Could You Cough Up For Care?

Thousands of vulnerable elderly people could continue to be wrongfully denied free NHS care, even if proposals to simplify the system are accepted, the UK’s largest charity for older people claims. The Department of Health is consulting on a national framework for fully funded NHS care for the elderly. The consultation period ends on Friday. People in care homes who have a combination of significant physical health needs, such as being confused, immobile and incontinent, should, in theory, be entitled to full funding from the NHS, regardless of their assets. Those who fail to qualify for NHS care have to meet the full costs if they have assets worth more than £21,000, including a house.

However, it has already been outlined by the courts that many who should have received NHS care have not and charities argue that this will continue under the new proposals.

If the NHS will not meet your full costs in a care home, it may offer help towards nursing costs. Currently, there are three bands for nursing costs: £133 a week for those with severe health problems who have complex needs, £83 a week for those with multiple care needs that require daily care from a registered nurse and up to £40 a week for those who need minimum input from a registered nurse. Under the consultation proposals, this will be simplified to one band for all eligible patients.

However, Gordon Lishman, the director-general of Age Concern, says: “Plans to simplify the system from three bands to one are welcome, but it will take more than that to remedy the care crisis. We are worried that the proposed £97 a week is nowhere near enough to cover nursing costs, and older people and their families will be left to foot the bill.

“The Government’s recent admission that ‘only’ one in five of those who should have received continuing care has not received the money is outrageous — particularly as we know that this is the tip of the iceberg.

“We have grave doubts about whether the national criteria and assessment tool will improve the situation. One of the biggest hurdles is the entrenched mindset within health and social services that only a few people in nursing homes are ill enough to be fully funded by the NHS.

“Whether someone should remain the responsibility of the NHS should not come down to finances. We urgently need a debate if we are to come up with long-term solutions to this funding crisis.”

If you or a relative have to self-fund long-term care, there are ways to ease the burden. First, remember that the local authority must disregard the value of your property for the first 12 weeks of residential care and provide funding towards your fees if your other capital is less than £21,000.

Philip Spiers, managing director of NHFA Care Fees Advice, says: “The local authority also only has the right to financially assess the member of a couple that requires the care. Individuals paying for accommodation from joint savings with a spouse at home should split joint accounts into separate single accounts immediately to benefit from state assistance as early as possible.

“If your partner needs to move into a care home, consider changing the ownership of your property from joint tenancy to tenants in common. You can then put your half in your will to your beneficiaries rather than it being caught up in the means test for care should you predecease your partner in the care home, therefore saving half the value of your home.”

Make sure that you also claim any benefits to which you are entitled. These include attendance allowance, which is a non-means-tested, non-taxable benefit from the Department for Work and Pensions. This is paid to people living at home who need help looking after themselves. It is also paid to those funding their own care in a care home, or those who receive NHS help only with nursing costs.

It is paid at two rates and is unaffected by savings or income. The lower rate, £41.65 a week, is paid if you need care by day or night. The higher rate, £62.25, is paid if you need care by day and night. To claim, contact your local social security office for an application form.

However, allowances only go so far. At the moment, about 70,000 people a year are forced to sell their homes to pay for long-term care.

One way to cover the cost is to buy an immediate-need care fee payment plan. You are eligible for this sort of cover only if you are already having difficulties with some daily activities, such as washing, dressing or feeding yourself.

Mr Spiers says: “If you have an immediate need for care and are selling your home to pay for it, consider buying an immediate-need care fee payment plan to deliver regular guaranteed tax-free income — higher than normally achieved from traditional investments or annuities. These are a way of meeting care costs for life while using up only part of the capital and enabling an inheritance to be left for the family. Although only four companies offer this product, their actuarial view of life expectancy can be quite varied and, consequently, so can the price.”

Prices can differ widely. For example, an 87-year-old male who requires a plan income of £1,000 a month would have to pay a lump sum of £90,206 to achieve this through an immediate-needs plan with Norwich Union. However, the same man could find the same level of income for a lump sum of a little more than half this, at £46,363, with GE Life.

However, if the man were a year younger, GE Life would provide £700 of income a month in return for a £94,456 lump sum, whereas Norwich Union would provide the same income for only £30,271.