A Guide to Funding Your Care

Accepting that you may need some form of care and support is the first step on a journey which is both complex and potentially expensive.  There is help available to meet these costs and at Island Healthcare we’re committed to supporting people at every part of their care journey and have put together this guide on paying for care.

Will the local council pay for my care home fees?

One of the first questions people ask when considering care is whether or not they’ll be eligible for support from the local council.  As with everything in social care funding the answer is not easy.  Your local council has a legal duty to carry out an assessment of your care needs and, if they find you have care needs, then ‘means test’ your finances by looking at your income and savings to see whether you can afford so pay for your own care.

The social care means test will look at your capital (savings and property) which will affect your care home fees in the following way:

Your capital

What you will have to pay 

Less than £14,250 This won’t be included in the means test and the local council will pay for your care but will still take your eligible income into account.
£14,250 – £23,250 The local council will fund some of your care and you’ll contribute to the rest.
Over £23,250 You must pay full fees (known as being self-funding).

What if I give away some of my money?

Giving away your money – whether to relatives, friends or charities – in order to avoid paying for care fees is called deprivation of assets.

If the Local Council thinks you have done this to avoid paying your fees they may still assess you as if you continued to have the money or property you have given away.

How much does care cost?

Care home fees will vary from care home to care home and the amount you have to pay will change depending on your own personal finances.

Certain types of income, such as money from certain disability benefits and pensions, may not be counted in the means test. This is the same for certain types of capital. All other income and capital can be taken into account.

If all your eligible income is counted in your means-test, you must be left with a Personal Expenses Allowance of £24.90 per week.

If you have a significant health care need the NHS may contribute towards the cost of your care under what is called NHS Continuing Healthcare. If you qualify for this you will be reviewed regularly to ensure you continue to ‘meet the checklist’ and the funding may be withdrawn by the NHS if your needs change to the point where you no longer meet the eligibility threshold.

In order to be eligible, you must first be assessed by a healthcare professional who will undertake a checklist to look at all your care needs and relate them to:

  • what help you need
  • how complex your needs are
  • how unpredictable they are, including any risks to your health if the right care isn’t provided at the right time
  • how intense your needs can be

A decision will then be taken as to whether you qualify for a full assessment and communicated to you within 28 days.  The full assessment will be undertaken by a team of professionals (at least 2 professionals from different professions) who will consider your needs against the following headings:

  • Breathing
  • nutrition (food and drink)
  • continence
  • skin (including wounds and ulcers)
  • mobility
  • communication
  • psychological and emotional needs
  • cognition (understanding)
  • behaviour
  • drug therapies and medication
  • altered states of consciousness
  • other significant care needs

These needs are marked “priority”, “severe”, “high”, “moderate”, “low” or “no needs”.  If you have at least one priority need, or severe needs in at least 2 areas, you can usually expect to be eligible for NHS continuing healthcare.

You may also be eligible if you have a severe need in one area plus a number of other needs, or a number of high or moderate needs, depending on their nature, intensity, complexity or unpredictability.

It’s important to note that a CHC assessment which comes back as eligible is not a guarantee that your care fees will be funded throughout your time at a home.

If you qualify for full support by the local council they have a legal obligation to provide you with enough money to access an appropriate local care home.

Will I have to sell my home?

A common concern is selling your home.  Under certain circumstances, your home won’t be taken into account in the means test, these are:

  • If only need short term residential care

Or if your home is still occupied by:

  • your spouse, unless they are estranged from you
  • your estranged or divorced spouse IF they are also a lone parent
  • a relative who is aged 60 or over
  • a child of yours aged under 18
  • a relative who is disabled.

Do I get a choice about which care home I live in?

if you are paying for your own care, you can choose to live wherever you wish, subject to an assessment from the care home.

If the local authority is paying some or all of your fees, under the care act you still have the right sot choose your care home, as long as the following criteria are met: If you prefer a particular care home, the local council must try to arrange accommodation in that home, as long as the following criteria are met:

  • the home chosen is suitable to meet your assessed needs
  • it doesn’t cost more than the local council would expect for this type of accommodation – unless you are willing and able to enter into a top-up agreement with the care provider.
  • the provider is willing to enter into a contract on the local council’s usual terms the care home is within the UK.

Care Fee Top-Ups

A top-up is the difference between the amount a care home charges for its services and the amount the council has assessed that you are eligible to receive.  Except in specific circumstances, you will not be able to fund a top-up yourself.  Instead, you must have a family member or friend – ‘a third party’ – who’s willing to pay this on your behalf.

Top-up’s will vary from care home to care home and will often depend on your specific care needs.

What if I run out of money?

If you are funding your care yourself you may get into the situation, officially called ‘capital depletion’, when your assets or savings fall below £23,250.  At this point, the council may assist with funding.

It’s important that you speak with your care provider and the local authority a few months before this happens.  In most circumstances, a care provider will support you through this and the local authority will need time to undertake a care assessment.

If you have any further questions about this complex subject, please contact us today.