on day 1, is his share now lost?




chadders74

104 posts

154 months

Friday 21st April 2017
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Whilst in hospital they should do an "NHS Continuing Care Assessment" - get clued up on that now, it's the difference between the NHS paying for everything based on his needs, rather than the Local Council financially assessing him to pay for social needs.

williaa68

1,527 posts

165 months

Friday 21st April 2017
quotequote all
chadders74 said:
Whilst in hospital they should do an "NHS Continuing Care Assessment" - get clued up on that now, it's the difference between the NHS paying for everything based on his needs, rather than the Local Council financially assessing him to pay for social needs.
This - absolutely. Have a read.https://www.mariecurie.org.uk/help/terminal-illness/care-needs/continuing-healthcare-assessment

You may also want to give some careful thought to why your Dad transferred the property to you when he did as the local authority will certainly ask and if it was to limit care home fees then they can in certain circumstances seek to reverse the transaction.

paulmakin

653 posts

140 months

Sunday 23rd April 2017
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the CHC assessment is to establish the split between health and social care costs and to establish eligibility - the NHS will only pay everything if total nursing care is required. local authority would be responsible for the residential care elements and this is subject to financial assessment.

the assessment of needs is "as is, where is" and the slough case established the precedent that future needs will not be taken into consideration. in practice, this means that you need to prepare for regular reviews and re-establishments of eligibility and contribution level.

my own mother was in a care home for approx a decade with her Alzheimer's. the level of personal care that she required fell far short of the legal definition of "nursing care" and the NHS funding was nil. until her last few weeks, she required no "nursing" care at all but very high levels of "personal" care

you can, of course, buy him out but the proceeds will be means tested and taken to be his assets.

be ready for scrutiny around his decision to divide the house. any suspicion that this was done to avoid future care costs will be seized upon by the local authority as a get out clause.

in the circumstances, he will almost certainly not be eligible for a "property disregard" in the financial assessment.

given his degenerative disorder, is he being cared for by the local older people's mental health services ? if not, get in touch and enlist their support. this is their bread and butter work.

from my professional position, don't assume that what the treating team are telling you is accurate. they have very polarised views about what people need (and, in my experience, they are frequently wide of the mark). i'm not saying that a placement isn't required but you need to know what else has been considered and excluded (and why). my personal experience is that, when we sat as a family, considered our strategies and restructured our own lives, we successfully maintained my mother in her own home for 3 years beyond the point that her hospital team considered viable

paul

Edited by paulmakin on Sunday 23 April 22:20


Edited by paulmakin on Sunday 23 April 22:26

winshent

Original Poster:

1,170 posts

194 months

Tuesday 25th April 2017
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I've been reading up about the Deprivation of Assets...

From what I've read on Age UK I don't think I should be concerned. When the house was split 8 years ago my father had no idea that he could potentially end up in a care home. The reason it split was to ensure that I inherited at least 50% of the property.

From AGE UK

"What is deprivation of assets?
Deliberate deprivation of assets is where you have intentionally
decreased your overall assets, in order to reduce the amount you are
charged towards your care and support.
The local authority must show that you knew that you would need care
and support and that you have reduced your assets in order to reduce
the contribution you are asked to make towards the cost.
The statutory guidance also states there may occasionally be other
reasons for disposing of eligible assets. For example, where you pay off
a debt, even if it is not immediately due, this must not be considered as
deprivation.
In this factsheet ‘assets’ refers to either capital or income."

AgeUK link

paulmakin

653 posts

140 months

Thursday 27th April 2017
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i think that 8 yrs will be totally defensible for various reasons - just be ready for the questions

paul

winshent

Original Poster:

1,170 posts

194 months

Wednesday 7th June 2017
quotequote all
Just an update on this..

My dad is still in hospital and has gone down rapidly over the last month... He had Urinary Tract Infection last week which he has just managed to recover from after a week of aggressive antibiotics..

He's now been put on an 'end of life' plan.. Classed as a fast track patient and its now over to social services to find him a nursing home even though NHS are funding it - find that a bit odd.

The 5 homes which he is eligible for are all full obviously.. Surprisingly though most are BUPA, which have good reviews... thought BUPA would be a 'premium' class home. I guess its all about preferred supplier lists etc..

Have been told that if I want to try and find a home myself that the rate is capped to £785 per week.. Went to see a home today, forgot to ask the costs when arranging the appointment... £1500 per week... didn't even seem that special.. large group of oldies watching TV in a room... was the 1st one i've seen so not sure what I was expecting to see though tbh!!

Aside from the finances which is what this was originally about.. This has been really hard to deal with.. being told last week that my dad's blood pressure was very high due to the UTI and being asked whether I would want him resuscitated.. proper stress.. then learninga couple of days later that's a standard question that should have been asked when he was admitted.. wtf..

All I can say is that if you have a loved one who goes in to hospital with early to mid stages of dementia... do your best to get them out asap.. I can't believe how quickly he has gone downhill..

egor110

16,818 posts

202 months

Wednesday 7th June 2017
quotequote all
winshent said:
Just an update on this..

My dad is still in hospital and has gone down rapidly over the last month... He had Urinary Tract Infection last week which he has just managed to recover from after a week of aggressive antibiotics..

He's now been put on an 'end of life' plan.. Classed as a fast track patient and its now over to social services to find him a nursing home even though NHS are funding it - find that a bit odd.

The 5 homes which he is eligible for are all full obviously.. Surprisingly though most are BUPA, which have good reviews... thought BUPA would be a 'premium' class home. I guess its all about preferred supplier lists etc..

Have been told that if I want to try and find a home myself that the rate is capped to £785 per week.. Went to see a home today, forgot to ask the costs when arranging the appointment... £1500 per week... didn't even seem that special.. large group of oldies watching TV in a room... was the 1st one i've seen so not sure what I was expecting to see though tbh!!

Aside from the finances which is what this was originally about.. This has been really hard to deal with.. being told last week that my dad's blood pressure was very high due to the UTI and being asked whether I would want him resuscitated.. proper stress.. then learninga couple of days later that's a standard question that should have been asked when he was admitted.. wtf..

All I can say is that if you have a loved one who goes in to hospital with early to mid stages of dementia... do your best to get them out asap.. I can't believe how quickly he has gone downhill..
You need to go and actually look at a lot of homes to get the feel for what's on offer.

Do you know anybody who works in a care home ? if so take them they'll know what there looking for , they'll work with bank staff who've worked in a lot of different homes and know the good and bad.

Ask how many staff work on the night shift as it's way lower than day shift and ask about the alarms in the rooms.

They can vary from a mat which sets a alarm off if they step on it to door alarms , also query what happens if the alarm is triggered , where my mrs works a buzzer/light goes in there nursing station it's logged on a computer and it also logs how long it takes for them to check the patient and reset the alarm.

Lastly has your relative served in the forces , if so check out the brtish legion homes.