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The soaring price of residential care for the elderly means that more families are opting to pay for their parents or relatives to be looked after in their own homes. Not only is the overall cost usually lower with this method, but by remaining in their own home, those needing care can sometimes qualify for greater financial contributions from their local authority.
The benefits of familiar surroundings and home-cooked food to the client are other powerful factors. The growing crisis around care funding and standards is also driving the trend: families want greater control over the quality of care and want to be spared the upheaval if residents have to move homes. The funding system means that in almost all cases homeowners have to pay all of their fees if they go into a care home. This is because anyone with assets of more than £23,250 does not qualify for funding help.
But for those staying in their own home, the value of the property is excluded from the means-testing process, so they can qualify for funding if their non-property assets are not above this threshold.
This can make at-home care an attractive prospect - although, where local authorities are contributing to the cost, choice of provider may be limited. A person could qualify for help with their care if they are at home, but must start paying their fees once they enter a care home. Why care is becoming cheaper at home Britain's creaking residential care home industry is facing a number of financial challenges, forcing homes to increase fees for those who pay them. Residential care homes face the same costs as every household in terms of fuel and food bills and the costs of cleaning and maintenance. But they have additional difficulties in the form of rising wage bills and rents. Some groups also have high borrowings.
However, one of the biggest factors driving up care home fees is the fact that those who pay their own way - because they failed the means-test - end up subsidising those who are paid for by local councils. Care homes say that local authorities don't pay them enough to fund the places, which forces them to squeeze the cash out of "self-funders". A 2pc levy added to council tax bills (rising to 3pc this coming tax year) will not solve the problem of local authority under-funding, experts say. According to healthcare analysts LaingBuisson, local authorities have reduced in real terms the amount they pay for each of the residents they fund in the years following 2010.
This is cranking up the pressure on providers. For self-payers, the fee increases are often abrupt as well as large. Citizens' Advice found that in 2015 fees increased by an average of £900 a year. Tens of thousands of older people were given just a few weeks' notice of the higher charges, the charity said. Paying for care at home avoids this problem of cross-subsidy. It should mean that you pay the same as anyone else in your region.
Martin Jones, of at-home care providers Home Instead, said that using an agency for care provision at home generally enabled families to keep a greater control of costs and inflation. "Our clients are all paying the same amount - we don't deal with the block contract work that a lot of providers deal with," he said. "Residential care providers have to deal with the leasing and upkeep of a building. There are a lot more lines on a care home's profit-and-loss sheet than there would be on ours," he said.
How much would you pay for at-home care?
Carers working in residential homes are generally paid the minimum wage, currently £7.20 and rising to £7.50 an hour from April. Many at-home carers are paid more than this. But the financial relationship between the carer and "client" - the person paying - can vary, depending on the firm involved and its model. The traditional arrangement of at-home care involves the carer being employed by an agency. The agency then manages the carer's tax, national insurance and other requirements. This is the set-up used by Home Instead, whose customers will pay £19 to £20 an hour for its carers. This includes the cost of the carers' travel.
A newer breed of agencies don't actually employ the carers directly. Instead, they act as "introducers" to vetted carers, who set themselves up as sole traders and so are responsible for their own tax arrangements. These companies include Elder and SuperCarers. In all cases, "clients" pay the agencies - who take more or less of a cut. With the newer types of agency, charges tend to be lower, at around £13 an hour.
This is for basic care, which could include help with meals, dressing and other household tasks. It is not specialist nursing, which costs more. Where live-in care is involved, charges tend to be lower - at around £600-£800 a week, reflecting the benefits the carer enjoys.
These services can be useful if care is needed at short notice, for example, if a family member is leaving hospital or when another arrangement has fallen through. Agencies can also provide relief carers when the main carer is on holiday. In most cases, the "default carer" would work for no more than two or three months at a stretch before taking two or three weeks off.
A care home is 'a last resort for dad'
- it would also cost considerably more Nick Kounoupias, 54, a lawyer, has found that 24-hour, seven-day a week care for his father Mikis, 93, is significantly cheaper than finding a good-quality care home. The family found a carer through one of a growing number of agencies that do not employ carers directly but instead put them in touch with suitable clients via an app. Two carers live with Mr Kounoupias for a fortnight at a time, looking after him for 24 hours a day, before taking the following fortnight off. He is in generally sound health, but is growing more frail. His sight and hearing is also deteriorating. The family wanted him to remain independent for as long as possible, and say he has benefited from being in familiar surroundings and eating home-cooked food.
Mr Kounoupias said: "If I did put him in a care home, I'd only do as a last resort. I wouldn't want to put him into some of the places I've seen. "The only one that we liked cost £5,500 a month. Using the carers comes out at £2,500 a month." The agency in this case was Elder, which vets carers on its books, including taking references. Carers are self-employed and thus pay their own tax and NI. Have your care fees gone up this year?
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