Care Review - Cost Not Set Out --Advice

Share your ideas about the practical side of caring.
My father is in supported living accommodation and pays for his own care, I organise the payments. His care was recently reviewed; the social worker agreed an increase to the morning care visit duration. The cost of the increase was not discussed and the letter of confirmation does not set out the cost of the new arrangement (1) is this normal (2) should it happen (3) how do i stop it happening in this way in future.

Cost is not the issue but it seems odd that the implications of a change are not set out and it feels wrong. The practical issue is that in this case the increase is significant and will require a finance reorganisation. As cost was not discussed my father thought it was free - which I see as a natural assumption.
Hello John

From your post I assume that your Dad is self funding ? and that Social Services are providing the care ? If this is the case then he should have had a financial assessment when the arrangement began (how ever long ago that was). If his Care Plan is changing then the full package (including cost) should have been put in writing. I would suggest contacting Dad's allocated Social Worker and asking for a complete breakdown of services and costs - do this by email or letter so that you have a record.

In the meantime one way to 'guesstimate' the cost would be to calculate the new number of hours allocated in the review and multiply that by the hourly cost currently being charged.

Do you have both kinds of Power of Attorney for your Dad ? (financial and health & welfare) If so you can advise Social Services that all discussions regarding Dad's care must include you and that you must be copied in on all written correspondence.
There seems to be a tendency for social workers to treat those who are "self funding" differently, ie. don't do their jobs properly. Dad should have an updated needs assessment , copied to you as you have POA, and then it should be costed, and then there should be the financial assessment. (have a look at the Care Act). Are you aware that when dad's funds go below £23,000 approx. then the LA will contribute towards his care?
Thanks both from what you both say there are a few issues. (1) I sense that their default posisition is that either the council are funding or cash is easily accessible (2) I have the revised care plan but it has not been costed (3) my sister coincidentally was there when the social work reassessed but she does not organise the care payment and therefore does not know the implications.

We do not have power of attorney as my dad is able to make decisions but we are getting to a stage where it needs to be organised for his overall benefit. It did happen once before but that time the episode had a silver lining because the finance people in the council were found that the care provision had not been adequately evidenced and he received a refund amounting to £3000 odd.

i can't think of anything in life where consumers of services would not be made clear on the likely cost exposure at the outset.

As an aside, since my dads outlook/health took a turn for the worse 5 years ago I hadn't realised how complicated, stressful and frustrating carer responsibilities or assumed responsibilities are. Its a minefield!
UK Care Guide ... assisted living ... full sp :

May be of assistance ?
Thanks, really helpful - this is exactly the position. Dad is renting a council flat, there are carers on site who provide some care but he also has a Carewatch carer mornings and evenings. Everything is fine and stable until Social Services appear and reassess his needs. It's a circle because on this occasion they have said that his mobility has reduced and the carer (Carewatch) needs more time to move him from bed to shower etc. The reality is that his mobility has reduced because he has got to a stage where he expects to have things done for him so doesn't feel he can do things for himself - I think it's called "Learned Helplessness".

It's the same but different scenario with children i.e. if things are constantly done for children they never learn to do them, with the elderly if things are done they "unlearn" things they can actually do - it's, to a degree, psychological.
Out of interest, I spoke with the council finance people today. They basically said that Social Services don't care about the money side of things and so long as the weekly care cost is less that £450 per week they will continue to act without regard to the cost. Even after that they are likely to continue to carry on as they are now.

The good news is that the finance people are continuing to scruitinise charges, on my dad's behalf (over a year after they first started doing so). He still has a credit of £3,200 with them and they therefore advised that I stop the current £800 pm standing order until things are settled, the credit will more thnt cover the demands they are still to go through + the increase of £90-odd per month (less than I thought!).

There's a lesson for all here - it was only by chance that the bill checking commenced, discrepancies totaling at least £4k have been identified so far. The problem is that the carers can't charge and be paid if they don't evidence that the service has been provided. In this case I have to praise the diligence of the council.
John, that is brilliant news. It just shows that some people in an LA are doing their jobs diligently.