Daily Mail: Rising Care Home Fees

Daily Mail – Rising Care Home Fees

Care Crisis!

The cost of a room in a care home, presently about £750 a week, will be £1,000 a week by 2020, experts warn. However, with Britain facing a nationwide care funding crisis, even that figure could soar. 

A report by the Care Quality Commission (CQC) last week found services for the elderly were nearing breaking point. The care watchdog warned of a wave of home closures if staff and funding gaps are not filled, adding that in the past six years 1,500 homes had closed. 

The firms running care homes will try to plug the gap by raising fees, experts say. Valuing Care, a respected care fees analyst, predicts they will rise 8 per cent a year ‘for the next decade’.

That would mean the average fee reaching £1,020 a week by 2020, or £53,040 a year and that accounts only for a place in a residential care home. Fees for elderly people needing specialist medical care may be even higher than that.

Most people will have to pay this themselves as local authorities currently cover your care bills only if you have less than £23,250 in savings, investments, properties and other assets (£26,250 in Scotland and £24,000 in Wales).

That means nearly all homeowners will face large weekly bills and, once their cash has drained away, they may have to sell that home to cover the cost. The exception is where a spouse still lives in the property or if you put a charge on it. The latter simply means the care provider collects its fees after the resident dies and their relatives sell the property.

The Government had wanted to place a £72,000 cap this year on the total cost of care for the over-65s but the measure has been delayed until 2020 at least. Experts now fear that it may never come in and even if it does, the cap is likely to exclude board and lodging.

So even residents who have spent £72,000 on fees could continue to face bills for as much as £12,000 in England (the new rules would not apply to Scotland and Wales).Most people think a care home stay will be relatively short but the typical stay is eight years.

Ray Hart, director of Valuing Care, says: ‘If you’re staying somewhere for that long, the cost becomes incredibly important. ‘In some cases, people are running out of equity in their homes, so they turn to their pension and use it all purely on care home fees.

‘Then you could be left turning to the council, which may have to move you somewhere completely different that doesn’t give the quality of care you need. That can be very traumatic.’

Money Mail, in association with Bupa, has produced an essential guide to care funding and the crucial decisions families have to make about choosing what kind of support their loved ones will need and how to pay for it. It aims to help all families through every step of this ‘traumatic’ process. Last week’s CQC report raised fears of a repeat of the collapse of Southern Cross healthcare group, which went into administration in 2011.

Southern Cross ran 750 homes across the country and its collapse left 30,000 elderly residents urgently seeking somewhere else to go. Earlier this month, a care home in North Wales closed, leaving 21 elderly people with dementia with nowhere to live. Rosewood Healthcare Group, which ran the home, said it was no longer viable and was losing money.

That is why choosing the right type of care and home is so important. Our guide will take you through all the options and provide you and your family with the best tools and information. One option is to have care in your own home, instead of moving into a residence permanently.

A carer might charge between £15 and £20 an hour — so you could get around 40 hours of care for the same price as the average week in a care home. Care homes also allow people short stays of anything from a few hours to a few weeks. If your assets are more than £23,250, however, you will still have to pay for this type of care.

However, anyone in England with nursing needs — regardless of how they pay for them — can apply for the Registered Nursing Care Contribution of £156.25 a week to offset the costs. The rules are different in Scotland, where as much as £249 is available, and in Wales, where it is £140.90.

Those with severe needs can apply to have their entire care bill paid by the NHS, through so-called Continuing Healthcare. This figure is not means-tested but whether you can claim depends on the local health service’s assessment of your nursing needs.The definition of ‘severe’ is vague, but tends to mean that you need round-the-clock attention. If the health of a loved one declines significantly, you can have them reassessed.

18th October 2016
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Health Tech Newspaper: New CHC Online System

Health Tech Newspaper: New CHC Online System

New Continuing Healthcare online system enables more cost-effective purchasing

Valuing Care has launched a new online ‘Continuing Healthcare (CHC) Cost Toolkit’ to help commissioners manage and purchase better, more cost-effective CHC placements.

This online system enables CHC placements to be commissioned in the most cost effective manner. Based on Valuing Care’s cost models and data built up from 10 years of collecting care provider costs, the evidence-based approach of the ‘CHC Cost Toolkit’ includes: 

  • Cloud based infrastructure to enable nurses and commissioners to complete and access the same patient’ calculations
  • Web access to allow usage whilst undertaking negotiations with providers
  • A clear audit trail of purchasing calculations and decisions made
  •  
  • Ability to tailor any national cost drivers to a more local level to deal with issues such as carer shortages
  • The ability to build up local data to benchmark and compare provider margins

With total spend on CHC across the country reported at £2.5 billion per annum, and as the number of CHC placements continue to rise, the ‘CHC Cost Toolkit’ provides a significant breakthrough for the market and enables commissioners to conduct informed negotiations and get their purchasing into better shape.

Ray Hart, managing director at Valuing Care said, “The cost of purchasing and managing CHC placements is a complex area that has been overlooked in recent years.  This has hampered the progress so desperately required to control costs; prices have continued to rise and yet costs have not been scrutinised. Our ‘CHC Cost Toolkit’ overcomes the inefficiencies that commissioners face with current systems and helps improve visibility, management and control of costs.”

By providing access to comprehensive market intelligence, the ‘CHC Costing Toolkit’ enables commissioners to gain a better understanding of costs, and be more price aware, which helps secure value for money care placements.  It also enables placements to be processed much quicker; reducing the amount of time commissioners spend on paperwork and enabling staff to reallocate their time. 

18th October, 2016
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Building Better Healthcare: Modernising CHC Purchasing

Building Better Healthcare: Modernising CHC Purchasing

From April 2015, councils will come under a duty to provide information and advice to people in their areas to enable them to plan for their care and support, including in relation to how they can benefit from independent financial advice.

As the NHS keeps having to find efficiencies, while also trying to identify new and better ways of working, many processes within healthcare have been examined to see what improvements can be made and what steps are needed to get them into better shape.

The cost of purchasing and managing Continuing Healthcare (CHC) placements is one of the few areas that has unfortunately been somewhat overlooked and overshadowed in favour of other procurement areas. And yet the purchasing process currently in place is long overdue an upgrade. As CCGs and CSUs continue to deal with ever-increasing CHC spend and care provider pressure, is now the time to update the systems used to purchase placements and move to an evidence-based approach using the latest on-line cost models?

Commissioning managers and nurses often voice the key functions needed in creating a system to manage and purchase better, and more-cost-effective, CHC placements. This includes:
 
  • A system that creates a standard cost model database to enable consistency across a CCG area
  • Cloud-based infrastructure to enable both nurses and commissioners to complete and access the same patient record
  • Market managing current vacancy rates and mapping supply to the needs of individuals.
  • Web access so that a system could be used while negotiations with the providers are being undertaken, either at the care home or in the office
  • A clear audit trail of purchasing calculations and decisions made
  • A workflow model that enables purchasing information to be collected once
  • The ability to tailor any national cost drivers to a more local level to deal with any issues such as carer shortages
  • The ability to build up a data set that can be used for reviewing contracts with providers and dealing with inflationary uplift

Most current systems that are not ‘home grown’ ones, record the outcomes of purchasing decisions made after they have been completed. These do not actually aid the purchasing decision, either through calculating the correct price or by helping find available vacancies.

To alleviate this problem, and improve the skill set and working practices, technology has been developed. Valuing Care, for instance, has turned its cost models and datasets into an online system.

Working with commissioners the company has built up standard models for care home purchasing that pull out the relevant data from the company’s national cost model to populate key cost fields. Applying technology in this way is a significant breakthrough for this area.

In addition, this national information can be tailored to a local cost model. This can either be populated before implementation, through a survey, or built up over time through data collected from actual negotiations.

The local cost data can be readily compared to the national database that has been created to ensure reasonableness. This will, over time, create an aggregate data set that will standardise the rates paid in a local area. The more data that is collected, the better the data set, and the better the decision-making process. The costs of CHC placements is a highly-complex area as individuals entitled to the service require different levels and types of care.

It has remained relatively unchallenged in some areas of the country, as has the way in which placements are purchased. In fact, the current approach to purchasing Continuing Healthcare placements is particularly paper-based or reliant on individual spreadsheets. As a result, this lack of investment is hampering the progress so desperately required to control costs.

Any new ways of working would need to reduce the amount of time spent on dealing with the paperwork of provider requests, and also create a solid basis to justify the prices providers are demanding for nursing places as costs continue to rise.

Automating the current process on its own would not be enough though. Decisions made to pay for placements need to be based on solid business intelligence that understands the underlying cost of care and forms the basis for smart negotiation with care providers. It is an ever-pressing issue due to the fact that the number of CHC placements to the NHS continues to rise, with 62,000 people eligible for Continuing Health Care funding in 2015/16.

The reasons for this increase are well known; primarily an ageing population with varying medical conditions requiring health intervention, and therefore funding for a variety of care packages. This has also been compounded by an increased awareness of CHC funding, and a number of legal test cases over the last 20 years.

With such a growing number CHC placements to process year on year, it is vital to move beyond this outdated, time-consuming, paper-based model of the past to a process that can cope with the ever-changing demands. Automating the process would lead to enormous improvements in staff efficiency. Heavily dependent on manpower, the current situation means that commissioners are tangled up completing excess paperwork and dealing with provider requests for uplifts.

A technology-based solution here could free up time, meaning that CHC placements could be processed through the system much quicker, leading to a better service. This allows more-effective commissioning as staff are able to reallocate their time to their primary duties. It would also allow commissioners to gain a better understanding of costs, and be clearer on the price they should be paying for all elements of the care including any additional services. Through being more price aware, this, in turn, helps commissioners secure value-for-money care placements and perhaps also consider other techniques to reduce costs.

For instance, commissioners are increasingly using negotiating techniques for individual packages, and report significant success in doing so.

As some patients require funding for a number of years, which can easily cost thousands of pounds per week with even a small saving on those costs soon adding up to a significant amount over the course of the placement, any improvement that reduces expenditure is crucial for future sustainability. 

Using technology throughout the purchasing process also improves visibility, and management and control of costs, and can really overcome the inefficiencies that commissioners face with the current system. Purchasing processes across different departments vary enormously in the health and social care sector, and it is time CHC processes were brought in line with the best. There is a better way to work here, and technology, coupled with business intelligence, can deliver the change so desperately needed.

22nd September 2016
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Community Care: Why council tax rise will not be enough to fill care home shortfall.

Community Care: Why council tax rise will not be enough to fill care home shortfall.

Councils will be forced to ration the extra money they get from council tax between providers in response to the cost pressures on residential care, says Ray Hart.

As expected, chancellor George Osborne announced additional funding for social care in the Autumn Statement in the form of an additional levy of 2% on council tax that can only be used to fund adult social care. In addition there will also be an additional investment in the Better Care fund of £1.5bn by 2019-20. However this will be unlikely to provide additional direct resources to providers in meeting the cost of care. 

The estimated income raised through this additional council tax will be £1.7bn a year by 2019-20 if all local authorities take it up. By 2020-21 there will be a shortfall of £1.1bn in the funding available for residential care from the public sector and the level of resource required, analysis by think-tank ResPublica has found. A third of this gap will be down to the new National Living Wage (NLW), which will come into force in April 2016.  

Thousands of beds lost

If funding for residential care remains at current levels, ResPublica estimates there will be a loss of 37,000 beds; if the NHS picked up the bill for just half of this loss it would cost it £1.5bn a year by 2020-21. With this being that case, will the additional income from council tax be passed onto providers in its entirety?

The first hurdle for the cost of care gap being funded relates to whether, and how much of, the money does indeed get added to local authority commissioning budgets to meet cost of care increases from 2016-17 onwards, and is not used elsewhere within social care. It is likely that the additional funding may also be needed to deal with overspends on council budgets and urgent unmet need. Examples include funding extra placements out of hospitals, and there will also be lots of people waiting for home care or additional community support.  

Significant variations

The second hurdle is the regional variations likely to occur from the 2% social care levy raised through council tax. Although the final details have not been shared yet, a flat 2% increase on the gross council tax taken by local authorities will lead to significant variations on the money raised regionally. The Institute for Fiscal Studies has estimated that the additional resource yielded for councils will be 11% of current adult social care budgets, but will range from 4% to 17% between areas.

As central government grants are formulated towards the neediest areas, conversely the council tax percentage levy will raise the least money in the areas with theoretically the most need.

To compound the problem, these areas are likely to have the lowest staffing hourly rates and will therefore be the most effected by the uplifts required in April 2016 and beyond by the living wage.  

Expect rationing

With this in mind, the most likely scenario is that councils will not have enough funds to meet providers’ demands to compensate for the possible underfunding of residential care rates and the living wage. So, unfortunately it is likely that the money will need to be increased on a rationed basis.

Working out which providers and how much they receive is a complex and detailed business. Councils can pre-determine how much each category of care will receive through re-examining of the current usual rates paid or they may deal with each case on an individual basis.

Either way this will involve a significant amount of additional work for commissioning and finance teams with the knowledge that challenges could be made to the calculations and that, because the pie is not big enough, there may be a lot of noise about who gets the biggest slice.  

1st December 2015
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Community Care: The Care Act 2014 places new responsibilities on local authorities

Community Care: The Care Act 2014 places new responsibilities on local authorities

From April 2015, councils will come under a duty to provide information and advice to people in their areas to enable them to plan for their care and support, including in relation to how they can benefit from independent financial advice.

A year later, the cap on care costs will come into force, enabling self-funders to receive state-funded care and support after accruing a certain level of cost, as measured by what the local authority would have spent on meeting their needs, calculated through regular assessments. 

At the same time, in April 2016, councils will come under a duty to arrange residential care for people who are not eligible for any financial support from their authority but ask the council to make arrangements for them. This duty comes into force a year earlier – in April 2015 – for non-residential care, though its biggest impact will be in the residential sector.

It seems the most relevant information a local authority could provide to its citizens, under the information and advice duty, are the rates at which the council can procure services for them – which is often substantially less than what a self-funder would have to pay. This information will become available to anyone assessed for the cap in any case from April 2016. And the duty on the council to arrange care, regardless of a person’s financial status,will give self-funders the power to have care arranged at council-procured prices, in return for an administration fee. This could potentially save people hundreds of pounds a week in care home fees.

The cost survey and negotiations service undertaken by Valuing Care for councils has highlighted self-funders who arrange and pay for care themselves, with no or little state support, pay a far higher price for a service than their local authority pays for the same service.

This may be a known fact in the market but the evidence from these cases is that this goes way above the expected 10% additional costs attributed to dealing with a number of single individuals compared to one council. Price discrimination between rates offered to councils and those offered to private citizens sometimes rises to 50% more for the same care.

For example, Valuing Care recently heard of an example of a person funded by a council in a care home at £650 per week. When the older person’s home was sold and they had sufficient means to pay for their own care, they became a self-funder charged £1,050 per week for exactly the same bed and facilities.

The local government funding squeeze has exacerbated the problem as councils choosing not to inflate their fees has encouraged providers to apply above-inflation increases to their self-funding residents who are signed up to the providers contract, under which they have limited or no protection.

The reforms coming into force in April 2016 – the care cap and the duty to arrange care for self-funders – create a ticking time bomb for authorities that would be better defused now. For councils that are prepared to grasp the nettle there are options to deal with the market issues. These include:

  • Conducting their own validations of Older People’s residential costs to get to the bottom of the problem and increase transparency.
  • Providing information and advice lines that provide much more than general signposting and support services.
  • Market managing current vacancy rates and mapping supply to the needs of individuals.
  • Providing direct advice and support on how to get the best price for their care, not just how to best fund it.
  • Providing simple contract support for self-funders through standard contracts.
  • Providing readily available and competitively priced alternative support packages in the community through proactive contract management.
  • Brokering preferred supply deals for self-funders with willing providers.

Acting in the financial interest of self-funders requires a significant change of thinking within councils who have historically overlooked their financial interests, whilst at the same time benefitting from the cross subsidisation of council funded residents. Councils embracing the new act should be recognising the enormous financial benefit they may be to their self-funding residents, and putting in place the necessary systems and processes to act on their behalf. It will be interesting to see which councils are ready and willing!

9th December 2014
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The MJ: Meeting Care Act Requirements

The MJ – Meeting Care Act Requirements

Self-funder support: are you meeting Care Act requirements?

With the Care Act due to have a significant impact on local authorities, and its implementation impending, it is ever more pressing for social care departments to understand the additional support required for those who are responsible for funding their own care.  

Many councils are yet to prepare and there are areas that must be given priority; key aspects that need to be administered to support implementation of the Care Act. 

The Act introduces new duties and obligations on local authorities in terms of those who pay for their own care, and as such there is a requirement to implement ambitious changes.  Regardless of whether people are local authority funded or responsible for paying for their own care costs, good quality information and advice must be available to everyone to help them make the right choices. 

Already there are implications on local government, and councils need to get started now as from April 2015 there are important changes to be met and achievements made.  The tasks for councils now is to review existing advice and information services, and be in a position where they can provide good quality, comprehensive information for people on how to fund their own care, and support and direct them to independent financial advice.   

28th November 2014 | Ray hart
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The Guardian: People who self-fund their social care need more help from Councils

The Guardian: People who self-fund their social care need more help from councils

The Care Act puts a responsibility on Councils to help self funders micro-commission care. Ray Hart from Valuing Care explains more read more The Care Act puts a responsibility on Councils to help self funders micro-commission care. Ray Hart from Valuing Care explains…

With the Care Act coming into force in April, it is time for social care departments to examine the additional support required for self-funders. A number of issues remain despite councils taking steps to improve their offering; many departments are unaware of the numbers of self-funders that will pass through the doors, or the level of professional support required.

There is a statutory responsibility for departments to help self-funders “micro-commission” care, and ensure a supporting infrastructure is available. In response to the government’s Putting People First agenda many local authorities have introduced web-based systems; e-marketplaces for people to search, and buy care and support services online, which also offer information to support safeguarding and advice on costs and quality of services.

Self-funders are making huge financial decisions which require expert purchasing advice and support. The right guidance at this point prevents people spending their assets too quickly and falling back on to local authority funding, something that often happens. It is crucial to fill these gaps in support with tried and tested approaches before the Care Act requirements are needed.

After those who will be funding their own care have qualified for assistance, the most critical factor is determining what services are needed. This can range from simple signposting and guidance through to financial and legal support services.

At Valuing Care, our experience of negotiating cases for self-funders has provided insight into this area. Residential or nursing care is the default option, particularly arranged during a crisis or hospital stay. The professional support provided at this time usually consists of information and advice, not the commercial elements of purchasing care, such as securing a good price on the placement. People often believe high costs mean high quality. And once the placement is made, self-funders and their relatives often feel trapped financially with little or no commercial leverage. It is common to see contracts signed enabling the provider to increase fees between 7 and 9 per cent a year.

Most departments split the assessment and support plan functions from the buying of care; a separation between social worker and purchaser. Those responsible for buying care will work on setting and maintaining contracts with care suppliers, and the prices paid to providers, as well as on wider market management.

This common split in council departments is not how self-funders are arranging care. Relatives are commonly undertaking their own needs assessment, arranging care and making the purchasing decisions, while having little or no understanding of the care market. Given their lack of experience in care commissioning they are probably not the right people to do this, particularly at a time of crisis.

Despite this being known, so far councils are focusing on increasing the amount of advice available, or outsourcing the self-funding support service to one professional support supplier.

Councils that are considering outsourcing to professional support suppliers are basing the requirements for support on existing arrangements they have with advice agencies, or through their contracts for personal budget support, which are primarily aimed at long-term complex cases. In our experience, the needs of self-funders tend to be completely different to long-term cases. They need an intensive six-week period of support, with a good proportion of this being commercial.

This is very similar to the support given to older people financially supported by the council. There is a need to mirror the current set up within councils, which has emerged through years of dealing with transactional support of care home and domiciliary placements. If these arrangements are good enough for public money, then why not the same for self-funders?

It’s time to look at existing arrangements for supporting self-funders and examine whether a central commercial self-funder purchasing team needs to be created, either within the council or outsourced to a third party. These teams could work at an individual council level or across a wider geographical area. This will enable the councils to give commercial power back to the self-funders in arranging their care.

6th November 2014 | Subscription Required
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High 50: Tips for staying afloat when paying for parents care

High 50: Tips for staying afloat when paying for parents care

A global community for people over the age of 50 who believe the journey, in all its wonder, has only just begun features Valuing Care. The publication covers the topic: Your folks’ care home could set you back six figures – even with the proposed cap. Fees specialist Ray Hart has tips for cost control.

New figures show that a place in a UK care home is now £28,666 a year (up 23 per cent) and more in the South-East. Fees specialist Ray Hart has tips on staying afloat when paying for parents’ care. With the cost of care rising at almost three times the rate of inflation, this is another worry for the majority of those who fund either their own care or that of a loved one.

In some circumstances, this can have tragic results. In 2013, a court heard that a 74-year-old, devoted son attempted to murder his frail 93-year-old mother because he felt the only way he could afford her care was by selling his own home. Although that’s an extreme incident, many members of the ‘sandwich generation’ find themselves in a similar position to this man: overwhelmed by spiralling costs. Consider these facts: more than 50 per cent of older people are billed for all or part of their residential and nursing costs, and the average weekly care home cost is between £500 and £900. Yet almost one in four people are unaware there may be any charge at all. No wonder it causes such a huge shock.

Cap on lifetime care fees
To be technical, when the care cap comes into force in April 2016, top-up fees paid above the standard local authority rate may not count towards the cap. Likewise, and logically, they may not be covered by the state once a relative has reached the £72,000 limit.

For example, if a care home’s fees were £650 a week and the local authority standard rate was £500, that might entail a top-up of £150 a week, plus a bed and breakfast charge.

Once the ‘extras’ have been stripped out, it would take more than four years before the private payer was deemed to have reached the cap. And rather than £72,000, this will actually cost more than £160,000.  

Cost of care rising more than inflation

With the cost of care rising at almost three times the rate of inflation, this is another worry for the majority of those who fund either their own care or that of a loved one.

In some circumstances, this can have tragic results. In 2013, a court heard that a 74-year-old, devoted son attempted to murder his frail 93-year-old mother because he felt the only way he could afford her care was by selling his own home.

Although that’s an extreme incident, many members of the ‘sandwich generation’ find themselves in a similar position to this man: overwhelmed by spiralling costs.

Consider these facts: more than 50 per cent of older people are billed for all or part of their residential and nursing costs, and the average weekly care home cost is between £500 and £900. Yet almost one in four people are unaware there may be any charge at all. No wonder it causes such a huge shock. High50 readers, though, can be prepared. You can read my article on fee negotiation and financial risk (below), and can consult the Valuing Care Fees Calculator.

You need the right information and a good understanding of the expenses involved. And only when you are familiar with the aspects that can alter the price are you ready to consider a home.

Here, then, are the five main elements to bear in mind. It’s interesting how many parallels there are to buying a house: 

The location
Generally speaking, care homes in the south-east or those in pretty coastal regions are the most expensive. So if location is not an issue, consider moving to a less expensive area such as the north-east, where rates are below the national average.

If, however, moving to a completely new area is out of the question, you could increase your options and look at care homes within a certain radius, as this may throw up cheaper options. 

Size and type of care home
Often the larger care homes have facilities to match. A small independent home may provide very basic facilities, whereas a large national chain may offer facilities comparable to a luxury hotel, with fees reflecting the difference in provision.

If a cinema room, library and onsite health spa are on your wish list, then expect to pay high sums for the privilege. Otherwise, decide exactly what facilities are required and which are not, so that you only pay for amenities your parent will use.

The type of care
Be prepared for the level of care to have a sizeable impact on costs. Nursing care is certainly more expensive than residential care. If full-time assistance is required, rather than part-time, again charges are higher, as is specialist care. 

Personal space in the home
Most homes these days provide private bedrooms. However, for those who are happy to share bathroom facilities, there should be a reduction in price. (Conversely, if a private bathroom or a seaview is a must, a premium is usually added.) 

Hidden extra charges
Those responsible for paying monthly care bills often notice additional charges for added value services such as hairdressing, days out, newspapers and so on. Unless you keep a close eye on them, they can soon accumulate. The best advice here is to understand what the standard fees cover and, if any additional costs are incurred, what these are likely to be.

1st November 2013
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Daily Mail: Best Ways to Negotiate Care Home Costs

Daily Mail – Best Ways to Negotiate Care Home Costs

Worried about care home fees? How negotiating could cut costs and save thousands

Many people who move into care homes do so at a time of great stress, often following a period of illness. Usually, they don’t think to scrutinise the price charged by their care home until it’s too late – but even a discount of £50 a week can save thousands in the long-term. Ray Hart, creator of the Valuing Care Fees Calculator, talks This is Money through the best ways to negotiate costs.

Which kind of care home fees are negotiable?

Most people who are planning on privately funding a residential home move will be looking for residential or nursing home care – both of which are negotiable. You normally agree a contract directly with the care or nursing home, which also sets aside a certain number of places for those that can’t afford to pay and are being supported by their local authority.

However, you may be charged substantially more than the local authority pays, because councils block book a sizeable number of places and can negotiate a cheaper price. However, you can negotiate, too – and if you do, savings can amount to thousands of pounds. At £500 per week, the average length of stay in a residential home would total £60,000, so even a £50 per week reduction could save £6,000 over the duration of the placement.

Are there any that aren’t?

As in any private marketplace, the laws of supply and demand prevail. If you are wishing to purchase a placement in a home with high demand, or a long waiting list, it is unlikely that you will be able to make a saving on the purchase price.

Alternatively, it may be that the home offers additional services above the standard care that may justify that additional fee.

If that is the case and you use the services of a care fees specialist (independent financial advisers that specialise in the care industry) you will still have the peace of mind of knowing that the fee that you pay can be justified by these extra services supplied by the home.

How do you actually negotiate?

Identify the expected price range
Understand the price range for the area in which you are searching. Free care comparator tools (such as this one) are available to help you.

If you get a quote that’s identified as not providing value for money, now is the time to get bargaining.  

Know what you want
Before negotiating, determine your exact needs, such as the level and type of care, and any extra facilities you require.

Clarify prices
Get a copy of the contract and ask the manager to confirm exactly what the fees cover, including additional charges.

This varies across care homes. While some have transparent pricing and make residents aware upfront of all potential costs, it may be more difficult to establish with others if only referred to in the small print.

Also, know what price you are prepared to pay for your individual requirements.

Meet with the manager
Ask to speak to the care home manager; the person who can make financial decisions.

Approach negotiations with a clear mind
Be clear on what it is you want, and for what price. Be chatty, and friendly. It should be a positive discussion for both parties.  

Consider the alternatives
If price isn’t negotiable, consider added value for the same fee such as a larger room.

Don’t take it personally
Although finding a care home for a loved one is an emotional decision, don’t take negotiations personally if they don’t materialise in the way envisaged.

Keep your options open
If you don’t get value for money from one provider, approach other suitable homes that meet your requirements. 

Top tips to keep costs down

Unfortunately self-funders are largely price-takers – accepting fees without trying to influence the price of an individual placement. Most people accept the first available space in a care home, limiting any chances of saving money. However, for those in the early phases of finding the right care home, it is worth remembering that there are ways to reduce costs:

Widen the search area
If you currently reside in an expensive location, think about moderately or lower-priced areas – you may be amazed what a difference adding 10 or 15 miles to the search area makes to the price.

If you’re looking for the lowest price area consider Yorkshire; avoid London, as this is the country’s highest. Generally speaking, places with a beautiful view, such as some of the pretty Cornish coastal towns and villages demand higher fees. 

Level of care
Although it’s wise to think ahead, and consider the type and level of care needed in the future, don’t overlook existing requirements. Some people find themselves in a situation where they are paying for unnecessary nursing care. 

Always remember that the greater level of care needed, and the more specialised, the more money charged. Hence, nursing homes are more expensive than residential homes.

The provider
There are more than 10,000 independent care homes in the UK, and 42 per cent of these are major corporate providers such as Bupa, Anchor Trust, Barchester Healthcare and so on. There are also hundreds of smaller care homes. There is no regulation on prices in the UK, and as such prices vary significantly between care homes, and also between providers.

Personal Space
Although a rarity, for those happy to share a bedroom, or a bathroom with another resident, rates are cheaper than having a private room, or an en-suite. There will also be additional supplements for different categories of rooms such as those with an en-suite, sea view, or a larger room for couples for example.

The facilities
The additional facilities that care homes provide varies enormously. While some are very modest, providing basic facilities such as homely lounges and quiet gardens, others boast seemingly endless facilities – guest accommodation, libraries, bistros, gift shops, and beauty rooms, to name a few.  As with anything in life, nothing is free, so expect rates to reflect provision of services. 

If you’re not going to make use of certain facilities, it may be worth revising your search.  

The extras
While optional activities or extras may be included in the fee at some homes, it’s best to check as others will charge, so clarify this with the care home manager. If they do charge, understand what the charges are for and how much they will be.

This may include items such as newspapers, transport or hairdressing, or activities such as boat trips, sightseeing trips, or cookery clubs. All of these extras could add up to an unexpected bill at the end of the month.

Is it value for money?
Unless you work in the industry, it’s difficult to know whether you have received a value for money quote. Use a free comparator tool such as this one to get a guideline on the level of fee that should be charged for that area. Alternatively, local authorities can assist.

If you think you’ve been quoted an unreasonably high rate, negotiate with the care home manager.

The experts
Specialist care fees advisers, the trade term for independent financial advisers who specialise in care funding, provide support and advice in care home costs. Their expertise covers all aspects of care fees funding so they are an invaluable point of call if you need extra guidance. 

Although these are paid-for services, if you don’t know what you’re doing, in the long run they could save you more money. 

16th October 2013
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