Fee And Funding

Many people think that care homes in the independent sector are only for the wealthy. You may be surprised to know that the majority of care homes in the UK are owned by the independent sector, and that 70 per cent of residents have their fees paid partly or wholly by their local authority.

If your local authority is assisting with funding, it doesn’t mean you have to choose one of their homes. You can request any home that accepts residents funded by the local authority. However, the local authority will want to be sure that the home is suitable for your needs and doesn’t cost more than it would usually pay for that type of care. If you want a more expensive home than the authority is willing to pay for, you are allowed to ‘top up’ their contribution from another source.

Sources of funding:

Self funding
Local Authority Funding
Local Authority plus Top Up
3rd Party Contribution
PCT/Continuing Care
Insurance
Other (i.e. charitable organisations)

What will the state normally provide?

Where it is likely that you have insufficient capital to pay the care home fees, the local authority will do a financial assessment to determine whether you are eligible for local authority funding. The state provides care for those with insufficient funds to pay their own costs; if they feel that you do have sufficient means you will be required to pay at least some of the fees.

If your capital exceeds £23,250 (England) then you will not be entitled to any funding
If your capital is between £14,000 – £23,250 (England), local authority may pay for some of the care home costs.
If your capital is less than £14,000 (England) the local authority will pay for residential or nursing home costs.

My mother is looking for residential care - will she have to sell her home to pay for her care?

If your mother has capital of over £23,250 (in England; £22,000 in Wales) she will not qualify for assistance from the Local Authority until such a time as her capital is below this amount. Any private care fees will therefore have to be met from existing capital and income. (If she has assets below £23,250, she would get increasing help on a sliding scale down to the lower limit of £14,250, where no contribution is needed)

Most savings and assets are included in a means test, but some confusion has surrounded the subject of whether or not a person’s home is included. To help clarify the situation, a person’s home is not included in the means test if:

Your father still resides in the home;
If a relative over 60 resides in the house;
if a disabled relative lives at the property;
If a child under 16 lives in the property;
She is in the first 12 weeks of needing permanent care;
The care is being provided on a temporary basis.

Can I keep my pension and benefits if I move into a care home?

If you are funded by the local authority you will be expected to use all of your income, including your pension and benefits to help fund your care except for a nominal sum of £21.90 (England) per week for your day to day spending money. However, if you are paid the Mobility component of the Disability Living Allowance you will continue to get this. If you are over 65 you will also be entitled to up to £5.25 per week of any savings credit.

Do I have to sell my house?

When the local authority completes their financial assessment they will look at all of your assets including your home and pensions. They will only include your home if you live alone or if both of you are moving into a care home. There are specific rules regarding whether certain close relatives are able to continue to live at the home.

What is a 3rd Party Contribution?

If you are entitled to full local authority funding and the home that you choose is more expensive than the local authority is willing to pay, a 3rd party contribution may be paid. This contribution cannot be paid by the prospective resident themselves for legal reasons; however someone else can do so such as a friend or family member.

Is there any difference in funding for nursing care?

If you require nursing care you will be entitled to a contribution from the NHS towards the cost of the care that a Registered Nurse provides, regardless of whether you are privately or local authority funded. This is called Registered Nursing Care Contribution (RNCC).

Where someone needs ongoing specialist medical treatment, the state will pay for the full cost of care; this is called Continuing Care. If you think that you might be entitled to continuing care you should discuss this with your GP, hospital or care home staff. A referral may be made by the care home on behalf of a resident if they feel that the resident’s needs have increased such that they may be entitled to continuing care funding.

An assessment is undertaken to decide whether someone is entitled to continuing care; there is an appeal process in the event that an application is turned down.

What happens if I run out of money?

If your capital falls below the upper limit whilst you are in a care home, you become ‘depleted’ and therefore you will be eligible for funding from the local authority. It is important that you keep the care home manager informed if this is likely to happen so that they can help you arrange the appropriate funding.

Can I get help in my own home?

It is possible that the local authority may be able to support you in your own home however this is down to individual authorities. They may assess your ability to contribute towards these costs just the same as if you required assistance with care home fees and you may be required to pay part or all of the costs accordingly.

You may be entitled to additional benefits to enable you to stay in your home as long as possible including: Disability Living Allowance, Attendance Allowance and Carers Allowance. Some benefits are not means tested, the Benefits Agency should be able to offer advice (Tel: 0800 009966).

Where can I get more advice?

Paying for care is a complex subject, and everybody’s situation is different. You should seek advice about your own personal circumstances from organisations such as:

Social Services
Benefits Agency (0800 882 200)
Age Concern (0800 00 99 66)
Counsel and Care (0845 300 7585)
Eldercare (01707 368 936)