The rules on NHS funding for care continue to cause many families financial and emotional difficulties. In this video, martin searle solicitors‘ care funding expert Cate Searle explains some of the key problems and issues relating to NHS funding for care.
The community care lawyers at martin searle solicitors have a great deal of experience helping families with problems securing NHS care home funding (including difficulties with the commnunity care assessment). The community care law team can also help with care planning for the elderly.
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Transcript of NHS continuing healthcare advice video
Introduction: Despite plans to change the system, the fact is many people who should receive funding for nursing home fees still do not. While every case is unique, there are many common problems. This video shows Cate Searle, a care funding expert at martin searle solicitors, advising a client on some of the main points that will affect his mother’s case.
Client: My mother is 82. She was diagnosed with Alzheimer’s disease five years ago and my father has been caring for her since then. He died unexpectedly last month and my mum has reacted very badly to his death and has been very aggressive and ended up in hospital. The doctors say they are ready to discharge her, but she isn’t well enough to go home. The social worker says she needs to go in to a 24-hour care nursing home and that we need to sell her house to pay the nursing home fees. Is that right?
Cate: Do you agree she is too unwell to go home? Could she go home with a care package, with people to look after her? Or could she have a temporary admission to a care home for a few weeks, or longer, and then return home?
Client: Maybe she could go home after a while. It’s too soon to say. Does that make a difference?
Cate: Yes. If she has a temporary admission to residential or nursing care, she does not need to sell her home to pay for it. Social Services will expect her to contribute to the fees from her pension and any savings over £14,000. But the value of her home has to be ignored for up to 52 weeks, if the stay is temporary and there is an intention to return home.
Client: That’s interesting. They did not tell me that. But what if we try a temporary period but it doesn’t work and she becomes permanent? Do we have to sell her home then?
Cate: You don’t have to sell it, but unless the NHS agree they have to pay the full costs of her care, your mother will be treated as a self funder by Social Services.
Client: What does that mean?
Cate: They will take the value of her house into account and say she has more than £23,000 in capital. She has to use most of the value of her home paying for her care. How much is the property worth, roughly?
Client: About £300,000.
Cate: Does anyone else live there?
Client: No. Just my mum
Cate: The basic position is that Social Services expect you to sell the house and use the sale proceeds and any other savings to pay for your mum’s care every week until your mother’s capital drops down to £14,000. At that stage, they will help with the costs, but they still expect your mother to use her pension income to pay towards the costs. When her capital drops to £14,000, Social Services ignore the capital and just expect her to pay her pension income to the costs.
Client: So what if I do not want to sell it? Can I rent it out?
Cate: Yes, but the value will still be taken in to account. However, you can use the rental income to pay towards the fees. You can ask Social Services to enter into a Deferred Payment Agreement where they pay some of the fees, as a loan, and put a charge, like a mortgage, against the property. It is an interest-fee loan until 56 days after your mother dies or 56 days after you sell the property - whichever is the sooner. Lots of people find this kind of arrangement helpful. Social Services don’t have to say yes - it is a discretion rather than something they have to do. It is always worth exploring.
Client: You mentioned about the NHS paying for my mum’s care. I heard something on Radio 4 about that. How do I get the NHS to pay? And does that mean I don’t need to sell her house?
Cate: It isn’t that straightforward, unfortunately. You or I can ask the Primary Care Trust - that is the local NHS - to carry out a community care assessment which assesses your mum’s needs. This will enable us to see if she qualifies for what we call NHS continuing healthcare funding. A Nurse Assessor looks at your mum’s needs and makes a decision about whether they fall into a ’social care category’ or a ‘primary health care category’. If the Assessor, or the PCT Panel, agree they are health needs, they have to pay for your mum’s care in full for a period of time - it may be three months or six months, or a year. Then they review the situation and make a new decision.
Client: But obviously she has health needs, otherwise she would not be in hospital or need to go into a nursing home
Cate: Again, unfortunately it isn’t that simple. It is quite difficult to pass the threshold to show that someone should qualify for NHS care funding. And the PCT does not always accept a duty even when we think there is a good case. You may have to go through a review or appeal process. What we need to do is sit down together and talk in detail about your mother’s condition and how it affects her and then I can advise you whether she has a case for NHS care funding. It is always worth looking at as it could save her £40,000 a year if the fees are £750 a week.
Client: This is all really useful information, thank you…..
