The decision to move an elderly relative into a care home can be a difficult one at the best of times, and this is made even more challenging where the relative is unable to pay for their own care.
Where this is the case, and local authorities pick up some of the cost, they will understandably look to find a lower-cost solution. This can leave families in a position whereby their preferred choice of home is not one of the options provided by the local authority and more expensive than they are willing to cover.
In this instance, the family can either choose one of the options provided by the authority or cover the top-up – the difference between the cost of the authority’s affordable option and the preferred choice.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Care Fees Affordability
Affordability for care fees is means-tested, with the cost of care taken from an individual’s assets unless they are eligible for assistance. Currently anybody with assets totalling less than £23,250 is entitled to partial assistance, which increases incrementally to the point full assistance is provided where assets total less than £14,250. These thresholds are scheduled to be increased from October 2023 to £100,000 and £20,000 respectively.
Wherever anybody is eligible for assistance the local authority must provide an option that is affordable within a person’s personal budget. This means they must provide a care home option for which the care element can be entirely covered by the combination of the care user’s assets and authority contribution.
We are seeing a large number of cases, however, of such affordable options being presented for places at care homes where there is no capacity for new residents, and this has left families feeling they have no option but to pay top-ups to secure a place for their loved one at a more expensive home.
This should not happen. In a complaint brought before the Local Government and Social Care Ombudsman recently clarified that there must be a genuine choice provided by the authority, pointing to statutory guidance that a person should not be asked to pay a ‘top-up’ towards the cost of their accommodation because of market inadequacies or commissioning failures. If no place is available at an affordable option provided, an alternative should be offered, with the local authority covering any additional cost required to facilitate this
.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]The Ombudsman Decision
The case involved a daughter who sought a residential care place for her elderly mother. She was eligible for support but the two affordable options provided by the local authority were full.
As a temporary measure, the daughter agreed to pay a top-up of £240 per week to secure a placement at an alternative home until an affordable option became available.
Six months passed without any such option, and the mother’s position in the home she was residing was made permanent. However the top-up payments continued, and it wasn’t until a further four years down the line the daughter complained to the local authority advising she could no longer afford these.
The authority responded months later to inform her that her complaint had been rejected as she had agreed to pay the top-up fees at the onset of care, despite the there being more affordable beds available elsewhere.
The daughter complained to the Ombudsman, who considered the authority’s claim that it had offered alternative accommodation which had been rejected, but could find no evidence of this.
It determined that the lack of places at the two affordable options represented ‘market inadequacy’ and so should have resulted in a third affordable option being offered, even if this meant the authority had to adjust the budget to accommodate it.
Following the ombudsman’s findings, the authority agreed to reimburse the daughter for all top-up fees paid since the place was allocated, plus a further amount to reflect the issues she had faced in making her complaint. They also undertook to remind all staff of the requirements in such situations to ensure there can be no repeat.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]What if I opted to pay a top-up but can no longer afford this.
Where a family has previously been able to and agreed to pay a top-up fee, this doesn’t mean that this would continue to be the case perpetually.
If your circumstances have changed and you can no longer afford to maintain top-up payments, you should make your local authority aware. They must then reassess affordability based on the new circumstances and provide new affordable options.
Whilst they are able to ask you questions to ascertain how much you are able to afford, you cannot be told that because you previously agreed to pay top-up fees you must continue to do so.
Please be aware that such circumstances could require your loved one moving from settled accommodation to a different, more affordable home, but there may be circumstances where it could be argued this would be against their best interests.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]What does this mean for me?
If you are paying top-up fees for a loved one’s residential care and feel you were not offered a genuine, accessible, affordable alternative at the onset of care, contact us; you may be entitled to reclaim the fees you have paid.
If you have previously agreed to pay top-up fees but can no longer afford these, and are being told you must continue to do so given your prior agreement, contact us! We can ensure your loved one is reassessed and you are given an affordable alternative[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_cta h2=”We’ve Got Your Back!”]If you need assistance with any such issues, we have experts who understand every aspect of the Care Fees minefield and can guide you through it with a positive outcome.
Furthermore, if you are in any way concerned about the impact the costs of future care fees could have on your assets, we cannot stress enough how important it is to seek professional advice.
There are many ways in which you can protect your assets against the cost of future care fees, and our experts are able to look at your individual circumstances and identify tailored solutions to do just this.
If you need such advice, speak to us today. Call Stuart on 01254 88 08 34, email email@example.com, talk to us via live chat or alternatively complete our Contact Us form and one of our expert advisors will be in touch[/vc_cta][/vc_column][/vc_row]