The benefits of providing equality of support for self-funders

Assessing and supporting self-funders to make choices about their care is not only good for families but saves money for the taxpayer, according to one council that has implemented this approach.

Hertfordshire council's Jane Aldwinckle advises self-funders on accessing care

Although local authorities have a legal duty to assess potential self-funding care users, this often does not happen, with lack of staff and resources cited as the excuse. At Hertfordshire council, however, self-funders are not treated any differently from those funded by the local authority, says Arnold Sami, an area manager responsible for adults’ services.

“We carry out a complete assessment of their care needs coupled with a proper screening of their financial situation,” says Sami. “We have learnt a valuable lesson – that lack of proper information can lead to people quickly running into trouble.”

Income manager Charles Crowe explains: “If someone comes to us with £50,000 in the bank we roughly calculate how long it will take for them to come back to us. Having an indicative date as to when someone may become eligible for local authority funding means that we can forward plan so that we don’t have to deal with crisis situations.”

So, for example, they know that over the next four months 60 self-funders are expected to turn to the council for financial support after running down their savings. The council also gathers market intelligence by tracking and monitoring self-funders and former self-funders, which helps it plan financially for the future.

The council has partnered with not-for-profit organisation Paying For Care and signposts self-funders there to receive advice from independent financial advisors.

Early investment is key

“We would rather people have the fullest information to make the right decision, because we recognise that by making the investment early on you see the benefits further down the line,” adds Sami.

Key to the support offered to self-funders is the role of the homefinder, a post based within each of the social work teams at the three main county hospitals and within a dedicated community homefinder service for those not admitted to hospital.

When it is clear that an individual cannot return home once they are discharged from hospital, an assessment is carried out by the social work team and then they are referred to the hospital homefinder – regardless of whether they are eligible for local authority funding or not.

The homefinder’s main role is to advise, support and signpost. “We advise people on local residential and nursing homes, vacancies, level of care, and which ones we think might be appropriate,” says Jane Aldwinckle, who now works for the community homefinder team and was the homefinder based at Lister Hospital from 2007 until June 2013.

‘You have to be very supportive’

“We always advise everyone to look at Care Quality Commission reports on homes and to visit more than one home, even if they have one in mind. It is an emotional time and a big decision for every family, especially if they promised a relative that it would never happen. And it is often a decision that has to be made quickly because most people [moving into residential care] are in acute medical beds so it can be a whirlwind for families. You have to be very supportive so I give them my direct phone number.”

At such a difficult time it is reassuring for families to know that there is continuity through the process: once someone is referred to the homefinder they keep the case until the individual moves into the home, even arranging transport on the day. If there are any queries or problems once the person has moved in, that is then referred to the social worker.

“The most reassuring thing for the family to know is that no placement is permanent until the six-week review,” says Aldwinckle. “We always say that if the relative improves enough to live back in the community or wants to move to another home we will support them.”

Getting to grips with finances

Advising on finding the right home is just part of the job; homefinders also help self-funders get to grips with their finances. “We have to ask the family intrusive questions about savings. If a self-funder picks a home that doesn’t accept the local authority rate I tell them what will happen when their money runs out.

“I negotiate with homes that once someone’s funds have gone below the [means-test] threshold they would accept the local authority rate. I’d ask for that in writing because to have someone in a care home for a couple of years and then have to move them would be awful. I’ve never had that situation.

“If I have a self-funder that I can advise and then negotiate good rates for then that is good for them and it also means the council isn’t responsible for funding them for a longer period.”

Homefinders also inform self-funders about public funding that they can potentially access, including continuing healthcare, free nursing care contributions, and benefits, particularly attendance allowance. If someone is funded by the local authority and moves into a residential home they receive attendance allowance for the first four weeks only, but a self-funder can receive attendance allowance on an ongoing basis.

“Basically, we treat everyone the same,” says Aldwinckle. “Whether someone is funding themselves or the local authority is funding them their needs are still the same and how it is funded is irrelevant.”

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