Getting financial help for long-term care
By Paul Davies
Getting financial help for long-term care
Working out how much funding your relative is eligible for can be very confusing: we explain the rules in this guide.
If an elderly relative would like to continue to stay at home but needs help to do so, home help or home care (also known as ‘domiciliary care’) might be the answer. However, most care agencies involve a cost of some kind.
If your relative needs to move to a care home, the rules around funding this involve a complicated means-tested system.
Some people with severe needs receive free NHS continuing care, but most will have to have a financial assessment, organised by the local authority. Following this assessment, your relative will know if he or she will have to contribute to their residential care and how much they are expected to pay.
For both types of care, the local authority carries out a financial assessment, or means test, to work out how much it will pay for and how much your relative must contribute.
If your relative moves into a care home, your local authority may pay the fees. But around a third of all residents are not eligible and have to pay the full cost of their care.
Even if your relative has to pay their own fees, they could be entitled to certain benefits that are not means-tested (rates below are for 2016-17).
NHS funding for nursing care
If you live in England or Wales and qualify, you get a flat rate of £112 a week in England and £140.90 in Wales, paid directly to the nursing home.
This is paid to over-65s, including self-funded care-home residents, who need help with personal care, such as washing or dressing. It is not normally paid if the local authority is paying for the care home.
The rates are £55.10 a week where care is needed either day or night, and £82.30 a week where it is needed for both (2016-17 rates). Read more about attendance allowance.
Disability living allowance
You may claim the care component of this (£21.80 to £82.30 a week), depending on the level of help you need. You also receive the mobility component (£21.80 or £57.45 a week – 2016/17 rates) if you were claiming this before entering the care home.
Paying for care at home
To qualify for financial support, your relative must have less than £23,250 (England and Northern Ireland), £24,000 (Wales) or £26,250 (Scotland) in savings and investments (not including your home).
If they hold these jointly, they will be assessed as owning half their value. If their spouse or civil partner has savings in their name alone, these will not be taken into account. Your relative will pay for care on a sliding scale, depending on their income after housing and disability-related costs.
Paying for residential care
The local authority will normally pay for your relative's care only up to an agreed limit.
If they have less than the upper assets limit (£23,250 in England and Northern Ireland, £24,000 in Wales, £26,250 in Scotland), they will receive some financial help from their local authority but will still be expected to contribute to care-home fees.
If their home is still occupied by their spouse or civil partner, a relative who is aged 60 or over or who is incapacitated, or a child under 16 for whom they are legally responsible, its value is excluded from their assets. They may also get non-means-tested financial help from the NHS for nursing care.
If they have to contribute, their assets below a lower limit (£14,250 in England and Northern Ireland, £24,000 in Wales, £16,250 in Scotland for 2016-17) are ignored.
They will pay £1 a week for each £250 of assets above this. They must also pay their occupational and state pension to the council, plus any benefits they are entitled to. The only income they can keep is £24.90 a week (£25.50 in Wales) for personal expenses (2016/17 rates).
The local authority will normally pay for your relative's care only up to an agreed limit, which may restrict their choice of home. If they want to go somewhere more expensive, you or another third party must pay 'top-up fees' to make good the shortfall.
Scotland – a special case
Scotland's funding system follows different rules to the rest of the UK. Your relative's needs are assessed in the same way but, if they need long-term care, they get a personal care allowance of £171 a week.
If they need nursing care, they also receive a £78-a-week nursing contribution. This money is not means-tested and is available for care in their own home as well as for residential care. Care at home is not limited to these sums – some people may get more.
Residential care is not free for all, however. If your relative has assets of more than £26,250, they still have to pay their own living costs. Scottish residents do not receive attendance allowance.
Challenging a health funding decision
If you think your relative should get continuing healthcare funding, ask for a review by your local health trust or board. If it decides that they do not meet the eligibility criteria, you can apply for a review of the decision or complain about criteria.
If you're unsuccessful, you can go to a regional independent review panel. If all else fails, contact Citizens Advice to help take the case further. Find out more on Which? Elderly Care and appealing a long-term care decision.
- Last updated: June 2016
- Updated by: Ian Robinson