Self funders - What do I do now?

When you are classified as a self funder - somebody who is paying for their own care because they have savings and assets, excluding property above £23,250 in England and Northern Ireland, £22,000 in Wales and £22,750 in Scotland, you will be unlikely to receive very much help from social services to find the care that you need, or be offered information to enable you to make an informed decision.  Facts about self funders
This guide will help you to make an informed decision.
When do I need care?
If there is a question over your safety within your current living arrangements you should start to look at what options are available to you that will either support you within your own home, or provide you with the support you need elsewhere.

Assessments
As a self funder you are entitled to an assessment - which is free, from social services. An Occupational Therapist will assess your needs and advise you what level of care you require. However, this assessment may take some time to organise and in addition to this you may find your needs are assessed in relation to the level of support that the council can offer - rather than the level of support you need.

Your alternative is to approach a care home or domiciliary agency to assess you. This can often be undertaken much more quickly.

Paying for your care
It is vital to establish how much you can afford to pay in care fees. Only 17% of self funders obtain specialist care fees advice about how they are going to pay for their care fees and studies suggest that a third of self funders run out of money and turn to social services to continue paying for their care. The problem with this is that many self funders are paying more for their nursing home or residential home than social services will pay. This leaves the self funder with the dilemma of either moving nursing home, ‘topping up’ the difference (asking family or friends to contribute towards the cost), or negotiating with the home over the fees or moving to a cheaper room.

Speak to a professional care fees advisor to establish how much you can afford and how long this will last.

How much will my care cost?
As a self funder you are responsible for your own costs whether or not you intend to live at home with the support of a domiciliary care agency, or whether you intend to live in a residential care home.

The average cost of care at home is £17.30.  So two hours of daily home care could amount to more than £12,600 a year - not including higher rates for weekends and holidays. If 24 hour care is required costs could rise to more than £150,000 per year based on this hourly rate.
The average costs for residential care can vary depending upon the location and whether nursing is required. A general guide for a residential care home is £24,908 a year and £34,788 for a nursing home.

Allowances
As a self funder you are entitled to very few benefits, however Attendance Allowance is a tax-free benefit for people aged 65 or over who need someone to help look after them because they are physically or mentally disabled. For full details of eligibility.  If you are under 65 you may be entitled to Disability Living Allowance and you may be entitled to Pension Credit.

A care home - or home care?
Moving into a nursing home or a residential home is a big decision to make and you may decide, regardless of the advice you have received from professionals, that you would like to try and stay at home. There are a variety of organisations that will help you to achieve this.

Finding the best care
Once you have established what type of care you need and how much you can afford to pay for it, you can begin to look for care homes or domiciliary agencies.

Domiciliary agencies
If you are choosing to stay in your own home and you are looking for a domiciliary care agency, or home help, there is a variety of support on offer. Ranging from a carer who will pop in and make you lunch, to full time live in carers. When choosing the agency remember that it is the staff you will be interacting with, ask whether you can choose your carer or change them if you do not get on. The Care Quality Commission regulates domiciliary agencies, so look for the 3 star ‘Excellent’ rated agencies.

Try and speak to other people who use the agencies as they will be a useful guide to the level of care being offered.

Residential care
When looking for a nursing home or residential home remember that as a self funder you are a preferred client. Statistics suggest that many social services placements in care homes are subsidised by the self funders within the same home. This is because social services set a maximum rate that they will pay. Visit as many nursing homes or residential homes as you can and begin with those that have achieved an ‘Excellent’ rating, 3 stars, from the Care Quality Commission.  We have a full list of 3 star care homes in England and a checklist for people who are entering permanent residential or nursing care.
Planning the move
It is really important to prepare yourself and your family for the move into residential care as proper preparation can seriously influence your attitude towards your new home Planning the move.
What do I take into a care home?
Having a checklist of items that are not only essential, but will also help you to settle in is really helpful.  Some items are very obvious, others less so - for example very few homes will allow you to have a kettle in your room.  It is better to know this before you move in rather than have it taken away after you have moved in Checklist: What to take into a care home.
Give yourself time
As with anything in life change can take a little getting used to.  So give yourself time and try and approach your new home with a positive attitude to give yourself the best chance of settling in and making the most of your new home.

Checklist: what to take when you move into a care home.

The first thing you need to know is that everything needs to be labelled - absolutely everything. Losing clothes or somebody else wearing your relatives clothes can be a big problem.

-Underwear.
Most care homes suggest you take in enough underwear for several weeks, bear in mind space will be limited. A word about tights, they are difficult to get on and off if you are a little unsteady on your feet, consider pop socks.

-Everyday clothing.
Again think about how much space is available, the type of clothes your relative would normally wear and feel comfortable in and the general style of the other residents. Being over or under dressed can be embarrassing and make it difficult to fit in.
Care homes tend to be warm for us, but chilly if you are sitting for long periods, consider layers of various thicknesses - cardigans are always useful and easy to get on and off, enabling your relative to do dress without having to ask for help.

-Accessories.
Shoes should be comfortable as they are likely to be worn most of the time when your relative is not in their room. Outdoor shoes and boots are unlikely to be used and take up a lot of space - perhaps store them on your relatives behalf. Other accessories, for example scarves should also be considered if they tend to form part of your relatives usual dressing habits.

- Jewellery.
Precious items for your relative should be taken into the home. However, valuable items may need to be considered separately. Have a word with the Matron or Manager and see what their policy is.

-Toiletries.
Clearly this is a personal issue, but you will need to take in all of the normal day to day toiletries. It is probably worth having a look in your relatives bathroom to make sure you know what brands they like - when you have been using Colgate toothpaste all of your life it's a bit much to be asked to switch to Macleans! It is also likely that you will be buying replacement toiletries, so it's quite useful to know what the brands are.

Keep an eye on how much space there is for potions and lotions and consider a wash bag that you can hang next to the sink with everything in it.

-Towels and Robes.
If you want your relative to use their own towels then its time to sew on more labels. Dressing gowns and slippers are a must.

-Furniture.
How big the room is will be the governing factor here. Familiar items of furniture, tables, favourite chairs and cushions and paintings are all really important and will help your relative to feel at home. Do not underestimate the importance of photos as their link with the past and the present reinforce who we are and our sense of identity.

-Television.
If space permits and I hope it does, then a TV in your room can be a godsend - you will need a TV licence though, this can be transferred from the old house, but don't forget to keep an eye on when it runs out.

-Radio.
A radio or music centre might be important to your relative, particularly if they have failing eyesight. Ask how they would normally spend their evenings and try to recreate that.

-Clock.
Knowing when somebody is going to call or it is time to go to lunch can be worrying if you don't know what the time is. Make sure the clock is large enough to tell the time - particularly if the numerals on a wrist watch are too small.

-Telephone.
Keeping in touch without having to go via the Managers office can be important. Mobile phones are often either too small or too technological to be of use. Sometimes there is a telephone point in the room in which case you can use a land line. However, there is a new phone that has been developed that takes a sim card, looks like a normal phone, doesn't need any wiring and most importantly, if the handset isn't replaced it recognises that nobody is talking and hangs up for you - enabling the next call to get through, it's new so email me at debbie.harris@best-care-home.co.uk if you would like more information.

-Books.
Check your relatives bedside table for any current books they are reading and do bear in mind that books are like old friends, there may be others that they would wish to take - however many times they have read them. Don't forget newspapers.

-Calendar.
Keeping track of time and marking birthdays and special events on a calendar, along with perhaps a supply of cards and stamps might be useful. Ask the Manager or Matron what the postal arrangements are.

-Phone numbers.
Don't forget the address book with all of the telephone numbers of friends.

-Paperwork.
Decide where the paperwork will be kept, either with your relative in a secure cupboard or depending upon their level of awareness with a relative.

Look around your relatives home - in particular the places where they spend a lot of time; their favourite chair, in bed, on the porch - what items surround them, it is these that are most likely to be missed. Try and take as many into their new home as your can.

I welcome any suggestions that will improve this checklist.

Are you sure you need a care home?

EIGHT WAYS TO HELP YOU MAKE THE RIGHT DECISION.


Moving into residential care is a big decision and sometimes it is clear that it is the best decision you can make, if this is the case visit preparing for residential care and discover how to make it a positive move.

Looking after somebody who is unable to care for themselves is exhausting, emotionally draining and isolating. Here are eight suggestions that might make life a little easier and help you, or the relative you are caring for to stay at home.

1. Get an assessment from Social Services.

Whether you qualify for financial help from Social Services or not, this assessment is free. The assessment will help you to recognise what your needs are and who might be able to help you.

The carer can also have their own needs assessed and may be eligible for help.

2. Home Improvement Agencies.

Concern about maintaining your house can be a great worry – poorly maintained homes can also create hazards; cold is a killer for the elderly.

Foundations is a government appointed national body of ‘home improvement agencies’. They will offer advice on keeping your home warm and safe and the types of equipment available to help you stay in your own home. They will also advise you on any grants that you may be able to apply for.

STEP 3. Help at Home.

Home help is called ‘Domiciliary Care’ and if you are relying on this to get out of bed, bathing, dressing or your meals you need to make sure that the agency is reliable and that you like your carers. This can be tricky if you are funded by Social Services.

Alternatives are Direct Payments, where money is paid directly into your bank account and you employ your own help.

Private or voluntary agencies also provide domiciliary care. All agencies need to be registered with the Care Quality Commission (CQC), have a look on their website for a list – my advice would be to start with the agencies that have the highest rating – 3 stars.

STEP 4. Food.

Keeping well depends upon eating well. Everybody has heard of Meals on Wheels, well they still exist so get in touch. Alternatively there are many companies that are local to you that deliver high quality food, find one that offers the food that you like with reliable drivers.

STEP 5. Pets.

Having a pet can be enormously rewarding, especially if you life alone. However, it can also be very worrying – who will look after him if I am ill, how will I get food in? The ‘Cinnamon Trust’ is a national charity that holds hands with owners to provide care for their pets – if your pet needs it, they will do it.

STEP 6. Disability Register.

The disability register is a not for profit organisation and provides details of new and second hand equipment that may make life a little easier. Items are bought and sold on a direct one-to-one basis, no middle men or commission involved.

STEP 7. Day centres.

Day care centres provide the opportunity to spend time with other people, as well as offering a range of activities – they also give the carer a break and some time to themselves. Run by the local authorities and local voluntary groups a national register doesn’t exist, but your local Age Concern will have a list of day centres.

STEP 8. Loneliness.

Being lonely can be a big problem when you are trying to remain independent in your own home. ‘Contact the Elderly’ is a volunteer organisation that organises regular Sunday afternoon tea parties for people over 75, who live alone with little or no social support.

If you decide that a care home is the right option for you, make sure you know what to ask when you visit your short list of homes, Questions to ask a care home gives you a list of questions that you can print off and take with you.