"Ask the expert" - Tuesday 9 June

For information and discussion about benefits
Scruffy, just to say that my mum had her teeth filled at home. I did find an NHS dentist who did housebound visits. Just depends on the area as to who is available but certainly possible.
How exactly are the 24/7 carers supposed to get a break wheb the childrens hospices have introduced a cut off age and the adult hospices don't offer respite care? This is our situation.

Eun
Jackie_1506 wrote:Hi new to this so hope it's in the right place!
My husband receives direct payments for 15 hours a week for a personal assistant. Due to my husbands health I am the employer. We are in receipt of ESSA and DLA but we have to contribute £42 per month towards the direct payments. This is quite a chunk for us to find each month, does everyone have to pay towards help regardless of their income?
Hi Jackie,

Thanks for your question.

If someone receives direct payments the local council will carry out a financial assessment to work out whether that person would need to contribute towards the direct payment, and if so by how much. This means that some people don’t have to contribute anything, some people have to contribute something, and some people have to pay the full amount.

The local council has to follow guidance when carrying out this financial assessment, to make sure that the person is left with a certain amount per week (called the ‘minimum income guarantee’ for non-residential care services). The local council can take the care component of DLA into account when they financially assess someone, however if they do, they must also take into account any disability related expenditure.

Our website has some information on charging (including information on disability related expenditure): http://www.carersuk.org/help-and-advice ... sment#sec5.

For more detailed information on the amount the ‘minimum income guarantee’ should be, Regulation 7 of The Care and Support (Charging and Assessment of Resources) Regulations 2014 outline the different figures for the ‘minimum income guarantee’ depending on the person’s circumstances: http://www.legislation.gov.uk/uksi/2014 ... ion/7/made.

If you want to check that your husband is not being overcharged you could ask the local council for a breakdown of the financial assessment, and either check it yourself if you feel comfortable doing this, or see if a local advice centre can have a look for you.

I hope this helps. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
I've got a question if an elderly person with no assets no savings does not own a home and decides/is advised to enter residential care but he/she has debts what happens tl the debts? will the elderly person continue to repay the debts and any monies remaining be used to pay for their residential care?
what do the elderly "give up " when they enter residential care facilities ??? if they dont have assets ie savings home ownership what pensions disability benefits do they "lose" if they have a motability car do they retain the car ?? and in my own case would my mother "give up " her war related pensions ie war widows allowance / war disablement pension which is set at 100% her own state pension is reduced due to overlapping benfits £30 per week state pension ......do veterans retain their war related pensions ????????
What happens to debts if someone goes into residential care?

Regarding this question, I cannot currently find any concrete information in the guidance as to what happens in this situation.

The only relevant information I can find is that if someone’s benefit is being reduced due to an earlier overpayment, the amount taken into account in the financial assessment should be the gross amount of the benefit before the reduction. Therefore, the debt is not taken into account in these situations. However I cannot say 100% that this would be the case for every debt.

If this is the case (and any debts are not taken into account when the financial assessment is carried out), it might be a good idea to seek some debt advice to work out the best way forward (somewhere like Step Change Debt Charity might be able to help: http://www.stepchange.org/).

I will see if I can find a more definitive answer for you, and is so will post it on this thread.

How are people financially assessed when they go into residential care?

When someone is assessed by the local council as needing residential care, the local council will carry out a financial assessment to work out how much the person will need to contribute towards the cost of the residential care. There is guidance that local councils have to follow when carrying out this financial assessment.

If someone does not have any savings or assets, then it would just be their income that would be taken into account. Most forms of income are taken into account although the local council have to leave the person with a Personal Expenses Allowance which from April 2015 will be £24.20 a week (this amount can be increased in certain situations).

State Pensions are taken into account in full, and although War Widows pension and War Disablement pensions are also taken partially into account, the first £10 per week of these should be disregarded. With Disability Living Allowance, the care component can be taken into account (if it is still in payment) however the mobility component should be disregarded.

If someone does go into residential care and the local council are partly funding this, then their Disability Living Allowance care component would stop after 28 days (this can be sooner if they have been in hospital or a care home in the 28 days before the current stay). The mobility component should not be affected, and therefore providing they still quality for the Motability scheme, this should continue. They (or someone on their behalf) would need to inform Motability of this change in circumstances (0300 456 4566).

Our website has some information on charging: http://www.carersuk.org/help-and-advice ... sment#sec5.

For more detailed information on charging you can look through Annex B (treatment of capital) and Annex C (treatment of income) of the Care and Support Statutory Guidance: https://www.gov.uk/government/uploads/s ... t_Book.pdf.

I hope this helps although apologies I couldn’t answer your first question. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
Lillian June_1506 wrote:Good morning. Do to my recent health problems I am really struggling to look after my husband and do my housework is there any help with this. Many thanks
Hi Lillian,

Thanks for your question.

If your husband has not had a needs assessment from your local council he should request one of these (if he has had one he can request another one if your circumstances have changed or if it has simply been a while since his last one). A needs assessment should look at his physical, mental and emotional needs. If the local council decides that your husband has eligible needs, then they should meet any of these needs that are not already being met (ie by someone like yourself).

Some examples of the kind of help that could be available to your husband:
• changes to his home to make it more suitable
• equipment such as a hoist or grab rail
• a care worker to help provide personal care at home
• a temporary stay in residential care/respite care
• meals delivered to his home
• a place at a day centre
• assistance with travel, for example to get to a day centre
• laundry services
• replacement care so you can have a break

If the local council assess your husband as needing support, they are allowed to charge for any support provided. They would carry out a financial assessment to work out whether he would have to pay, and if so how much.

You can see further information on needs assessments (and download our assessments factsheet) on our website: http://www.carersuk.org/help-and-advice ... assessment.

If you have not had a carer’s assessment from your local council you should request one of these (if you have had one you can request another one if your circumstances have changed or if it has simply been a while since your last one). A carer’s assessment is an opportunity to discuss with the local council what support or services you need as a carer. The assessment will look at how caring affects your life, including for example, physical, mental and emotional needs, and whether you are able or willing to carry on caring. If the local council decides that your needs are eligible, then they should provide services to meet these needs.

Some examples of the kind of help that could be available to you:
• help getting around: taxi fares, driving lessons, repairs and insurance, costs for a car where transport was crucial
• technology to support you: mobile phone, computer where it is not possible to access computer services from a local library
• help with housework or gardening
• help to relieve stress, improve health and promote wellbeing such as gym membership

The local council may or may not charge you for carers services, most councils do not. If they do, they must carry out a financial assessment to work out whether you have to pay, and if so how much.

You can see further information on carer’s assessments (and download our assessments factsheet) on our website: http://www.carersuk.org/help-and-advice ... assessment.

I hope this helps. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
Scruffy wrote:Hello Jen,
I'd like to know what the options are for treatment for an elderly bedridden lady with dementia who might need a tooth filled ?
Is there any way this kind of treatment could be done at home as other options would be both difficult and extremely distressing for this lady ?

Involving social services is not an option by choice after a previous negative experience.

Many thanks
Scruffy.
Hi Scruffy,

Thanks for your question.

There are sometimes community dental services available, which could include home visits. The NHS website has further information about such services: http://www.nhs.uk/NHSEngland/AboutNHSse ... vices.aspx.

To find out more about the community dental services available in your area you can contact your local NHS England Area Team, which you can search for here: http://www.nhs.uk/ServiceDirectories/Pa ... sting.aspx.

I hope this helps. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
Scruffy wrote:Hi Jen,
I hope it's ok to ask a second question. My other query is about brief, temporary help for when a second pair of hands are required but won't be required in any ongoing way. Is there anyone who can be called on to come out and help like that ?

I'm thinking of the odd time when I've not seemed to be able to get mum's sling centred and could have done with someone to come and direct me as to how to re-adjust it so that mum is sitting straighter.

Again I'd prefer not to involve social services or occupational health due to a past experience.

I'd happily pay for one-off help as and when it might be required but have no idea what kind of organisation to approach for this kind of help.

Many thanks
Scruffy.
Hi Scruffy,

Thanks for your question.

You might be able to get help via district nurses, although you would need to speak to your mum’s GP to see whether this might be required and whether this could be available.

If you just want to find care providers in the local area (without going through social services) you could search on the Care Quality Commission website (http://www.cqc.org.uk/) or the Good Care Guide website (https://www.goodcareguide.co.uk/). You could see if any local care providers could offer this type of service.

You could also see if there is a local organisation that might be able to offer a service such as this. A local carer’s centre might know whether there is any such service available. You can search for a local carer’s centre on our website: http://www.carersuk.org/help-and-advice ... al-support.

I hope this helps. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
As a mother of a disabled child who I care for 24/7, way over the expected 35 hours you need to get carers allowance, why when I wanted to better myself by doing an access coarse which wud be during the day while kids at school, but because it's classed as full time (even tho its about 21 hours a week) I was told my carers allowance would stop? How can you justify that? This has now stopped me from the chance of maybe getting back to work eventually? Thanks.
Hi Helen,

Thanks for your question.

Unfortunately, one of the conditions for Carer’s Allowance is that you cannot be in full-time education.

You will be generally be considered to be in full-time education if the institution where you are studying describes your course as full-time, or if your course is for 21 hours or more a week (even if the institution where you are studying does not describe your course as full-time).

If the institution where you are studying describes your course as full-time, then generally the Carer’s Allowance Unit would agree that this is a full-time course. However, there is some case law which suggests that some courses classed as full-time by the institution may in fact not be classed as full-time by the Carer’s Allowance Unit, if the actual course is for less than 21 hours a week (see below). For more information you can look in the Decision Makers Guide “Chapter 60 – Carer’s Allowance” at paragraphs 60068 – 60071: https://www.gov.uk/government/uploads/s ... mgch60.pdf.

When calculating whether your course is for 21 hours or more a week you include only hours spent in ‘supervised study’. You ignore any time spent on meal breaks or unsupervised study on or off the premises of the educational establishment. Supervised study does not depend on whether your supervisor (ie, teacher, tutor, lecturer) is present with you. If your study is directed to your course of education and the curriculum of your course and it is undertaken to meet the reasonable requirements of your course, it normally counts as supervised study. It counts regardless of whether that study is undertake on or off the premises of the educational institution you attend. Unsupervised study means work beyond the reasonable requirement of your course. In assessing your hours of attendance, evidence from your educational institution about the amount of time you are expected to study to complete your course can be important.

Here at Carers UK we are aware that this is a hindrance to carers who also want to study. In our Carers Manifesto one of our recommendations is: ‘Urgent measures to improve the level and structure of Carer’s Allowance, including applying an earnings taper, the removal of barriers to study and training and improving how older carers are supported.’. You can view our Carers Manifesto on our website: http://www.carersuk.org/for-professiona ... -manifesto.

I hope this helps, although sorry it’s not more positive news currently. If you have any further questions then do get back in touch with the Carers UK Adviceline.

Kind regards,
Jen
I have several questions about car expenses: given that many households do not keep separate personal accounts, as all the money goes into a single pot and is then spent for the benefit of all, including the shared use of a single family car.

1. Can car lease costs be deducted either:
a) in full or
b) in part from the carers earnings as a work-related expense where a vehicle is required to do the job?

2. Can a carer use a caree's motability car to commute to work, or indeed for work-related travel?

3. Can a car lease that is actually paid for in full or in part by Motability or simply using the caree's Mobility benefits to pay for a lease also be deducted from earnings?
Several people have asked about NHS Continuing Healthcare, and what this is. Below is a brief overview of NHS Continuing Healthcare, and details of where to access further advice.
NHS Continuing Healthcare is a package of care that is arranged and funded solely by the NHS.

To qualify for NHS Continuing Healthcare the person must have been assessed as having a "primary health need", which means that their main or primary need for care must relate to their health. Be aware that the eligibility criteria are very tight and most people with ongoing care needs won’t qualify. Around 60,000 people in England are currently in receipt NHS Continuing Healthcare.

If it seems like a person might be eligible for NHS Continuing Healthcare an assessment should be carried out for this. Generally there is an initial checklist assessment which determines whether the person will be told they don’t meet the criteria for a full assessment and are therefore not eligible, or whether they will have a full assessment of eligibility.

The NHS has a webpage which outlines more information about how eligibility for NHS Continuing Healthcare will be assessed: http://www.nhs.uk/chq/Pages/eligibility ... hcare.aspx.

NHS Continuing Healthcare is a complicated topic so if you have any specific questions contact the Carers UK Adviceline, and if we cannot help ourselves we can hopefully signpost to some other organisations who might be able to assist.