To ask the Secretary of State for Health who pays the monetary difference when there are shortfalls between care home fees and local authority contributions for people who are in need of long term care but (a) have no income or third-party financial help and (b) have capital wealth below the lower capital limit set out in Local Authority Circular (LAC(2003)8).
It is rare for individuals to have no income whatsoever. However, the majority of care home residents do not have sufficient income to meet care home fees and have assets below the upper capital limit. In these situations, they can approach their local council for financial support. Residents should contribute to care costs according to the National Assistance (Assessment of Resources) Regulations 1992, and neither they nor third parties should be asked to make top-up payments in addition to the resident's assessed contribution in order to meet assessed needs.If there is a difference between what a council would usually expect to pay for residential care and care home fees, the burden of meeting the shortfall should not be borne by residents or third parties if the residential services are necessary to meet assessed need. It is the council that should make up the difference. These matters are fully set out in the National Assistance Act 1948 (Choice of Accommodation) Directions 1992 ("The Direction on Choice") and the amending Direction, the National Assistance Act 1948 (Choice of Accommodation) (Amendment) (England) Directions 2001.Where residents choose to enter more expensive accommodation than the council would usually pay, it is appropriate for residents, in limited circumstances, or third parties to make up the difference between the care home fees and the sum of the resident's assessed contribution and the council's contribution up to its usual cost.
To ask the Secretary of State for Health (1) what measures he took to consult care home owners before the recent increase in fees paid by care providers for registration to the National Care Standards Commission;(2) if he will make a statement on his policy towards fee increases for care providers registering with the National Care Standards Commission.
It has always been the Government's policy that the recurrent regulatory costs of the National Care Standards Commission should be borne by providers and purchasers of care.The Government undertook a wide-ranging, public, consultation on the framework for registration fees during the summer of 2001.
To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated on (i) care home accommodation prices and (ii) nursing care prices for the last five years in (A) St Helens and(B) Merseyside; and if she will make a statement.
The Department has not commissioned or evaluated research on care home accommodation prices and nursing care for the last five years in St Helens and Merseyside.Recent research on care homes issues can be found in the document titled The Residential Care and Nursing Home Sector for Older People: An Analysis of Past Trends, Current and Future Demand, published on 8 August 2002, copies of which are available in the Library and on the Department's website at
To ask the Secretary of State for Health what assistance is provided to the elderly to negotiate contracts with care home owners if they are considered financially able to pay under the guidelines set out in Local Authority Circular (LAC(2003)8).
Where individuals have the capacity or the support of their families to enter residential accommodation themselves, and are not entitled to public funding, councils should nevertheless carry out assessments of their needs if requested and provide general information on residential care and specific information on care homes in their areas. It will be up to individuals or their families to negotiate their own contracts. In doing so they should be directed to Standard 2 of the National Minimum Standards for Care Homes for Older People, Much sets out the terms and conditions that should underpin such contracts.
To ask the Secretary of State for Health what research his Department has (a) commissioned and (b) evaluated on the improper use of personal expense allowances (PEA) by care homes; what means exist to ensure patients receive their PEA; and if he will make a statement.
The Department of Health has not commissioned research into the use of the personal expenses allowance. However, the Department has been grateful for the research conducted by Help the Aged into this matter and the subsequent report "Friday is pay day"published in December 2001.On the basis of the Help the Aged report, dialogue with other national organisations and correspondence received by the Department, Local Authority Circular LAC(2002)11 reminded councils in March 2002 that personal expenses allowances should not be spent on aspects of board, lodgings and care that have been contracted for by the council and/or assessed as necessary to meet individuals' needs by the council or the national health service. This advice was repeated in Local Authority Circular LAC(2003)8.
To ask the Secretary of State for Health what the ratio is of registered nurses to residents in care homes in (a) Merseyside, (b) St Helens, (c) Wigan and (d) Warrington.
The information requested is not centrally available.