Fees and Funding
Care homes are run by a variety of providers including independent (private) providers, local authorities and charitable organisations. The majority of homes are run by independent providers including small family run businesses as well as the larger corporate groups.
If you are paying the care home fees privately you may choose any care home according to your budget (see Types of Care).
If you are funded by a local authority this does not mean that you can only go to a Local Authority Home; independent care homes may accept both private and local authority funded placements. You may choose any care home that accepts local authority funding although the local authority will want to be sure that the care centre is able to meet your needs and would not cost more than it usually pays for that type of care. If the care home of your choice is more expensive than the authority normally pays, you are allowed to make a 'top up' payment from another source (see below).
Summary of funding:
- Self funding (private)
- Local Authority Funding
- Local Authority plus Top Up
- 3rd Party Contribution
- PCT/Continuing Care
- Other (i.e. charitable organisations)
How do I know who should pay the fees?
Sai Care Home Managers are able to offer advice in obtaining assistance with the payment of fees from government bodies or social services etc. Subject to qualification and means, it is possible to obtain full funding funding towards the cost of care from the relevant funding body.
What will the state normally provide?
Where it is likely that you have insufficient capital to pay the care home fees, the local authority will do a financial assessment to determine whether you are eligible for local authority funding. The state provides care for those with insufficient funds to pay their own costs; if they feel that you do have sufficient means you will be required to pay at least some of the fees.
- If your capital exceeds £ 23,000 (England) then you will not be entitled to any funding at all and you will have to pay your own costs.
- If your capital is between £14,000 - £23,000 (England), the local authority may pay for some of the care home costs. For every £250 that you have over the lower amount, the local authority will deduct £1 per week from their contribution.
- If your capital is less than £14,000 (England) the local authority will pay for residential or nursing home costs.
Can I keep my pension and benefits if I move into a care home?
If you are paying the fees privately you may keep your pensions and some benefits. If you are funded by the local authority you will be expected to use all of your income, including your pension and benefits to help fund your care except for a nominal sum of £21.90 (England) per week for your day to day spending money. However, if you are paid the Mobility component of the Disability Living Allowance you will continue to get this. If you are over 65 you will also be entitled to up to £5.25 per week of any savings credit.
Do I have to sell my house?
When the local authority completes their financial assessment they will look at all of your assets including your home and pensions. They will only include your home if you live alone or if both of you are moving into a care home. There are specific rules regarding whether certain close relatives are able to continue to live at the home.
Additionally the local authority will disregard the value of your property for the 12 weeks after your admission to a care home, as long as your stay is permanent. This is called a ‘12 week disregard’.
What is a 3rd Party Contribution?
If you are entitled to full local authority funding and the home that you choose is more expensive than the local authority is willing to pay, a 3rd party contribution may be paid. This contribution cannot be paid by the prospective resident themselves for legal reasons; however someone else can do so such as a friend or family member.
Is there any difference in funding for nursing care?
If you require nursing care you will be entitled to a contribution from the NHS towards the cost of the care that a Registered Nurse provides, regardless of whether you are privately or local authority funded. This is called Registered Nursing Care Contribution (RNCC). The RNCC is currently £108.70 or £149.60 at the enhanced rate.
Where someone needs ongoing specialist medical treatment, the state will pay for the full cost of care; this is called ‘Continuing Care’. If you think that you might be entitled to continuing care you should discuss this with your GP, hospital or care home staff. A referral may be made by the care home on behalf of a resident if they feel that the resident’s needs have increased such that they may be entitled to continuing care funding.
An assessment is undertaken to decide whether someone is entitled to continuing care; there is an appeal process in the event that an application is turned down.
What happens if I run out of money?
If your capital falls below the upper limit whilst you are in a care home, you become ‘depleted’ and therefore you will be eligible for funding from the local authority. It is important that you keep the care home manager informed if this is likely to happen so that they can help you arrange the appropriate funding. Sai Care Homes do not evict those who run out of money although they may move them into a different room if for example they are in a premium room. They will always discuss this with the resident and their family or representative.
Is there insurance for care costs?
It is possible to purchase a one-off insurance premium that will cover the cost of care. The cost is determined by an assessment of the level of care that you need, as well as an estimation of the duration of time it is likely that you will need care. Whilst this premium may represent a large sum of money it would normally provide a fixed payment for as long as care is needed and it would also protect your assets. The payments are usually made directly to a care home and as such are tax free. The payments are also transferrable in the event that you decide to move to a different home.
Please note Long-Term Care Insurance where you have paid installments over some period of time is no longer available. If you have previously taken out one of these policies, it should still be honoured. However we recommend that you speak to an Independent Financial Advisor to ascertain what the maximum amount is that the insurer will pay out on a monthly basis, how long the benefits will be paid for, who the benefits are paid to, and whether the benefits are protected against inflation.
Can I get help in my own home?
It is possible that the local authority may be able to support you in your own home however this is down to individual authorities. They may assess your ability to contribute towards these costs just the same as if you required assistance with care home fees and you may be required to pay part or all of the costs accordingly.
You may be entitled to additional benefits to enable you to stay in your home as long as possible including: Disability Living Allowance, Attendance Allowance and Carers Allowance. Some benefits are not means tested, the Benefits Agency should be able to offer advice (Tel: 0800 009966).
Where can I get more advice?
Paying for care is a complex subject, and everybody’s situation is different. You should seek advice about your own personal circumstances from organisations such as:
- Social Services
- Benefits Agency (0800 882 200)
- Age Concern (0800 00 99 66)
- Counsel and Care (0845 300 7585)
- Eldercare (01707 368 936)
- Insurers who specialise in care fees
- Independent Financial Advisers (0117 971 1177)