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Paying for Care

Information on Paying For Care is detailed below.  Please note that every individual’s situation is unique. For advice tailored to your specific needs it is suggested you speak to an Independent Care Adviser.

 

Qualification for Local Authority Funding

Generally, people are expected to pay privately for a care home or care home with nursing if they have more than £23,250 of savings and investments in England and Northern Ireland, £23,500 in Scotland and £22,500 in Wales, including the value of their home. These amounts are called the upper threshold.

People in England and Wales are also expected to pay privately for care at home if they have more than the above amounts, although for care at home the value of the property is excluded from the means test. However, in Scotland personal care at home is free of charge and in Northern Ireland personal care at home is free of charge for over 75s, as long as it is assessed as a requirement by Social Services.

There is a sliding scale of State contribution to the cost of care where savings are between this upper threshold (£23,250 in England and Northern Ireland, and in £23,500 in Scotland) and the lower threshold, which is £14,250 in England and Northern Ireland and £14,500 in Scotland. There is now just one threshold for Wales. When an individual’s savings are below this lower threshold, the cost of the individual’s care, generally speaking, is funded by the State, although in this situation if the individual has an income, such as a pension, this must be used first (the individual can keep a small amount, currently £22.60 per week in England) with the State paying the balance up to set limits. 

If an individual owns his or her house and needs care in a care home or care home with nursing, the value of the property is normally included in the financial assessment.  There are some exceptions to this though, for example, the value will not be included in the assessment when the individual’s partner or other dependent will be continuing to live in the house.

If an older person needs financial help funding their future care, he or she needs to contact the local Social Services Department.  Individuals will then be assessed to see if they need care, determine the level of care required and also to assess their financial resources.

If the individual is assessed by social services as requiring care and qualifies for state funding of care, the amount the Local Authority Social Services Department will pay will depend on the type of care required and in what setting. The amount paid will tend to vary from one Local Authority to another, in accordance with each Authority’s own budgetary constraints.

With reference to residential care, within any Local Authority district there should be a number of care homes whose fees fall within that Local Authority’s funding limits. Unfortunately this is not always the case.  However, an individual is not restricted to homes within the funding Local Authority’s borders: a qualifying person is entitled to choose any home in the UK regardless of cost, provided that

• it offers appropriate care
• if the fees are more than the funding Local Authority pays, any surplus (generally called a ‘top up’) will be paid by a third party
• the home is willing to agree to the Local Authority’s standard terms of service

If the older person has an income, such as a pension, that income is taken into account when calculating the amount that the Local Authority contributes.

Before making any making any financial commitments you should take expert advice.

Self-Funded Care

If an older person does not qualify for Local Authority funding for care, they may still have access to funding for Nursing Care from the NHS (see below – the Set Contribution) and may still be entitled to Attendance Allowance from the Benefits Agency (see below).

Costs of care vary greatly depending on location and level of care chosen. As a very general guide, costs of care tend to fall within the following bands:

Care Homes - From £400 per week to £850 per week
Care Homes with Nursing  - From £450 per week to over £1,000 per week
Home Care Agencies - From £10 per hour to £30 per hour

Care can be very expensive! What is more, care provision is an open marketplace, so prices for the same care services will differ from one care provider to another. Individuals are always strongly advised to discuss their care needs with an Independent Care Adviser to ensure that they receive the right care at the right price.

Attendance Allowance

Attendance Allowance is a benefit paid by the Benefits Agency to people over the age of 65 years, who need help with personal care and/or supervision.

It is not taxable and is not subject to a financial means test.

The benefit is paid at two different rates and is the same in all areas of the UK.  As from April 2010, the rates are:

• Lower Rate = £49.30 per week
  If an older needs help in either the day or the night but not both.
• High Rate = £73.60 per week
  If an older person needs help both day and night.

In England and Wales, Attendance Allowance is still paid if an older person enters a care home where they are paying for their own care.  However, it is withdrawn if an older person enters a NHS hospital for more than 28 days or if their care is being paid for out of public funds.  It is the older person’s or the individual looking after their funds responsibility to notify the Department of Work and Pensions of this.  It can be reinstated when an individual returns home if their care is not paid out of public funds.

In Scotland, Attendance Allowance can be claimed in addition to free personal care at home but stops if the older person moves into a care home and receives the Set Contribution for personal care. In Northern Ireland, Attendance Allowance can be claimed in addition to free personal care at home but stops if the Local Authority pays for the care in a care home.

For your information an application form for Attendance Allowance can be obtained by contacting The Benefit Enquiry Line on Tel. 0800 882200 in England, Wales and Scotland, and 0800 220674 in Northern Ireland.

Twelve Week Property Disregard

The twelve week property disregard is extra assistance given to people whose assets would have been below the upper threshold (see paragraph 1 above) if their property had not been included in the valuation. For the first twelve weeks from admission into residential care, or for 12 weeks from the point at which they require local authority assistance, the value of the older person’s home is disregarded from the means test. In other words, for such individuals the state pays the costs of the care home (up to a maximum of each Local Authority’s normal funding thresholds) for the twelve weeks of care. This money does not have to be paid back.

The twelve week property disregard was originally intended to give the older person twelve weeks between going into residential care and the sale of their house, either giving them time to consider returning home or time to sell the property to fund their care. However it is important to recognise that this funding is dependent on social services assessing the individual as requiring residential care. After twelve weeks, the individual becomes liable for the full cost of ongoing care, although if the property has not been sold after this time, the individual may be able to enter into a deferred payment scheme with the local authority, which is repaid out of the proceeds of the sale of the property in due course.

Residents are not allowed to make their own top up payments except during the first twelve weeks of permanent care when a property is being disregarded or where there is a deferred payment agreement in place.

Self-Funded Care When Assets Are Close to Social Services Thresholds

Care must be taken by a self-funder where it can be reasonably predicted that his or her assets will shortly be reduced, due to paying care costs, to a level where the individual will qualify for State-funded care.

Many care providers charge fees that are higher than Social Services rates. The self-funder in this situation is advised to exercise caution when choosing a care provider such as a care home – if the care home charges fees in excess of State allowances, or if the care home provides care that Social Services have not assessed as being required, the individual may need to move when State-funding of care comes into effect.

NHS Funding for Nursing Care within Care Homes with Nursing (the Set Contribution)

The NHS funds registered nursing care for residents in care homes with nursing. An NHS Nurse assesses the level of nursing care a resident needs and the NHS pays for this nursing care in the home as per the table below, regardless of how and by whom the care is paid.

The level of funding available will vary throughout the UK.  As from April 2011 the current rates are:

England	Wales	Scotland	Northern Ireland
£108.70 per week	£120.55 per week	£159 per week for personal care plus £72 per week if nursing care is required Total = £231 per week	£100 per week

NHS Continuing Healthcare

This is a care package of continuing care arranged and funded solely by the NHS where it has been assessed that the individual’s primary need is a health need. It can be provided in any setting. In a person’s home it means that the NHS funds all the care that is required to meet their assessed health needs. In care homes it means that the NHS also makes a contract with the care

 

home and pays for the full fees for the person’s accommodation as well as their care.

Primary health need is determined by consideration of certain characteristics of that individual’s care needs, that is, nature, intensity, complexity and unpredictability.

Pension Credit

From October 2003 older people can claim Pension Credit.  This replaces Minimum Income Guarantee (Income Support).

Pension Credit aims to:

• Provide people aged 60 and over with a minimum level of income. This is referred to as a “guarantee credit”.  A guarantee credit tops up an individual’s income to an “appropriate amount”.  For a single person this amount is currently £137.35 per week and for a couple, £209.70 per week.  The amount could be more if the person is disabled.
• Give extra income to people aged 65 and over who have modest incomes and have made savings for their retirement.  This is known as a “savings credit”.

There will be an assessment of income and capital to establish whether a person is eligible for Pension Credit.

For further information about Pension Credit and how to make a claim, people will need to contact their local Pension Service or local advice agency.

 

Mental Health Act 1983 – Section 117

 

Section 117 of the Mental Health Act 1983 applies if a person has been detained (sectioned) in hospital under Section 3 of the Act. (Section 3 gives authority for an individual to be detained in hospital for treatment for up to 6 months initially).

Section 117 states that the Health Authority should provide aftercare services where needed due to mental disorder until they are satisfied that the person in question is no longer in need of these aftercare services.

Whilst the Act states this duty to arrange aftercare services, there is no obligation for the person concerned to accept the services, which are offered to them.

If a person is detained under Section 2 of the Act they do not get the benefit of the Section 117 aftercare provisions.

(Section 2 gives authority for an individual to be detained in hospital for assessment for a period up to 28 days).