The Ultimate Care FeesPlanning Handbook 6 April 2010 – 5 April 2011

We firmly believe that you and your family deserve the best possible financial advice. Symponiawas established to fulfil that very statement; we have brought together some of the best andmost caring advisers from across the whole of the United Kingdom to form the unified, nationalprofessional body known as Symponia. Symponia is very much a family company formed on anoverriding foundation of traditional values and the real wish to help people at what can be a very difficult and highly emotional time.

The emphasis of all our Symponia members is very much on respect and care, with thefundamental objective of enabling people to choose where they are cared for, with the peace ofmind that they will be able to meet rising care costs indefinitely; whether care is needed now, orat an unknown time in the future. Not all advisers have dedicated care fees planning experience,the required knowledge levels, the appropriate qualifications or even the necessary empathy torecognise the emotion associated with placing a family member in a care home.

Symponia members really are different, we can promise you that they will all:

We fully appreciate that different people will have differing needs and objectives, meaning thatthe solution for each family will also differ, but whatever the situation, with careful planning,current or future care fees need not be a problem.

However we believe that it is essential that you talk to a recognised specialist. The details ofyour local member are printed on the back page; alternatively contact us direct using thedetails below.

• hold an FSA-recognised long-term care qualification.

• offer a personal face-to-face meeting.

• follow a printed Code of Practice & Conduct.

• present you with a Customer Charter.

• have undergone a current Criminal Records Bureau check.

Registered Office: Barclays Bank Chambers, Stratford upon Avon, CV37 6AH

Registered in England & Wales No: 354984

In March 2010, Andy Burnham MP,unveiled a white paper on the futureof adult social care, which sets outsteps for a radical shake up of thewhole subject. Amongst other thingsit offers an end to means testing andthe common disparity that existsthroughout the United Kingdom.He has promised us a new NationalCare Service, which like its NHScounterpart will deliver a universallevel of care and services to all,regardless of means and location.On paper the proposals have definitemerits, but behind the rhetoric, thereare clearly more fundamental,

logistical issues that need to be sortedout and clarified, which, given thecomplexity of the subject and the factthat it is highly emotive is going totake several years before theproposals turn into statute.Sadly, this will mean that any peoplefacing the need for care throughout2010 and early 2011 will be requiredto follow the existing regime and fallin line with current legislation.Should any changes be brought aboutbefore April 2011, these will beposted on www.symponia.co.uk assoon as they occur.

Foreword

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01789 774595 care@symponia.co.uk www.symponia.co.uk

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 06

What types of care are there? . . . . . . . . . . . . . . . . . . 07• Staying at Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . 08• Sheltered Accommodation . . . . . . . . . . . . . . . . . . 10• Close Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10• Moving into a Care Home . . . . . . . . . . . . . . . . . . . 12• Check List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13• Associated Governance . . . . . . . . . . . . . . . . . . . . . . 15

Ensure you have the Legal Power to Act . . . . . . 16• Powers of Attorney . . . . . . . . . . . . . . . . . . . . . . . . . . 16• Office of the Public Guardian . . . . . . . . . . . . . . . . 18

Funding Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20• Immediate Care Plans . . . . . . . . . . . . . . . . . . . . . . . 22• Costs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22• The Carter Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22• Care at Home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24• Martha . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 24• How can we consider a plan?. . . . . . . . . . . . . . . . 26

What about the Property? . . . . . . . . . . . . . . . . . . . . . . 28• Should we rent the house out? . . . . . . . . . . . . . . 30• Should we sell it? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31• Who should we ask to sell it?. . . . . . . . . . . . . . . . 32• What Mrs Adams did. . . . . . . . . . . . . . . . . . . . . . . . . 33• Using Equity Release to pay for care? . . . . . . . 36• Eric & Alma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

Legislation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40• Local Authority Support . . . . . . . . . . . . . . . . . . . . . . 40• 12 week Property Disregard . . . . . . . . . . . . . . . . . 40• Deferred Payment Agreement. . . . . . . . . . . . . . . 41• NHS & State Benefits. . . . . . . . . . . . . . . . . . . . . . . . . 42• NHS Continuing Healthcare . . . . . . . . . . . . . . . . . . 44

Our Top Ten Tips. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

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Contents

The process of finding suitable care and sorting out the legislation, not tomention helping your loved one cometo terms with the significant changesto their lifestyle can be extremely hard.Add to this the emotive, and oftenconfusing, financial situation and it is not surprising to learn that manypeople feel tired, stressed and worriedat a time like this.Symponia was formed to bringtogether a national, unified andprofessional body to ensure that everyfamily facing the dilemma of fundingprivate care fees would have access toa suitably qualified adviser, not justlocal to them, but also well versed inthe subject of care fees planning andable to demonstrate a genuine andcaring approach at what is one of themost demanding times of family life. We have brought together what we believe are the salient points, and although not designed to negate the need for professionaladvice we are pleased to bring you this comprehensive Care Fees Planning Handbook.

All our members are hand-selected fortheir compassion, knowledge levelsand empathy. They are all authorisedand regulated by the correct governingbody which, depending on theirmembership status, will either be theFinancial Services Authority or theSolicitors Regulatory Authority.Each one will have already undergonea Criminal Records Bureau check, whichautomatically investigates forinformation on the Vulnerable AdultsBarred List. This additional processensures that they can be invited intoyour home or that of your relativeswith complete safety. The details of your nearest membershould be on the very back page of the handbook, or in the letteraccompanying the publication.Alternatively, if you are viewing thisonline, simply use the ‘find a localmember’ section on the left hand side of the website.

Sometimes the only known option might not be the best solution. A move into a care home is a huge step, sometimes it will be thebetter choice for everyone concerned, but for others, staying athome and buying in care will present a more bespoke answer.

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IntroductionIf you are currently faced with the prospect of finding care for yourself, arelative or a friend you are probably feeling emotionally drained right now.

Once you know that the person can no longer live independently,you need to adopt a level of pragmatism.

What types of care are there?

Staying at HomeIt is possible that a great number of people moving into care homes are doing so because they don’t realise that staying at home is arealistic alternative.

Care provided at home could be assimple as someone coming in to cookand clean, it could involve helping theperson to get in and out of bed and/orhelp with some basic daily tasks such aswashing and dressing. This may beprovided on an ad-hoc hourly basis or toa more regular and/or formal schedule.

If the person needing care requires a more permanent and tailoredarrangement, live-in care could provide the answer.

Live-in careThis is as, it sounds, a service thatprovides support and assistance by acarer living with the person needing careon an ongoing basis in their home.

Live-in care offers quality, personal one-to-one care in the comfort of the person’sown home, bringing peace of mind to allconcerned, knowing that the disruption ofmoving away from familiar surroundingshas been avoided, without compromisingthe level of care and support received.

As the term live-in suggests, the carerlives in the house with the person thatthey have been asked to look after.

They sleep there, so they will need their own room, but they will follow abespoke care plan that will have beencreated specifically for that individual.

The carer will be able to support withsome or all of the following:• Companionship – sometimes just

having somebody around, someone to talk to, to enjoy a meal with, couldmake all the difference

• Personal care – this could encompassassistance with toileting, bathingand/or the overseeing of the correct medication

• Housekeeping – this would normallyinclude help with laundry, shopping,cleaning and cooking

Some of the reasons live-in care can work:• People value their independence

and want to stay at home• People want to be surrounded by

the comfort and familiarity of their own home

• People don't want to change theirroutines and have to fit in with others

• The family wants the freedom to visitand call whenever they want to

• People want to select and know theperson who is caring for them

• Many people want to stay with their pets

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Reasons live-in care can work cont’d:• The care changes simultaneously

with needs• The costs are comparable with

many care homes

If considering live-in care then thereare a number of questions to ask when choosing your provider:• Is the agency registered with the

Care Quality Commission (CQC) or their national equivalent andwhat was the result of their last inspection?

• Are the carers directly employed by the care agency?

• What training is provided for the carers?

• How often is there a change of carer?

• What happens when a carer is unwell?

• Before care begins, will an assessment take place and a care plan be produced?

• What happens if the condition of the person receiving care changes?

Sheltered Accommodation

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If staying at home is a realistic option, but the house is just that little too big,too isolated, or not near enough to family and friends, then sheltered housingmight appeal, especially as it still presents the ability to live independentlywith live-in care if needed, but usually in a smaller, purpose-built and easier-to-manage home.

Most developments will consist of self-contained apartments with:

• a laundry• a communal sitting room• communal gardens • security & safety systems• a house manager or warden • 24-hour assistance via an alarm.

Close CareIf staying at home isn’t possible, for whatever reason, but moving into a carehome just doesn’t feel right at the moment, then Close Care (also known asExtra Care and Assisted Living) could provide another ideal solution.

Like sheltered houses, close care homes are self contained, they have theirown front door granting coveted privacy, but with the added reassurance ofbeing within the grounds of an existing care home should an unexpectedemergency arise at any time of the day.

A further benefit is the availability to select from a menu of services, whichusually includes help with household chores, catering, laundry, social andpersonal care.

What to look for? • Does it feel like a care home? • Does it smell clean and fresh?• Are fresh flowers provided? • Do the residents appear content? • Can we arrange a stay for a week

or so before we commit? • Do we need to book an appointment

before arriving/if you do, why is that? • Is there a garden? • Is there a car park?

Should it be purpose-built or a conversion? • Some people prefer modern homes,

whilst others will want old, morehistoric properties

• Modern purpose-built homes canappear more spacious

• Older homes may have strangelyshaped corridors that you will eitherlove or hate

Antique or modern furniture? • This will be down to personal taste,

but if antique furniture is preferred,will the person be happy withmodern lines?

Town or country? • Location will always play a big part in

choices. If the person is used to livingin a town centre, will they feel lost in the country?

• If it is in the country, does the home have transport?

• If located in a town centre, will it betoo noisy at night?

Rooms/facilities • Are they large enough? • What sort of views do they have?• Are there en-suite facilities? If not,

how many people share a bathroom? • Can we bring in our own furniture? • Are televisions provided or can we

bring our own?• Are telephones and/or phone lines

in the room? • Will the person be encouraged

and/or taught how to use a computer?

• If yes, does the home havebroadband and a Wi-Fi connection?

• Does a hairdresser visit the home? • Is there a laundry service and/or

dry cleaning service?

If moving into a care home is the only real solution, then there are things thatyou can do to ensure the chosen care home matches expectations.

Don’t feel rushed into this decision; take time to visit several homes so you havethe ability to compare facilities and costs. In the main you should apply the samecriteria and preferences you would if you were purchasing a property; after all thechosen care home will become a permanent home for the person needing care.

If you are in any doubt or can’t make up your mind, ask to see the home’sinspection report, these are usually also available online.

Compile a check-list before you go which could help with some much-neededpointers. Our list is intended to act as a guide, the points covered are notexhaustive, and of course some of the questions won’t apply if your loved one is very poorly or confused.

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Moving into a Care Home Check List

Each has published their own mission statements and objectives on theirrespective websites, also on these sites you should be able to access the latestinspection reports for the care provider(s) you are considering, which could justhelp you with that all important decision.

Sitting rooms • Is there a choice of sitting room? • Does the furniture look comfortable? • Does the room get overcrowded? • Can residents stay up as long as

they like?• Is there a residents’ piano? • Is there a separate TV lounge?• Is there a DVD player? Are movies

shown on a regular basis?

Dining rooms • Does the home have a separate

dining room? • Are all meals served at the table? • Is there a choice of dining room? • Can meals be eaten in residents’

rooms (if preferred)?

Meals and drinks • Is there a choice of food at

each meal? • Are special diets/religions

catered for? • Can we come for a lunch before

we decide? • Can family members come along

for meals?• Can the resident host private

lunches/dinners? • What happens on special occasions

like Christmas and Easter? • Are warm drinks served outside

meal times?• Could residents make their

own drinks? • Can residents still enjoy their

favourite tipple?

Pets • Does the home have any pets? • Can residents bring their own pets?• If residents don’t like animals, can

they get away from them?

Visitors• Is there a limit on the number

of visitors?• Can they come at any

(reasonable) time?• Are there overnight facilities for

relatives travelling long distances? • Is it ok to bring the baby?

Activities • Does the home have an

activities coordinator? • Do they organise trips out? • Does the home arrange

entertainment? • What about bingo? • Is opting out of activities ok?

Check List ...continued

Country Regulatory Body

England Care Quality Commission

Scotland Care Commission Scotland

Wales Care & Social Services Inspectorate

Northern Ireland Regulation & Quality Improvement Authority

The care sector in the United Kingdom is governed by dedicated regulatorybodies, and they exist to impose, monitor and improve the standards of caredelivered by the relevant care providers from live-in care agencies to carehomes with nursing.

Associated Governance

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Ensure you have the Legal Power to ActIf you and or other members of yourfamily want to look after the financialaffairs of the person needing care, and the person is able to give theirconsent, the best and most effectiveway to do this is by means of a Lasting Power of Attorney (known as a Continuing Power of Attorney in Scotland).

This is a legal process whereby theperson, acting as the donor (granter in Scotland); gives permission for one or more people to act and makedecisions about their property andfinancial affairs (becoming theattorneys) on their behalf, eitherimmediately or at a specified time in the future.

This authority can be limited to one or two specific items or it can be all-encompassing, but the wholeprocess can only be established if thedonor/granter has full mental capacityat the time the power is granted.

If a person does not have close familymembers to appoint, it is possible thata solicitor and/or family friend couldbe nominated instead. It may be awise decision for everyone regardlessof age and health to establish aLasting Power of Attorney assoon as possible.

There are two different types ofLasting (Continuing) Power ofAttorney (LPA):

Property & Financial Affairs: This issimilar to the old-style Enduring Power of Attorney (pre-dating 1stOctober 2007) and can be used bothbefore and/or after loss of mentalcapacity (depending on thedonor/granter’s wishes).

But unlike the old system the LPAmust be registered with the Office ofthe Public Guardian before it can beused (regardless of mental capacity).

Health & Welfare: This includesmaking provisions for the giving or refusing of consent to medicaltreatment/intervention incircumstances where the donor/granter can no longer make such adecision. It is important to note thatthe welfare LPA can only be used afterthe donor has lost mental capacity.

Enduring Power of Attorney:

Up until 30th September 2007, it was possible for people to draw up an Enduring Power of Attorney; thesedocuments are still perfectly legal,and it will be possible for namedattorneys to use the powers withinthese existing documents, althoughthe following points should be observed carefully:

• No new Enduring Powers of Attorney can be made

• Amendments cannot be made to existing documents

Should an attorney pre-decease the donor, a new Lasting Power ofAttorney may need to be drawn upand if the donor no longer has mentalcapacity then an application will haveto be made to the Court of Protection.This will necessitate the appointmentof a Deputy to manage the donor’sproperty and financial affairs.

It isn’t necessary to register theEnduring Power of Attorney before itcan become effective, providing thedonor still has mental capacity.

The document must be registeredwith the Office of the Public Guardianat the onset of mental incapacity. An Enduring Power of Attorneydoesn’t enable the attorney to makesubstantive decisions about thedonor’s health and welfare.

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Office of the Public GuardianWhat if no Power of Attorney exists?

A lasting power of attorney can onlybe drawn up if the donor/granter hassufficient mental capacity, meaningthat if the person needing care hasalready lost this ability and can nolonger make reasoned decisions ontheir own, then they will need tomake an application to the Court ofProtection (Sheriff Court in Scotland)for the appointment of a Deputy.

A representative of the person(relative, close friend or solicitor)aged 18 or over will need to apply to become their Deputy (Guardian in Scotland), which involves anapplication, associated fee and avetting process, resulting in therepresentative being legallyresponsible for the following:

• Finances

• Property, where they live and/orwhether they need to go into care

• Healthcare, including medicationand surgical consent

• Personal welfare, encompassingclothes, food and general well-being

The Deputy must be able to complywith five statutory principles laid outin the Mental Capacity Act 2005:

• A person must be assumed to havecapacity unless it is medicallyestablished that he lacks it

• A person is not to be treated asunable to make a decision unlessall practical steps have been takento assist without success

• A person is not to be treated asunable to make a decision merelybecause he makes an unwise one

• An act done or decision madeunder the act on behalf of a person who lacks capacity mustonly be done or made in their best interests

• Before the act is carried out or thedecision is made, regard must begiven to whether the purpose forwhich it is needed can beeffectively achieved in a way that is less restrictive of the person’srights and freedom of action

Deputies are assessed to see whatlevel of supervision they need by theOffice of the Public Guardian and thelevel of support is reviewed regularly.Deputies should seek advice fromfinancial advisers qualified in carefees planning when looking to fundcare fees or investing capital to meettheir ongoing needs.

If a person’s capital and savings and/orincome push them outside the meanstest thresholds (see page 40) they will generally be responsible for thefunding of their own care fees untilsuch time as their money falls belowthe appropriate threshold.

However, with careful planning it maybe possible to structure their finances in such a way that care fees can bepaid indefinitely, without worry aboutthe future or what might happen if themoney runs out.

Most families wish to ensure that theirrelative can stay in the chosen carehome for the rest of their lives as wellas safeguarding as much of the existingcapital as possible.

There are dedicated tax efficientfinancial policies available. These arecalled Immediate Care Plans (alsoknown as ICPs, Immediate Annuitiesor Care Fees Payment Plans), and arespecially designed to cover all or partof the cost of a person’s care fees, and, whilst they are not a universalpanacea, they can, in the rightcircumstances, provide an ideal solution.

Once established, the plan will pay an agreed tax-free amount at regularintervals, directly to the care provider, for the rest of that person’s life.

Benefits can increase over the years to help keep pace with care fee increases.

A lump sum is required to purchasesuch a plan and this is calculatedindividually on age, health and gender.

This type of policy should always beconsidered as part of the solution andincluded as an integral part of theoverall financial plan for the elderlyperson concerned, especially as it can help to cap the cost of care andprotect the elderly person fromoutliving their capital.

As mentioned they will not be rightfor everyone, but they should always be considered alongside all the otheroptions for paying for care.

An Immediate Care Plan provides peaceof mind and enables the person in careto have financial independence, dignityand choice of where they receive care.

Capital protection can also be included,to cover situations where the elderlyperson dies shortly after purchasing the plan. It is essential that advice issought from qualified long-term careadvisers when looking at the funding of any care fees.

It is extremely important that you seekout advisers who have the qualifications

required by the Financial ServicesAuthority (FSA) to give long-term careadvice and who are also experienced indealing with elderly-care matters. Ifyou would like to discuss an ICP with aqualified adviser, with no obligation,please give us a call by using thenumber on the back page.

Funding Care

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If we took out a care planwhat would it cost?As mentioned, the cost of an Immediate Care Plan is individual and tailored to thecircumstances of the person needing care, the points taken into consideration areage, gender, medical condition and the amount of annual benefit needed.

Care costs do vary throughout the country, and as everybody’s financial situation is different it is not possible to give a definite cost. However, we have included asynopsis from a real case, the Carter family, and this gives an idea of the sorts ofcalculations involved.

Jeff and Sophie Carter sought advice inFebruary. They had been referred by alocal care home, and they were anxiousto sort out the continued care fees forJeff’s mum, Mildred. At 86 Mildred wasin hospital after a period of memory lossand a series of falls necessitated heradmission, and although her healthimproved slightly, her family did notbelieve that she could continue to livesafely in her own home.

The family found a care home that theywere all happy with and Mildred movedin for a trial period. It was just after thisstage that they met their specialistadviser, and during the first meetingthey discussed their wishes andobjectives. Firstly the family wanted tomake sure that Mildred could stay in

this home for the rest of her life, andsecondly they wanted to make surethat she didn’t worry about her money.Mildred herself also had concerns; shereally wanted to leave some of hermoney as an inheritance to her family,and she was really worried that hercare bills would prevent this wish.

Local Authority help with care fees isrigorously means-tested and as MrsCarter had over the threshold in capitaland income, she would not qualify forany state assistance.

The family placed the property on themarket and by mid April they wereready to implement a structuredfinancial plan. The important part of any care fees planning exercise is toestablish several key points, makingsure that the actual plan, the monthly

benefit level and the premium methodmatch each individual circumstance.From discussions we knew that Mildredhad £157,000 from the sale of herhouse and some savings, her combinednet annual income came to £15,439and her care costs and incidentalexpense budget total £33,540.

This left Mildred with an annualdeficit between her income andexpenses of £18,101.

After the completion of the medicalunderwriting, the family received theircomprehensive report, which includedseveral options, one of which was to doabsolutely nothing, using the savingson an annual basis, but because theCarter family wanted guaranteedpeace of mind and the reassurancethat the money should never run out,they discounted this option.

Instead, and in order to achieve thepeace of mind they craved, theypurchased an immediate care plan forMildred, and this plan cost £62,674.

The plan will pay the care home£18,101 each year (plus annualincreases of 5%) for the rest ofMildred’s life, the remaining capital of £94,326 was placed in a secureinvestment, which pleased Mildred no end, as she now knows that herfamily will receive the inheritance thatshe wished to leave them, and thefamily knows that Mildred shouldnever run out of money, no matterhow long she needs care.

Meet the Carters

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Martha is an 87 years old widow, shehas one daughter Caroline who lives nearby but works full time and has a growing family.

Martha has lived in her current housefor over 60 years, but following asevere stroke she was admitted tohospital and needed constant round-the-clock care. Martha and Carolinelooked at various care homes, but in all honesty, Martha desperately wantedto stay in her own home; a home filled with a lifetime of memories and possessions.

Caroline knew that her mother wasunhappy about the prospect of movinginto a care home, but didn’t really thinkthat staying at home was a possibility,mainly because she thought it wouldbe far too expensive.

However, after discussing the matterwith a specialist care fees adviser, thefamily met with a live-in care agencyand realised that not only was it a lot less than they thought, but itrepresented a real alternative to goinginto a care home.

Once the cost of the care package wasknown, their financial adviser carefullycalculated the financial implicationslooking at care costs, householdexpenses, discretionary spending,existing and potential future income.

Martha wasn’t aware that she couldclaim Attendance Allowance;following the meeting with theadviser a claim was made straightaway. Martha had a differencebetween her income and totalexpenses of £25,000 per annum.

If care is being received at home,can we still take out a plan?

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Certainly, Immediate Care Plans are just as practical for people choosing to stayin their own homes. The calculations will of course be slightly different, but theconcepts and benefits are exactly the same. Immediate Care Plans are also fullyportable so should a person originally establish a plan to cover their care athome, and at some time in the future they moved into a care home, the plansimply moves with them.

In addition to her property Martha hadabout £100,000 held in a bank depositbond; it was producing very littleinterest and wasn’t really being utilisedto its full potential. Martha usedapproximately £80,000 of this moneyto purchase an Immediate Care Plan,which now pays out £25,000 towardsher care fees each year, the money ispaid directly to the care agency and hasan integral 5% annual escalation tohelp offset the annual increases.

Martha is thrilled that she can stay at home, and her daughter has said “It is great to see mum so settled and content. The care plan has removed mum’s anxiety about moving and the live-in carer hasmitigated my worries about mum’ssafety and independence”.

The care plan will continue for the rest of Martha’s life and, shouldcircumstances unexpectedly change in the future and Martha has to enter a care home, the care plan will simply move with her.

Here’s how it helped Martha and her family:

It is not possible to purchase a plandirectly; both the Financial ServicesAuthority and the companies providingthese types of policies require you to use the services of a suitablyqualified adviser.

We would recommend that you discussthe matter with a specially trained and qualified care fees specialist; onethat satisfies all your questions,demonstrates real compassion andradiates trust.

The important part of any care feesplanning exercise is to establish severalkey points, making sure that the actualplan (if appropriate), the monthlybenefit level, the amount of capitalprotection and the premium matcheach individual circumstance.

It is for this reason that Symponiamembers will always offer you aninitial personal face-to-faceconsultation, without cost or obligationon your part, to ensure that all theircurrent and future recommendationsare tailor-made to your own specific requirements.

Even though we accept that these plansare not suitable for every situation, wedo believe very firmly that everyoneshould at least consider them.Dismissing something as unviable ismuch better than never knowing aboutit in the first place.

As more than one company providesthis type of plan, the only way toobtain accurate and confirmedpremiums is to ask each company toundertake full medical underwriting.This is a simple straightforward processand doesn’t involve anyone in amedical examination.

Receiving any form of indicative quote,is not advisable and can lead tounrealistic expectations.

It is much more beneficial for thoseinvolved if they are basing theircalculations and decisions on realfigures. Establishing full medicalunderwriting at the earliest opportunitywill give you the best opportunity toplan effectively with reassurance andpeace of mind.

Partnership is the market leading supplier of insuranceproducts to fund care fees and offers a range of plans thatare tailored to an individual’s needs. By taking health intoconsideration, Partnership is able to provide enhancedlevels of income to help meet care fees payments.

Partnership is recognised as an expert in the long-term carefunding industry and was awarded ‘Best Long-Term CareProvider’ at 2009’s Health Insurance awards.

Talk to your Symponia member about how Partnershipcould help you and/or your family.

How can we consider a plan?

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We are grateful to Partnership for supporting this section

Our homes are our castles, a traditional saying with a lot of heritage inthe United Kingdom.

Sadly, when care fees are needed, a person’s property could well be includedin the means test, but it isn’t all bad news. With a practical approach themoney tied up in a house could go a long way to provide the ideal solutionto the ongoing funding of care fees.

Can we give the property away?

In an attempt to protect the property,many families have considered orhave actually taken steps to giftproperties or other assets to try toremove the financial value fromfuture means testing.

As you would expect the Governmentis wise to this and the specific“deliberate deprivation” rules preventthe giving away of property which inturn, would necessitate the LocalAuthority contributing to the person'scare costs.

Under current legislation, LocalAuthorities have the power torecover any sums gifted from theperson to whom the asset wastransferred, but this power can onlybe used if the gift occurred within sixmonths of the donor requiring care,or if the person is already in care.

However, if the Local Authoritysuspects deliberate deprivation, it isimportant to note that there is notime limit to their investigations,with motivation being the key, i.e.“why was the property giftedaway?” and “how old was theperson when they made the gift?”

Any such gifting should only be doneby using the services of a specialistsolicitor, but a vital fact to consider isthe implications such a transactioncould have on the person doing thegifting; they may find themselveswith restricted financialindependence and choice of wherethey receive care in the future.

What about the Property?

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When a person moves into a care homethere is often a property left empty.Families can feel emotional attachmentto the former home and a popularthought is to rent it out rather than tosell, especially during periods ofstagnating or reducing property prices.

When choosing the best way forwardconsideration should always be made as to how the ongoing care fees would be met from the income generated.Bearing in mind that the rent willprobably be subject to tax, the netgenerated income will bear little relationto the amount needed for care fees, nor will it increase at the same rate as the fees each year.

There is no guarantee that the homewill be generating rental incomethroughout the lifetime of the personrequiring care. There could be periodsof time when tenants move on andfurther tenants need to be sought.

The home will still need to bemaintained and there may be othercosts associated with renting out the property.

Should we rent the house out? Should we sell it?Selling a property could ensure thatsome or all of the proceeds could beused to purchase an Immediate CarePlan with the remainder investedsafely for growth.

According to recent statistics over40,000 homes are sold each year sothat the owners can pay for theirprivate care fees. That said, selling an empty property itself isn’t usuallythe problem; the main issue tends to focus on what can be done with theproceeds to ensure that the moneynever runs out.

But also during a recession, one of thefirst things to suffer is the housingmarket, and despite Estate Agentpromises many families haveproperties stuck on the market.

This means that they are unable torelease the money tied up in theproperty and are either relying on theLocal Authority to provide the DeferredPayment Scheme or asking the carehome to run up a debt. Some families,especially where the previous twooptions are not forthcoming, arefunding the fees themselves.

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Who should we ask to sell it?If the decision has been made tomove into a care home, it may be that selling the property to fund theassociated care fees is the only option.Whilst it is a time fraught withemotion and memories, the decisionto sell is probably the right one.

But, at such a difficult time, whoshould you trust to sell the property for you?

Companies do exist that are dedicatedto the needs of elderly homeownersmoving into care.

These specialist companies can provide a simple tailored service to fit your needs exactly, often realisingmoney prior to the sale or purchasingthe house.

They fully understand and appreciateall the emotions associated with selling a home at such a stressful andemotional time and by workingdifferently to standard estate agencies,can usually ensure a smoother chain-free sale at a guaranteed price thatinvolves a much quicker sales process.

Your specialist financial adviser will beable to introduce you to the mostappropriate company and liaise withthem on your behalf to ensure the best possible solution.

Mrs Adams moved into a nursinghome costing £600 per week, whichshe initially funded from savings.

After several detailed meetings withMrs Adams and her family (acting asher attorneys), her financial adviserrecommended that she shouldpurchase an Immediate Care Plan.

This action would ensure that her carefees would be funded for the rest ofher life without worry about whatwould happen if the money ran out.

Mrs Adams was also pleased that the legacies in her will would be able to be met.

However, as most of her capital wastied up in her previous home thefamily was unable to proceed, and as the property had been on themarket for some time the family wasbecoming worried and anxious.

The adviser introduced the family to a specialist company who, afterassessing the property and meetingwith the family, purchased theproperty without protractedcommunications and at a mutuallyagreed/guaranteed price. In turn the process enabled the family to purchase the much valued Immediate Care Plan.

What Mrs Adams did

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Funding for Care

How will you fund care for your loved ones?

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For more information:

0800 043 4036www.fundingforcare.co.uk

We could buy your house now to release cash to pay for care

Funding for Care will purchase property at a guaranteedprice, providing money immediately, instead of youbeing involved in a lengthy sale process.

The service is totally flexible to suit yourindividual needs. The offer made will bea fair reflection of the cost and riskinvolved and crucially it gives quickaccess to the cash to fund care withoutthe ongoing cost, hassle and uncertaintyof selling in the current conditions.

Funding for Care can offer you:

• Guaranteed purchase price

• Fast exchange giving financial certainty

• Quick release of funds to pay for care

• An avoidance of the hassle and stress of selling

• No estate agent, solicitor ormanagement fees

• Transactions can be made using Powers of Attorney

The final purchase price is based on anindependent RICS (Royal Institute ofChartered Surveyors) valuation.

Once agreed, Funding for Care willcommit to buy your property and theprice is guaranteed with contracts and can be exchanged and completed quickly.

Talk to your Symponia member abouthow this service could help you and/oryour family.

Equity release is a term used to describe the various ways people canfinancially benefit from the value of their home. Equity release enablespeople to raise capital, income or a combination of the two whilecontinuing to live in the property. Borrowers are free to use the monieshowever they wish, which in the past has included: home improvements,a much longed-for holiday, to help maintain or increase their standard ofliving in retirement, or to mitigate Inheritance Tax.

However, as more and more people face the need for care, equity release isbecoming a popular and realistic way of enabling people to receive formalcare in their own homes, delaying or preventing altogether the move intoalternative accommodation.

If care is being received at home, the question about what to do withthe house may sound academic, but it is just possible that using anEquity Release product could make all the difference to the longevityof the live-in care package.

Using Equity Release to pay for care?

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Eric and Alma’s daughter picked upthis handbook in a local care home.Sadly Eric had recently suffered astroke and was in hospital. Althoughhe was undergoing intensivephysiotherapy his care team hadreached the conclusion that hewouldn’t be able to return home.

Not sure how to react, Eric’s family hadstarted to look at care homes. They hadfound a suitable room, with the quotedweekly care fees in the region of £950,and all were resigned to the fact thatthe move was inevitable. However,underlying concerns existed on severallevels: firstly they were obviouslyanxious about the future health andwelfare of Eric, but just as importantwas the likely impact his permanentresidency in a care home would haveon Alma. Eric and Alma had beenmarried for over 65 years and since theend of the World War II they had rarelyspent a night apart.

During the first meeting, the familywas asked a fundamental question,“accepting the fact that you can’tchange the medical diagnosis, whatwould you do if you could wave amagic wand?”

The response was unanimous, theywanted Eric to go back home. How then could this happen? Eric neededspecialist personal care and Alma was unable to do this. As a potentialsolution, the family were asked toconsider a live-in-carer.

Eric and Alma arranged a meetingwith an agency; an assessment wascarried out both physically on Ericwhilst he was in hospital, but also atthe house so that the carers could geta sense, not just for the type of careneeded but, where it would be delivered.

Following this the agency was able todeliver a weekly fee structure. For £700per week, a qualified and vetted carerwould live in one of the spare rooms atEric and Alma’s home.

The remaining focus and objective now centred around how the carecould/should be funded. Had Ericentered the care home, their housewould have been excluded from themeans test whilst Alma lived in it. Thissituation would be replicated now thatthe care was being received at home,but as Eric had other savings in excessof the current threshold, he wouldreceive no other funding from theLocal Authority.

Eric had a private pension and over£200,000 invested; Alma also had asimilar amount held in her own name,but as these investments contributed a high proportion of their income,neither partner wanted to alter theinvestments in any way.

They then talked through the option of Equity Release, not just with Eric and Alma, but, with their permission,the whole family became involved inthe discussions.

Moving to a different, smaller propertyto realise funds was a non-starter; if theproperty was to be sold in the lifetimeof Eric and Alma, Eric might just as wellhave moved into his care home.

Neither of them were entitled to anymeans-tested state benefits so therelease of capital wouldn’t have anegative effect on their current incomelevels. The adviser did, however, makesure that Eric put in a claim forAttendance Allowance.

The next decision was how muchmoney should be released? Did thefamily just take enough for one yearand continue to draw down eachsubsequent year until the maximumsum had been exhausted?

Eric was uneasy about this, as he couldsee a finite and therefore limitednumber of years involved in the plan.

To help the family gain additional peaceof mind, the adviser suggested thatthey explore the possibility of anImmediate Care Plan; they calculatedthe income, which could now includeAttendance Allowance and comparedthat to the expenses, which had totake account not only of thehousehold costs (which largelyremained unaltered) but the carecosts of £700 each week.

This bespoke calculation left adeficit/shortfall of just under £15,000and it was this amount that wassubmitted to the underwriters for consideration.

After assessing Eric’s health andmortality the cost of the ImmediateCare Plan with a built-in automatic 5% annual escalation was £67,000.

As their property was valued at over£500,000 the release of equity was lessthan 14% of the total value. The familyalso consulted with a solicitor withexpertise in equity release whoensured that they understood all theimplications of the transaction.

Eric and Alma

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England upper £23,250 lower £14,250

Scotland upper £22,750 lower £14,000

Wales upper £22,000 lower £22,000

Northern Ireland upper £23,250 lower £14,250

If someone needs to move into a care home what Government support can theyexpect? If an individual has capital over the upper threshold level they will not qualifyfor financial assistance from the Local Authority until such a time as their capital fallsbelow the stated amount. Financial thresholds vary from country to country:

Unfortunately, in the meantime, privatecare fees will have to be met fromexisting capital and income.

Most savings and assets are included inthe means test, but some confusion hassurrounded the subject of whether ornot a person’s home is included. To helpclarify the situation, a person’s home isnot included in the means test if:

• the spouse or partner still resides atthe home.

• a relative aged 60 or over lives at the house.

• a disabled relative lives at the house.

• a dependent child under 16 lives atthe house.

• the person is in the first twelve weeksof needing permanent care.

• the care is being provided on a temporary basis.

The 12-week Property Disregard

As mentioned above, a person’sproperty is excluded from the meanstest for the first twelve weeks followingadmission to a care home and once apermanent contract is established. Thismeans that if their remaining capitalfalls inside the current threshold thenthe Local Authority should assist with the payment of the care fees.

Legislation

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It is worth noting that they will in mostcases only pay up to their publishedlimits, which could leave a person with a deficit and what isknown as a ‘top up’ situation. It will beup to the individual themselves to coverany difference in actual care fees andthe local authority contribution duringthis 12-week period and after this periodthe difference may only be met by athird-party such as a relative or friend.

The money paid out by the LocalAuthority during the first twelve weeks is not repayable.

Deferred Payment Agreement

If, after the first twelve weeks theproperty has not been sold, the LocalAuthority can continue to pay towardsthe care fees, under the ‘deferredpayment agreement’.

The money is repayable once theproperty has sold or the resident dies(called the event), but for the most partthe loan is interest free, providing themoney owed is paid back within 56 daysof the event. (If more than 56 dayselapse, the Local Authority will start tocharge interest on the loan).

England £108.70

Scotland £71

Wales £120.55 or determined by Local Health Boards

Northern Ireland £100

NHS funded Nursing Care?

Following the implementation of the Health & Social Care Act 2001,individuals assessed, as needing nursing care at home or in a nursing home,are entitled to receive an additional nursing care allowance. This allowanceis non-means tested and tax-free, although how much is paid will dependon where you live.

In addition to the above a person may qualify for NHS fully-fundedContinuing Healthcare, where the cost of care is paid by the NHS (but toqualify for this benefit, patients must be unstable and/or unpredictable and need constant 24-hour specialist/acute nursing care).

The local Primary Care Trust will carry out a NHS Continuing Careassessment on request (see separate section).

What about Personal Care?

Personal Care is only available in Scotland and is currently paid at £156per week. Should a resident living in Scotland qualify for Personal Care,they are no longer eligible to receive Attendance Allowance.

Most state benefits are means-tested,however, Attendance Allowance is anon-means tested, tax-free statebenefit, payable to all individuals overthe age of 65 who have needed care(defined as help with essential dailytasks, such as washing and dressing) for longer than six consecutive months,regardless of whether or not they are in a care home.

Attendance Allowance is available attwo rates: a lower rate, for those whoneed help during the day or the nightand a higher rate, for those needing care during both the day and night.

The current weekly figures are £47.80 lower rate and £71.40 for the higher rate.

Claim forms can be obtained from larger Post Offices, Citizens’ AdviceBureau, Age Concern Shops, the BenefitsAgency themselves or downloadeddirectly from direct.gov.uk.

Individuals needing care under the ageof 65 will still qualify for an allowance,but this is paid in the form of DisabilityLiving Allowance (full details can be supplied on request).

NHS & State Benefits

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If a person’s medical condition isunstable and/or unpredictable andnecessitates the need for constant 24-hour specialist/acute nursing care,they may be eligible to receive NHSContinuing Healthcare.

Sadly, during recent years the systemhas been slightly flawed with manyfamilies complaining to the HealthService Ombudsman. In an attempt toend the perceived post-code disparity,a new National Framework wasimplemented in October 2007 whichestablished a much clearer nationaleligibility criteria.

The National Framework documentsets out the processes for establishingeligibility for Continuing Healthcareand should be read in conjunctionwith the support tools that assist withthe decision making. These includethe Checklist, Decision Support Tooland the Fast Track (used when theperson is considered to have a rapidlydeteriorating condition which may be entering a terminal phase). All of these documents can bedownloaded from the Department of Health website.

Although the National Framework setsout to make the assessment processmore person centred and transparent,

experience has shown that the wholeprocess is still unduly complicatedwith different Primary Care Trustsusing their own definitions ofeligibility within the tools that areused Nationally to assess eligibilityand therefore it is arguable that the‘postcode disparity’ still exists.

Opportunities for assessing as towhether someone may qualify forContinuing Healthcare are oftenmissed, for example when a person isplaced in a care home setting havingbeen discharged from hospital. Asocial worker may be appointed andan appropriate placement found, but ifthe person has assets in excess of thecapital threshold, social services willdeem them as self funding residentsand will then close their files. Nofurther assessments will be carriedout until the residents assets fallunder the capital threshold.

This should not happen as under“Section 47 of the National HealthService and Community Care Act1990”, the Local Authority should,through Social Services, continue tomonitor a person who has beenbrought to their attention as being inneed and the person should thereforebe visited on at least a yearly basis

NHS Continuing Healthcare

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and a care needs assessment carriedout. At each assessment there wouldthen be an opportunity to review theneeds of that person and to refer themover to the local Primary Care Trust if ahealthcare need is identified so that afull healthcare needs assessment canbe carried out.

There are literally thousands of caseswhere NHS Continuing Healthcarewould have been awarded if only it had

been considered in the first instance.Anyone can ask for a healthcare needsassessment so that their individualneeds can be considered for NHSContinuing Healthcare.

If you know someone who you thinkshould have been awarded NHSContinuing Healthcare and wouldbenefit from some expert advice pleasespeak to your Symponia member.

1. Don’t be overly rushed

If the person needing care is in hospital,pending discharge into a careenvironment, don’t be rushed by thestaff to move them before you have put the necessary steps in place.

It’s true that once there is no longer amedical need for them to stay, themedical staff are only doing their jobasking the person to leave, but there isalso the person’s entitlement to bedischarged to a suitable environment.

2. Explore all the possibilities

Once you know that the person can nolonger live independently, you need toadopt a level of pragmatism.

Would the person be better off in a carehome, where they will have the chanceto meet other like-minded people andforge new friendships or would they bebetter staying in their own home with alive-in carer and still enjoy being part ofthe community?

Sadly, sometimes medical conditionsmay dictate the care situation.

3. Consider care at home

Most people like living in their ownhomes, the familiar and comfortablesurroundings of home provide thehappiest environment, and this does notchange as we become older and/or wehave a disability.

Would the person be happier if theywere in their own home?

Is it possible for them to cope?

Have we located a care agency and hadan assessment?

4. Practical hints for moving into a care home

Entering a care home can be the bestsolution for many people, and in factaround 100,000 people have to do thisfor the first time each year.

Draw up a shortlist of potential homesand before you settle on a suitableplace, take the time to visit each homeon your shortlist, preferablyunannounced and use a check-list suchas ours as your guide.

Consider a trial stay, that way the personmoving into the care home knows theyhave choices.

When the person moves into their carehome on a permanent basis, treat it as a positive step, send out ‘new home’announcements just as they would ifthey moved to a new house.

If the person is well enough, why nothold a small room warming party? Send invites to existing friends, but alsoinclude potential new ones from withinthe home. This does not need to be overgrand or elaborate, coffee and chocolatecake will work just as well aschampagne and canapés.

5. Ensure you have the legal authority to act

Drawing up the correct legal authority in advance can be a timely and cost-effective exercise, it could save resourcesand finance in the future.

It is possible to download the forms, butbecause of the legality and far-reachingscope of the documentation andauthority, it would be wise to use theservices of a specialist solicitor.

Should you not already have your ownsolicitor, your local Symponia memberwill be pleased to introduce you.

6. Seek specialist financial advice

Paying for care can often be more of atricky subject than choosing it. As such itis important for you to select the righttype of adviser. The emphasis of allSymponia member advisers is verymuch on respect and care, with thefundamental objective of enablingpeople to choose where they are caredfor, with the peace of mind that they will be able to meet rising care costs indefinitely.

Our Top Ten Tips

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6a. Steps in the process

We strongly recommend that youarrange to meet with one of ourmembers; they will be able to guide you through the myriad of legislation,take you through how this will affectyou and your family and present youwith a comprehensive report detailingall of your options.

Even if your final choice is to do nothing,at least you will have explored all thepossibilities, and will have made a trulyinformed decision, whilst weighing upall the facts. We would much rather youexplore all your options and dismissthem as unsuitable, than never knowthey existed in the first place.

7. Ensure all state benefits are being claimed

Working with your adviser will ensurethat all the relevant benefits are beingclaimed. Even if someone is paying theirown care fees, they will still be entitledto receive certain non-means testedbenefits, such as:

• Attendance Allowance

• Disability Living Allowance (if the person is under 65)

• Nursing Care Allowance

• Personal Care Allowance (Scotland only)

• Other benefits such as Pension Credit and Carers Allowance may be claimable

8. Review or write a will?

Having an up-to-date will is the onlyway a person can be sure that theirestate (i.e. hard earned money) isdistributed in accordance with their wishes.

If a will is not in place, or incorrectlydrawn up, then the fairly strict rules ofintestacy will apply to the whole of theestate. These can be considered harshand could be completely at odds with aperson’s real wishes.

The need for care provides an ideal timeas any to make sure that the person’swill is still current.

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We firmly believe that you and your family deserve the best possible financial advice. Symponiawas established to fulfil that very statement; we have brought together some of the best andmost caring advisers from across the whole of the United Kingdom to form the unified, nationalprofessional body known as Symponia. Symponia is very much a family company formed on anoverriding foundation of traditional values and the real wish to help people at what can be a verydifficult and highly emotional time.

The emphasis of all our Symponia members is very much on respect and care, with thefundamental objective of enabling people to choose where they are cared for, with the peace ofmind that they will be able to meet rising care costs indefinitely; whether care is needed now, orat an unknown time in the future. Not all advisers have dedicated care fees planning experience,the required knowledge levels, the appropriate qualifications or even the necessary empathy torecognise the emotion associated with placing a family member in a care home.

Symponia members really are different, we can promise you that they will all:

We fully appreciate that different people will have differing needs and objectives, meaning thatthe solution for each family will also differ, but whatever the situation, with careful planning,current or future care fees need not be a problem.

However we believe that it is essential that you talk to a recognised specialist. The details ofyour local member are printed on the back page; alternatively contact us direct using thedetails below.

• hold an FSA-recognised long-term care qualification.

• offer a personal face-to-face meeting.

• follow a printed Code of Practice & Conduct.

• present you with a Customer Charter.

• have undergone a current Criminal Records Bureau check.

Registered Office: Barclays Bank Chambers, Stratford upon Avon, CV37 6AH

Registered in England & Wales No: 354984

9. Inheritance Tax

More and more people are findingthemselves with an Inheritance Taxliability, and whilst scope does exist forsome mitigation it is wise to seek theexpert knowledge of a specialist beforeembarking on a mitigation project.

Inheritance Tax is divided into twoparts. Firstly, the nil-rate band refersto an amount up to a pre-set limit (athreshold), and this means that no taxis due if the value of a person’s estateis less than the threshold.

However, if the estate value is overthe threshold, currently frozen at£325,000, tax becomes payable, andanything over the limit is taxed at40% (regardless of person’s nominalrate during their lifetime).

Recent changes mean that couples(married and civil partners) can passtheir nil rate band (in full or the unused portion) onto the surviving spouse or partner.

Our experience has shown thatimmediate or future care fees planning can be an effective way tohelp reduce or mitigate this tax.

10. Consider funeral planning

Often known as the last taboo, ourthoughts about dying will vary fromperson to person and generally it isstill considered a very sensitive andsometimes no-go subject. But asdeath will happen to each and everyone of us, nothing in our lives is more certain.

It is not such a macabre thought when looked at practically. A funeralprovides peace, comfort and offersfamily and friends that chance for aformal ‘goodbye’.

Some people wish to plan their ownfunerals a long time in advance whilethey are still relatively healthy andput in place pre-paid funeral plans,whilst others find the thought just toomorbid and don’t want to think aboutit at all.

Should you want to put some steps inplace, planning ahead doesn’t justmean selecting the coffin, but couldgo as far reaching as choosing thehymns and/or selecting the venueand catering for the wake.

Should you or any members of yourfamily wish to do this, again, your localSymponia member will be able to steeryou in the right direction.

01789 774595 care@symponia.co.uk www.symponia.co.uk