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Paying for a care home stay

It is important that you understand your rights in relation to funding a stay at a care home.

The Daily Telegraph has a good article about care funding here: http://www.telegraph.co.uk/finance/personalfinance/insurance/longtermcare/8328992/Long-term-care-seven-ways-to-master-the-fees-system.html

This page is a summary of the information provided by the government on this website:

http://www.direct.gov.uk/en/CaringForSomeone/CareHomes/DG_10031525

Some people will have to contribute towards their care home fees. Your local council will work out how much you may have to pay by doing a financial assessment.

Your financial assessment

Before you move into a care home, you’ll have a financial assessment with your local council. The council will look at your income and capital and decide how much you may have to pay towards your care home fees.

Examples of income include:

  • interest on your savings
  • private and/or State Pension
  • some benefits like Pension Credit, Attendance Allowance or the care component of Disability Living Allowance

Your capital might include:

  • savings
  • investments
  • any property you might own (like your home or holiday home, for example)

Before your financial assessment, make sure you’re getting all the benefits you’re entitled to. This is important because your contribution to your care home fees will be worked out as if you’re receiving all relevant benefits.

No matter how much you have to pay towards your care home fees, you must be left with £21.90 a week (£22 if you live in Wales) to spend as you choose. If you get the mobility component of Disability Living Allowance, you will keep getting it.

Capital and the value of your home

In England if you have over £23,000 in capital you’ll be assessed as being able to meet the full cost of your care. Your capital will be counted as generating an income according to the following table:

Amount of capital How your capital is used to calculate your contribution to your care home fees
Over £23,000 You will be assessed as being able to meet the full cost of your care
Between £14,000 and £23,000 Capital between these amounts will be calculated as providing you with an income of £1 per week for every £250 of your savings
£14,000 or under Your capital will be ignored in calculating how much you have to contribute to the cost of your care

If you own your home then it will usually be counted as capital 12 weeks after you move permanently into a care home. The value of your home will not be counted as capital if certain close relatives still live there.

Getting your needs assessed

Usually you will have a needs assessment before a financial assessment. Your local council will be able to tell you how much they usually pay for a care home that will meet your needs.

They can then arrange a care home for you or you can choose one yourself that charges the same sort of price that they usually pay. This is important if you are paying your own fees to start with but think you might need to ask your council for help later on.

What if you want a more expensive care home?

You can choose a care home that is more expensive than your local council usually pays for a person with your assessed needs, but you may need to find a way to pay the difference.

If the council can suggest a place that meets your needs and you still want to move into a more expensive care home then they can ask a third party (usually a relative or friend) to pay the extra. This is called a ‘top-up fee’. You are not able to pay this yourself as you have been financially assessed to pay what you can afford.

If your local council cannot suggest a place that meets your needs in your local area then they should be prepared to pay more than their usual amount.

Your right to choose

You have the right to choose which care home you live in. If your local council is helping with your fees you can still choose as long as:

  • your choice is suitable for your care needs
  • there is a place available
  • they can agree a contract with the care home to make sure you receive the support you need
  • the cost is not more than the local council normally pays for someone with your assessed needs

Visiting care homes you are interested in

If possible you should visit care homes that you are considering to make sure they meet your current and possible future needs. You might like to have a checklist with you of points that are important to you in case you forget to ask something.

Things you might want to consider:

  • are staff adequately trained to care for people with your disability or needs?
  • is it accessible?
  • is appropriate equipment available – for example handrails, hoists, adjustable baths and armchairs?
  • can you keep your own doctor?
  • can your food and dietary needs be met?
  • can your religious or cultural needs be met?

Talking to staff, residents and managers can help you get an idea what living there might be like. You should feel able to visit more than once.

Finding the right care home

Finding the right care home can take some time. If you have specific or complex care needs it can sometimes be difficult. Charities and organisations related to your specific disability might be able to offer advice about choosing a care home.

There are relatively few care homes able to meet the needs of younger disabled people – your local council should be able to tell you about those in your area.

The Care Quality Commission (CQC) inspects all registered care homes and writes a report on what they find. Reading the reports of the care homes you are considering might help you make a choice – you can read them online on the CQC website.

On the CQC website you can search for care homes with and without nursing care. You can also look for care homes that provide care for people with:

  • learning disabilities
  • physical disabilities
  • sensory impairments
  • dementia
  • mental disorders

National minimum standards issued by the Department of Health state that care homes should offer trial stays. This may include the chance to meet staff, have a meal and an overnight stay.

Nursing care funded by the National Health Service

If you live in a care home that provides nursing care, the National Health Service (NHS) would normally contribute £101 per week towards the fees to cover the cost of the nursing element. Some people will have the full cost of their care paid for by the NHS; this is called ‘continuing health care’.

People who qualify for this type of care usually need ongoing specialist medical treatment on a regular basis.

Hospital staff, or your local doctor (GP), can help arrange an assessment if you think you qualify. If you disagree with the decision made after your assessment you can appeal. If you are assessed as needing some regular nursing care you may receive a contribution towards your care home fees from the NHS.

Direct payments

Direct payments from your local council are intended to support adults in independent living and are not intended to finance permanent residential care. However, you may be able to use direct payments to secure occasional short periods in residential accommodation, if your local council agrees that is what is needed.

If you are in a care home

In some situations, people who are living in residential care can have temporary access to direct payments. For example, this could enable them to try out independent living arrangements before deciding to move out of residential care.

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