Finding the right care for yourself or a loved one is an important decision – and we know that the cost of care is one of the main worries for people taking the first steps in their care journey.
If you feel overwhelmed or confused about how you will fund the care you or a loved one needs, you have come to the right place. From continuing healthcare funding to local authority top-up fees, we will support you to navigate the jargon and understand what affects cost and how care is funded, so you can take the next step with confidence.
How care is funded
Your loved one’s financial situation and their needs will affect what funding they’re entitled to.
Care can be funded through:
- Self-funding: You are likely to have to pay the full cost of your accommodation and personal care if you have capital over:
- £23,250 in England
- £24,000 in Wales
- £27,250 in Scotland
- Local authority funding: Your local authority may contribute some or all of your care costs.
- NHS funding: NHS continuing healthcare offers support for people with severe or complex health needs. NHS-funded nursing care is available if you are assessed as requiring nursing care in a care home.
To understand what funding you’re entitled to, the first step to take is to book a care needs assessment and financial assessment These are free and are arranged through your local authority. They will help you to clarify what kind of care you need, as well as any support, including benefits, that you or your family may be entitled to.
What is NHS continuing healthcare (CHC)?
NHS continuing healthcare is available for people in England, Wales and Northern Ireland with severe or complex health needs. It may cover all of a person’s care home fees.
Scotland has different care arrangements, called Hospital Based Complex Clinical Care, which is only available to people in hospital.
NHS CHC is a package of care arranged by the NHS for people with what’s called a ‘primary health need’, which is decided through an assessment of eligibility.
Who is eligible for CHC and how it works
CHC funding is available for a small number of people who have a ‘primary health need’ and are aged 18 or over. Eligibility is not dependent on whether you have a certain disease, diagnosis or condition.
The NHS looks at:
- The type of needs you have and the effect these have on you
- The extent and severity of your needs and support required to meet them
- How complex your needs are
- How unpredictable your needs are
NHS CHC is free, and if you are eligible, you can receive it in any setting (except for acute hospitals). This includes at your own home or in a care home.
The CHC assessment process
An assessment of your needs will be undertaken by the NHS to determine whether you have a primary health need that is best treated outside hospital (for example dementia).
This process usually involves two stages. First, a screening is done using a checklist. This will decide whether you need a full assessment.
If you ‘screen in’ with a positive checklist, you will have a full assessment of eligibility. A multidisciplinary team of professionals will assess whether you have a primary health need.
If you are found to be eligible for CHC funding, you will normally have your care package reviewed after three months, and then every 12 months to determine whether you continue to receive this type of funding.
Read more about NHS continuing healthcare.
What is NHS-funded nursing care?
If you’re not eligible for NHS CHC but you’re assessed as needing nursing care in a care home, you will be eligible for NHS-funded nursing care.
This is when the NHS pays a flat rate towards the cost of your nursing care. The NHS will pay this directly to the care home.
Learn more about NHS-funded nursing care.
How does local authority (LA) funding work?
Your local authority may pay towards some, or all, of the cost of your care, depending on your situation. You might be eligible if you have capital of less than
- £23,250 in England
- £24,000 in Wales
- £27,250 in Scotland
A care needs assessment will determine what care you need, and a financial assessment, also called a means test, will confirm how much your local authority will contribute towards your care.
Find out more about how to get a free care needs assessment and financial assessment from your local council.
Read more on local authority funding.
What are local authority (LA) top-up fees?
A local authority top-up fee is an extra amount of money paid to cover the cost of a care home that is more expensive than your council is willing to pay. This can be paid by a family member or friend.
Your local authority must ensure you have a genuine choice about where you live. Local authorities run their own care homes and have arrangements with independent care home providers – like Care UK – that will provide care at the local authority’s agreed rate.
If your local authority says that your chosen home is too expensive for your level of need, they may not cover your full costs. In that case, if possible, a relative or other source of funding, such as a charity or benevolent fund, can make up the difference with care home top-up fees. Top-up fees are also referred to as ‘additional charges’ or ‘lifestyle choice’ in Scotland.
The person or fund covering your care home top-up fees will sign an agreement with the council and care home on the costs, when they are paid and what will happen if payment can’t be made.
When might top-ups be required?
You might choose a care home that is more expensive than the amount your local authority allocates to meet your needs for a few reasons. For example, your family might choose to pay a top-up fee for a care home that is closer to them, or you might prefer a more expensive care home that offers more on-site amenities.
You will only have to pay a care home top-up fee if the home you’ve chosen is more expensive out of preference rather than need.
Combining funding options: NHS CHC, LA, and self-funding
You may need to combine local authority funding and self-funding if your council doesn’t pay the full amount of your care following your financial assessment.
If you are eligible for CHC funding, the NHS will typically cover all of your care costs.
However, NHS-funded nursing care is available whoever is funding the rest of your care home fees.
Getting support to understand your funding options
It’s important that you understand your funding options, and we would recommend speaking to a financial adviser who specialises in care fees planning if you’re likely to be funding most of your care.
Organisations such as Age UK and Age UK Scotland, Alzheimer’s Society and Alzheimer Scotland provide information, support and – in some cases – financial advice to help you work out what benefits you’re still entitled to when you move to a care home.
You can find more organisations that could offer help in our list of other sources of support.
How Care UK can help
At Care UK, we provide a clear guide to our fees for each care home because we believe in supporting your family to understand care funding options, ensuring you can trust us to care from that very first step.
And remember, if you have any questions our team is always available to help. To get started, search for your local care home.
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