A spider’s web of costs, means testing and rules in regards to care for the elderly is one which many of us will have to face at some point.
Who should pay for our care when we are too old to live independently?
In Scotland, the average stay in long-term care is around 2.5 years, with average annual private fees of around £42,000 (including nursing care). Therefore the ‘average’ stay might cost upwards of £100,000.
If your personal assets exceed the upper threshold (£26,500) you will not get state financial assistance and will be deemed to be ‘self-funding’.
The rules for ‘self funding’ seem clear cut, but when rules crash into people desperate to get the best care for their loved ones, suddenly black and white becomes varying shades of grey.
This has been the stark reality faced by Islander Danny Mackay from Ness who has been fighting a war of attrition over care costs since 2009.
Danny returned to the Islands from London in 2007 due to ill-health following a stroke and had been living with his mother at the old family home in Ness.He had bought the holding connected to the house built by his grandfather, in equal share with his mother, so that she felt she had some financial security.
However when Mrs Mackay had to go into care two years later, Danny faced a financial nightmare, that has only recently been concluded, eight years later.
Telling his story to the Gazette this week he revealed: “The mistake happened right at the beginning, when my mother first went into care.
“When I was applying for her funding I didn’t mention that at that time I was on incapacity benefit after suffering my stroke, and no one asked me about benefits, so the value of the house was taken into the assessment when it shouldn’t have been.”
This meant that Danny’s mother was assessed to be ‘self funding’ and immediately had to start paying towards her care costs. Mrs Mackay’s pension and her husband’s were swallowed up to pay towards those costs, which amounted to more than £27,000 during her time in care. However this was not the whole bill, as it was also determined that due to her half share in the holding, Danny would also have to find another £40,000 in order to keep the family home.
The situation has meant a stressful drawn out battle for Danny with the local authority about what should be paid towards his mother’s care. At one point he faced the prospect of being taken to court over the matter.
Over the years of wrangling with the Council additional financial assessments resulted in the bill being reduced first to £25,000, then further down to £7,500.
And it was only in April this year that Danny received written confirmation that the property had been “fully disregarded from the financial assessment”.
An interesting point also popped up during this epic financial wrestling match, Danny’s friend questioned the cost of the care, highlighting that there is a maximum rate for private care providers that local authorities will pay at around £550 per week, however Danny’s mother was charged a much higher rate - over £900 per week - for council provided care.
However, worn down by the stress of the situation, and despite not really understanding why there was still a figure of £7, 500 being demanded, nevertheless, Danny has reluctantly accepted this final bill.
Now back to full health and no longer reliant on benefits, luckily he has a small private pension he can use to pay the bill, and he has made an agreement to pay the sum over time, although there is a final sting in the tail, he will not be able to take full ownership of the property until the bill is paid in full.
When asked about Danny’s story Comhairle nan Eilean Siar stated they would not comment on individual cases, however they did provide some general information about care costs (see below).
Danny’s story is most certainly a warning tale for all of us. Who will pay our costs if we need care, will the burden fall on our children?
General advice on care cost
Although not able to comment on individual cases Comhairle nan Eilean Siar did offer some general advice.
“The Comhairle undertakes financial assessments for care charges using the Charging for Residential Care Guidance. http://www.sehd.scot.nhs.uk/publications/CC2016_02.pdf Ability to pay is an integral part of this.
Charges are assessed based on evidence provided; if further information is made available these can be revisited and amendments made.
There was a backlog in financial assessments which was recognised by the Comhairle in 2016 and additional resources have put in place. The position relating to assessments is monitored at every Audit and Scrutiny Committee. The assessments are carried out by the Finance and Corporate Resources Department. The new performance target for completing new assessments, once information has been provided, is 90 days and this is being achieved in the majority of cases where the determination of financial guardianship is not an issue.
The Comhairle charges a standard rate across all care homes and is determined based on the cost of service provision.
The rate by each external provider is a contracted rate determined as part of a procurement process.
Service users or their representatives should seek independent advice if they have concerns about the financial assessment which has been determined. They can also appeal the assessment using the Comhairle’s formal complaints process.”
MSP gives his view on case
One of the people Danny turned to for help over his care cost battle was Western Isles MSP Alasdair Allan.
Mr Allan told the Gazette:“I was delighted to hear that after years of dispute the council have agreed to significantly reduce the final bill to something sensible. As local MSP, I take up cases for hundreds of islanders every year and it is always great to see a positive resolution like this.
“Councils have a discretionary ability to disregard property from the financial assessment of someone receiving care under special circumstances and I strongly believe Danny’s situation warranted that. At the moment, care home residents with assets of more than £26,250 have to pay the “hotel” element of their care home costs.
“However, free personal and nursing care benefits older and vulnerable people in Scotland each year - something that is not available in England - and over the course of this parliamentary session, £1.3 billion of resources will go into social care. I am very willing to try to assist other people who are having difficulties of this kind if I can.”