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Spring 2012

The Newsletter on issues of long term care for older people

AVOIDING CARE FEES An assessment of how families seek to hide assets to avoid paying for care and the consequences this can bring for the individual, local authorities and the wider community DOES YOUR BANK UNDERSTAND? The difficulties caused to those acting on behalf of other people when the high street banks dont understand the system CARE CHARGE CRISIS A review of opposition claims about cost cutting and regional inequalities in funding care needs NEWS IN BRIEF A round-up of whats happening in the world of care CARER COMMENDATIONS Announcement of the latest awards for those individuals in the community who are committed to improving public awareness about care funding


A new service has been launched by Suffolk County Council that will see individuals with long term care needs receive specialist, independent help in meeting the costs.
The local authoritys new provisions will refer residents and families in the first instance to our Helpline for advice on a wide range of funding, benefit and associated care issues. Where necessary CareAware will refer cases to other specialists and for personalised financial advice, to an endorsed later life adviser and member of the Society of Later Life Advisers from Care Asset Management. The service has been launched in direct response to the recommendations in the recent Dilnot report which encouraged local authorities to work in partnership with charities and the financial services sector to help improve levels of information and advice. Councillor Colin Noble, Suffolk County Councils portfolio holder for Adult and Community Services, said, I am delighted to announce the launch of the CareAware service in Suffolk. It is designed to help people make informed choices about paying for care and to reduce the risk of money running out whilst still protecting any inheritance legacies. I am confident that this new service will really help people better understand what options are available to them and I believe it will go a long way to helping individuals and families understand the true cost of care in later life and help them plan for the future. The launch of the free helpline service in Suffolk has been the result of initial work undertaken by specialist annuity provider Partnership who have recently announced that they are also in advanced discussions with a number of other local authorities around the country. Chris Horlick, Managing Director of Care at Partnership, said: We are encouraging local authorities to put in place arrangements whereby they can ensure that citizens get access to proper financial advice and to ensure that the local authority delivers a better service than has previously been the case to those who have to fund a long term care need. We believe the initiative in Suffolk is an example of best practice in this field. Suffolk County Council has become the first local authority in the country to adopt a proactive stance in referring its care residents to a single advisory service to help families deal with the financial, tax and legal issues of a care need. In some areas, the local authority has chosen to direct consumers to a panel of specialist financial advisers to offer wider choice. This is an understandable preference from a local authority perspective, explains Care Asset Management Director Stuart Cartwright. However, in our practical experience, this has resulted in significantly worse outcomes for both the local authority and the individual as it can often be a more confusing option, he adds. The care system can be complex and often has far reaching implications for individuals and their families. A care need invariably creates issues across a range of professional matters including health, finance, taxation and law and therefore it is important that any advice takes into account each of these issues. It is not easy to Stuart Cartwright separate out those who just need assistance with financial matters and the real benefit we can offer to local authorities is the triage service of CareAware, who are able to provide guidance on all issues which are likely to be associated with long term care, from re-homing a pet to explaining how jointly owned property might be assessed for care fee funding, explains Stuart. More enquiries have been generated in Suffolk in a few short months than we have seen collectively from all the panels we are involved in around the country and we believe this is a direct result of making the process easier for both the council and service users. We are also delighted to report that we have been appointed as the single adviser by neighbouring Norfolk County Council and City of York Council and we are in dialogue with a number of other local authorities in England, concludes Stuart. CareAwares Marketing Manager, Jacqui Thomson endorses Stuarts comments. Our experience over the last 16 years means that we can offer a wide range of advice services. Only around a quarter of our callers ultimately need to speak to a specialist financial adviser and the service we offer to the other 75% has been the cornerstone of our success. Many families simply dont realise what help they need in doing battle with the challenges of our care system and our role is to guide them through the maze of complication and ensure that they are able to do the best for their loved one. CareAware comment over the page.

Caring Solutions For Age Old Problems
PO Box 8, Manchester M30 9NY
No section of this document may be photocopied or otherwise reproduced without written permission CareAware

For all your questions and queries simply call our helpline

0161 707 1107 or visit our website www.careaware.co.uk

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CareAware Comment:
For over 15 years, we have campaigned for better advice, guidance and information for individuals with a care need and the families who try to support them. The decision by Suffolk County Council is therefore extremely welcome as it seeks to offer practical guidance from proven specialists at the time it is needed most. We are delighted to be associated with the initiative and we have already enjoyed excellent feedback from those who have used the service. We very much look forward to working with local authorities around the country for the benefit of everyone involved in care fee funding.


The annual level of the NHS contribution towards the costs of a place in a care home with nursing for those people assessed as requiring the help of a registered nurse (RNCC) has been frozen. When NHS-funded nursing care was introduced in October 2001, the Government made a commitment to regularly reassess the payment attached to the banding, which in line with nurses pay will remain unchanged for 2012/13 so, from 1 April 2012, for eligible care home residents, the standard rate will be 108.70 per week and the higher rate will be 149.60 per week. The decision to freeze this care contribution has been condemned by the care sector particularly as the NHS has been unwilling to discuss the fairness of the base rates in the first place.


A recent report from 5 Live Investigates highlighted how some families are hiding wealth to avoid paying care home fees and how many local authorities are failing to use the available legal powers to claw the money back. The programme highlighted a case in which two siblings were able to get away with not telling their local authority about their elderly mother's assets, leaving the council to pick up much of the cost of her residential care. By not disclosing the truth they were able to protect her wealth - and their own inheritance. Once she was in care, the siblings sold their mother's house and put the proceeds of the sale into an investment bond as they were advised this would put the assets out of the reach of any local authority means testing of their mother's wealth. But their brother was not in agreement with the deceit and couldn't understand how they had been able to get away with it. This led to a rift in the family over whether they or the state should be funding their mother's care and the dissenting child was accused of upsetting the family, even though he explained that he didn't want to sound pious or righteous, but just wanted to tell the truth. The question of who should fund the residential care of the elderly is one that divides public opinion and the programme also discovered that local authorities are also split on how to tackle the issue. If a council can prove that individuals have deliberately deprived themselves of assets in order to avoid paying care fees, they can take legal action to recoup what should have been paid. The BBC contacted local authorities across the UK using the Freedom of Information Act to find out which had used the powers available to them. Only 16 of the 121 councils that responded said they had recouped money back using legal powers with Surrey Council recovering the largest amount - more than 250,000 since 2009. The lack of uniformity in the local authorities' approach to the issue has been criticised by advisers. George Hodgson, Deputy Chief Executive of the Society of Trust and Estate Practitioners explained, "There's no confidence that the rules, as written down, will be applied consistently. It's not just the local authorities, the Government itself needs to come to a clear position on what it's going to do about this problem." The continuing uncertainty about how care fees will be funded in the future will inevitably encourage some families to seek ways of protecting their assets by breaking the law. The disgruntled child in the 5 Live programme explained, The most upsetting thing is that he believes his mother and father would not have approved of what his family had done. They had always paid their taxes and done the right thing. They would just have paid and would have wanted everything to be declared."

In this feature, we look at some of the questions received to our Helpline that we think might be of interest to readers.

How Do I Complain about Care?

"A few years ago I had an Aunt who was receiving care from a care agency. I had a complaint about the care service which I could not resolve with them. My next step was to go to the CSCI organisation who helped me to get a satisfactory conclusion to the complaint. I now have an uncle who is not receiving good practice from a local care company and again I have not been able to resolve the problem. Thinking I would get the same service from CSCIs successor, I looked up the Care Quality Commission only to find that they do not provide the same complaints service as CSCI did. Is this right?"
Unfortunately, the answer is yes. The Care Quality Commission advise on their website that they cannot investigate an individual complaint but would like to hear about your experience. Their advice is, if you have a complaint that after investigation by the care provider you are not happy with, it is for you to contact your Local Government Ombudsman.

A lack of knowledge and understanding amongst the high street banks about the Power of Attorney system is leaving many families feeling frustrated. A review of calls and enquiries to our Helpline suggests that bank staff have an inadequate knowledge of legislation leading to delays in arranging and processing transactions. Some banks are demanding to see irrelevant documents while refusing to accept others which are entirely legitimate. CareAware Helpline Adviser Sally Kenyon has spoken to many who are frustrated in their efforts to act on behalf of a relative or friend. The calls we receive demonstrate clearly that many banks simply dont understand the documents they are being presented with, or perhaps more importantly, the implications of their action. The difficulties of being a substitute decision maker can be demanding enough without the added complication of having to deal with professionals who dont understand the process.

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Hundreds of thousands of older people in England who need social care are not getting any support from the state or private sector, campaigners say. Age UK suggests more than three quarters of a million people are excluded from the system - and the figure is set to top one million within four years. It said budgets had hardly risen in recent years even before the spending cuts, despite the rise in the ageing population. Councils are also accused of making it more difficult for those who do meet the income threshold to get care, by tightening the eligibility criteria. Six years ago, half of councils provided support to people with moderate needs, but that figure has now dropped to 18%. It means only 1.2 million are getting formal care either at home or in a care home. The report, based on previously published data by government bodies and independent researchers, pointed out while the NHS had received significant budget rises in recent years, social care increases had stalled. Once inflation is taken into account, funding has only been rising by 0.1% a year since 2004 equivalent to 43m. By comparison, the NHS budget rose by 25billion over the same period. Michelle Mitchell, Charity Director of Age UK, said: "The figures we have uncovered beggar belief. Care and support in England has reached breaking point, putting older people at risk and their families under intolerable strain." The charity has been calling for means-testing to be scrapped so that a universal system could be created, guaranteeing everyone a certain level of support if needed. A Department of Health spokesman said: "The Government recognises the urgent need to reform the social care system - an ageing population and rising expectations make the current system completely unsustainable."

The Association of Directors of Adult Social Services President Peter Hay has made an unprecedented offer to private care home owners to join him and other Directors of Adult Social Services in talks about fee levels paid by local councils. In the middle of a continuing series of judicial reviews concerning fee levels paid for older and vulnerable adults in residential care, and at the end of a gruelling transfer of some 750 Southern Cross homes to other providers, Peter Hay Mr Hay asked the home owners: Can we agree on some simple guidelines for a common approach to fees or shall we pull apart when, really, we have a greater, common cause in the care of your residents and our citizens? Shouldnt we consider mediation before we rush to judicial reviews and having to spend money that neither of us have on legal actions? Shouldnt we do this at a speed which allows us to show the quality the very high quality of our business to the people that matter, rather than letting others talk that business down? Mr Hay has extended this olive branch in a time which he described as chillingly austere when events at Southern Cross and Castlebeck have vividly illuminated what can happen to vulnerable people when social care goes missing, and when social care budgets for 2013/14 could well be cut by more than the 1 billion they have been cut by this year.


As the country awaits word from the Government on how it intends to revamp the way in which adult social care is funded, the latest research from Laing & Buisson has found that despite public policy favouring non-residential solutions to support the needs of the country's ageing population, efforts to divert demand away from care homes appear to be running out of steam. After a year which saw much heated debate on how to shape the future of elderly care, as well as the high profile collapse of Southern Cross, the 2011/12 edition of the Care of Elderly People UK Market survey reports that the number of elderly or physically disabled people living in care homes in the UK rose to 421,000 a rise of 6,500 since 2010. Reflecting the gradual decline in the number of people who qualify for state support, the funding profile of England's care home population continues to move towards private payers in 2011. Some 159,000 residents are now fully responsible for their care fees - 41% of the country's care home population. However, if the number of residents who have 'top up' fees are taken into account, 55% now pay something towards their care costs, over and above their pension and benefits.


A new survey of care provided by local councils, published by Labour, reveals shocking increases and wide disparities in charges for services. Councils have been found to be increasing charges for home care, meals on wheels and transport which mean that the average yearly cost for an older person who pays for 10 hours of home care a week is now 7,015. According to the survey, there are huge differences in the price people pay for care, depending on where they live. This ranges from free home care in Tower Hamlets to care costing 20.34 per hour in Cheshire East. Some councils limit the weekly costs people are required to pay, but this also varies hugely ranging from a cap of 105 per week in Hackney to 900 per week in Brighton and Hove. Four out of ten Councils who had a charging cap in 2009/10 have increased it, and another four out of ten have abolished it altogether, leaving people to face all the costs of their care. The survey also indicates that the number of vulnerable older and disabled people receiving services free of charge has dropped significantly, by more than 15% since 2009/10. Liz Kendall MP, Shadow Minister for Care and Older People, said, "More people are having to pay more for vital services such as help getting up, meals on wheels, and transport to day centres. These services are a lifeline and are Liz Kendall crucial in helping people live independently in their own homes. The huge variations in the costs of care across the country mean elderly people face a post-code lottery, through no fault of their own.

A car crash waiting to happen is how the Registered Nursing Home Association (RNHA) has described the Governments failure to ring-fence new funding for councils to spend on elderly care services. RNHA Chief Executive Officer Frank Ursell expressed no surprise at House of Commons research figures showing that, despite previous Government assurances that it was giving councils a real terms increase to spend on social care, the fact that there was no ring-fencing of the cash means the money has been diverted elsewhere. He added: It gives the RNHA and its members no pleasure at all to say told you so. The Government, it seems, wants to blame the councils. The councils will no doubt want to blame the Government. In the meantime, the people who will suffer are the older people who will be denied the care they need or will not receive the quality of care they deserve. If things carry on at this rate, budgets for meeting the nursing and social care needs of older people are likely to fall in real terms by at least 20% over the next three years when the effects of inflation are also taken into account.

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Care News In Brief

DLA Reforms Disability Living Allowance (DLA) will become Personal Independence Payment in 2013/14 although disabled people in residential care will continue to receive any mobility component they are entitled to. 2.27 a day for Food A care home for the elderly is spending as little as 2.27 a day to feed its residents, according to figures. An assessment of care home finances in Sefton, Merseyside, found an average spend of 27.50 on a weeks food for one resident, the equivalent of 3.93 per day. One unnamed home spent just 15.86 a week per resident an average of 2.27 a day. Dentures Liechtenstein is very small in size measuring around 15 miles long and 7.5 miles wide. However the country has a health claim to fame in that it is the worlds largest exporter of false teeth but we dont know why. Do you? A Snip for a Hip A hip replacement costs the NHS around 13,000. Pensioners dont need winter fuel payment Dame Joan Bakewell has argued that winter fuel payments should be meanstested to help target the benefit. New Carers Website Carewell, a partnership between Bupa, Carers UK and MEND is a new website designed to encourage and support carers. Carewell pulls together a range of information, support and guidance aimed at helping to improve the health and quality of life for carers themselves and supporting them in continuing to provide better care for their friends and family. For more information visit www.carewelluk.org Social Care Cuts Spending on social care for the elderly in England is falling again this year. An Age UK report said 7.3bn was being budgeted this year - the same as in 2011 - but it represented a drop of 4.5% once inflation was taken into account. The charity said the squeeze meant thousands were missing out on care. Stair lifts There are in the UK companies which rent out stair lifts. The rental contract will include maintenance and a 24 hour call out system. There is usually an installation charge which covers both the fitting and removing of the stair lift, with a guide cost of around 350 for a basic model and then the average hire cost is around 10.00 per week. Care and Dignity The Patients Association has published a report calling for hospitals to commit to treating patients with dignity. In response, a Department of Health spokesperson said, Everyone admitted to hospital deserves to be treated with compassion and dignity. Many parts of the NHS provide really good care, but some sadly fall short of what we demand. Thats why we asked the Care Quality Commission to carry out unannounced inspections on issues including patient dignity and nutrition. So far, 100 inspections have already been carried out and 700 more are planned. Elderly struggling to pay back debts More than 400,000 pensioners are struggling due to the rising cost of living and debts, the Consumer Credit Counselling Services has warned. 2 million campaign launched Six out of ten people with dementia in England go undiagnosed. This means almost 400,000 people could be going without the vital support the NHS and social care services can offer. Families are being urged to look out for the warning signs of dementia when they visit their elderly relatives. It is part of a Government advertising campaign in England aimed at encouraging early diagnosis. Correction In our last edition, we stated that carers support saves the country 87 billion a year. We have since been advised that as at May 2011 this figure exceeded 119 billion. Our thanks to Jennifer Stenson, Vice Chair of the Portsmouth and SE Hants Branch of Carers UK for providing the updated figure.

Community Carer Commendation

The success of CareAware in assisting people to better understand their rights and choices on matters of funding care, is dependent upon the efforts of individuals and groups in the community. To acknowledge and recognise their contribution, we announce regular COMMUNITY CARER COMMENDATIONS. Each will receive a bouquet of flowers and an elegant display certificate. Judging is based on our own assessment of their efforts in promoting awareness about funding care in their local community, through use of the CareAware initiative. If you would like to nominate someone, please let us know!

Congratulations to: Ralph Holland

Oakhaven Care Home Cheltenham

Caring Solutions For Age Old Problems

PO Box 8, Manchester M30 9NY


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