Local Authority Financial Assessments: Top Tips For Getting These Right
When a person requires residential care, the family’s priority is to ensure they are in a safe and comfortable environment. They want to know that their parent or grandparent’s needs will be met by kind and compassionate care staff.
Sadly, in George Osborne’s age of austerity, the question of ‘who pays?’ has become more important than questions of meal times and the activities available for residents. The words ‘financial assessment’ can strike fear into the heart of the most level-headed person. We have heard of countless examples of the elderly being forced to spend virtually every penny of their life-savings on care home fees when a fair assessment shouldn’t have resulted in this.
Whilst many people do self-fund their care following a financial assessment, there are things that can and should be done to ensure that nobody pays more than they should for their care, without facing allegations of deprivation of capital.
Who else lives in the house?
For most people, their property is not only their most valuable asset but also a home they fear losing.
There are a number of provisions that may allow the value of the property to be excluded from a Local Authority financial assessment. For example when occupied by a relative who is disabled or is over 60. These are known as ‘property disregards’.
Some Local Authorities omit to apply property disregards which results in the client being treated as a self-funder for care fees. In many cases they are forced to sell their home to pay for their care.
Relatives who move in at the eleventh hour in the hope of securing a disregard will not succeed, but there are many genuine cases where Social Services should be asked to reconsider their decision.
Who owns the house?
The ownership of the property is also an important factor for a financial assessment.
Complicated family arrangements where adult children own a share of their parents’ home are increasingly common and will affect how much of the property valuation the Local Authority can take into account.
There is a huge difference between legal and beneficial ownership of property. The circumstances in which the co-ownership came about is likely to have a significant impact on the valuation of the person in care’s interest in that property, and upon the financial assessment.
Social care or health care?
If a relative is receiving care at home or moving into a care home as a result of a ‘primary healthcare need’, they should be eligible for NHS Continuing Healthcare (NHS CHC) funding.
This means that the NHS has to pay their care fees. Unfortunately NHS CHC eligibility is increasingly difficult to establish, but if the application is successful, it will save thousands of pounds in care fees each year.
Has the individual ever been sectioned?
Where an individual has been detained under Section 3 of the Mental Health Act 1983 (MHA 1983) they may be entitled to aftercare paid for by the Local Authority.
If a relative who needs care has been ‘sectioned’, it is crucial this information is shared with the Local Authority. We have helped families recover many thousands of pounds for people who were charged for aftercare which they should have received for free under Section 117 MHA 1983.
If all else fails – Top-up?
If the relative in residential care is not eligible for NHS CHC, has never been sectioned and has self-funded down to their £23,250 capital threshold, many people think that Social Services will step in and take over paying the full care costs.
Unfortunately the Local Authority will fund only up to a maximum weekly rate for the care home placement. However, few care homes are prepared, or able to provide care at the cost that the Local Authority is willing to pay.
This means that family members find themselves being asked for ‘third party top-ups’ to bridge the gap between the Local Authority’s weekly rate and the true cost of care. If no one is willing or able to top up, the person in care may be moved to a cheaper care home.
It is possible to challenge the Local Authority decision about the cost of meeting your relative’s eligible needs, to increase the Local Authority’s weekly rate and decrease the amount of top up required from their family.
How we can help
Taking advice before a financial assessment will help you from falling foul of the rules or will help you challenge incorrect decisions. Specialist advice in challenging NHS CHC funding decisions, or knowing when to apply, can also make all the difference.