7 Steps to sorting Long Term Care

Step 1

Get someone to help

If you find the process difficult or confusing a younger or more experienced person could help – maybe a family member. The best way is to appoint a Power of Attorney to one or more people, you should take legal advice – more of which is in step 6.

If you do not know anyone that could help a local council social worker can help you appoint someone, or you could contact Age Concern.

Even if you can manage now – it is a good idea to consider preparing for a time when you might be unable or unwilling to make decisions for yourself.

Step 2

Have your health needs assessed by the NHS

Your GP can refer you, or alternatively you can approach your local primary care trust (PCT) – The NHS has a statutory obligation to provide for your health needs.

The Continuing Care Team asses your medical requirements independently of any financial assessment – this is very important because establishing your needs must be separate from how the help is to be provided and paid for.

You may or may not qualify for continuing care by the NHS. If you do qualify step 3 may be less important – if you do not qualify the following step is the logical progression.

Step 3

Have your Social needs assessed by your local council

You might be able to do this online if their web site supports it, the assessment may be conducted over the telephone – more likely you will need to arrange a visit. The adult social care department provides advice and services, their first priority is to enable individuals to remain independent and in their own homes for as long as possible.

This assessment is free and everyone is entitled to it. Financial questions should not form any part of this stage. The assessment will clarify the sort of care and support that is available to you.

Once the care plan has been proposed the financial assessment comes into play – depending on your circumstances you may need to contribute towards the cost. The second point is that you cannot be forced to receive help or services that you do not want. You should discuss alternatives with your social worker.

Step 4

Find out how you can make your home easier to live in.

Make sure you are introduced to an Occupational Therapist whose job it is to help people of all ages and abilities to do the things you want to do. You could be offered help with day to day activities, personal care or maintaining your social life, for example.

Some practical adaptions might be welcome such as grab rails, bathroom adaptions, ramps, alarms or easier parking facilities.

If you qualify for a Community Care Assessment, all equipment and modifications costing less than £1,000 may be provided free of charge. For larger adaptions financial assistance might come from the Disabled Facilities Grant. The Home Improvement Agency (HIA) may also be able to help with information and advice.

Step 5

Discover what funding is available and what you have to contribute

Attendance Allowance may be payable to someone over age 65 (Disability Living Allowance if under age 65). These are non means tested and are not taxable benefits.

If you qualify for Continuing Care – there should be no cost for your care whether it is in your own home or elsewhere. If not – after Step 3 and 4 a local authority officer will conduct a financial assessment. Currently if you have capital or savings above the upper threshold of £23,250 you will have to meet the full cost of care. This threshold may change in 2016 or 2017 along with other proposed changes.

If you receive care in your home – the value of your home is not taken into account in the means test. Similarly if one member of the couple requires care just the resources of that person and half any jointly owned assets are taken into account.

Some investments and policies may be excluded from the means test – Step 6 will explain further. In the event of a sole property owner going into care – there is a 12 week period during which the property is disregarded – so you are assessed as if that asset does not exist, it is important that this time is used constructively – see Step 6.

Below the threshold described earlier your share of the cost will be calculated depending on your circumstances. Local Authorities must allow individuals to retain a set minimum amount of money for their own use.

It is important to understand the implications of Deliberate Deprivation of Asset rules before considering changing ownership of assets or making gifts – Step 6 will refer to this in more detail. If your health deteriorates, you may still ask to be reassessed by the NHS for Continuing Care.

Step 6

Speak to an Independent Financial Adviser (IFA)

If you are faced with having to fund, or partly fund, the cost of your care you should seek comprehensive specialist advice through a qualified IFA before making any financial decisions.

If you select a member of the Society of Later Life Advisers (SOLLA) you can rest assured that the adviser is a specialist in this area of work and holds all the additional qualifications necessary to provide comprehensive advice and access to the whole market in terms of solutions.

Usually the cost of Care in your own home, residential care or nursing care can be substantial. Choosing the most suitable care could include releasing equity from a property or using investments to generate enough income.

Some options that might be considered:

•  Releasing equity from your home as a tax free lump sum
• Selling part of your home whilst retaining the right to live there, or own your share for the rest of your life
• Purchase an Immediate Needs annuity that will guarantee an income for the rest of your life.

An experienced specialist may provide additional information that will help preserve your estate for longer.

Step 7

Arrange your Care

In Step 6, if you have not appointed an attorney – your adviser will have discussed the options with you fully and encouraged you to have someone that you trust sit in on the meeting(s) if you desire. The IFA will have professional contacts so that if you have not worked with a solicitor recently you can be introduced to a specialist in order to ensure your Will is up to date and that Enduring Power of Attorney (EPA) and/or Lasting Power of Attorney (LPA) is set up correctly.

Once your finances are sorted out you can receive care in the location you prefer. Some would like to continue living in their own home – your adviser will be able to introduce professionals in that area. Alternatively some care homes and nursing homes specialise in certain types of care (for example dementia).

Make sure the care required is provided by an organisation that is approved and regulated by the Care Quality Commission (CQC).

You could consider appointing your own Personal Assistant, this brings with it a level of administration including selection checks, PAYE and compliance as an employer – it might be simpler to engage a specialist care provider that does all this for you.