This month the Lester Aldridge feature article in the "Life Matters for Lymington" series is about the often thorny subject of who pays for social care. The vast majority of people fund some or all of their care costs whether in a residential setting or living at home. However, there may be funding available and it's definitely worth understanding under what circumstances this may happen.

These monthly articles are so helpful in setting out clearly what can be very complicated subjects to understand. Do take advantage of the free initial consultation which Lester Aldridge offers - it's a great opportunity to explain your individual situation and ask specific questions. 

As we age, the likelihood of needing some additional help or care increases, whether this is arranging care for ourselves or supporting a spouse, partner or parent to access care. We recognise that this can be a worrying time and in this article, we aim to provide an overview to explain who pays for care and who decides what care is needed.

This can vary, depending on what care or support is required. There may potentially be funding available from either the local authority (which is means tested) or NHS (depending on the severity of healthcare needs). However, the vast majority of people fund some or all of their care costs whether this is in a residential setting or care whilst living at home.

Will I get any support?

Home care (also known as domiciliary care)

If you wish to stay in your own home, have care needs or require help with general household tasks like laundry and cooking, you can ask your local authority to conduct a care needs assessment. If you have capital over £23,250, you will be required to pay the full fees of any home care, known as self-funding. You can choose how much care you buy and from whom.

If you have capital between £14,250 and £23,250, you will be required to contribute from your income and a ‘tariff income’ is applied of £1 for every £250 between £14,250 and £23,250. The needs assessment will have identified how much care the local authority considers is required to meet your needs.

If you have capital of less than £14,250, you may still have to pay a contribution but the local authority will not apply a tariff.

When the local authority has completed a needs assessment and a financial assessment, they can either source the care you need or you can request a personal budget. This will give you money to spend on arranging the care and support you need. The local authority can manage this budget or it can be managed by another organisation that will likely charge for doing so, alternatively, your personal budget can be received into a new bank account created to receive it.

Local authorities can also support self-funders to source their care and may charge an administration fee.

There are some benefits which aren’t means-tested that you may be eligible for, including Attendance Allowance or Personal Independence Payment. If you have a carer they may be eligible for Carer’s Allowance.

Residential and nursing care

If you feel your needs will be most appropriately met by living in a residential care home and you are a self-funder, so long as the care home assesses that it can meet your needs you can choose which care home to live in. If you have capital over £23,250 you will be required to pay the full fees, known as self-funding. If you need nursing care you will need a nursing home that is required to have nursing staff available 24 hours a day. Even if you are a self-funder, you can request that your local authority assess your needs to help you understand your options.

Anyone who is not a self-funder will require the local authority to carry out a care needs assessment, if the assessment concludes a care or nursing home will best meet your needs the local authority will assess your finances by applying the means test. The local authority will have care homes it purchases placements from and will likely guide you to one of these homes. If you have capital between £14,250 and £23,250 you will be required to contribute from income included in the means test, such as pensions, plus a ‘tariff’ based on your capital between these amounts, the remainder of the cost of your care is paid by the local authority, provided that you move into one of the homes with which the local authority has an arrangement.

If you have capital less than £14,250, you will be required to contribute from the income included in the means test without an additional tariff being applied. The local authority pays the remainder of the cost of your care.

If you are already in a care home and your capital is approaching the £23,250 threshold you can still ask the local authority if you can remain in the home you live in. The local authority has criteria that they need to satisfy including assessing if the existing provider can meet your needs and is willing to enter into a contract with the local authority. If the home you live in costs more than the local authority is willing to pay you may be asked if someone else is willing to pay the price difference, this is known as a ‘top-up’. Similarly, if you choose a home more expensive than the local authority would usually pay to meet your assessed needs, someone may need to pay a 'top up' (usually a family member).

NHS Continuing Healthcare (NHS CHC)

Sometimes some funding may be available from the NHS. This is not means-tested or dependent on your savings but is dependent on the nature, complexity, unpredictability and severity of your care needs.   

Where you are assessed as having nursing needs and live in a nursing home, the NHS will usually pay a set sum of money towards the cost of the nursing part of your care. The remainder will need to be paid by you or the local authority (depending on the outcome of the means test, as above). If you are in your own home, District Nurses will usually help you with nursing care.

If your needs are assessed as having primary health needs, the NHS pay for care by way of continuing healthcare (CHC) funding. In these circumstances, you do not contribute any funds to your care home placement or to the care you receive at home. However, there are strict criteria that need to be met and CHC can be agreed upon for a time and then withdrawn following reassessment.

There is a process which should be followed concerning the assessment of eligibility for CHC, including the involvement of a family member, and rules that should be followed in undertaking the assessment. If eligibility is refused, there is an appeals process and medical evidence is usually an advantage. 

We understand the processes and can explain your options clearly 

Our specialist team have extensive experience in the health and social care sector. If you have any questions about the CHC appeals process, choice of care setting or funding care please contact our health and social care lawyers to discuss how we can help at 01202 786187 or This email address is being protected from spambots. You need JavaScript enabled to view it..

This article on the cost of social care was written by Laura Guntrip in the Lester Aldridge Healthcare team.

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Life Matters is a regular monthly feature on Lymington.com, which covers a wide range of legal subjects and is always written by one of the Lester Aldridge team.

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