Choice of
Accommodation
and Top-ups
Introduction
Moving into residential accommodation such as a care home or supported living scheme is an important decision so all the options need to be carefully considered beforehand. This leaflet will help you to think about the choices available to you if you, your family and your social worker have decided that it would be in your best interests to move into a residential setting, either on a temporary or permanent basis. It is important that you understand what your rights are when choosing a care home and also how staff from Adult Social Care will work with you to ensure that you are happy with the decisions that are made about your future accommodation. This leaflet also has some useful information about the costs involved and what happens if you want to move to more expensive accommodation.
Type of accommodation
If you have had an assessment from Adult Social Care, your needs will have been considered and a support plan drawn up which includes information on how your needs are to be met. If you need to move to a care setting, the options that will have been considered and discussed with you are:
Care homes – this could be a residential or nursing home where staff are always available to help you. Placements can be short term or offered on a long term basis.
Supported living – this is accommodation that has been designed or adapted to suit the needs of people who need care and support to enable them to live as independently as possible. Staff are based onsite and they can help you with personal care if you need this. An example of this is extra-care housing.
Shared Lives Scheme – this accommodation is provided by a shared lives carer. The carer offers support to adults, who move into their home on a short term or long term basis. This type of service used to be known as an Adult Placement Scheme.
Choosing a care home
Your social worker will help you and your family to find accommodation that best suits your needs. You have the right to choose between different providers and/or locations. If you would like to move to another area to be closer to your support network of family and friends this can be arranged. There are cross-border arrangements in place should you wish to move within the United Kingdom, and the Council will look at the cost of care in your chosen area when deciding your personal budget.
There are four questions that need to be considered before a placement can be agreed.
1. Is the accommodation suitable?
The accommodation must be suitable for your needs as outlined in your support plan. Your social worker will be able to guide you and help you to understand which care setting will be best for you.
2. Is the accommodation affordable?
Your personal budget will be agreed by Adult Social Care. This will reflect your care and support needs and the cost of the placement. If you have savings below the upper capital limit of £23,250 you will receive a contribution towards the cost of your placement, although the amount of funding available will depend on your savings and income. You will also have to make a contribution yourself based upon a financial assessment of your ability to pay.
The Council will always make sure that you have at least one choice of care setting that can be paid for from your personal budget. If no suitable accommodation is available at the amount identified in your personal budget, the Council will pay for you to move into a more expensive setting. You may decide to pay extra to move to more expensive accommodation, in which case the difference between the care homes weekly charge and your personal budget will have to be met by you, or someone else such as a relative, depending on your circumstances. These are called top-up payments and are explained later in this leaflet.
3. Is the accommodation available?
Some providers operate a waiting list so you may have to wait for a place. In the meantime you could consider receiving care at home or moving to an alternative care setting on a short term basis, which is often referred to as an ‘interim placement’. If there are no interim placements available that can be fully funded by your personal budget, the Council will increase your budget to make sure that you have at least one offer of affordable accommodation.
Your social worker will confirm the interim arrangements in writing. They will do their best to tell you how long it will take for a place to become available in your chosen care setting, but this will be an estimate and cannot be guaranteed.
If a place does not become available in your preferred accommodation within 12 weeks, we will carry out a reassessment to make sure that you are happy that your needs are being met and also to check that you still want to move to your preferred choice of accommodation. If at this point you decide to stay in the temporary care setting on a long term basis, we will do our best to arrange this for you but you should be aware that if it costs more than your personal budget, you or a third party will have to pay a top-up.
This is explained later in the leaflet.
4. Will the provider agree to a Council contract?
In order to agree a placement, the provider must be prepared to enter into a contract with the Council to provide the care at the rate that can be met by your personal budget. By doing this they are also agreeing to keep to the Council’s contract terms and conditions. If you decide to move out of the Stockport area, the Council will make sure that the accommodation is registered with the Care Quality Commission and will also expect the provider to enter into a contract.
Leaving hospital
If it has been decided that you are medically fit for discharge, but are unable to return home, the hospital staff will work with Adult Social Care staff to find you a temporary or permanent care setting to move to. You have the same right to choose where you would like to move to as anyone else, but you should be aware that your preferred accommodation may not have a place available on the day you are discharged, so you may have to move to an interim placement whilst you are on the waiting list. There will be an expectation that you work with staff to find a suitable interim placement as you will not be able to stay in hospital until a permanent placement becomes available.
Paying for more expensive accommodation
The Council will always make sure that there is accommodation available that is affordable within your personal budget. If there is none available at the time, your personal budget will be increased to enable you to move into more expensive accommodation.
However, if there is accommodation available that is affordable within your personal budget but you choose to move into a care setting that costs more than your personal budget, a member of your family or a friend will have to pay the difference between your personal budget and the actual cost, this is called a ‘top-up’. Care homes may increase the amount of top-up that is charged annually so it is important that you consider this when deciding who should pay the top-up charge.
First party top-ups
In some circumstances you may be able to pay the top-up yourself. If you own a property you can pay the top-up out of your own savings and possibly some of your income during the first 12 weeks of you moving into a care home, this is called the Property Disregard Scheme.
After the 12 weeks is over, you may decide to join the Deferred Payment Scheme, where you can use the equity in your property to pay towards your care. You can add any costs associated with top-ups to the loan. If after the 12 weeks is over you decide not to join the Deferred Payment Scheme, you can no longer pay the top-up yourself and a third party will have to pay the top-up (see next section).
Third party top-ups
This is when the top-up is paid by someone else, usually a relative, friend or an organisation or charity. Everyone involved needs to be certain that the third party can afford to pay the top-up for however long you will be in the care setting, as failure to do so may result in you having to move to another home. It is important to note that they cannot use your money to pay the top-up at any time. The person who agrees to be the third party will need to sign an agreement between themselves, the care home and the Council to confirm the arrangement.
We always advise anyone considering this option to take independent financial advice before they commit to the agreement; further details are included at the back of this leaflet.
It should be noted that if you have a change in circumstances a new financial assessment will need to be completed. If this results in a change to your contribution, this will not reduce the amount of the top-up payment.
Price increases
Care homes increase their prices on an annual basis, which will be considered by the Council as part of its annual review of care costs.
However, there is no guarantee that any increases to accommodation fees will be covered by the Council. This may mean that there is a greater difference between your personal budget and the increased accommodation charge. Any additional amount that the Council is not able to pay will need to be funded through an increase to the amount of top-up paid by the third party or be added to the loan available through the Deferred Payment Agreement.
Further information
For more information on the 12 week Property Disregard Scheme or the Deferred Payment Scheme please see the leaflet ‘Paying for residential and nursing home care if you own property’.
If you would like more detailed information you can also refer to our policies on Top-ups and the Deferred Payment Scheme which are available on Stockport Council’s website: www.stockport.gov.uk
What if I’m not happy?
If you are not satisfied with the way the Council has dealt with your accommodation needs, we would like to discuss this with you at the earliest opportunity. Please speak to your social worker in the first instance. Whilst we will always do our best to arrange a placement for you at your preferred accommodation, sometimes this will not be possible. This could be because it is not suitable for your needs or simply because the provider does not have any places available and has a long waiting list. We will always work with you and your family to explore suitable alternatives.
If you refuse to enter a care setting that has been arranged on an interim or permanent basis and will not consider alternatives that are available, we will write to you to explain that you will have to make your own arrangements.
This does not mean that you cannot contact the Council again at a later date for assistance.
If at any point you would like to make a formal complaint, please contact the Council’s Quality Team:
E-mail:
Telephone: 0161 474 4600
Useful contacts:
Age UK have leaflets and factsheets available on their website which contain useful information www.ageuk.org.uk
They also have a telephone advice line, Tel 0800 678 1174
The Society of Later Life Advisers (SOLLA) aims to help people and their families to find trusted accredited financial advisers who understand financial needs in later life.
You can visit their website
www.societyoflaterlifeadvisers.co.uk
The ‘Paying For Care’ website also contains useful information as well as a directory of specialist care fees advisers
www.payingforcare.org
Stockport Council’s Advice and Information Team can help you to find out what benefits you are entitled to. You can call into a local advice centre or if you are unable to leave the home you can request a home visit. An online service called ‘Better Off Stockport’ is also a useful resource; you can find out what benefits you are entitled to and apply online. For more information on all these advice and information services please visit the Council website
www.stockport.gov.uk/advice