Dementia: The Cost Of Care At Home
Rachel Burley-Stower, a community care law solicitor in Brighton, explores the issues around funding for care at home, in recognition of National Dementia Carers’ Day 2016.
Sunday 11 September is the third annual National Dementia Carers’ Day. Part of Alzheimer’s Awareness Month, Dementia Carers’ Day seeks to raise awareness of and celebrate the support and care of family members, friends and unpaid carers which is relied on by so many people living with dementia. Founded by the Alzheimer’s Society, Dementia UK and SweetTree Home Care Services. The event aims to highlight examples of innovative and compassionate support. Stories, shared recognition and pledges of support are welcomed by the organisation.
At Martin Searle Solicitors many of our clients are family members caring for a close relative with dementia in their own homes. Increasingly those with care needs caused by dementia are assessed by social services as having eligible needs but are offered a care home placement instead of care at home. Families of dementia sufferers tell us that staying in their own familiar home for as long as they can is the most important thing for their loved one. Informal family carers contribute many hours of care each day or week to ensure their relative can remain at home. Carers aren’t asking social services to take over their informal caring role, but to recognise it and offer a meaningful care at home package to balance their unpaid carer contributions.
Where a person with care needs, or their carer or Attorney, turns down the offer of a care home placement, they may find that funding for any care at home package is limited to the cost of a care home, at the local authority rate. The funding offered is usually much lower than the cost of care at home and families struggle to find the money to make up the difference when the relative with care needs can no longer privately fund their care at home.
Following the introduction of The Care Act 2014 in April 2015, we found that some local authorities reigned back from the resource-led policy of care home instead of care at home. However, over the past year, it appears that social services funding for care at home is being increasingly squeezed. Local authorities are openly arguing that an individual with care needs should move to a care home because it is cheaper to provide residential care than care at home. Social services may argue that the individual has a preference, not a need, to remain at home. Carers of people with dementia are left in a very difficult position – how to argue for their loved one’s need to remain at home to be respected, whilst finding funds for the care at home package?
The Care Act 2014 and the Care and Support Statutory Guidance contain helpful points for a carer discussing funding levels with social services. For example:
The personal budget should not assume that people are forced to accept specific care options, such a moving into care homes, against their will because this is perceived to be the cheapest option.
Local authorities should not have arbitrary ceilings to personal budgets that result in people being forced to accept to move into care homes against their will.
“Independent living” is a core part of the wellbeing principle and the wellbeing principle includes matters such as individual control of their day to day life, suitability of living accommodation…and crucially requires local authorities to consider each person’s views and wishes, feelings and beliefs.
In reality social services do not have to follow such guidelines, but the guidelines have some force. Local authorities are required to act in accordance with statutory guidance unless there is good reason for departing from it.
In many local authorities there appears to be an unofficial cap on funding for care at home at the cost of a care home placement. This has yet to be challenged in court under the Care Act and with reference to the statutory well-being principle. Unfortunately, there are no guarantees that if placed before a Judge they would not rule in favour of a local authority. In the meantime, until there is some precedent case law, families are left to argue with social services on a case by case basis.
At Martin Searle Solicitors we believe that care at home for dementia suffers should be properly funded and are proud to support events such as National Dementia Carers Day, which both celebrates carers and raise awareness of how much they contribute.