Taking care
If you are contemplating moving into a care home there is one vital thing you must first ask yourself: Do you actually need to move into a home? Is the move because you want it to happen, or because others are forcing you into it?
Yet even when you’re reconciled with this point, there’s clearly a huge disparity in terms of choice and quality. ‘Not all care homes are the same. Some offer accommodation and help with personal care, such as washing and dressing. Other care homes offer nursing care, as well as the basic help,’ says a spokesperson for Age UK.
This is the difference between residential and nursing homes – although they’re no longer termed as such. Other care homes offer extra care and support, as often required by dementia sufferers. Both types of homes vary wildly in cost and reputation.
Some – such as West Hall, a new flagship care home in West Byfleet, Surrey – seem to offer an entire lifestyle… ‘Stylish and spacious private living spaces… a wide range of activities and facilities, such as a hair salon, library, quiet room, bistro and exceptional landscaped gardens…’
Other homes may be lower priced, or may not sound quite so appealing. A good place to start any research is the online Good Care Guide, which gives a ‘warts-and-all’ review of every care home in England – from the very people who use them. The website, designed along the lines of sites like TripAdvisor, lists all registered care homes and home-care agencies in England – and enables users and their families to rate quality of care, facilities and value for money, as well as making positive or negative comments.
Director Stephen Burke says the intention is to add to the transparency of the care sector. ‘The greater scrutiny will help improve the quality and standards of care.’
But even if a place sounds attractive, go and see it for yourself, advises Sunil Kapil, the managing director of Kapil Care Homes. ‘Look round at a reasonable time, without making an appointment, if possible. That way you know no one has specially prepared for your visit.’
Things you should be asking are: is there a choice of food on the menu, can you choose when and where to eat, is there a good programme of activities? Also, find out the terms and conditions of the home… how and when you will be required to pay, how much, what notice period you have to give if you want to move, if there is a trial period, if you can spend the day there before you commit, if there are rules on visiting times, and so on.
‘Everyone has a different idea of when they want to get up, eat, go to bed,’ adds Sunil Kapil. ‘It’s about checking it will fit in with your lifestyle, and a quality establishment would want to adapt to, and support, you and not impose its own rules.’
Financing such a move can be deeply problematic, not least because choices are being made at a time when the person involved may be feeling vulnerable or emotional.
Indeed, the cost of long-term residential care for the elderly is set to increase dramatically, according to the latest research, that predicts that, by 2025, the annual cost of care will be £33,000 per person.
That’s why it is crucial to find out if you’re eligible for any assistance, and to have health needs fully assessed before paying for care, says Chris Partington, head of private client services at law firm Slater Heelis in Sale, Greater Manchester.
‘For those who are eligible,’ he says, ‘there is NHS funding and it covers 100 per cent of the costs of being in a care home, or receiving full-time care at home. Unfortunately, many people don’t realise they are entitled to this, since they have to ask for this assessment to be undertaken.’
This assessment is based on two things: your savings and assets, including your home and your income.
Approximately 130,000 elderly people go into care each year and, in 2011, 53,000 were self-funding. In fact, a recent survey suggests that just 10 per cent seek financial advice and guidance. It’s possible that a lack of knowledge about the options available for paying for care could leave elderly people financially vulnerable.
Sean McCann, personal finance specialist at NFU Mutual, says more people need to make financial provisions for their retirement and beyond. Discretionary trusts are just one of the measures people are taking to help protect their wealth and savings from being eroded.
‘It makes sense for married couples to set up a discretionary trust in their will,’ says McCann.
‘Primarily used to protect family wealth, it can also provide a measure of protection against costs such as care-home fees. Crucially with a discretionary trust, the surviving spouse does not own the trust assets. As a result, the local authority normally can’t assess it to meet ever-expensive care-home fees.’
Many are pinning their hopes on the introduction of the Care and Support White Paper, that will see care assessments contracted out to provide clients with a choice over who carries them out, bringing with it a touch of clarity. This includes deploying the principle of a ‘cap’ on care costs, limiting the amount any individual pays. Currently, some families are hit with bills of £100,000 or more, wiping out their entire life savings.
As for means tests (or, as some have described it, the meanest of means tests), the deferred payment scheme is currently discretionary and available only if your capital is less than £23,250. An individual’s local authority may meet the cost of the person’s care and, although this ‘loan’ will have to be paid at some point, the local authority cannot charge any interest during the lifetime of the person who requires care.
‘This scheme is for homeowners moving permanently into residential care funded by the local authority, who either do not wish to sell their home, or are unable to sell quickly enough to pay for their care,’ says John Kelly, partner at financial advisors CareSure.
Given that the average cost of care in a nursing home is £26,000 a year, and that, in the South East, it can top £50,000, it is not hard to see how people’s assets are soon depleted and why a ‘cap’ would appear attractive.
Other options include renting out your property and putting the rental income towards the cost of care, or to use some capital to buy a guaranteed lifetime tax-free income. This would help to solve the care-funding problem as well as protect the remaining capital. Again, independent advice from an accredited source is vital.
John Kelly adds: ‘The White Paper has good intentions, but, as ever, the difficulty of the country’s problems over paying for care are not being addressed. It is vital that individuals and families have considered each option from all angles.’
Andrew Dixson-Smith of Care Fees Investment, a firm of specialist advisers, agrees: ‘One in four people who “self funds”, runs out of money, so it pays to plan. An adviser should ensure you are claiming the correct benefits as well as helping you plan the best way to meet costs, whether it’s via an annuity, equity release, or using savings or other assets.’
FOR FURTHER INFORMATION
Age UK 0800-169 6565, www.ageuk.org.uk
Good Care Guide 0845-300 3086, www.goodcareguide.co.uk
Kapil Care Homes 01724-289555/01724-867261, www.kapilcare.co.uk
West Hall 0845-140 2020, www.anchor.org.uk