Diary of a busy practitioner, juggling work and family somewhere in England

Earlier this month Mr Johnson (don’t call him by his first name, it is part of the trick) announced reforms to care home fee funding that would involve a cap on care costs. As someone who has to give talks on this subject, I’ve decided not to read the details.


Nine or so years ago I was trying to memorise the Dilnot recommendations so that I would be able to continue to give such talks when I returned from maternity leave. In case you are wondering, this is exactly what I wanted to be doing as a brand new mum. Then four years ago I nearly choked on my sandwich as I sat at my desk and saw that Mrs May, apparently off the cuff, had decided that instead of a cap on care costs we were going to have a cut-off of £100,000 that people would be allowed to keep and at which point the local authority would step in to pay for care. I’m going to wait a bit longer before I bother myself with these latest 'reforms' in case it is just another waste of my time.

Most of my clients are around retirement age and lots of them - fuelled by certain newspapers - are scared stiff of having to pay for care. Even Keir has let me down, not for the first time this year, choosing to ask the question that he knew would be the news soundbite that evening - essentially 'can the prime minister assure us that no one will have to sell their home to pay for care?'.

Oh, Keir, if we can’t rely on you to ask intelligent, sensible questions, I might have to retract my previous blog and go and live…what sensible countries are we left with? Somewhere in Scandinavia? The point is - as Keir and I both know - there are major political points to be made in claiming that you want to protect the 'family home'. It was the thought process (if it is not too far stretched to say there was one) behind the SRNRB (the Stupid Residential Nil Rate Band) and continues to be everyone’s focus when discussing care home fees. It is the politics of fear and I want to explore the issue for a moment.

Firstly, Keir, I assure you that no one will lose their home to pay for their care fees. Feel free to quote me on that. Do you know why? Because a home stops being a home when YOU DON’T LIVE THERE ANY MORE. It becomes a pile of bricks and memories, and (dementia aside) you can take the memories with you. This was something my gran explained to me when she moved out of what truly was our family home - where my mum and her siblings had their wedding receptions, where she had actual land, where my mum had horses and 30 years later we had a camp in the woods called 'The Kingdom', where the wind whistled through the front door and my grandad sat unseen in his armchair behind a cloud of pipe smoke. She was right, we were too old for camps by then, and my grandad and the pipe would be coming with her to their new, sensibly smaller house.

But let’s think about most people’s 'family homes'. My mum recently moved from the house we grew up in, into a two bed bungalow. My friend Sarah’s mum and dad moved to be closer to her. My friend Megan’s mum and dad divorced and her mum now lives with her boyfriend. I suppose I have some clients with lovely traditional 'family homes' but they also have money to pay for care fees. Why would you want a house to stand empty, no doubt deteriorating, whether it was a retirement bungalow or an old country house you have lots of childhood memories of?

Because, let’s be clear (unlike certain newspapers), if your partner, or a relative who is over 60, under 16 or incapacitated lives in the property, the value of the property will be disregarded when assessing you for care home fees. The only people that would potentially be made homeless in this situation are people who don’t fit in one of these categories - for example an independent child of working age. Hopefully I am not alone in thinking that an independent child of working age should perhaps find their own place to live? I certainly hope mine will, Deceptively Angelic Looking Child 1’s room is big enough for a nice sewing table.

I also find it is important to remind clients that they might not go into a care home, that if they do they may qualify for NHS continuing healthcare, and it is likely they will only go in for a short time and may be able to finance it quite easily. For example, if you go into a care home that costs £3,000 per month and your income is £1,000 a month, you only have to find an additional £2,000 each month that you are there. If you are there for 12 months, you have had to find a total of £24,000. I know that is still a lot of money, but it is important that clients realise that they don’t 'take your house' when you walk in the door.

I go to a lot of care homes. I’ve marvelled at cinema rooms, and complained about beds smelling of urine. If my kids want the house (the one that me and my husband paid for, by working hard - not them) so that I can go in the one with the cinema room that smells nice and watch Sleepless in Seattle every day for the last year or two of my life, then they can buy it from us at the market price.


*Some facts and identities have been altered in the above article