Paying for a care home

Paying for a care home www.brent.gov.uk Information for those considering residential or nursing care Revised April 2010

Who is this booklet for? This booklet is to help adults living in Brent who have decided to move to a care home in England, or who are thinking of doing so. We hope this booklet will: inform you of the financial help Brent Council may be able to provide provide information about how we work out your contribution to care home fees direct you to other sources of advice and assistance where appropriate. When is living in a care home free? Continuing care If medical staff looking after you decide you will have continuing medical needs the NHS may offer you a permanent place in a nursing home. This service will be provided free of charge by the NHS. Leaflets providing more information about hospital services and procedures are available from health authority premises, such as GP surgeries. Intermediate care If you go into hospital and are unable to manage to return home immediately, the NHS or the council may arrange a short stay in a care home to help you regain your strength and independence to go home. Short stays are no longer than six weeks. This service is provided free of charge by the NHS and is mainly available to older people. 2

Nursing care The NHS will pay for any element of nursing care carried out by a registered nurse. You will be asked to pay towards the rest of your care fees (see page 5 for more details). Nursing care means any element of nursing care provided by a registered nurse either in your own home or in a care home. During your assessment it will be worked out how much support you will need from a registered nurse. A booklet entitled NHS funded nursing care in nursing homes What it means for you is available from the Department of Health (see page 13) Paying for care Introduction This booklet explains the rules on working out how much financial help you can receive towards care home fees. Before deciding whether to move to a care home, you can ask your care manager to explain the rules in full and get an estimate of how much you will be asked to pay towards the cost of your residential or nursing care. The amount you pay will usually be the same if your care is for a temporary or respite stay or if you move permanently to a care home. Mental health patients If you are discharged from hospital and receive aftercare in a care home, you will not be charged for your care. Your social worker can advise you if this will apply to you. For adults in all other circumstances, you will be asked to pay towards your care home fees depending on how much money you have. This applies whether your stay in a care home is for a short or temporary care period or a permanent stay. 3

Help with managing finances If you are assisting a relative or friend with their finances, and they are likely to move into a care home, you can receive further advice from a social worker or a council finance officer about the help they may need. If the person you are assisting is not able to manage their own finances, or will need help to do this in the near future, they may need someone to be appointed formally to do this for them. The Age Concern Factsheet 22 Legal arrangements for managing financial affairs offers good advice on the arrangements that can be made. See page 14 What if I don t need financial help from the council? If you are able to pay the full cost of the care home yourself, many care homes will be happy for you to approach them independently. You are still entitled to receive an assessment of your needs to help you decide if moving to a care home is your best option. You can also receive assistance in finding a suitable home from the agencies listed on pages 14-15. If you are making your own arrangements you should make sure you, or someone acting on your behalf, such as a relative or friend, have read and understood the contract with the care home before you sign it. While you are paying the full cost of your care yourself you may be entitled to claim Attendance Allowance. Your local Benefits Agency office can advise you on how to claim or you can ring the Benefits Agency enquiry line on 0800 88 22 00. 4

What happens if I can only pay the fees once I have sold my house? Some care homes may agree to special arrangements until your house is sold. If you want, you can make your own arrangements with one of them. Otherwise, the council may be able to help pay towards your fees until your property is sold and you can settle the outstanding amount. If you may need to sell your home to raise the money for your care fees, you should also seek advice from a solicitor and a financial adviser. Paying for a care home will I have to sell my home? is a council booklet that explains in more detail the options that you can consider if you may need to sell your home to pay for your care home fees. See page 12 if you would like a copy of this booklet. What other help can I get to pay the fees? If you need some nursing care provided by a registered nurse, the NHS will pay an amount towards the full cost of your care. The amount depends on how much help you need. From April 2010 the nursing band of care will be: Standard Rate 108.70 per week These may change after April 2011. If you have arranged to pay the home yourself, the NHS will usually pay this amount to the nursing home. This should reduce the amount you pay the home. If the council is paying the home, then this will reduce the amount you pay only if you are paying the full cost or if the council help pay towards your fees until your property is sold. 5

What happens if I run out of money after moving into a care home independently? Once your capital falls below 23,250 you can seek assistance from the council in the area where the home is based. For example, if you chose to move from Brent to Surrey, you would need to approach Surrey Council once your capital falls below 23,250 (April 2010). However, you may find you have chosen a care home that costs more than the local council is prepared to pay. To avoid this situation you should speak to your local council before arranging a contract to make sure it will be able to provide the additional funding at that care home or seek specialist advice from one of the organisations listed on pages 13-15. If it is likely that your capital will fall below 23,250 within a year or two, you should also discuss this with the care home owner to check you can remain in your chosen accommodation. Financial help from the council It is important to be aware that Brent Council is only able to help you to pay care home fees if a care assessment (carried out by a social worker) reveals that you need residential or nursing care. The amount you will be asked to contribute will depend upon your ability to pay. The details in this booklet refer to the Department of Health guidelines English councils follow to work out how much you will pay. If you choose a home in Wales, Scotland or Northern Ireland there will be some differences. See page 13 for sources of advice for care homes outside England. 6

What am I paying for? Once the council has worked out your contribution toward the cost of your care, we will write to you about the amount you are required to pay. Generally, the amount you pay will cover all the normal things a care home would be expected to provide. The home should not ask you for any more money, except for extra things which you may choose to buy such as newspapers, outings or hairdressing. Who pays the home? The council will usually pay the home the full amount for your care and send you an invoice for your assessed contribution. Who do I approach when my capital falls to 23,250? If you have arranged the contract with the care home yourself (even if a Brent Council social worker provided you with advice at the time) you will need to approach the local council in the borough where the care home is located. The manager of the care home can provide you with contact details. If Brent has agreed a contract with the care home, we will write to you each April to ask if your capital is still above 23,250 or you can tell us at any time that your capital has fallen to 23,250. We will then ask you for updated information to work out how much you will be asked to pay. What if I do not qualify for financial help? If you do not initially qualify for financial help from the council because you have more than 23,250 in capital, you should ask for your situation to be reviewed nearer the time your capital falls below this level. 7

How is my contribution worked out? If you think you need help with the cost of your care you will need to tell your social worker about: your capital your income This information will then be used to work out your contribution using national guidelines described in detail in the Charging for Residential Care Guide. Full details of this guide are available on the Department of Health website (see page 13). If you decide not to provide the requested details, you will be charged the full cost of your care fees. What is my capital? Capital includes savings in a bank, building society or post office account, national savings certificates, bonds, stocks and shares and the value of any property you own. If you have joint accounts, only your share of this money will be taken into account. If you own your own home, the value of your home will be included in the assessment of your total capital 12 weeks after you move permanently to a care home. If your stay is temporary and you will be returning home, your property is not included. However, the value of your house will not be counted as part of the capital if it continues to be occupied by: your husband, wife, partner or former partner (except where you are divorced/separated from your former partner) or a relative aged 60 or over or a relative aged under 16 who is a child you are legally liable to maintain or a relative who is disabled or has a long-term illness and who qualifies for incapacity benefit, severe disablement allowance, disability living allowance, attendance allowance or a similar benefit. Brent Council may be able to exclude the value of your home in some other circumstances for example, if your carer has been looking after you for some time and still lives there. 8

Will I have to sell my home? If you own or partly own your home, you may not need to sell it immediately if you move permanently to a care home. The value of your home will not be included in your assessment for the first 12 weeks. But you will need to consider how you will be able to pay your contribution towards your care home fees after 12 weeks. We recommend you take advice from a solicitor and financial advisor, who may suggest alternatives to selling your home. If you are unable to sell your house at present, the council can agree with you to pay the care home fees initially and then recover the cost when your house is eventually sold or transferred at a later date. To do this, the council will arrange a legal charge on your property. If you own your own home, or part of it, Brent Council can provide a more detailed booklet called, Paying for care will I have to sell my home? see page 12 for details on how to obtain a copy. How is my capital assessed? To find out how much you can afford to pay, the council looks first at your capital. As of April 2010, if you have capital worth over 23,250, you will not get any financial help from the council. You will be asked to pay the full cost of your care until your capital reduces to this amount. If you can pay the full amount for more than six months, then you or your representative will need to arrange your care yourself. If you have between 14,250 and 23,250 in capital, some of this capital will be used to pay towards the cost of your care. Any capital you have up to a value of 14,250 will be ignored when calculating your contribution to the cost of your care home. The amounts of capital shown here may be subject to change over time. 9

What if I give away any capital before the assessment is made? If you give away money or property to someone else or spend money on expensive possessions, holidays or gifts, the council can still take that capital or property into account if we consider you are trying to avoid paying your proper contribution. What is my income and how is it assessed? Your income is the money you receive weekly or monthly, for example from state benefits like retirement pension or occupational pension. Generally, most of your income will go towards the cost of your care. We will work out from the information you give us how much you can afford to pay towards the cost of the home. If the amount you can pay is less than the full charge for the home of your choice then the council will make up the difference. You will always be left with a minimum sum of money to pay for personal items. This is called the personal allowance and is currently 22.30 a week (April 2010). Does anyone else have to help pay for my care? Your husband or wife may be asked to contribute towards your care, unless you are paying the full fees yourself. If you and your husband or wife both live in a care home, you are both treated separately for assessment purposes, and capital which is held jointly is divided equally. A couple in a care home can have up to 28,500 ( 14,250 each) before capital is taken into account. Other members of your family do not have to pay anything. Parents do not have to pay for the costs of their adult children, or adult children for their elderly parents. What if my finances change? You must tell Brent Council if your income or capital changes, since this could affect your contribution. The council reviews all financial assessments each April. 10

Will my state benefits change? Moving into a care home will affect your entitlement to some state benefits. Your social worker will advise you about these changes when you enter the care home. If the council is not involved in your care, you must let the relevant benefit agencies know when you move to a care home. It is important that you take the necessary steps to claim any new or extra benefits to which you are entitled. This is because you may be expected to use those benefits to pay for your care. The important changes to your benefit entitlement following a move to a care home are summarised below: Attendance Allowance: Four weeks after moving to a care home your Attendance Allowance will stop. The only exception to this rule is if you are paying the full cost of your care yourself in a care home or will be selling your home to meet the full cost of your care. Disability Living Allowance: You can continue to receive the mobility part of your Disability Living Allowance when you move into a care home. The care part of your Disability Living Allowance stops after being in a care home for four weeks. The Benefit Agency will need to be informed of your move. Retirement pension: Your state retirement pension will not be affected if you move to a care home (unless the NHS pays for your care). Housing and council tax benefits: If you move to a care home on a trial basis, and you are not sure if you will stay permanently or return home, you can continue to claim housing benefit and council tax benefit for up to 13 weeks. If you decide that you are not returning home, you should inform the council immediately and these benefits will stop. Your local Benefits Agency office can give you further advice about state benefits by telephone and can provide you with leaflets on the subject. 11

Other sources of information and advice Making a complaint Brent Council aims to provide the best service possible, but things do go wrong from time to time. We value your comments on our services. Your comments and complaints can be the first step towards putting things right. If you are unhappy about any aspect of our service, please talk to the member of staff concerned or ask to speak to their manager. Then, if you wish to take things further, contact: Brent Council complaints team 6th Floor Mahatma Gandhi House 34 Wembley Hill Road Wembley Middlesex HA9 8AD TEL 020 8937 4240 You can ask for a leaflet that outlines the complaints procedure. And, please feel free to let us know when you are particularly happy with our service. Other sources of information and advice Brent Council publishes a range of free booklets: Paying for a care home will I have to sell my home? Fairer Charging for non-residential community care services Will I have to pay for the care I receive? They are available by ringing the council s One Stop Service information line, or you can pick up copies of the booklets at any of the council s One Stop Service local offices: TEL 020 8937 1200 MINICOM 020 8937 1993 GUJARATI LINE 020 8937 1996 FAX 020 8937 1989 Brent Town Hall Forty Lane, Wembley Brent House 349-357 High Road, Wembley Harlesden, Challenge House 1-2 Bank Buildings High Street, Harlesden Willesden, Willesden Green Library, 95 High Road, Willesden 12

Information from independent organisations The following independent organisations can provide information and advice on residential and nursing homecare: The Commission for Social Care Inspection This has responsibility for the registration and inspection of residential and nursing homes in England. It can provide lists of homes and copies of inspection reports. Care Quality Commision WEBSITE www.cqc.org.uk Care and Social Services Inspectorate for Wales (CSSIW) TEL 0845 010 3300 Northern Ireland Department of Health, Social Services and Public Safety Social Services Inspectorate TEL 0289 052 0500 Department of Health The Department of Health is the government department responsible for all matters relating to care homes. It produces two free leaflets entitled Moving into a Care Home and NHS Funded Nursing Care in Nursing Homes What it means for you. It also produces the rules councils in England use to work out care fees. These are described in full in the Charging for Residential Accommodation Guide. Department of Health PO Box 777 London SE1 6XH CUSTOMER SERVICE CENTRE 020 7210 4850 FAX 01623 724 524 WEBSITE www.doh.gov.uk 13

Alzheimer s Society For advice and information for people with dementia, their families and carers. Alzheimer s Disease Society Devon House 58 St Katherine s Way London E1W 1JX TEL 020 7423 3500 EMAIL enquiries@alzheimers.org.uk WEBSITE www.alzheimers.org.uk Age Concern Age Concern produces a range of up-to-date leaflets on all financial aspects of paying for care. Some are listed below: Factsheet 10: Local authority charging procedures for care homes Factsheet 22: Legal Arrangements for Managing Financial Affairs Factsheet 38: Treatment of the Former Home as Capital for People in Care Homes Factsheet 40: Transfer of Assets and Paying for Care in a Care Home Age UK/Age Concern England Astral House 1268 London Road London SW16 4EJ INFORMATION LINE 0800 169 65 65 WEBSITE www.age.org.uk Age Concern Brent 6 Craven Park Harlesden London NW10 8SY TEL 020 8965 7711 EMAIL www.ageconcern.org.uk Carers UK For advice and support for people looking after relatives or friends. Carers UK 20 Great Dover Street London SE1 4LX TEL 020 7378 4999 EMAIL info@carersuk.org WEBSITE www.carersuk.org 14

Counsel and Care for the Elderly This provides factsheets free of charge if you send a stamped addressed envelope. Counsel and Care for the Elderly Twyman House 16 Bonny Street London NW1 9PG TEL 020 7485 8555 ADVICE LINE 0845 300 7585 EMAIL advice@counselandcare.org.uk WEBSITE www.counselandcare.org.uk Elderly Accommodation Counsel Elderly Accommodation Counsel can provide information on possible sources of top-up funding when financial help from the council does not cover the full cost of the home you have chosen. It can also provide information about finding care homes inside or outside Brent. Elderly Accommodation Counsel 89 Albert Embankment London SE1 7TP TEL 020 7820 1343 WEBSITE www.housingcare.org Help the Aged A national charity dedicated to improving the quality of life for elderly people in need of help in the United Kingdom. Help the Aged York House 207-221 Pentonville Road London N1 9UZ TEL 020 7278 1114 FAX 020 7278 1116 EMAIL info@helptheaged.org.uk WEBSITE www.helptheaged.org.uk FREEPHONE ADVICE LINE 0808 800 6565 The Relatives and Residents Association For advice and support for relatives and friends of older people in homes. The Relatives and Residents Association 24 The Ivories 6 18 Northampton Street London N1 2HY ADVICE LINE 020 7359 8148 WEBSITE www.relres.org 15

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