Paying for care and support
Paying for care is a concern for many people and their families. It is important that you understand the facts and the help available to you so you can make the right choices for yourself or the person you are caring for.
Do I have to pay? Can I get financial help?
Social care, unlike healthcare, is not free to everyone. Councils only have a limited amount of money and it may choose to pay for only those people who are in most need of help. When you contact your council about getting a care service it will carry out a care assessment. Depending on where you live, if your needs are assessed as low or moderate you may not be entitled to free care. If your needs do match the level set by your council, the council will carry out a financial assessment. Depending on your income, savings and assets, such as your home, you may have to pay for some or all of your care:
- For non-residential services, such as home care, the value of your home will not be taken into account when working out your charges.
- For residential services, such as care homes, the council may ignore the value of your home if your husband, wife or partner is still living there.
The council may also be able to ignore the value of your home for up to 12 weeks and offer you a loan to give you time to decide what to do with your property.
Your local council should have information leaflets about its charging policies and the processes it follows.
What other help can I get to pay for care?
- Third party top-up payments: your local council might ask a friend or a relative if they can top up your fees.
- Fully-funded NHS care: if you have more complex health needs, you may be eligible for what is known as continuing NHS healthcare (which is free).
- Free care under the Mental Health Act: if you have been kept in hospital under certain sections of the Mental Health Act, you may be eligible for free care when you go home.
- Benefits: you should also make sure you claim all the benefits to which you are entitled. More than £2bn is left unclaimed by older people each year.
Will I have to sell my house to pay for care?
If you need to move into a care home your local authority will decide whether you have to make a contribution towards the costs. It will look at your income and savings. If you have less than £21,000 in savings, and this may include the value of your home, then your local authority may pay all or part of the fees.You will have to pay the full costs of your accommodation and personal care if your capital is over £22,250 in England, £22,000 in Wales and £21,500 in Scotland.
If you own your own home and move into a care home permanently, your local authority will ignore the value of your home for the first 12 weeks of your stay. After that, it will usually include the value of your home when deciding whether you have to pay.You may be expected to sell your home to pay the fees.
Staying in control with direct payments
You have a right to buy and manage your own care and your council must offer you the option of direct payments. With direct payments the council pays you an agreed amount. This can be known as an individual budget or a personal budget. You can then hire the care service of your choice. This could be a relative or friend, or you could employ a care agency to send care workers to your home.
What will the council pay direct payments for?
Your local council will pay for social care services that charge weekly or monthly fees which fall within the council's budget. If you want to use a care service that charges more, you can do so as long as you, a relative or friend can pay a top-up that covers the extra cost.
However, if your health or personal circumstances mean you need to use a more expensive care service the council should not expect you to pay a top-up.
Are direct payments right for me?
You need to think about whether direct payments are best for you. If you hire your own care worker the contract is with you and not the council. Remember to read all contracts very carefully and make sure there are no hidden charges. You should also know your obligations in law as an employer.
Make sure you get a good deal for your money. Be careful about letting others pay for things on your behalf, or if they ask you for large lump-sum payments up front. Do not be afraid to question them and find out exactly what the money is for.
Get help with direct payments
In most areas you can speak to the direct payments support scheme before you make a final decision. It can tell you the different options available. Your local direct payments or independent living support scheme will advise you about contracts and other things you need to know as an employer.
Call the National Centre for Independent Living on 020 7587 1663 for details of your local support scheme.
What do I do if I have problems paying for my care?
If you have problems paying for your care you should talk to your council's social services. Sometimes councils have reasons for not paying for people's care and they should explain this to you.
At other times, it may not be following government rules. For example, you could be told that you are eligible for financial help only to be then told that the council does not have enough money to pay for you, or you could be asked to join a waiting list. If this happens, or if there are any others ways you feel that the decision is not fair, you do have the right to question the decision.
Contact your council if you are not happy with its decision.
Find your council's contact details on the DirectGov website
Can I take out an insurance policy to pay for my care in later life?
Long term care insurance, where you pay premiums over a lengthy period before you actually need care, is no longer widely available. If you already have one of these policies it should still be honoured. You may be able to take out an immediate insurance policy. This requires you to pay a lump sum which then provides a fixed payment for as long as you need care. The fixed sum is tax free.
Get independent financial advice
You may find it useful to get some independent financial advice before deciding how to manage your money. Always make sure the firm you use is on the Financial Services Authority (FSA) register. Visit the FSA website.
You may also want to talk to a solicitor, for example, if you want to set up a power of attorney to let a relative or friend act on your behalf.
Paying for care is a complex area but there are many specialist organisations ready to help - whatever your particular circumstances.
Tel: 0808 808 6060 or visit: www.ageconcern.co.uk
Help the Aged
Tel: 0808 800 6565 or visit: www.helptheaged.org.uk
Counsel and Care
Tel: 0845 300 7585 or visit: www.counselandcare.org.uk
The Benefits Agency
Tel: 0800 88 22 00 or visit www.direct.gov.uk
Nursing Homes Fees Agency
Tel: 0800 99 88 33 or visit: www.nhfa.co.uk
Eldercare Solutions Ltd
Tel: 01707 368 945 or visit: www.eldercare-solutions.co.uk
Your local social services department
Please find your local social services number in your local telephone book.