Long Term Care

You may have worked and saved hard, paying taxes and national insurance all your working life. However, should you need to go into residential or nursing care, the cost of care fees can be enormous and often means that you may have to use your savings, and even sell your home, to pay for your care.

There are steps that can be taken to minimise this, including obtaining free care from the NHS.

Even if you think you can afford to pay for a place in a home yourself, and don’t need to seek local council funding, early planning now can enable you to protect your assets, so that should you have to enter long term care, you can still leave a legacy to those who you care about most.

Our team at Glazer Delmar will be happy to discuss any aspect of law relating to care for the elderly or sick. We specialise in providing comprehensive and sympathetic legal advice to older people, their families and carers. We have experience in advising and assisting clients on all legal issues concerning elderly care ranging from assessing an individual’s entitlements, submitting requests for assessment and challenging the NHS’s refusal to fund care for an individual.

We have set out below some basic information about long term care, but since everyone’s rights and entitlements are different you should always take specialist legal advice on your particular circumstances.

Finding a care home
Even if you are seeking local council funding, you have a right to choose which home you move into. This will normally be within your local authority area, but in certain circumstances you can choose from within another area. For example, if you would like a home that is near your children or family, the local authority where they live may pick up your funding.

In either case you will probably want to find out what homes there are in the local area and visit a few to get an idea of what they are like.

To find out about care homes in the local area, you can contact the Commission for Social Care Inspection (CSCI), and they can provide you with a list of care homes in the area. You can also search on its website at www.csci.org.uk. It has recently introduced a three star rating system to assess the quality of care homes which may help you decide whether a care home is suitable for your needs.

There is also a charity called Counsel and Care which can give you information and advice on how to go about finding a home and what to look for. The Counsel and Care website is at www.counselandcare.org.uk. In addition, the Elderly Accommodation Counsel (EAC) has a comprehensive database of care homes in the UK, and the EAC website is at www.housingcare.org.

 Funding long term care
The financial aspect of local council funding for your care home can seem complicated, but there are rules for working out how much you will pay. This will depend on your income and savings. There is a fixed upper limit to the amount of savings you can have and still get local council funding. The upper limit for 2010-11 is £23,250 so, for example, if you have £30,000 in savings (including the value of your house), you will have to pay the full cost of your care.

There is also a lower limit and any savings you have below this cannot be counted. The lower limit for 2010 -11 is £14,250 ( as of April 2010) so, for example, if you have £10,000 in savings, this would be completely ignored when your local council is working out how much you should pay.

If you own your home, its value will be disregarded for the first 12 weeks you are in care as a permanent resident. After that, the value of your home will usually be counted as capital. This usually means that you will be expected to sell it to pay the fees. However, your house will not count as capital if it is occupied by certain relatives or dependents. The local council may also ignore the value of the house in certain other circumstances – it doesn’t have to do this, but it can choose to. Please get in touch with us if you need further information about these issues.

If your house is counted as capital, but you don’t wish to sell it, the local council may allow you to defer payment of your contribution. It will effectively be giving you an interest-free loan to be paid back when your property is eventually sold.

Giving away property and savings
You cannot give away property or savings to another person in order to qualify for financial help from your local council. The council can, when assessing someone’s eligibility for funding, look for evidence of deliberate, or intentional deprivation of capital such as a property. Deliberate deprivation occurs when someone transfers an asset out of his or her possession in order to put him or herself in a better position to obtain funding. This is called deprivation of assets. If the local council believes that you have deliberately given away assets to reduce or avoid care home fees it may try to claim the fees back.

Nursing care contribution
If you are assessed as needing care from a registered nurse, the NHS should make a contribution towards your care home fees. As from 1 October 2007 the amount the NHS will contribute towards nursing care costs for care home residents is a flat rate of £103.80 per week.

Continuing NHS health care
If you are assessed as needing nursing care, you may also qualify for continuing NHS health care. You may qualify for this if your needs are considered to be primarily complex, healthcare needs.

The NHS will use a framework called The National Framework for NHS Continuing Healthcare and NHS-Funded Nursing Care which was introduced in October 2007. The framework looks at different areas of your needs when making a decision about whether you are entitled to NHS continuing care:

Firstly; the nature of your needs, including the type of help you require

Secondly; the intensity, that is the extent and severity of your needs, including the need for constant care

Thirdly; the complexity of your needs

Fourthly; the predictability, the extent to which your needs and the level of risk change, if adequate and timely care is not provided

If you are eligible for continuing NHS health care the NHS will pay the full cost of your care.

Top-up fees
You may want to move to a home that costs more than the council would normally pay. In this case, someone else (usually a relative or a charity) will need to make up the difference. You cannot usually top up your own fees, unless you have a deferred payment agreement with the local council or if your property is being disregarded for the first 12 weeks of entering into care.

Liable relatives rule
Until recently, the council could ask your husband or wife to make a contribution towards your care home fees. This has been changed by the Health and Social Care Act 2008, which received Royal Assent on 21 July 2008. Until the Act actually comes into force, local councils have been told not ask your spouse for a contribution.

Home care
The local council social services department is the main state provider of services in the home, particularly if help is required with the cost of the service. When arranged by the local council such services are often referred to as domiciliary, non-residential or community care services. If you do not qualify for assistance from the local council, or would prefer not to deal with it, similar services may be available through private agencies or local voluntary organisations.

Contact us
All this can seem quite complicated and daunting, but at Glazer Delmar we have a wealth of experience in this area and can advise you on the best and most cost effective solutions.
If you would like to talk to us, please get in touch.

Call 020 7639 8801 or e mail willsandprobate@glazerdelmar.com