Care Flashcards

1
Q

Benefits of Ingenious Care Plan (8)

A
  • for clients who may need care in the future
  • plan is liquid / funds provided (by ingenious) within 2 weeks
  • ingenious provide help selecting a suitable care package
  • funds outside estate after 2 years /qualify for BR
  • maximising the estate
  • client has CFL
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2
Q

Benefits of immediate Needs Annuity (6)

A
  • no investment risk/guaranteed income
  • if client lives longer than expected then will help cap cost of care
  • meets ATR
  • simple to understand
  • payable for life
  • income is index linked to help with increases in care costs
  • payment to REGISTERED care provider is tax free
  • immediately outside the estate for IHT purposes
  • due to age/medical conditions should get enhanced income
  • helps enable future gifts of remainder of estate
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3
Q

Drawbacks to Immediate Needs Annuity (6)

A
  • client may not live long enough to receive full value
  • no capital protection / if client dies prematurely then less in estate to pass to family
  • income taxed if care provider not registered
  • care fees may increase by a greater amount than index linking of the INA
  • this will lead to an increasing shortfall each year
  • income is fixed/ can not be altered
  • may be costs of setting up INA
  • income provided may not cover full care costs
  • if health worsens INA May be seen as poor value
  • takes no account of future increases in care costs
  • inflexible / no ability to change after cooling off period
  • loss of capital in event of early death
  • loss of potential returns from investing
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4
Q

SJP Special Care / vulnerable client Procedures (5)

A
  • should have a third party present
  • if an LPA is in place then attorney should be present
  • establish if client has mental capacity
  • must not give advice to client if unable to make their own decisions
  • 3rd party must be copied in on correspondence
  • relevant section of CFR complete
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5
Q

Duties of attorneys (10)

A
  • duty of care
  • carry out donors instructions
  • not to take advantage of their position
  • duty of good faith
  • confidentiality
  • not to delegate unless authorised to do so
  • comply with directions from CoP
  • not to disclose information without complying with relevant guidance
  • keep accounts
  • keep donors property and money separate from their own
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6
Q

Long term care fact finding considerations (10)

A

CLIENT:

  • Health/disability
  • life expectancy
  • clients attitudes to remaining at home
  • IHT considerations
  • any care benefits currently being claimed? AA?
  • CFL
  • future gifts planned?
  • likely timeframe until care is needed
  • have they had a care assessment?
  • do they need guaranteed income
  • no they need any capital lump sums?
  • any tax implications from selling existing assets?

FAMILY:

  • family support (care available)
  • who is making the decisions - POA details
  • third party top ups
  • prepared to use other assets to fund
  • would they downsize?

CARE:

  • legal provisions / will provisions
  • timing of care - availability and type of care available
  • likely care costs
  • inflation assumptions
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7
Q

Advantages of downsizing to pay for care (5)

A
  • equity released to invest
  • maintenance costs are reduced
  • smaller property more suited to needs
  • independence retained
  • reduces exposure to property / increases diversification
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8
Q

Disadvantages of downsizing (6)

A
  • costs of selling will reduce the amount available
  • family home lost for next generation
  • state benefits may be lost
  • new investment may lose value
  • stress
  • may impact on means tested state bens / local authority funding
  • GWR rules
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9
Q

Advantages of renting out he family home (4)

A
  • future property growth retained
  • more suitable property can be rented
  • rental income may contribute to care costs
  • deferring property may benefit from future price rises (though opposite may be true also)
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10
Q

Disadvantages of renting out the family home (7)

A
  • doesn’t release equity as a lump sum
  • ongoing responsibility for property maintenance
  • may impact on men’s tested state benefits and LA funding
  • need to managed tenants / employ management firm
  • CGT implications
  • income is taxable
  • probable void periods
  • income generated may not meet care costs
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11
Q

Reasons to set up / process of setting up an LPA (7)

A
  • LPA should be set up so that it only becomes active once capacity has been lost
  • so that others can’t make decision until they have lost capacity
  • the mental health act 2005 recognises the mental capacity can come and go
  • end of life instructions can be included in the H and W LPA
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12
Q

Advantages of using a lifetime mortgage with a drawdown facility to fund ongoing care costs (6)

A
  • flexibility in the amount and frequency of withdrawals
  • interest is only charged on amounts withdrawn
  • income is tax free
  • there is a ‘no negative equity’ guarantee
  • can remain in their own home
  • enable them to pass on property to children
  • benefit from future increases in property value
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13
Q

Drawbacks of using a lifetime mortgage with a drawdown facility (6)

A
  • set up costs/ legal fees
  • still responsible for maintaining the property
  • reduces inheritance for beneficiaries
  • interest rate likely to be higher than a normal SVR
  • inflexible
  • likely to be restrictions in downsizing
  • likely they loan will need to be repaid if they enter permanent care
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14
Q

Purpose of Certificate Provider’s Statement? (4)

A
  • purpose is that someone independent of the client
  • and the attorneys
  • can confirm that Philip understands the purpose and scope of the LPA
  • and to establish that he is not acting under duress
  • his mental competence will be established by his GP
  • using a mini mental state exam
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15
Q

How does lacking mental capacity affect how future care decisions can be made in clients behalf?

A
  • LPA can not be set up
  • CoP will decide who will be appointed as deputy
  • the deputy’s powers are likely to be more restricted than under an LPA
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16
Q

Reasons for an H&W LPA over an Advance decision

A
  • advance decision only covers end of life medical decisions
  • a advance decision is legally binding but can be challenged if not clear
  • a correctly prepared LPA can not be challenged
  • clients should both write a H&W LPA whilst they have capacity
  • clients can take account of their current circumstances e.g m. Early onset of altzhiemers
  • LPA sets Out how they wish to be cared for on an ongoing basis ASWELL AS end of life care requirements
  • LPA should be set up on a jointly and severally basis
  • Allow the attorneys to act Independently of each other
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17
Q

Implications of financial / health decisions if lose capacity without an LPA in place

A
  • no instructions will have been provided about future finance/health care needs
  • this would now come under the jurisdiction of the Court of Protection
  • a Deputy would be appointed by the CoP
  • this may end up being a close family member
  • until a Deputy is appointed no financial transactions can take place
  • and no arrangements for care can be made
  • Deputy is unlikely to be granted powers to make gifts, any estate planning or make any end of life decisions
18
Q

Decisions required in an LPA

A
  • who will be the attorneys
  • same attorneys for each LPA
  • do they want replacement attorneys
  • whether attorneys have the power to act jointly or jointly and severally
  • who the certificate provider will be
  • when does the donor want the LPA to come into effect
  • instructions for future gifts/ care/ end of life decisions
  • who the donor would like to be notified when the LPA is registered
19
Q

How would you ‘check out’ a new attorney? (6)

A
  • do they have authority to represent the client
  • LPA documentation ha OPG stamp on each page
  • Type of POA?
  • are there any restrictions on how they can act?
  • how many attorneys/replacement attorneys are there?
  • can they act jointly or jointly and severally?
20
Q

How are income and assets assessed for care provision

A
  • any DLA is disregarded
  • the value of any property is disregarded if anyone else lives there too eg. Spouse
  • FAD are treated as what income they would have produced if they bought an annuity
  • any due inheritances are included
  • 50% of joint savings is included
21
Q

Factors to consider regarding long term care:

A

Level of disability/ attitude of the family

  • when is care likely to be needed
  • how long for
  • what is the current medical and family opinion regarding about the clients current care requirements
  • possible future changes
  • what care is available at home
  • clients and families attitude towards care provision
  • if residential or nursing care is needed to they have a particular care home in mind?
  • has a care assessment been completed

INCOME:

  • what income do they currently have
  • what benefits are they currently receiving
  • what is their marital status, jointly held assets generally treated as owned 50/50
  • any unearned income
  • what pensions do they have ?
  • TFC to be taken?

ASSETS:

  • what assets do they have?
  • share portfolio with CGT?
  • tax implications
  • inheritances due?
  • liabilities
  • is it important to maximise income to pay for fees or maximise estate
  • can they encash investments to pay for care
  • aims, Growth/income

ATR
CFL

  • desire to remain independent
  • do they have a will
  • has an LPA been set up?
  • what type?
  • who are the attorneys
  • any restrictions?
  • are the family aware of the clients intentions
  • clients views towards gifting and IHT planning
  • previous gifts made
22
Q

Factors to consider for funding of care costs (10)

A
  • cost of care
  • stability of the condition
  • assumed inflation
  • assets
  • CFL
  • ATR
  • other sources of income eg pension, investment income
  • IHT consideration
  • family considerations, eg ability to part fund/ provide care
  • attitude towards IHT planning / gifting
  • affordability for the client
  • possible third party top ups
  • clients desire to remain independant
  • level of benefits to be received
23
Q

Advantages of domiciles care (3)

A
  • peace of mind, the client can stay in familiar surroundings and still receive care
  • often cheapest way to receive care
  • no restrictions on eg visitors or keeping pets
24
Q

Disadvantages of domilcilary care (4)

A
  • care not 24/7 so maybe a risk
  • appointing carers needs to be managed
  • agency carers give no guarantee of continuity of staff
  • may not be suitable when a significant amount of care is needed
25
Q

Sheltered accommodation

A
  • range from Luxury apartments to self contained flats
  • private or public
  • ability to live independently but knowing help is close by in an emergency
  • not suitable for people with high levels of care requirements
  • costs similar to domicilary care
  • typically used by people to downsize
26
Q

Immediate care and reablement

A
  • provided free by NHS
  • for patients who need short term intensive medical care
  • usually at home
  • for individuals who would otherwise have to have inappropriate in patient care
  • result of assessment of needs
  • must have planned outcome
  • time limited - usually 2-6 weeks
  • aimed to promoted independence
  • and limit time in hospital
27
Q

Respite care

A
  • provide cover for normal cater if they are unable to care or need a break
  • provided free by NHS if they qualify
  • or local authority if not, who will probably charge
28
Q

Residential care home

A
  • technically known as ‘care homes without nursing’
  • run by councils or usually commercial care homes
  • provide personal care for people who do not need medical care
29
Q

Nursing care home

A
  • similar to residential care homes but provide registered nursing care
  • client likely to be highly dependant on care
  • costs higher than residential care due to medical support or additional staffing levels needed
30
Q

Hospital care

A
  • for individuals with high degree of medical care needs

- usually highly dependent on care provided by others

31
Q

Elderly mentally ill care

A
  • care for elderly with illnesses such as dementia

- nhs provision

32
Q

Qualification rules for Financial Assistance

A
  • income and assets under £23,250

- in England

33
Q

Reasons not to recommend the SJP Later life planning scheme (6)

A
  • where client can not afford to make an outright gift
  • where client is already in receipt of AA or DLA
  • particularly if they are funding care costs
  • if funding care then An INA would usually be more appropriate
  • where client is not concerned about care in the future
  • it is unlikely the client will survive 7 years
34
Q

Benefits of SJP Later Later Planning Scheme

A
  • income for life or until fund exhaustion on qualification to pay for care costs
  • investment free of IHT after 7 years
  • all growth immediately outside estate
  • freedom to vary beneficiaries
  • IB must be written on lives of some or all beneficiaries which gives the trustees flexibility to defer encashing the investment until a more opportune time
  • ability to select a rising income on qualification under the scheme
35
Q

Drawbacks of SJP LLP Scheme

A
  • NRB needs to be available
  • DOV should be considered if client has received inheritance in last two years
  • BR/EIS solutions should be discounted first
  • outright gifting should be discounted
  • where client has sufficient assets to fund care then a Gift Plan should be considered
  • where client wishes to access capital then a loan plan should be considered
36
Q

Why is it important to have at least one replacement attorney for each power of attorney:

A
  • if attorney is unable to act / dies
  • then the LPAs will end
  • if this happens then future decisions will fall to a Deputy
  • who is appointed by CoP
  • and may not act in the way the client wishes
  • replacement is likely to act as client would want
37
Q

Gifts that attorneys may make under an LPA (5)

A
  • gifts on customary occasions (birthdays etc)
  • gifts that follow any previous pattern
  • under the ‘de minim is’ Rio, gifts up to £5500 per year may be made
  • however the size of gif t must not be unreasonable in relation to the size of the donors estate (not them them short is money)
  • unable to make substantial gifts even if for IHT purposes, without permission of CoP
38
Q

6 advantages and 6 disadvantages of an immediate needs annuity (12)

A

Advantages:

  • guaranteed income
  • for life
  • tax free if paid to registered care home
  • simple to understand
  • immediately outside estate for IHT
  • if in poor health then could get enhanced rate
  • enables to make further gifts from estate in the future
  • if live longer than expected then caps the cost of cap

Disadvantages:

  • income taxed if care provider not registered
  • costs of setting up INA
  • costs of selling existing investments
  • takes not account of future care cost increases
  • inflexible
  • loss of capital on early death
  • loss of access to capital
  • loss of potential returns from investing in asset backer investments
39
Q

How must an attorney of an lpa act? 5

A
  • follow instructions the donor included in LPA
  • consider any preferences the donor included in the LPA
  • help the donor make own decisions as much as they can
  • make decisions in the donors best interests
  • respect donors human and civil rights
  • make the decisions themselves / not ask someone else to make the decisions for them
  • though they can get help with difficult decisions
40
Q

What a donor can and cannot do (re gifts etc)

A
  • can make gifts for occupations such as birthdays
  • make donations that the donor would not object to Eg to charities they had previously donated to

Must apply to CoP for any other type of gift
Such as:
- making interest free loans
- letting someone live in the donor is property without paying market rent
- pay school fees

Must ensure the donor can afford them and is not left short of cash

When selling donors property they must get legal advice if:

  • sale price is less than market value
  • they intend to purchase the property themselves

Attorney can apply for a statutory will if donor needs to make one but cannot make one themselves

  • can not change donors will
41
Q

Principles of the mental health act 2005 (4)

A
  • MHA recognises that mental capacity can come and go
  • when exercising powers under the MHA
  • the attorney is required to let the donor make their own decisions
  • unless it can be shown that they are unable to do so
  • must also recognise that just because the donor makes a decision that the attorney feels is strange or unwise does not mean they are mentally incapable of making a decision