BUPA care home fees - remaining family savings

[MasterMunchkin]

Hello. We’d appreciate some LF advice please. Our parents, 79 & 84 and have been in a BUPA nursing home since late 2015 where the fees/total costs are close to £1,800 per week. They have cash savings left of around £170,000 in a Lloyds current account. Their house, not on the market yet, is worth £280,000. The estate is around £450,000, total. However the total combined care costs are close to £100,000 a year for both. Total joint pension income remains around £26,000 a year.

Both went into care earlier than expected (result of a brain injury road accident, Mum, and epilepsy complications, Dad). The three middle-aged children have been scrupulous in terms of husbanding their remaining cash assets (power of attorney arrangements are approved). The only money spent from their savings has been spent on their combined intense care needs.

We are aware the local council will pay our parents care fees once their assets are cut to £23,000 approx. We know our parents would have preferred their family to benefit in some way from their savings, to a degree. The three 'children' have a measure of financial security up to a point, in different ways. However, looking ahead, a chunk or two of cash would be welcome: one of us has a special needs child with considerable school fees (two sets) to pay who is also facing imminent redundancy, for example.

We are thinking of talking to a family financial lawyer who could give us some perspective on our situation. We’d appreciate any thoughts on asset conservation in this...care home context!

With many thanks

MM

[supremetwo]

Hello. We’d appreciate some LF advice please. Our parents, 79 & 84 and have been in a BUPA nursing home since late 2015 where the fees/total costs are close to £1,800 per week. They have cash savings left of around £170,000 in a Lloyds current account. Their house, not on the market yet, is worth £280,000. The estate is around £450,000, total. However the total combined care costs are close to £100,000 a year for both. Total joint pension income remains around £26,000 a year.

Both went into care earlier than expected (result of a brain injury road accident, Mum, and epilepsy complications, Dad). The three middle-aged children have been scrupulous in terms of husbanding their remaining cash assets (power of attorney arrangements are approved). The only money spent from their savings has been spent on their combined intense care needs.

We are aware the local council will pay our parents care fees once their assets are cut to £23,000 approx. We know our parents would have preferred their family to benefit in some way from their savings, to a degree. The three 'children' have a measure of financial security up to a point, in different ways. However, looking ahead, a chunk or two of cash would be welcome: one of us has a special needs child with considerable school fees (two sets) to pay who is also facing imminent redundancy, for example.

We are thinking of talking to a family financial lawyer who could give us some perspective on our situation. We’d appreciate any thoughts on asset conservation in this...care home context!

With many thanks

MM

I doubt there is now any legal way to overcome 'Deprivation of assets' if the Council is involved as explained here:-

https://www.ageuk.org.uk/information-ad ... of-assets/

What counts as deprivation of assets?
Deprivation of assets applies when you intentionally reduce your assets, such as money, property or income, so these won’t be included when the council calculates how much you need to pay towards the care you receive.

When your council is deciding whether getting rid of property and money has been a deliberate deprivation of assets, they will consider two things:

You must have known at the time you got rid of your property or money that you needed or may need care and support.
Avoiding paying for care must have been a significant reason for giving away your home or reducing your savings.

However, there is the health aspect:-
https://www.aprilking.co.uk/2017/02/09/ ... care-fees/

NHS Continuing Healthcare/NHS Continuing Care is a scheme run by the NHS which funds the full cost of care for certain people. Funding may be available if you have:

a complex medical condition that requires additional care and support
a long-term medical condition
a physical or mental disability
a terminal illness
rapidly deteriorating health
mobility problems
behavioural or cognitive disorders
and you need a lot of nursing support.
If you are entitled under the scheme, the NHS will pay for the full cost of your care, even if you have substantial assets.
The funding can pay for you to be cared for in your own home, in a nursing home or in a hospice.
----------------------------------------
Am I eligible?
Many people who have long term health conditions are not available for NHS Continuing Healthcare or NHS Continuing Care. The assessment criteria is quite strict and it is certainly not something you should count on getting with any certainty. On the other hand, many people who are eligible don’t ask for an assessment and end up having to fund the cost of care themselves.

[quelquod]

It's too late now. Given the condition of the parents is as you describe I would suggest there is no possibility whatever of any distribution of assets being ignored by the council if the parents should ever apply for a contribution towards their care. And anyone acting on their behalf is legally bound to use the assets for the parents' benefit.

[MasterMunchkin]

Thank you very much for the replies. I didn't think there was much leeway. But I though it worth asking around. Thank you for the trouble you've both taken here, plus all the links.

Appreciated.

MM

[Clitheroekid]

What a dreadful situation. The amount of care home fees is unbelievable these days, and there must be very few people who could contemplate the cost of long term care with equanimity.

Unfortunately, I'd have to agree with other posters. Any disposal of assets when the prospect of having to claim state benefits is more a probability than a possibility would undoubtedly be seen as deliberate deprivation of assets.

As supremetwo has indicated you should make absolutely sure that a correct NHS assessment has been carried out, so that if either of your parents is entitled to nursing care as such the NHS contribute their share to the fees.

Although I appreciate it's a sensitive subject your parents' life expectancy may be highly relevant. If it's very limited, so that they are likely to die before their savings run out then there would probably be a good defence to a deprivation claim, on the basis that at the time of making the gift it didn't appear likely that they would live long enough to claim state benefits.

You would need a written opinion from a medical expert who had examined your parents by way of evidence, and I'm all too aware that such a report would be very difficult to deal with on a personal level.

If neither of these suggestions is of any assistance then there is an arguable case to say just give some of the assets away anyway. This is on the rather cynical basis that many local authorities have neither the time nor the resources to take civil recovery action in these situations, and that even if they do the net outcome may be no worse.

I hasten to add that I'm not recommending this course of action, merely reporting that I've seen it happen without any action taken to recover the assets.

Both went into care earlier than expected (result of a brain injury road accident, Mum

Assuming the accident wasn't your mother's fault I would have expected the cost of care to have been included in the personal injury settlement if having to go into a care home was foreseeable at the time of the settlement. Have you any idea why it wasn't?

[MasterMunchkin]

Thanks Clitheroekid for your words. There was no third party involved. Just a push bike, a patch of black ice and no bike helmet. Their health is quite volatile as a result of their complications but they were both very health-conscious before 2015. Our father had a period of Continuing Care funding for 18 months which was a big help but this was withdrawn after his health stabilised somewhat in the nursing home.

Thanks again.

[Mike88]

Just a couple of observations based on my similar experience of caring for an elderly parent. If you're assessed as needing nursing care, the NHS will pay a contribution towards your nursing fees' currently around £155 per week. It's paid directly to the care home to reimburse them for the nursing care they're providing.The OP may wish to investigate this as the amount could at least partly offset the costs being faced.

Another option is the NHS Continuing Healthcare Funding which is the mechanism through which the NHS pays “in full” for a person’s care, without the need for any means testing, where that person has primary health needs. The NHS has an established procedure to assess a person’s eligibility. I went through this process with my mother after she had resided in a home for a couple of years and the NHS eventually agreed to fund her total care. Fortunately she was able to remain in the home whose staff agreed to accept the NHS sum as full payment even though their fees were far in excess of the amount the NHS were prepared to pay.

https://www.farleydwek.com/?gclid=Cj0KC ... JNEALw_wcB

PS. I note you are already aware of continuing funding by the NHS but it's worth keeping on top of this as the parents health state deteriorates over time.

[didds]

[quote="Mike88"... and the NHS eventually agreed to fund her total care. Fortunately she was able to remain in the home whose staff agreed to accept the NHS sum as full payment even though their fees were far in excess of the amount the NHS were prepared to pay.
.[/quote]


This is the bit I don;t quite understand.

"the NHS eventually agreed to fund her total care"

BUT

"fees were far in excess of the amount the NHS were prepared to pay"

So the NHS weren't going to fund her total care at all? And you/she would have had to have still paid despite "the NHS eventually agreed to fund her total care" if the home hadn;t taken the difference on their own chin? So in effect the care home were paying for her _total_ care.

This isn't a dig Mike88 It just seems somewhat odd - when does "total care" start and end because clearly her total care was not being met by the NHS.

didds

[Mike88]

[quote="Mike88"... and the NHS eventually agreed to fund her total care. Fortunately she was able to remain in the home whose staff agreed to accept the NHS sum as full payment even though their fees were far in excess of the amount the NHS were prepared to pay.
.

This is the bit I don;t quite understand.

"the NHS eventually agreed to fund her total care"

BUT

"fees were far in excess of the amount the NHS were prepared to pay"

So the NHS weren't going to fund her total care at all? And you/she would have had to have still paid despite "the NHS eventually agreed to fund her total care" if the home hadn;t taken the difference on their own chin? So in effect the care home were paying for her _total_ care.

This isn't a dig Mike88 It just seems somewhat odd - when does "total care" start and end because clearly her total care was not being met by the NHS.

didds[/quote]

The amount the NHS was prepared to pay was less than the care home fees and in such cases I think the NHS would require the "patient" to move to cheaper accommodation with costs falling within the amount they were prepared to pay to fund total care. Given that the OP's relatives are in a BUPA home I couldn't imagine the NHS paying BUPA rates but they may be prepared to offset their costs by the value of the NHS contribution. In my mother's case the care home were prepared to accept the NHS amount as the total cost - in other words they were subsidising her care - so that she should not have to move.

[beeswax]

As said you may be able to get the NHS contribution of 155 pounds a week as the criteria for that is less than the NHS continuous health care where they generally pay all of the care home fees but appreciate they may have a limit on them.

My MIL is 99 now and in a terrible state and has very severe dementia and a host of other things that are on that list above but as said its very very difficult to get NHS CHC and she has been turned down twice for that but I have appealed their decisions and even that has been a year since I started doing that and have a letter every six months telling me they are still looking into it..I will go to the ombudsman if its turned down again but NHS England review it first.

The problem is that although there is supposed to be a national standard for claims and assessment, I have read that some local health authorities apply different rules as to who gets it...The other thing is the assessments are done by the NHS with the help of social services and a family member present but its not difficult to see its in their interests to stop people getting it because it does put an awful strain on the NHS budget that is so short of dosh anyway...

There is plenty of information on the internet, case studies and of course the Age UK website. It can take many years to get a final decision which of course could put a lot of people of from pursuing their claim..

It is dreadful to think all that money/inheritance may be gone but I also have sympathy with those taxpayers who don't have a lot of savings or other assets, having to contribute to the care needs of other people who are much wealthier than them and so it does seem fair in that respect...Just to add that the Government was about to cap these care home fees but the figure keeps changing....it was 35K at one time and now possibly 100K? But because the LA would then have to pick up the bill, they can't afford to do that either but they can raise council taxes now for social care...

It was Tony Blair that stood with a halo around his head just prior to the 1997 General Election and said it was wrong that people have to sell their homes to fund their long term care! Thirteen years later...Nothing! and still waiting!

BTW, Do the same rules apply in Scotland as we heard at one time all that was free? To families I mean!

Try the NHS Nursing Premium as that is comparatively simpler to claim and get...

ATB,

Mike

[didds]

[quote="beeswax"
... I also have sympathy with those taxpayers who don't have a lot of savings or other assets, having to contribute to the care needs of other people who are much wealthier than them and so it does seem fair in that respect..[/quote]

the reverse of that coin being those that had maybe not earned a great deal but have saved and have what assets they could afford to have end up using them to pay for care whilst others don't bother, are profligate with their cash, and get cover from the tax payer

it is of course the nub of means tested benefits. its not right nor wrong, it just is.

didds

[staffordian]

Apologies if this has already been mentioned, I've skimmed the thread and didn't spot it.

Would an Immediate Needs Annuity be worth investigating?

A fair chunk of money would be "lost", but it should cap the outlay to a predetermined figure.

https://www.moneyadviceservice.org.uk/e ... ds-annuity

[scotia]

BTW, Do the same rules apply in Scotland as we heard at one time all that was free? To families I mean!

Free Personal Care in Scotland is a much (possibly deliberately) misunderstood policy.
It simply means that you (theoretically) get a contribution towards care home fees which is higher than the attendance allowance available in England. If you are assessed as needing it, then £171 per week will be paid to your care home. If in addition you are assessed as requiring nursing care, then an additional £78 per week will be paid to your care home (figures from http://www.gov.scot website).
The problem is that it is the local authority that need to pay the contribution, and you may find (as we did) that they will try to avoid doing so. In our case we wished our parents to enter care homes near to where we reside, rather than in a care home in their own local authority area. And, as you probably have guessed, this was an excellent reason for passing the buck. In the first case we found the MSP (Member of the Scottish Parliament) in my mother-in-law's constituency helpful, and after a considerable delay the contribution was paid. In my father's case the MSPs in both my own and my father's constituency were useless. Eventually, after a severe reprimand by the Ombudsman (in a similar case), my father's Local authority paid up.
All of this required considerable perseverance by ourselves, and could not possibly have been carried out by our parents.
That is Scottish "Free Personal Care"!

[scotia]

An acquaintance has been active on the care contract for an in-law in a Care home in the South of England. It seemed that not all (private) residents were paying the same rate. In particular there appeared to be an element of a lower introductory rate, followed by substantial annual increases which could not be justified purely on inflation terms. Being in the senior management team for a leading law firm, my acquaintance pursued the Care home, and got agreement (with confidentiality terms) on the rate and on an inflation linked annual increase for their in-law. This, at least, provided some measure of certainty on future costs.
Back to my own experience in Scotland, we were fortunate that our parent's savings, coupled with the sale of their houses covered the Care home fees. I think every politician agrees that it is an unfair system, but I can't see where the public money can come from to alleviate the problem.

[sg31]

Apologies if this has already been mentioned, I've skimmed the thread and didn't spot it.

Would an Immediate Needs Annuity be worth investigating?

A fair chunk of money would be "lost", but it should cap the outlay to a predetermined figure.

https://www.moneyadviceservice.org.uk/e ... ds-annuity

That's the route I went down. MIL had no assets but needed to go into a care home, she was 89 and not able to look after herself. The council decided that she should have carer visit rather than go into care. It soon became obvious that it wasn't adequate but the council were adamant they wouldn't fund a care home. I the end my wife and I decided to fund her. Because of the possibility of her living a long time I was concerned that we would eventually run out of money. I didn't think it was likely but it was possible so we paid for a immediate needs annuity for her with a 3 year deferral. The cost at that time was <> £40k.

MIL went into the home in May 2015 at £625 p.w., her pension, pension credit and attendance allowance paid part of the cost we paid the rest. The annuity was due to start paying out this year but sadly MIL died about 3 weeks ago.

I'm happy with our decision to buy the INA, it was an insurance for our future financial security. It may not be suitable for the OP but it would be worthwhile discussing the options with a care needs provider to see if a one off payment could offer some protection for the rest of the money.