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Long Term Care - Local Authority & NHS funding

Find out more about what funding is available for long term care and how to pay for it.

SOLVING PERSONAL LEGAL MATTERS

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Long term care

The question of the payment of care fees is a common concern for most families faced with a situation where a family member needs to go into care. Most people will want to know:

  • How much will it cost?
  • Who has to pay for it?
  • Will it affect my family home?
  • What can be done to protect the family wealth?

In England and Wales it is common for care fees to cost in the region of £600 per week but this can vary dependent on the care home. Where a person needs residential or nursing home care, the Local Authority will carry out a financial assessment to calculate whether they are required to fund the person going into care and how much, if anything, they are required to pay towards the care fees.

Who Will Pay for Long Term Care?

In short, most people over the age of eighteen will pay for some or all of their care, either because they have income that can be contributed and/or capital that can be used towards the payment of fees. There are three exceptions to this:

  • people funded wholly in nursing homes by the NHS known as 'Continuing Care'
  • people who receive a short stay in care for rehabilitation purposes known as 'intermediate care'
  • people who have residential care provided for them as aftercare under S117 of the Mental Health Act 1983.

Local Authority Funding

Your Local Authority Social Services is responsible for identifying the needs of the person going into care. Funding is only available where a need has been identified. If someone chooses to go into care because it is more convenient but not a necessity then it would have to be on the basis that they can fund the care themselves.

Your local council will carry out a care needs assessment which includes a financial assessment, called a means test. The means test looks at your income, which is any money received on a regular basis such as pensions, benefits, and also capital which will include any savings, shares, investments and potentially the value of the person's home.

The means test will assess whether you can afford to pay for your own care and whether you're eligible for financial help from the Local Authority.

In terms of income, each person is currently entitled to keep a personal allowance of £24.90 per week. The Local Authority will have details of what income is fully included and what income is partly disregarded. Details of the criteria are contained in CRAG - Charging for Residential Accommodation guide, available online or from your Local Authority.

Capital Thresholds for Long Term Care

In relation to capital the UK Government set the capital thresholds. Currently if you have capital above £23,250, you pay all your care fees. If you have capital below £14,250 you will be fully funded, subject to your income. If you have a capital balance falling in between the two thresholds you will have a contribution to pay towards your care. For every £250 you have over the £14,250 you will be deemed to have an extra £1 income.

Certain types of capital may be disregarded such as money in a personal injury trust, or the surrender value of a life insurance policy or annuity.

Your Property and Long Term Care

With regard to the family home, the property value will not be included for the first twelve weeks stay in care. After twelve weeks it will not be included if you have living at your home:

  • a partner or
  • a close relative over the age of 60
  • a child under the age of 18
  • an ex partner living there who is also single parent.

The Local Authority can choose to exclude the property if the person's carer is living at the property.

It is also possible to enter into a 'Deferred Payment Agreement'. This generally means the fees are calculated, records will be kept but payment is put off until a later agreed date such as the death of the person in care.

It may also be useful to you to see one of our Independent Financial Advisors. They can advise on how best to hold or invest capital, to either maximise income or to invest it so that it may be disregarded as available capital. It is important to remember that whatever you do will be subject to the Deprivation of Assets rules.

Deprivation of Assets

When the Local Authority carry out a financial assessment to see if you should be contributing towards the cost of your care, there are strict rules regarding "Deprivation of Assets" where your objective is to obtain assistance with care fees.

If the Local Authority believes you have given your assets away to avoid the payment of care fees, they may decide that you have deprived yourself of assets and calculate your ability to pay as if you still owned them.

Generally, it is the motive and intention behind making the gift that is the important factor. There is no time period after which it can be said that the gift is likely to be successful. If the gift took place at a time when a person is fit and healthy and could not have foreseen the need for a move to nursing or residential care, then it is more likely that the gift will be successful. However, there are no guarantees.

NHS Funding of Care

People funded wholly in nursing homes by the health authority known as 'Continuing Care'

This is a package of care arranged and funded solely by NHS where a person's primary need is a health need. It can be provided in hospital, a person's own home or a care home setting. This can be to meet a physical or a mental health need that has arisen as a result of a disability, accident or illness.

The criteria are set out in a National Framework for NHS Continuing Health Care. There is a two stage assessment to see if someone qualifies. The first stage is an initial screening and the second stage is a more in-depth assessment involving different agencies to look at all aspects of someone's physical and mental health.

If you believe a family member should be in receipt of NHS Continuing Care, you can ask for an assessment and it is recommended that you ask for some literature to inform you of the process and to take part in the meetings.

People who receive a short stay in care for rehabilitation purposes known as 'intermediate care'

This basically covers the situation where someone may go into care to give their carer a break, often referred to as respite care. It also covers situations where someone may be in hospital on a rehabilitation ward trying to establish what type of care will be needed next depending upon what progress the patient can make.

People who have residential care provided for them as aftercare under S117 of the Mental Health Act 1983

This occurs where someone has been sectioned under section 3 of the Mental Capacity Act 1983 in order to receive medical treatment and also includes specialist mental health nursing. In this situation local authorities have a duty to make arrangements for the continuing care and support of someone detained under this section. If the condition for which they have been sectioned for continues then funding to support the care should be available.

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