Care home funding - Guarantor - DPA

[DT1975]

My mum has recently gone into a care home for respite. She's decided she would like to stay and the family are 'finally' in full agreement. She is 93, very frail with liver cancer. No further diagnosis due to fragility, it was only unearthed on a scan for something else. She's losing weight rapidly but we have no idea if this is connected to her cancer, no other symptoms.

In short she currently has enough savings for 9 months at the care home (including income). We are marketing her property this week which would enable another 16 months so potentially 25 months of quality care which I doubt she would need but obviously we have no idea.

I appreciate that when equity drops to around £23k (21 months in) we can ask for council assistance that may result in her moving homes.

We cannot proceed unless I sign as a Guarantor - has anyone done this? If her flat doesn't sell I'm potentially liable for nearly £6k a month unless we get a DPA, so a council loan against the value of the property I understand.

Has anyone done this ie applied for this loan, any help on whats involved, more importantly timescale in getting the loan and when can you apply. Needless to say this is giving me a few sleepless nights as I can forsee me having to dig deep to fill any transition period . Any help appreciated cheers.

ps not sure if this should be on health thread ?

[highpeakrider]

DPA example below.

https://www.derbyshire.gov.uk/site-elements/docume...

[Panamax]

DT1975 said:

My mum has recently gone into a care home for respite.

We cannot proceed unless I sign as a Guarantor - has anyone done this? If her flat doesn't sell I'm potentially liable for nearly £6k a month

I don't understand. If she's already in the care home then what were the contractual terms when she started? Why would you suddenly need to join in as guarantor after the event? Surely so long as the fees are getting paid each month the care home isn't going to kick her out?

My starting point is never, ever sign as a guarantor for anything. I'll gift cash but I won't sign guarantees.

[DT1975]

Panamax said:

I don't understand. If she's already in the care home then what were the contractual terms when she started? Why would you suddenly need to join in as guarantor after the event? Surely so long as the fees are getting paid each month the care home isn't going to kick her out?

My starting point is never, ever sign as a guarantor for anything. I'll gift cash but I won't sign guarantees.

The current contract is for respite only, the guarantor is required for permanent residence. It's required because she doesn't have two years of funding without selling the property.

[contractor]

Have you spoken to the GP about palliative care and NHS continuing care? If the cancer is not going to be treated then there may be path there.

[Panamax]

DT1975 said:

The current contract is for respite only, the guarantor is required for permanent residence. It's required because she doesn't have two years of funding without selling the property.

OK, that's a difference of terminology that's new to me. A quick google suggests that respite care is, "temporary care".

I'd nonetheless be inclined to push back against the idea of a guarantee. Whatever label is put on the situation I'm unclear why they would kick anyone out so long as the bills are being paid and irrespective of the paper-work.

Is the "respite" care in a physically different place/building than longer term care?

[DT1975]

Panamax said:

OK, that's a difference of terminology that's new to me. A quick google suggests that respite care is, "temporary care".

I'd nonetheless be inclined to push back against the idea of a guarantee. Whatever label is put on the situation I'm unclear why they would kick anyone out so long as the bills are being paid and irrespective of the paper-work.

Is the "respite" care in a physically different place/building than longer term care?

Respite is quite a well known terminology in this sort of field . It can either be for the patient or the carers, yes so temporary .As I said she's in for respite (we were providing care and its very hard work ) and she's happy to stay full time although we've considered part time carers at home.

It's all in the same building, many are permanent, quite a few are respite, all share same facilities and get the same care dependent on needs.

Sadly they do kick people out. Our problem is a potential gap between her savings getting used up and the sale of the house, hence the council step in , offer a DPA and could move her. It's that process I need help with.

[DT1975]

contractor said:

Have you spoken to the GP about palliative care and NHS continuing care? If the cancer is not going to be treated then there may be path there.

Thanks. I think the issue is they can't confirm if the cancer is the cause of her current symptoms but yes I'll chase up. To be honest my head's spinning at the moment.

[alscar]

Sorry about your Mum.
Mine has just been diagnosed with Alzheimer’s ( she’s 86 ) and after spending Christmas with us I can vouch for that diagnosis sadly.
At the moment she is quite able to look after herself but we are obviously aware that may not always be the case.
Having been LPA for her sister and arranged a care home and sold her house in order to a) buy an immediate needs annuity and b) ensure she was happy where she was going we had numerous conversations and “ meetings “ with various care homes.
Looks like at some point that exercise will need repeating for Mum.
In general it seemed that all were happy to accept our money and given the immediate needs annuity paid around 80% of the weekly cost were not asked for any guarantor signing.
I had to go through the LA’s financial assessment even though we knew we were over the £23k amount.
During this time I kept the chosen care home fully aware of where we were with the house sale etc.
From memory of our various care home conversations all were prepared to accept my aunt on the basis of how I proposed to pay and had pointed out that once the funds left were lower than £23k they / I would talk to the LA.
None said she would be moved.
I’ve just asked my wife who also went through something similar a few years ago with her Uncle and she pretty much confirmed the same.
I think the thing to do is just be honest and up front with them.
Whilst I was happy enough to be at various stages guarantor for my now Adult children for rent and the like I wouldn’t be quite so keen to do that in care home situations and from my experience there appeared no real need to do so.
Best of luck in sorting and to your Mum.

[DT1975]

alscar said:

Sorry about your Mum.
Mine has just been diagnosed with Alzheimer s ( she s 86 ) and after spending Christmas with us I can vouch for that diagnosis sadly.
At the moment she is quite able to look after herself but we are obviously aware that may not always be the case.
Having been LPA for her sister and arranged a care home and sold her house in order to a) buy an immediate needs annuity and b) ensure she was happy where she was going we had numerous conversations and meetings with various care homes.
Looks like at some point that exercise will need repeating for Mum.
In general it seemed that all were happy to accept our money and given the immediate needs annuity paid around 80% of the weekly cost were not asked for any guarantor signing.
I had to go through the LA s financial assessment even though we knew we were over the £23k amount.
During this time I kept the chosen care home fully aware of where we were with the house sale etc.
From memory of our various care home conversations all were prepared to accept my aunt on the basis of how I proposed to pay and had pointed out that once the funds left were lower than £23k they / I would talk to the LA.
None said she would be moved.
I ve just asked my wife who also went through something similar a few years ago with her Uncle and she pretty much confirmed the same.
I think the thing to do is just be honest and up front with them.
Whilst I was happy enough to be at various stages guarantor for my now Adult children for rent and the like I wouldn t be quite so keen to do that in care home situations and from my experience there appeared no real need to do so.
Best of luck in sorting and to your Mum.

Thanks for that. Having viewed a number of quite frankly depressing care homes we have today decided to keep my mum in the current home which is bright, airy, modern and vibrant. She's in week 4 of respite and she's very happy. Having viewed the contract the 'guarantor' status is actually referred to as 'a third party contributor', however the point is the same in that I would be liable for any unpaid bills - fair enough.

I've contacted social services who have advised to apply for a deferred payment agreement now so at least its in place for when we reach the £23k limit. If her property doesn't sell the DPA (which is a loan against the property) should fund most of the care home fees, if it doesn't I'll fund the difference and reclaim the money from the house sale in due course. The absolute worst case scenario is mum gets moved to another home or back to her unsold home with suitable care provided. Sadly I can't see her reaching that point.

Since the original post the care home have also agreed to price match a local BUPA home saving £800 a month in the process.

[The Gauge]

DT1975 said:

Sadly they do kick people out. Our problem is a potential gap between her savings getting used up and the sale of the house, hence the council step in , offer a DPA and could move her. It's that process I need help with.

I assumed the local authority put a charge on the house, so that when it is sold they claw back any payments due?

[Badda]

Panamax said:

OK, that's a difference of terminology that's new to me. A quick google suggests that respite care is, "temporary care".

I'd nonetheless be inclined to push back against the idea of a guarantee. Whatever label is put on the situation I'm unclear why they would kick anyone out so long as the bills are being paid and irrespective of the paper-work.

Is the "respite" care in a physically different place/building than longer term care?

If you’ve never heard of respite care, might be best to avoid trying to advise in this sensitive affair.

[DT1975]

The Gauge said:

I assumed the local authority put a charge on the house, so that when it is sold they claw back any payments due?

Yes, £800 fee and interest I think is in line with RPI ? It's a charge on the property as you say however I've no idea yet of what happens if onguing fees ever exceeded flat valuation, I assume they swallow it and we sign the place over.

[alscar]

DT1975 said:

Thanks for that. Having viewed a number of quite frankly depressing care homes we have today decided to keep my mum in the current home which is bright, airy, modern and vibrant. She's in week 4 of respite and she's very happy. Having viewed the contract the 'guarantor' status is actually referred to as 'a third party contributor', however the point is the same in that I would be liable for any unpaid bills - fair enough.

I've contacted social services who have advised to apply for a deferred payment agreement now so at least its in place for when we reach the £23k limit. If her property doesn't sell the DPA (which is a loan against the property) should fund most of the care home fees, if it doesn't I'll fund the difference and reclaim the money from the house sale in due course. The absolute worst case scenario is mum gets moved to another home or back to her unsold home with suitable care provided. Sadly I can't see her reaching that point.

Since the original post the care home have also agreed to price match a local BUPA home saving £800 a month in the process.

That sounds slightly more positive on the Financial side.
I don’t think you need to do anything quickly as a consequence and ultimately if needed knowing they have a charge on your Mums house that should suffice.
Not knowing how far you live from Mum can I just be boring and say that making sure her house is secure and given the weather ensuring adequate heat is being maintained overnight might be sensible.
I might also even think of just letting her Insurers know that her house is temporarily unoccupied as such.

[DT1975]

alscar said:

That sounds slightly more positive on the Financial side.
I don t think you need to do anything quickly as a consequence and ultimately if needed knowing they have a charge on your Mums house that should suffice.
Not knowing how far you live from Mum can I just be boring and say that making sure her house is secure and given the weather ensuring adequate heat is being maintained overnight might be sensible.
I might also even think of just letting her Insurers know that her house is temporarily unoccupied as such.

Cheers.

As we progress I'm learning what a dog eat dog minefield situation these cared homes are.

We had a look at another home, they're coming into assess mum. As soon as the current care home found out they said they'd price match and apply for FCN funding. The price match was on their website tucked away. Fine I said, however once I'd submitted mums financial docs they went cool on the idea coming out with some BS that head office probably won't price match and quoted small print about only the first 5 applications being accepted. Likewise they'd assessed mum and she wouldn't get FCN funding.

Mum is clearly terminal with liver cancer. We / she made a mistake however. When the large liver tumor was seen on MRI she requested ( and they advised) no further intervention as 93 and frail just let nature take its course. The scan said it required further urgent investigation but she wasn't in the home then. Now the home won't accept her worsening condition is due to liver cancer (even on balance of probablities) and brushed off the NHS funded nursing care application (£254 a week)

As such we have no concrete evidence that her continued weight loss is linked to cancer, they literally have her top of the scale for malnutrition and trying to force calories into her , we're trying to get her GP to escalate this and get a concrete answer on mums condition.

[omniflow]

This is possibly of little / no help considering you're currently outside of the hospital system, but what helped us massively recently was pushing for, and getting, a COTE assessment for my Mum. COTE is the new name for Geriatric, and stands for Care Of The Elderly. There should be specialist consultant within the Oncology team whose role it is to liaise with the COTE team. Find out who this person is and get them to assess your Mum and you could get what you need, which is a diagnosis.

I'm also very firmly in agreement that many Care Homes are completely dire - totally depressing places. If you've found a good one, then stop looking. The price difference between good and dire isn't huge in relative terms.

[alscar]

[quote=omniflow

I'm also very firmly in agreement that many Care Homes are completely dire - totally depressing places. If you've found a good one, then stop looking. The price difference between good and dire isn't huge in relative terms.
[/quote]

Indeed - good advice on the price correlation.

[DT1975]

omniflow said:

This is possibly of little / no help considering you're currently outside of the hospital system, but what helped us massively recently was pushing for, and getting, a COTE assessment for my Mum. COTE is the new name for Geriatric, and stands for Care Of The Elderly. There should be specialist consultant within the Oncology team whose role it is to liaise with the COTE team. Find out who this person is and get them to assess your Mum and you could get what you need, which is a diagnosis.

I'm also very firmly in agreement that many Care Homes are completely dire - totally depressing places. If you've found a good one, then stop looking. The price difference between good and dire isn't huge in relative terms.

Many thanks and a good point well noted about having found a decent home.

[CambsBill]

DT1975 said:

Cheers.

As we progress I'm learning what a dog eat dog minefield situation these cared homes are.

We had a look at another home, they're coming into assess mum. As soon as the current care home found out they said they'd price match and apply for FCN funding. The price match was on their website tucked away. Fine I said, however once I'd submitted mums financial docs they went cool on the idea coming out with some BS that head office probably won't price match and quoted small print about only the first 5 applications being accepted. Likewise they'd assessed mum and she wouldn't get FCN funding.

Mum is clearly terminal with liver cancer. We / she made a mistake however. When the large liver tumor was seen on MRI she requested ( and they advised) no further intervention as 93 and frail just let nature take its course. The scan said it required further urgent investigation but she wasn't in the home then. Now the home won't accept her worsening condition is due to liver cancer (even on balance of probablities) and brushed off the NHS funded nursing care application (£254 a week)

As such we have no concrete evidence that her continued weight loss is linked to cancer, they literally have her top of the scale for malnutrition and trying to force calories into her , we're trying to get her GP to escalate this and get a concrete answer on mums condition.

I must admit that I'm confused at all this, or maybe at what happened with my old man just over a year ago. Early 90's, he was taken in to Wexham Park in Slough where they did some tests, concluded that he had cancer of some form but decided that his weakened state meant that further tests would merely cause distress & not result in any meaningful treatment. In order to clear the bed he was transferred to a (very good) palliative home a couple of miles away where he hung on for a few weeks before passing away. The odd bit is that we were never asked about payment at any time. Is this normal with palliative care?

Stubborn old git did get into trouble even when he was supposedly on his death bed - complained about the management not allowing him to have his air rifle to take pot shots at the squirrels in the grounds & had his pipe & baccy confiscated when he was caught smoking in his room

[DT1975]

CambsBill said:

I must admit that I'm confused at all this, or maybe at what happened with my old man just over a year ago. Early 90's, he was taken in to Wexham Park in Slough where they did some tests, concluded that he had cancer of some form but decided that his weakened state meant that further tests would merely cause distress & not result in any meaningful treatment. In order to clear the bed he was transferred to a (very good) palliative home a couple of miles away where he hung on for a few weeks before passing away. The odd bit is that we were never asked about payment at any time. Is this normal with palliative care?

Stubborn old git did get into trouble even when he was supposedly on his death bed - complained about the management not allowing him to have his air rifle to take pot shots at the squirrels in the grounds & had his pipe & baccy confiscated when he was caught smoking in his room

Sorry to hear about your dad, had a chuckle at your last paragraph :-) I think our issue was this. My mum was suffering weight loss and pain and was admitted to hospital 3 times in as many days. She was diagnosed with shingles then the scans showed up the liver cancer. She was deemed well enough to go home as we said we'd care for her(with no further investigation on the cancer the same as your dad).

We managed as well as we could caring for her, assuming symptoms were shingles but were eventually forced to admit her to a care home for respite . However its becoming obvious, with the massive continuing weight loss that its more than likely the cancer doing its thing.

We just need that confirmation that she should be deemed palliative, her GP is visiting the home on Monday.

I'm trying to spend as much time as I can with her, despite doing all the other stuff funding etc, putting her flat on the market, luckily I have power of attorney. It's all consuming , just taking time out to post on here I guess.