Live from Sheffield: Affording Care

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Hello. Today we're live in Sheffield at the Grange Crescent Residential Care Home for a special Moneybox Live on the cost of care. It is a freezing cold day in the city, lots of ice on the ground, but it's nice and warm here inside the house. homes cafe where i'm joined by residents staff and experts to discuss the cost of care in older age it's a purpose-built residential home it's out in the suburbs it's home to 54 people including 16 in its specialist dementia

And it's also run by a charity. So unlike many homes, it's not being run to make a profit. Now, of course, the moment you realise you or a loved one needs the support of residential care. can be hugely stressful. And we get a lot of emails from listeners about the financial stresses too. When the letter came through for the price increase for this year, I just thought, wow, how am I going to cope?

Well, we'll be asking how people can cope in today's programme. The cost of care, of course, is a national conversation. Unlike NHS services, social care is not free at the point of use. In fact, to live here at Grange Crescent costs just over £48,000 a year. Now that is a huge amount, but it's better than the national average of just over £60,000.

we'll also be looking at the kind of care and the facilities that those big bills provide and in fact if i go into the next room two residents carol and john are playing dominoes at the table hello Hello. Thank you very much for having Moneybox Live to visit. Carol, there's lots of different activities, aren't there, here at Grange Crescent? Yes, very much. Yeah, we like to do quizzes regularly, don't we?

And board games. Yeah, lots going on. And in fact, I was admiring your manicure a little bit earlier. Tell me who did your nails. One of the staff. I can't remember which one. Natalie, I think it was. It's nice we gave her a name check, isn't it? John, who's winning at Domino's? Me.

Now, I heard from Carol earlier that you cheat because you can see her dominoes reflected in her glasses. That's a lie. Scandalous lie. Well, I'll come back and chat to you both very, very shortly. And I'll tell you what, when Moneybox is over, I'll play whoever the winner is. Thank you.

we're asking then how people can prepare for and manage the cost of care we're in Sheffield but wherever you are get in touch with your questions and your comments you can email moneybox at bbc.co.uk or you can send us a whatsapp message the number is

Now before we meet today's experts, let's get a flavour of what life is like here at Grange Crescent. Asha Oliver, the registered manager, has been giving me the tour. Right, this obviously is the reception area and then I can now show you onto a corridor with the people living with dementia. Okay, thank you. This one here, we have... 16 people on here, all with different levels of dementia. Hello, my love. Hello. How are you? Are you all right? That's just one of our ladies.

We've got a good mixture of people on here, again with different levels of dementia. So is 16U at max capacity? It is, it is on this corridor. This is our... dining room and also a lounge together. We also have a conservatory area as well and I think just here at the moment some people are just kind of getting ready.

close to dinner time so you're giving me the tour you must give this tour to people who are thinking about moving in or thinking about moving their loved ones in yes we do we get quite a lot of what we call show rounds Because obviously it's a time what can be quite upsetting for families as well, especially when they don't know what they're looking for. So I come, show people around.

And I also give them an honest opinion of what it's like to live in a care home. Do people talk about the money? Do people seem worried about the cost? Absolutely. I think sometimes that's one of the first things that they do ask, especially for people who are self-funding as well, or some people just coming through the door and they haven't got a clue. And when we say to them, have they had a financial assessment, things like that, they just don't understand what one is.

And actually quite horrified as well when they say, well, actually, my mum has got a house. Does that mean she's got to sell it, you know? And unfortunately, you know, we say you need to get a financial assessment done, you know, by the social services. And unfortunately, that can, you know, that can sometimes.

make it or break it, whether they're moving to the home. Now I can see on the board here the what's on. Tell me about some of the activities that you offer. We've got memory joggers, board games. On Wednesday we've actually got a singer in, which goes down really well. Paul Barry is really well. I mean, I can just see Sunday, coffee morning, afternoon, bingo, and then nail care. I mean, sounds like my dream day. Yeah.

Absolutely, you know, that's what we try and do. We try and do a bit of mix and match with everybody, plus it's a bit of pampering as well, a bit of one-to-one time, a bit of pampering and everything else. I think everybody likes that, don't they? I certainly do. Yeah, absolutely. If I was looking around, what would you say to me when I asked what the fees were, how much it was going to cost? At the moment at Grange Crescent, if you are a self-funder, it's £930 a week.

If you are funded by social services, they actually only pay us £700 a week. So there's a gap? There's a tremendous gap because obviously Sheffield City Council only pays that £700. So unfortunately, you know, it can sometimes penalise the full fee payers. So that's why...

either full fee pays or sometimes just that little bit higher. I mean, in an ideal world, Sheffield City Council should be paying us the £900, you know, so there wouldn't be such a big gap between the self-funders and the funded. Oh what's in here? This is our hairdressing room. This is a very important room, can I just say. I believe you. Especially on a Wednesday and Friday, all the ladies and gents queue up to have the hair done. Everyone.

Needs to feel glamorous. Absolutely. And like I said, there is a queue, so, you know, so it is quite funny. And it is quite funny, especially if one lady thinks another lady's pushing in front. You know, again, it's just a bit of pampering time for them. Is the cost of this included in the fees or are these extra? No, a hairdresser, a hairdresser is extra. So it's things like shiropa did as well. Things like that are extra.

Why is care so expensive? We provide 24-hour care. We obviously feed people, you know, and I think what people have got to understand that now people's care needs are more complex, you know, whereas I've been in this job for quite a while and, like, 30-plus years ago. So you've got a little old lady who wanted to come into a home because they wanted company.

That is no longer the case. You know, people's needs are greater. The equipment that they need now, they need more equipment. And before we could get somebody what might be in a care home for like 10, 15 years, now I reckon the average. is probably about between a year and a half and two year because the greater the resident is now is that much the care needs are much more.

Thank you so much to Asha for the tour. Well, listening to that and joining me here in the Home Cafe are three experts. I'm joined by Claire Rintold, the CEO of Chef Care, the charity that operates this care home and eight others, by Professor Vic Rayner, the chair of care providers. I'm joined by the independent financial advisor, Jonathan Rowley. Good afternoon.

Hi. Thank you all for being with us. Jonathan, Asher told me then that the people come for the tour, they've often never had to think about the care that their loved one will need. And quite often by the time, of course, somebody's looking at care homes, it's because they're at a crisis point.

possible for them to stay at home it can be hugely stressful if someone is listening and they are in that position what do they need to think about firstly we always say to people try and just put together a budget of your income and the assets

you've got at the end of the day you're going through a different stage in your life when everything's changing so one minute you're at home probably living independently or with some level of care and all of a sudden you're wanting to move into a care home which is very expensive. For the majority of people that we come across, the level of income that they've got isn't sufficient to pay those care costs, therefore they've got to look at other assets that they can then use.

like savings, investments, property, that type of thing. So have a plan. What resources have you got? And then how can you utilise those to pay? Thank you. Well, Vic, we're already getting lots of emails from people asking whether they can shield their money from the...

cost of care to protect their children's inheritance a lot of people do feel quite strongly don't they about wanting to leave something for their children and then other people feel quite strongly that that shouldn't be at the expense of the taxpayer that's a big part of why it's so hard to solve this issue who pays for care.

Yeah, I mean, I think that we are in a situation where many people, as Jonathan has described, are just not thinking about what care they might need. They don't understand that they will have to pay for that care. They don't understand how those decisions will be made and who will make... So I think it comes as a great shock to people, and therefore some of those reactions to it are based on that shock. I mean, the kind of care, the things that happen within a care...

setting, like a care home, and Asha's described them brilliantly, are very comprehensive. So people are getting 24-hour care, they're obviously getting their accommodation, they're getting food, they're getting often... a wide range of activities. They're getting, you know, a safe space, a regulated space, a well-insured space. There's lots and lots of costs attached to that. And so I think what we need to do is have a proper debate about exactly what... we expect.

from care in the future. Claire, earlier Asha mentioned then that funding gap between what councils pay for care and what self-funders have to pay. Now Sheffield City Council told us lots of different factors influence that difference in price. Things like councils buying power. And also said it's increased rates paid to care homes above inflation for the past three years. But does that mean that self-funders, people who pay more, get priority for spaces in your homes? No, absolutely not.

as a person who makes a decision and they base their decision purely on can we look after this person safely, give them a good quality of care and that's not based on money.

Thank you. Vic, when we talk about the cost of care, it varies hugely. £48,000 here, some homes closer to £90,000 a year. Now, this is a devolved issue. How does the kind of support that you can get or the amount of savings you're allowed to have vary across the different nations? Well it does vary, you're right. So in Wales for example the threshold level which the local authority will pick up the rate is much.

higher so it's about it's over double so it's around about £50,000 in Scotland it's a different rate as well and in Scotland for example you have a negotiated nationally negotiated contract for care homes so you're not getting a situation that you have in

England where different homes in different parts of the country are paid differential rates by the local authority so it's very complicated and that is one of the challenges so if you try to be in a position like Jonathan's in or Claire and colleagues you're trying to explain

a situation that people may not understand because they've heard it in a different way in a different part of the country. So we're making it very complicated for people. Yes, and people might just not have thought about it or heard anything about it at all. Jonathan, I picked up this flyer in the reception here. investment company suggesting a care fee annuity could be one way to manage these costs. What does that involve? What is that?

Yeah, so immediate care annuities are typically for when people are going into a care home and they've worked out that there's a shortfall in their income of, let's say, £20,000 a year. it's possible to approach insurance companies and apply for an immediate care and annuity. And the insurance company will then look at your age. They will medically underwrite you, so they'll be contacting your GP for medical details.

to try and establish how long they think you're going to be around. In return, they will quote a premium and if you pay that lump sum, then they will provide you with a guaranteed income for the rest of your life. We often find that people overlook this when they're looking at care fees planning, but it is really one of the best things to look at.

at the beginning the reason for that is that any income is paid out tax-free if it's paid to the care provider and also it gives the family and the individual peace of mind of knowing that they're going to cover the Make money predicting football. Now you can. Now in Texas with Calci. Calci is the only platform that lets you legally trade on real world events in all 50 states from football to Bitcoin, the Oscars, and even politics. If it matters, you can trade on.

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OK, well, let's move on. Let's hear from Pam next. Her mother, Thelma, lives with dementia and moved here very recently. My mum is now 94. She actually grew up in poverty but was very clever. student got into grammar school she eventually went on to become a teacher and a head teacher a few years ago she started to develop dementia we managed to keep her in her flat in a retirement complex where we paid carers to come in twice a day.

My sister and I live locally so we also called in every day, did the practical things like washing, the groceries, the medicines. Perhaps a couple of months ago she deteriorated significantly that we had to get her into care. As a matter of urgency, the carers could no longer cope and we couldn't cope. It became dangerous for her to stay in the flat she was in. It's a very stressful time. There's a lot to think about and there's obviously the anxiety about your mum.

How much did the finances of care play into that anxiety? It was very worrying and we contacted... Sheffield Adult Social Care who were very helpful. They put us in touch with their financial advisor but my mother owns her flat and she had some savings so we realised that Even though we could defer payment for 12 weeks, as a matter of urgency, we had to get her here. So my sister and I decided that we would somehow self-finance it.

Because she's on quite a good pension as a head teacher, retired head teacher, we can finance it, some from her pension, some from the savings. We think we have about four to five months while we are selling her flat. After that, my sister and I are going to have to pay the extra. Probably at least £1,000 for every four weeks that my sister and I will have to pay put towards it.

We are hoping we will sell the flat. The flat is on the market. Can I ask, do you have power of attorney for your mother? Yes, definitely. That, I would say to everyone, get power of attorney. I'm going to do it. with my son, give him power of attorney for me. That made things so much easier because we were able to put the flat on the market. We were able to handle her finances and her health.

Were you surprised by the cost of care? I was at first until I saw it and then I realised just what it takes. The staff are highly skilled. I think they're amazing. If she is awkward because she has dementia and she can resist, they leave and then come back in 10 minutes and try again. And they keep trying to get her cleaned up, to help her eat.

Do you think that it's right that your mother pays for an element of her care? That's an interesting one because every other illness, disease I can think of is funded by the NHS. If you get Alzheimer's, then you pay for your own care. I'm sure there are other instances where you have to pay for your own care. Personally, I would like... social care to be part of a centrally funded NHS.

Well, thank you to Pam for telling me about her mum, Thelma. Jonathan, Pam's mother's pension isn't covering the cost, so they're using her savings, they're selling her home. Eventually, potentially, they're going to pay for the care themselves.

That is all a lot more straightforward when you have power of attorney, isn't it? Yeah, it's far better. If you haven't got power of attorney, then effectively you haven't got somebody that can act on your behalf. So it's always something that we would, when meeting with clients or prospective clients, say... to them the most important things are the wills and the enduring powers of attorney.

Lots of people getting in touch, as they always do on this topic. Here's a message from Sarah who says, I'm self-funding my mum's care, but I won't have any money for my own. So I worry about the cost to my children. Thank you very much for that. Do keep your thoughts coming. Claire, we heard from Pam.

This is definitely the right place for her mother. She's really pleased with the care she's getting. Sometimes things do go wrong, though. One of your other homes was rated as requires improvement. How do you deal with that? It's horrible. You want things to be perfect, and they're not going to be perfect. What you can do really is...

Apologise, put it right, make a plan, make sure you know what you're doing, who's doing it, by when. But also we try and be really proactive. So we do audits, mock inspections, surveys, feedback, so you get ahead of problems, stop them happening. OK, Vic, all of this, the finances of this, it puts pressure on local councils, doesn't it? So let's just take an example from where we are. Sheffield City Council told us its adult health and social budget is...

30% of its overall spending, its total overall spending. And the local government association told us adult social care has faced decades of underfunding, leaving services at breaking point. The cost of care does put a huge amount of pressure on council finances, doesn't it?

Yeah, and I think that the other element of that is, of course, the costs are... The needs of people who are receiving care are changing and increasing very significantly. So councils are trying to support a group of people who have increasingly... complex needs we heard in the latest government announcements that there's an intention to focus on increasing delegated health care tasks into the care sector these all have additional costs attached to them and so local authorities

I mean, the 30% figure is actually quite low. There's plenty of places around the country which are looking at more like 50 to 60% of their overall spend being on care. So it's absolutely essential that we have a national conversation about what care should look like.

what people's expectations are, and so that everybody is aware of what councils are actually contributing. Now, part of that conversation, of course, will be this new review into care costs that you mentioned. The Department of Health and Social Care told us that's being carried out. It'll publish its first report.

report next year. It's also giving local authorities up to £3.7 billion extra this year and £880 million as an increase in the social care grant as part of that. Vic, we're a personal finance... program. We're not a political one. But part of the issue here is that it's a very difficult problem to solve politically. There have been so many attempts to fix it. Yes. And I think it is.

political with both a large and small p in a sense. Everybody should be concerned about social care. It's an issue that affects all of the population. I think that the number of calls coming in from your listeners will show just how prevalent it is. It is, and I think we have to make really clear to politicians that this isn't an issue that can continue to be kicked down the lane. It's something we've got to address quickly and rapidly. And the problem with the...

The current review is the length of time for us to find out what the solutions will be. We've been promised lots of reviews over the years. Legislation came in in 2014 with an amendment around that. We haven't had that scene to be put in place yet. So we've got to get to that. And I think everybody needs to try and think about how...

How do we want care to operate and to influence and to feed into that consultation when it comes forward? Well, as I say, that new review, although a lot of that will come forth in 2028, the Department of Health and Social Care told us it's going to publish the first...

Right, we're talking about... what a shock the cost of care can be. What about when each year brings a fresh shock because the bill goes up? Let's hear from Stephanie next. She emailed Moneybox because she's worried about the rising cost of her mum's care home. She went into care home and the care home is, in my opinion, wonderful. However, the cost of care is just, yeah, phenomenal. And the year on year... cost moving forward. I've paid 8%, then 8.8%. And this year's come in just under 11%.

It's just something I hadn't budgeted for. I'd sort of budgeted for inflation and a little bit. I've had to sell my mother's house to help fund this care. When she first went in, I can't remember exactly, but it was about £51,000 a year. The cost with the increase takes it over £64,000 a year when the letter came through for the price increase for this year.

I was very upset. You can probably hear it in my voice. I just thought, wow, how am I going to cope? Sorry, I didn't mean to cry, but it's just got me.

It feels a bit like profiteering, but at the end of the day, I know people have got to pay the bills, they've got to pay the staff, and they do need to make a profit. They're a business. But I must have spent hours sitting... weighing up what I can do with the finances so yeah that's how it gets you and one of the questions I've asked of the care home where my mother is is what are you doing to mitigate some of this cost

What can you do in businesses of which they are? You have to do that, don't you? You really can hear how distressing it is for Stephanie. Claire. She feels that her mum's home is profiteering. Now you're a not-for-profit organisation. How are your own costs changing and how much have you had to increase fees in recent years? The costs are horrendous, aren't they? We only charge really what it costs. If we're lucky, we make 1% each year to invest back.

But everything costs a lot of money. So our wages account for about 72.5% of our spend. That's 11.5 million last year. This is across your nine homes? Across nine homes. We spend about a million pound a year on food. We spend £750,000 on utilities. All of these costs are going up. People know they see it themselves. There's also hidden costs around. Insurance, regulation, that's another 350 grand. So it kind of costs what it costs. I appreciate it is super expensive, but everything is going up.

And Vic, a lot of people listening then, though, will think, well, let's find a charity-based care home. If it's cheaper at places like the home we're in today, how easy is it to find one like that? So there's a problem somewhere between 12% to 15% of all provision is done by the charity. So there will be premises and locations within where you are. You can find out through using some of the bodies like carehome.co.uk where you can look to see what not-for-profit provision is.

there and i think the point that claire's making is is in that context it doesn't mean that people are only working with local authority clients they're working with self-funders as well but any surplus that is made is reinvested and we are desperate to get sort of

really fundamental changes into the care sector. There's huge amounts of potential for technology, for example. There's huge amounts of changes in the context of the skills and expertise staff need and are delivering. There's increasing requirements around equipment and compliance. of care needs so in order to get those

those staff and those bits of equipment in there, we need any surplus funding to go back into the provision of care. And that's what the not-for-profit sector does. Well, we've had an email from Jackie to say, my father's care fees were increased by 10% in October due to the rising costs.

to national insurance in April. We feel like this is unfair as the costs won't be increased for them until April. Lots of you getting in touch, making very similar points. But I want to get back now to Carol and John and, hello, disturb their game of dominoes once again. Carol, is he still cheating?

Yes. No. No. No. Carol, can I ask you, tell me about your care. Are you self-funding or are you getting financial support? Financial support. So you're getting some support then, but are you paying something towards your care? Is that eating into your own savings? No. No. I do pay for my own, but it's not eating into my savings.

Okay, so that's good. That must be a weight off your mind. Well, it's more a weight off my children's mind because they haven't got to pay it. Now, you were showing me, before we came on air, you were showing me photos of your grandson, your very beautiful newborn granddaughter on your phone as well. Do you worry about not being able to leave anything for your loved ones? Yes, I do. Because it's just not something that's not done anymore. You like to do something to see my best start in life.

So even if it's only a few hundred quid, you know, it's better than nothing. And do you think that the cost of care, is that a conversation people who also live here alongside you are having? Does it worry other people who live here? I've not really heard anything about things like that. You know, we don't really talk about that sort of thing, do we? I suppose quite often it's a conversation families are having or that they're having with their families. Yes, definitely.

How reassuring do you think it is for your family to know that you are in a home like this, you are getting that level of support and help that you need and you're still able to hang out with your friends and get your nails done? Yeah. Definitely, because I used to have been lower stops in Suffolk, and I kept having falls. My son had to keep getting called out of work, which wasn't very good for him, so my daughter decided to find here.

And that's where I moved from lowest start up to here. Well, it shows the importance of having a different care home if it's needed for you. Right, they actually need this room back for the next activity. So it's a good thing that we're almost...

out of time in today's program. Thank you so much to all the residents and to the staff here for making us so welcome. And thank you to the many people who emailed and messaged us. Thank you, of course, to our experts, Claire Rental, the CEO of ChefCare, Professor Vic Rayner, the CEO of ChefCare. National Care Forum and the IFA, Jonathan Rowley from the Society of Later Life Advisors. Paul Lewis, as always, is back on Saturday. He'll be talking about rent and housing costs. So another...

very big issue. If you've got a story that you want Moneybox to look at, then you just get in touch. You can email moneybox at bbc.co.uk. You can also send us a voice note or a message on WhatsApp. The number is 033 067 83 183 183. Right, I am off to get beaten at Domino's by Carol and John. I don't actually know how to play. What do I do first? Seven Domino's. Have a very good afternoon.

I'm Michael Gove, and on a new series for Radio 4, I'll be discussing how to survive politics. I'll be joined by fellow politicians to discuss how politics really works. It is only because of your principles that it is worthwhile. We'll be talking about how to build alliances. You're all trying to make the world a better place and you have quite a lot in common. How to cope with being unpopular and how to stick to your principles when things get tough.

Faith, family and friends are very important. Has there been a time when you felt betrayed? Do you think you've ever done the betraying? When Vivint Smart Security gives you a smarter way to protect, and its smart thermostats give you a smarter way to save, well, that's a smarter way to live. Get the smarter home system that just gets you at Vivint.com.

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This is an investment that carries risk. CalSheet.com.