State Assistance and Long Term Care

The need for care often arises when least expected and you may find you have to make very difficult decisions on matters of which you may have very little understanding. NHFA can provide the clear advice, information and guidance you may need and have also produced a number of useful information sheets which provide detailed information on many of the common problems people encounter when this need arises. Please call our Care Advice Line 0800 99 88 33 and talk to one of our advisers to discuss your particular circumstances or request further information.

Commonly Asked Questions:

Do you need care?

If you, a friend or relative is in need of care you can ask Social Services to carry out what is called a section 47 assessment of your/their needs. Once informed that somebody may need care, the authority, often jointly with the Health Authority or GP, has a duty to carry out an assessment. This may reveal that you or your friend/relative need care at home or in a residential setting.

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Do I have to pay for my care?

Unfortunately, the concept of free care from cradle to grave does not apply to long term care provided through Social Services. If you need care in a nursing or residential care home, you will have to undergo a financial assessment which has set rules for means testing whether or not you qualify for State assistance. If you need care at home you may be asked to contribute towards the cost if it is considered you can afford it. Unlike residential care there are no set rules for calculating your contribution towards home care costs and each local authority sets its own eligibility criteria.

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How does this means test work?

If you have capital of below £23,000, you may be entitled to some assistance from the State towards your care costs. First your Social Services department will carry out an assessment of your care needs under Section 47of the NHS Community Care Act 1990. If you are assessed as needing nursing home or residential care, you will be asked to claim any Income Support benefits or Pension credit you may be entitled to and these will be taken into account in a means test to ascertain how much you can afford to pay. Normally you will have to pay all your income towards the fees, less £21.90 per week you must retain for personal expenses. If you have capital of below £14,000, you will receive the maximum help. If you have capital of between £14,000 and £23,000 you will also have to make a capital contribution of £1 for each £250 of capital between these two figures. The above applies to England and Northern Ireland. Scotland £22,500/£13,750, personal expenses allowance £21.90 per week. Wales £22,000/£20,750, personal expenses allowance £22.00 per week.

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What is the personal expenses allowance?

This is the fixed amount of money you must be allowed to keep for your personal expenses. It should not be used to top-up care fees.

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Is the value of my home taken into account?

The value of your home will be disregarded for the first 12 weeks of permanent nursing home or residential care. Otherwise, it will be treated as capital unless it is occupied by your partner, a relative who is aged over 60, or incapacitated, child under the age of 16 years who you are liable to maintain, or an estranged partner who is a lone parent. There is also a discretion to ignore property if it is occupied by someone who gave up their home to be a carer.

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What if it is jointly owned by somebody other than my partner?

Because the value taken into account should be the market value and it could be impossible to find an outsider to be a willing buyer for a share of a jointly owned property, it could be argued that in these circumstances the capital value is nil.

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Can I give my home away to avoid the cost of care?

This is not recommended. Consider the consequences of the recipient of the property undergoing divorce proceedings, insolvency or defaulting on borrowing against the property. In any event, the authorities can go back as far as they wish when considering whether a property has been given away to avoid care costs. Consider also, that if you did get away with it, your choice of care would be restricted to what the Local Authority could afford which may not be what you would otherwise choose if you were independent. And, remember there are now ways that care costs can be met which may only use up part of your capital.

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Will Social Services pay my fees whilst I am selling the property?

Yes, if you have other capital of below £23,000, there is provision for the Local Authority to help you while your property is on the market. You will be asked to claim any Pension Credit you may be entitled to bringing your income up to £130.00 of which you keep £21.90 per week for personal expenses and contribute the balance of £108.10 towards your care fees. For the first twelve weeks of permanent residence in a care home the local authority ignore the value of your property. Beyond that period the balance that Social Services lay out on your behalf will form a charge against the property and be recovered from the sale proceeds.

If it is intended to sell the property, entitlement to attendance allowance and Pension Credit continues during this 'loan' period. However, if the property is not being sold it may be treated as capital by the Department for Work and Pensions (DWP) and, subject to its value, entitlement to Pension Credit could cease.

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My partner needs care. How does this affect me?

Social Services only have the right to means test the spouse requiring care. In which case, they will take into account any capital they own and all their income. However, property occupied by a partner is disregarded and fifty percent of any private pension must be returned to the partner at home.

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Money tip where couples have joint savings:

In assessing entitlement to financial assistance, the DWP and Local Authority will take into account joint savings with a spouse and, until those joint savings fall to £46,000, no financial help is available (i.e. ½ of £46,000 = £23,000 capital limit).

Those who are paying for their care home accommodation from joint savings with a spouse at home, should split their accounts into separate single accounts immediately to benefit from State assistance as early as possible.

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What if we both need care?

Again, it is important to remember that members of a couple must be financially assessed separately and each required to contribute according to their individual resources.

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If the State is paying do I have a choice of care home?

Yes, you do. You can choose a State home, a private home or one owned by a charity. It does not have to be in the same county as your Local Authority so if you wish to move to be near friends or relatives you can do so. There are conditions. The home you choose must be suitable for your assessed needs, it must comply with any terms and conditions set by the authority and, often the stumbling block, it must not cost any more than the Local Authority would usually pay for someone with your assessed needs.

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What if the home costs more than the Local Authority are prepared to pay for?

You will be permitted to top-up your fees during the temporary disregard of your property period or whilst your property is on the market as long as the value of this and other capital exceeds £23,000. If the local authority is funding your care they will allow a top-up from a third party who is able and willing to do so over the long term. You are not allowed to top-up the fees yourself from your remaining £23,000.

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Is there any State Help I can claim that is not means tested?

Attendance Allowance

Yes, Attendance Allowance is a non-means tested, non-taxable allowance paid at the lower rate of £47.10 per week for those needing care by day or night and, at a higher rate of £70.35 per week for those needing care by day and night. However, it is not payable if the Local Authority are paying towards your care.


NHS Nursing Contribution

If you are living in a care home which provides you with nursing care, subject to assessment of how much registered nursing time you need, you may be entitled to a contribution towards these costs from the NHS paid direct to the care home. If applicable, an amount of £106.30 per week will be paid by the NHS direct to the nursing home as a contribution towards the weekly fees.If your needs are primarily health care needs you may be entitled to full funding from your local health authority under their continuing care eligibility criteria.

Until 30th September 2007, nursing care funding was divided into three bands - high, medium and low. The National Framework for NHS Continuing Healthcare and NHS-funded Nursing Care implemented from 1 October 2007, has introduced a single band for NHS-funded Nursing Care, currently £106.30 per week. People who, prior to 1st October 2007, were receiving the low and medium payments were moved onto the new standard weekly payment. Any resident who was receiving the high band funding, currently £146.30 per week, continued to receive this higher level of payment until their case was fully reviewed in line with the National Framework. If their needs were still such that they would have been granted the higher payment then this would continue. If their needs were such that they would have received the medium or lower payment then they would move onto the new standard rate. If they were assessed as eligible for NHS Continuing Healthcare then NHS-funded Nursing Care payments would cease.

This same procedure should be followed at all subsequent reviews.

Please note, the higher rate of £146.30 is not available to new applicants and will eventually be phased out.

The above applies to England only. Wales pays £119.66* and Northern Ireland pays £100 per week for those assessed as needing nursing care. Scotland pays up to £153 per week for personal care plus £69 per week for nursing care.

* The rate for Wales has been collectively set by the Welsh local health boards.

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What happens if after I have moved into a care home independently I run out of money?

Once your capital reduces to £23,000 you can seek assistance from the Local Authority. However, you may find you have chosen a care home which costs more than the Local Authority is prepared to pay. For example, if the home you choose independently charges £400 per week, you may find the Local Authority will only pay £340 per week. Families can find themselves in the precarious situation of having taken responsibility for care home contracts for full fees but later realise they are unable to fulfil the commitment. The problem you have is then either to find a source of top-up, ask the home to reduce their fees or move to cheaper accommodation which could be detrimental to an older person's health and well being. The result is distress and disharmony between Social Services, the care provider and the family. At the centre of all this is the vulnerable older person ending their days in a situation that can hardly be described as dignified.

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What can I do to avoid this situation?

It is important to seek specialist advice when moving into a care home. NHFA research found that over 90% of older people who sold their properties to meet care costs left their money on deposit. Consequently, especially when interest rates are low, many older people run out of money long before their need for care ceases. With that loss, often goes the independence, dignity and right of choice they deserve at perhaps the most vulnerable time of their life.

If on examination of your finances it is likely that you will run out of money, you should discuss this matter with Social Services to make sure they will step in to help. You should also discuss the matter with the care home owner to obtain the reassurance that you can remain in your chosen accommodation at Social Services funding rates. This situation need not arise.

Seek NHFA advice to ensure you maximise your assistance from the State and find out ways in which care costs can be met and capped and money can be left for your children.

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Where can I get more advice and information?

Click here to complete your 'Care Fees Funding Advice Application Form'

You can telephone our Care Advice Line 0800 99 88 33 for advice and information or contact us