Navigating the care system

Paying for care is thought to be the second biggest financial commitment that we make during our lifetime, after taking out a mortgage.

Navigating the care market is, however, a minefield, so this adds to the financial pressure people feel. Jacqueline Berry set up My Care Consultant to help people find the services they need, understand the funding available and secure any funding and, importantly, the long term security of your loved ones. I chatted with Jacqueline for The Retirement Café podcast and share her tips and experience in this blog post.

The care maze

Care. Many people and their families tend to be scrambling around from one source to another, trying to find answers and information desperately, on behalf of themselves or a loved one. So it’s really important that people get access to the help they need, certainly at this time.

There is a huge need and value in getting financial advice around paying for care. But the actual care advice remit is much more broad than just paying for care. And for financial advisers, it’s often very complicated and time consuming to provide everything in-house that their clients need.

Jacqueline founded My Care Consultant with the view to support consumers, but also professional connections of ours like financial advisors, solicitors, care providers, anybody that’s engaging with people and their families that need care, that perhaps would like to get sort of information and support from a safe space, really, normally, they need that very quickly.

The first port of call

If you or someone you know needs help, the first people to contact are your local authority – they’re the people you pay your council tax to!

You contact them directly and ask for a care needs assessment. So that is an assessment about looking at the care needs that you have.

The local authority will arrange a care assessment, usually within 28 days, every local authority has their own standards. But if it is urgent, of course, you can arrange for that sooner. They often come out to see you in person and they will do an assessment with you. And we recommend your loved one or family members attend and input into that assessment.

The care needs assessment

They will look at what your day-to-day needs are and how those needs are best met. And they’ll provide a recommendation in the form of a report, which outlines all of those things mentioned, with an inclusion of a recommendation around who you can actually contact, for example, a care provider, that can offer you those services, whether that’s at home, in a care home or otherwise.

After that’s been done, they will then look at who pays and that’s where there’s a financial assessment to work out that aspect of it.

Even for people that are paying for their care themselves, we always say it’s great to deal with the local authorities and get a benchmark, in terms of what your actual needs are, even though you might decide to set it up and pay for it independently. Essentially, just to an understanding as to what you need and how those services are best administered.

Who pays?

Most people will contribute something towards their care, regardless of how much they have in savings. Because firstly, they’ll look at your income. So depending on whether you’re living at home or in a care home, you’re allowed to keep some of your income to pay for things like food and bills, if you’re at home, for example. The rest of your income will go towards your care fees.

If there is still a shortfall, that’s when the local authority will look at, okay, who pays for that shortfall? Is it you? Is it us? Is it a combination of the two, or indeed a combination of the two of us, plus the NHS? And that’s where the conversation around is your need of a social care nature or a healthcare nature? And that again, causes confusion with many of the people that we’re dealing with.

Do you need Social Care or Healthcare?

The social care side of the care system refers to sort of day-to-day social needs. So for example, things like getting up in the morning, getting washed, getting dressed, moving from room to room, going to the toilet, things that don’t require necessarily a registered nurse to help you do.

Social care is the remit of the local authorities and is means tested, it has always been means tested. And I think this is a real misconception, certainly clients that we’re dealing with and have been for years, who don’t realise that social care is not free. And actually, the likelihood of needing it is quite high and the cost of it can be quite high.

Nursing care refers to people that have a primary health need, which essentially is care needs driven by some sort of an illness or a disease that needs to be treated. Essentially, more complex needs. And there is a separate assessment for that, which is conducted by the NHS, and they have bodies called Clinical Commissioning Groups, which quite simply are the alternative to local authorities on the NHS side of things. And they will assess you and they are responsible for administering the funding, if you qualify for that.

NHS continuing healthcare

Then there is a fully qualified, fully funded package, which is called NHS continuing healthcare. And there is a part funded package, which is the funded nursing payments. So that’s for people that have healthcare needs, but perhaps they’re not as complex as somebody who qualifies for the full, free package of care under the NHS.

The access to continuing healthcare is not dependent on diagnosis alone, it’s based on your needs, and sort of your individual complex needs, not on have you got dementia, have you got Parkinson’s, for example? It’s based on how that’s impacting you, and what your needs are as a result.

What I would recommend to people is, anybody that is being discharged from hospital that has relatively complex needs, anybody is entitled to ask for a continuing healthcare assessment. The first stage of the assessment is a checklist assessment, which is essentially a quick spot check to look at whether you have complex enough needs to go through to that full assessment.

The worst that can happen is that you’ll just be told, well, you’re not actually ill enough and here’s your checklist result. But absolutely, the main thing is that people ask for it. And the worst that can happen is that they’re told they don’t qualify.

If it’s somebody with complex needs, they can go direct to their Clinical Commissioning Group to set up or request an assessment. The quickest route is via your GP, as they are connected to their local Clinical Commissioning Groups. And you can ask your GP to arrange this assessment for you. Quite frankly, the GP should say to you, you’ve got no chance, it’s a waste of time, or actually, absolutely, we will set it up for you. That’s what they’re there for.

There is another point to add in that some people are told they don’t qualify. And actually, there is a bit of a grey area as to whether that’s the right result. And again, there are services that are available that can help people essentially revert back and ask for a reassessment in how to position their case.

even if it is awarded is not necessarily permanent. Somebody could improve in the same way a young person could develop a condition, for example, and go into hospital and receive free healthcare under the NHS. And once they’ve recovered, they are obviously discharged and they live their lives as normal.

So as somebody goes through the care journey, it’s important that they access what they should and they deserve. But it’s not necessarily a permanent, free benefit under the NHS, it is for people with complex health needs.

A lack of planning

Most people don’t plan for care. Most behavioural studies tell us that it’s just human nature, most people don’t want to think about it. I completely understand that mentality.

The issue however is that most people don’t realise it’s not free if you need social care, and they don’t realise the likelihood of needing it. And so what happens is they’re dealing with a critical need. Often, it’s family members making decisions on behalf of loved ones. And the local authorities do do a very good job, but essentially, people, what we believe people need is actually everything pieced together with a route forward.

It’s really helpful to think ahead, not just about what’s the situation now, from a care and funding perspective, but what happens if my needs change, if my partner’s needs change, if I move out of my house, if my partner moves out of my house? How does that all impact on me? And how does that impact financially when people have clearly got savings that have been very hard earned?

What My Care Consultant does

They are a nationwide business operating across England, Northern Ireland, Scotland and Wales, who’ve spent a great deal of time checking out services across the UK, ranging from care providers at home, care homes, and also local support services and charities.

They will ask the client, create a detailed fact find, find out about their bespoke needs and wishes. And they then draw upon their list or library of contacts to provide to them based on their bespoke needs.

They sort of put everything together for the client and signpost them to the relevant specialist at the right time, with that continual touchpoint to us throughout their care journey. So if they have questions along the way, they can come back to My Care Consultant.

The questions most commonly asked include:

Which providers are there locally to provide the care? How much does it cost? Who pays? If it’s me, how do I pay? And what about that ongoing planning? So if I develop more complex needs, how do I access an assessment for NHS continuing healthcare? Who do I speak to? And ultimately, if I’m paying, how best do I pay for that, so I can afford my care for longevity, but also, ideally, protect some of my hard earned savings, so I can leave a legacy to my family?

Find out more about My Care Consultant at www.mycareconsultant.co.uk and listen to the podcast interview here.