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Considering Care Home Fees

8th October 2020 | Alisha Francis

“The NHS was created out of the ideal that good healthcare should be available to all, regardless of wealth. When it was launched by the then minister of health, Aneurin Bevan, on July 5 1948, it was based on three core principles:

  • that it meet the needs of everyone
  • that it be free at the point of delivery
  • that it be based on clinical need, not ability to pay

These three principles have guided the development of the NHS over more than 60 years and remain at its core.”

This position has not changed. Legislation still supports this founding principle and our Solicitors are here to explain how these core principles are being misunderstood when it comes to considering care home fees.

Generally, we see 6 incorrect assumptions with care fees as follows:

  1. Assuming all care is the same

Whether or not you pay for care does NOT depend on your money. Nor does it depend on whether you have a house, how old you are, whether you live in a care home or receive care from home, nor does it matter what kind of care home it is nor does it matter how many houses you have, or how much money you have in the bank. It depends on your care needs ONLY. Social care vs health care – the difference is VITAL.

  • Assuming you have to answer questions about your relative’s money – and agree to a means test (a financial assessment)

The very first question ANYONE should ask when a person needs care is about the kind of care needs they have. When a local authority or the NHS ask about someone’s money or funding without doing proper assessments for NHS Continuing Healthcare funding first, it’s not only a breach of clear NHS guidelines AND against the law, but it’s also an attempt to defraud the person needing care.

  • Assuming you have to start paying for care when you leave hospital.

Anyone who needs ongoing care – whether discharged from hospital back into their pre-admission place of residency (e.g. back to their own home or care home), or going into a care home for the first time – should be properly assessed for NHS Continuing Healthcare funding, before paying a penny.

  • Assuming you have to sell your home (even if you DO have to pay for care)

You can negotiate a Deferred Payment Arrangement with the local authority. It means that the local authority will pay the care fees for the time being and will then recoup the costs from your relative’s assets/estate at a later date. If someone else lives at the property, it may also be protected. The value of a property can’t be included in any means testing if certain criteria are met, including if your relative is receiving care at home (as opposed to in a care home).

The value of a property should be disregarded for the first 12 weeks of care. This is called the ’12 Week Property Disregard’.

However, if your relative has other savings (aside from the property) over the means test threshold during this time, the 12 Week Disregard does not apply. The Disregard starts from the beginning of a permanent (as opposed to temporary) placement in a care home, or once other reasons for the disregard cease.

  • Assuming you should not have an NHS Continuing Healthcare funding assessment

NHS Continuing Healthcare is NHS funding to cover care fees, and it’s something the NHS seems to keep well hidden. To be eligible, a person will be assessed as having what’s called a ‘primary health need’.

There are clear guidelines setting out what should happen in assessments – what should be assessed and how – and what determines eligibility. These guidelines are called the National Framework for NHS Continuing Healthcare and NHS funded Nursing Care. These guidelines also set out the difference between social care needs and health/nursing care needs.

  • Assuming what you read regarding payment of care is correct and that you do not need to take advice

There are two main stages to the assessment process. The first stage is called a ‘Checklist assessment’. This initial Checklist does not determine eligibility, but instead determines whether a person should go through to stage two, the full assessment. This is called a Multidisciplinary Team assessment.

If you disagree with anything said or done during the process, challenge it there and then. If you disagree with the outcome, there is an appeal process.

If your relative only has a short time left to live and is in ‘terminal decline’, or if they are in a period of rapid deterioration but not necessarily at the end of their life, there’s a Fast Track assessment process for NHS Continuing Healthcare. This should be to get a funding decision made quickly. A care home manager, district nurse, social worker, GP or other social or health care professional can initiate getting this done.

Here at Landons our Private Client team have specialist knowledge in this field and would be happy to speak you to clarify the position on care home fees. Call us on 01277 210021 or email us on [email protected] for more information…our doors are always open.