Paul Burstow announcement - A vision for adult social care

Care Services Minister Paul Burstow has announced his vision for social care:

http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_121508

Response from the Alzheimer's Society

http://www.alzheimers.org.uk/site/scripts/news_article.php?newsID=836

Paying care home fees

This excellent article on Citywire looks at ways of funding long term care.
http://m.citywire.co.uk/money/long-term-care-your-questions-answered/a444447?re=11620&ea=51797

They estimate that the average cost of a place in a nursing home is £36,000 rising to £50,000 a year for a good home in the South East.

Of the 8,211 homes in England that have specified their minimum fee rate in their latest CQC report we have calculated that the average is £31,400.  You can see fee information for the whole of England or for any county or London borough by selecting the fees filter on the CareHomeMap regions page
http://www.carehomemap.co.uk/Regions.aspx?Category=Fees.

Grim news on care home funding

This article on the channel4 web-site makes worrying reading about the future of care home funding and standards http://www.channel4.com/news/care-home-crisis-as-funding-cuts-loom

CQC Quality Ratings

CQC have decided to stop providing quality ratings and the last set were issued at the end of June 2010.  They have carried out a consultation and will launch a new process in May 2011.  How we are supposed to get an idea of the quality of a home that opens between July 2010 and May 2011 is unclear.

Their document about this is here
http://www.cqc.org.uk/guidanceforprofessionals/adultsocialcare/changestoourassessmentsystem.cfm. 

The results of the consultation process are here
http://www.cqc.org.uk/_db/_documents/Analysis_of_consultation_on_CQC_assessments_2010-11_201009133532.pdf

Cuts to public spending hit Care Homes

This article in the Guardian highlights how cuts to local authority spending is affecting Southern Cross - the UK's biggest Care Home operator http://www.guardian.co.uk/business/2010/aug/09/southern-cross-care-home-profits.

The group's solution is to sell off the freeholds of their homes and lease them back http://www.nebusiness.co.uk/business-news/latest-business-news/2010/04/22/southern-cross-home-group-s-bid-to-be-debt-free-51140-26291819/.
which is the same strategy as Woolworths took before going into administration.
http://www.telegraph.co.uk/finance/newsbysector/retailandconsumer/3699784/Comment-Woolworths-comes-full-circle.html

Latest Alzheimer's Research

This article in the New Scientist is an in-depth study of the causes of Alzheimer's and current state of Alzheimer's Research
http://www.newscientist.com/article/mg20727701.400-alzheimers-unlocked-new-keys-to-a-cure.html?full=true

Outlook for UK Care

This article in the Daily Telegraph reports on a Price Waterhouse Cooper's survey of care home providers which concludes that there could be tough times ahead.
http://www.telegraph.co.uk/health/healthnews/7879910/Care-home-standards-could-fall-because-of-spending-cuts-PWC-survey-warns.html.

The full text of the new Health Secretary's speech about the future of care is here
http://www.dh.gov.uk/en/MediaCentre/Speeches/DH_117331.

He says in this speech that he wants to hear all our views so feel free to get in touch. His contact details are here
http://www.andrewlansley.co.uk/index.php?pageid=5

Radio London spotlights care standards

Eddie Nestor's radio program on Radio London on Friday 16th July featured standards of care and covered the story of Sandra Blight whose parents were told by Bexley council that they could not both go into the same care home after 66 years of marriage. Full story is here http://www.thisislocallondon.co.uk/whereilive/localheadlines/8275109.BEXLEYHEATH__Council_parts_couple_married_for_66_years/.

Eddie Nestor read out an email from us about CareHomeMap and also interviewed Caroline Bernard from Counsel and Care - a charity which supports elderly people and their families in making decisions about care. Their web-site has various factsheets which are a mine of information
http://www.counselandcare.org.uk/helping-you/.

You can listen to the whole Eddie Nestor show on Radio London 'Listen Again' although this will only be available for a few weeks http://www.bbc.co.uk/iplayer/episode/p008ry60/Drivetime_with_Eddie_Nestor_16_07_2010/.

Errors in CQC data

The CQC does an extraordinary job in collection and publishing all of the inspection reports. However they make mistakes every so often and there are several cases where reports are incorrectly dated with the earliest dated October 1972 and the latest dated December 2010. These have been reported to them but they don't seem very interested in correcting them.

The CQC issued a press release in May saying that they are going to stop rating Care Homes and are also going to take on responsibility for assessing Hospitals and GPs. This is supposed to start in October but details are a bit sketchy so far: http://www.cqc.org.uk//newsandevents/pressreleases.cfm?cit_id=36253&FAArea1=customWidgets.content_view_1&usecache=false

A later press release seems to say that they are going to keep things pretty much as they are but share their data with Healthwatch England and Monitor http://www.cqc.org.uk//newsandevents/pressreleases.cfm?cit_id=36429&FAArea1=customWidgets.content_view_1&usecache=false

Obtaining Lasting Power of Attorney

In order to be allowed to deal with someone's financial affairs you need to have Power of Attorney. Without this, as mentioned in the NatWest post, the banks will act entirely in their own interests.

If the person that you are taking Power of Attorney for still has sufficient mental capacity to make their own decisions they can download application forms from http://www.publicguardian.gov.uk/forms/Making-an-LPA.htm. A doctor or other professional will need to sign this form to confirm that there is sufficient capacity.

A Lasting Power of Attorney is by far the best way to manage someone's financial affairs. Just because your elderly relative has Alzheimer's or dementia does not mean that they are not mentally competant to make decisions.  The guiding principles of the Mental Capacity Act are here http://www.publicguardian.gov.uk/mca/mca.htm

An older form of Power of Attorney called Enduring Power of Attorney is also still valid if it was made before 1st October 2007. There's information about this here http://www.publicguardian.gov.uk/arrangements/epa.htm.
If Attorneys are appointed jointly under Enduring Power of Attorney and one of them dies then the whole Enduring Power of Attorney is invalidated.

If the person no longer has sufficient mental capacity the only way to be appointed an attorney is to apply to the Court of Protection to be appointed a Deputy which is a slow and costly business.
http://www.publicguardian.gov.uk/about/court-of-protection.htm

When a Lasting Power of Attorney is applied for and multiple Attorneys are appointed a choice must be made as to whether these Attorneys should act independently or jointly. If you are appointed independently you and the other attorney can act alone so this is appropriate if you agree with the other attorney about all courses of action. If you are appointed jointly then you will both need to sign all the forms that banks require, all cheques and so on.  If one of the jointly appointed Attorneys dies there is provision in the Lasting Power of Attorney document to appoint a replacement.

Dealing with Share Registrars under Power of Attorney

My mother has a small number of shares and I have been writing to the registrars of each to redirect the miniscule dividend payments that she receives. Each one requires the Lasting Power of Attorney document but they don't seem to need separate identification like the banks.

I had another time-consuming situation this week when I wrote to Equinti who are registrars for British Telecom. They wrote back saying that I needed to send the original Lasting Power of Attorney document but when I checked I found that this was what I had already sent. It seems that because the document is stamped with "Office Copy" at the top they thought it was a copy so now I've had to send it back again with instructions on how to verify an official document that the Office of the Public Guardian provides. Here's the link http://www.publicguardian.gov.uk/docs/validation-veaflet-0909.pdf

Closing bank accounts under Power of Attorney

Whatever they say in their advertising the real purpose of all banks is to make as much money from their customers as they can.  They do this by paying as little interest as possible on the money that they borrow and charging as much interest as they can on the money that they lend.

Banks have many tricks and procedures for doing this and my father fell foul of many of them. A standard trick is to advertise a high rate of interest for savings to get you to open an account and drop the rate after a few months without telling you. Similarly they will lend to you at a low rate of interest and then put the interest rate up.  They will also make it as hard as they can for you to close an account or withdraw money from it.

After my father's death I took over my mother's financial affairs under Lasting Power of Attorney (see below).  She had small amounts of money in accounts with the following companies:  NatWest, Egg, Brittania, ING, N&SI, Sainsbury's, Nationwide, Yorkshire, Alliance Trust.

Over the past few months I've been trying to either close these accounts or register myself as an attorney and I have listed my experiences here in the hope that it will be of help to other people.

Name	Interest Rate (Gross)	Time taken to answer my letter	No. of items of ID required	No. of forms to fill out	LPA verified every page
N&SI Direct ISA	2.5%	5 days	0	0	Yes
Nationwide ISA	0.25%	7 days	4	1	Unknown
Yorkshire ISA	1.1%	7 days	6	1	No
Sainsbury's (RBS)	0.1%	9 days	4	2	No
Egg	1.25%	12 days	0	0	No
Britannia	0.1%	13 days	4	0	No
ING	0.5%	13 days	0	2	No

The Sainsbury's account which is run by the Royal Bank of Scotland had £84 in it. In order to close this account I had to send 4 verified copies of identification (2 for me and 2 for my brother who I have joint LPA with), a verified copy of the Lasting Power of Attorney plus two copies of their form for opening a new account as an attorney.

I had also asked Britannia if they held any accounts for my father and they replied asking for his death certificate.  Once I had sent this they replied that he didn't hold any accounts with them. Surely the wrong way around?

Nationwide has better ISA rates available but you have to go to a branch to switch.  I have now switched the Yorkshire ISA by post to a different ISA paying 2.25%.

I think that banks make closing an account complicated on purpose so that you get put off. Then after a few months they transfer the money to a dormant account which pays next to nothing in interest and they can lend
your money to other people. Of course, if you ask for your money back they have to give it to you but most people forget about it.

If you are taking over the financial affairs of an elderly person it's worth checking the British Banker's Association dormant account register http://www.bba.org.uk/bba/jsp/polopoly.jsp?d=144
to see if they have any accounts that they've forgotten about. It's also worth going through all old piles of papers in detail and writing to any company where they appear to have ever held an account.

To help this process along it's a good idea to go to a solicitor and get verified copies of your passport, a recent utility bill, a second utility bill and the Lasting Power of Attorney. The going rate is £5 per copy but my helpful local solicitor copied around 20 documents for £30. Some banks insist on every page of a document being verified and others accept documents where just the first page is verified. An alternative is to go into a branch of the bank where they are obliged to make copies free of charge or you can also send original documents and ask for them to be returned.

The Post Office offers a Signed For service http://www.royalmail.com/portal/rm/jump2?catId=400028&mediaId=500201 which costs £1.15 for a letter and £1.40 for a large letter. My experience is that documents sent Signed For are dealt with more quickly as the banks take them more seriously.

NatWest frozen interest

Both my parents banked with NatWest all of their working lives and my mother's main day to day account was held with them. Just after she had paid the proceeds of her house sale into it and just before she was able to buy an annuity the bank froze the account after a junior bank clerk decided that she was not mentally competent.

This caused many severe problems and financial loss as it took 6 months to resolve. Despite many requests from my mother and me the interest rate for this period was fixed at 0.1%. The bank also threatened to stop paying care home fees and made charges for unpaid cheques as the money was held in a deposit account. My brother and I were not allowed to access the account to transfer money into the current account so there was nothing that we could do to prevent this. After many complaints and the involvement of a newspaper the bank did finally repay the charges but they are still refusing to pay a fair rate of interest for the period that the account was frozen.

The whole episode is now the subject of a complaint to the Financial Ombudsman http://www.financial-ombudsman.org.uk/consumer/complaints.htm and we will never hold accounts with NatWest or their parent company RBS again.

Caring for someone with Alzheimer's yourself

I've always had a nagging feeling of guilt that when my mother was diagnosed with Alzheimer's I should have cared for her myself.  I know that this would have been impractical as I have a demanding job and two children at school.

I've seen this referred to as the sandwich generation - caring for children and ageing parents at the same time leaves you feeling like a thin slice of cheese.  Fifty years ago it would be normal for each generation to have children in their twenties so grandparents would be in their 40s or 50s and children would have left home by the time parents became elderly.  Now that we're often waiting to have children until our late thirties or older the demands of young children and ageing parents happen at the same time.

This excellent article describes Andrea Gillie's experience of caring for someone with Alzheimer's herself and really helped me in coming to terms with this feeling of guilt. http://www.guardian.co.uk/lifeandstyle/2010/jun/01/andrea-gillies-mother-in-law-alzheimers