Who pays for your place in a care home?
This will depend on a number of factors and the Health and Social Services staff who assess your needs will advise you, but as a general guide you could be:
- Fully funded- that is your fees would be met by the NHS or other government sources, but this only occurs in very limited circumstances
- Self funding- that is you have to pay your own costs
- Funded with Council Support- you will be funded in part by your local Council. You will be financially assessed to work out how much you can afford to pay towards the cost of your care.
Who decides if you are self-funded or eligible for Council support?
Following the assessment of your needs you will be advised about any likely charges. If it is possible that you would qualify for help with the charges you will be asked to complete a financial assessment form. If you are unable to do this your family, carer or legal representative can help you. This form asks for details about your income, savings and other capital assets (eg any property that you own). From this form, it will be possible for the Assessment and Income staff to work out whether you would be entitled to Council assistance in paying towards a care home placement, or whether you would have to pay for your own placement.
You should not try to dispose of any savings or capital assets you have (for example your home), in order to try and reduce your contribution to the cost. If you do so, the Council will still include those savings and capital assets when your share of the charge is worked out.
All people whose assessed needs can best be met by being cared for in a nursing care home are entitled to receive the nursing element of their care for free. A nurse from will assess your level of nursing needs and the home will be paid directly in accordance with this assessment. This scheme is referred to as free nursing care. Thistop up ‘payment’ will have been taken into consideration by the home when it sets its fees to you or to the Council.
You pay
If you have savings and capital which amount to more than £23,250 you will have to pay your own costs. You might also have to pay if your income is high enough to meet the fees.
How your Contribution is worked out
Income
All your income including most of the pensions and benefits you receive will be taken into account but you are entitled to retain a Personal Expenses Allowance _ a sum which the government reviews each year. Your Social Worker will tell you about this and can also explain how other benefits you receive would be affected.
If you have an income from a private or occupational pension or retirement annuity contract, even if your savings and capital are below the £23,250 level you will be expected to pay the care home fee from this income. However, the Council will ignore up to half this pension or annuity if you are using it to support your wife, husband (and possibly at their discretion, a partner).
Capital
Capital is any property, savings and investments, cash, premium bonds, stocks and shares that you have. If you have joint savings or capital assets with your husband, wife, partner or another person, then a proportion will be taken into consideration.
Property, including your home, will be valued at its current market value less any outstanding mortgage. The Council is required to ignore the value of property if:
- * Your husband, wife or partner is living there
- * Another close relative lives there who is over 60 or has a disability or is aged under 16 and is dependent on you. The Government has ruled that the value of a person’s home will not be counted for the first 12 weeks following admission to a care home. On this basis your local Council will ignore the value of your home for 12 weeks from the time when your placement is made permanent when working out whether you qualify for support with funding. This scheme is called a property disregard.
In certain very limited circumstances the Council has the discretion to agree to defer part of the payment towards the cost of the placement. This is referred to as deferred payment.
Your social worker will advise you whether either of these schemes might apply to you.
The Government requires you to contribute a proportion of your savings between £14,250 and £23,250 towards the cost of your placement but savings below this are not taken into consideration.
Choosing a more expensive home?
Where you qualify for Council help with payment of your fees and the Council can find you a suitable home within their usual costs you can only choose a more expensive home if:
- Someone else (for example a relative, friend or charitable organisation) agrees to pay a ‘top up’, i.e. the difference between the actual fee for the placement and the amount the Council would usually have expected to pay for similar suitable accommodation, i.e. the usual cost. The person who agrees to pay the top up is referred to as a third party sponsor.
- Very exceptionally if you are being funded under property disregard or deferred payment schemes, you could pay the difference from your own funds. Failure to keep up top up payments is likely to result in your being asked to move to a suitable alternative home, available at a cost the Council would usually expect to pay.
You and your family can discuss top up arrangements with your Social Worker who can provide further information to you and to anyone who might be prepared to act as your third party sponsor.
Assistance in funding your care at home
Personal budgets for social care
Introduced by the government, personal budgets give you the choice to decide what kind of support you need to improve your quality of life and live as independently as possible.
What a personal budget means for you:
- *Getting the right kind of support, when you need it, and
- *Getting the help you need quickly and in a way that fits into your lifestyle.
Once you have chosen the support you need, you pay for it using money from your personal budget, which is allocated to you by the Council.
How it’s different to traditional ways of receiving services
Previously, if you were eligible to receive social care services from the Council, your social worker would have arranged your support (called a ‘care package’). This may have included a visit to a day centre, transport to the centre, home care and meals-on-wheels.
By offering you a personal budget, you now have much more choice and control over how you live your life. You may, for example, want to attend college, go swimming or go to the cinema instead of going to a day centre. You can still choose the traditional methods of support, but the important thing is that now with a personal budget the choice is yours, as long as it is used to support your social care needs.
How it works
The Council will carry out an assessment of your needs to decide whether or not you are eligible to receive social care services, using the government’s ‘Fair Access to Care Services’ guidelines to help work out your eligibility.
If your needs are assessed as either ‘critical’ or ‘substantial’, you will be offered a personal budget. The assessment will help to determine how much your budget will be, based on your assessed needs.
Your social worker will tell you how much your personal budget is going to be, based on the information you have given in your assessment. Most local Council’s operate a ‘charging policy’ and this is used to work out the amount (if any) you have to contribute towards the support you receive. This will all depend on your income and savings.
The next step is to write your care support plan. You can:
- * Ask your social worker, a friend, relative, a support broker or someone else to help you to produce it.Your support plan will give details of:
- * What’s important to you
- * What you want to change or achieve in your life (your outcomes)
- * How you will be supported
- * How you will use your personal budget
- * How your support will be managed
- * How you will stay in control of your life
- * Any contingency plans you have in place, in case something unexpected happens.
Your social worker will then ask a social care team manager to approve it.
What you can spend the money on
Many people will still spend their budget on traditional methods of social care, like attending a day centre or receiving support at home to help them get up, get washed and dressed. Lots of people have personal assistants to help them to do the things they want to do, such as going to the gym, walking the dog or visiting the shops.
What you can′t spend the money on
Your budget must not be used in any way which will harm your health, safety or wellbeing, or purposely used for an illegal act. It also can’t be used to buy goods or services which would normally be provided by another statutory organisation, such as health or housing without full agreement from the Council.
Personal budgets must be agreed by the Council and only used to support you with your care needs. Personal budgets cannot be used to pay for residential or nursing care.
How you will receive your personal budget
You can ask your social worker or support broker to arrange services on your behalf using the money allocated to you from your personal budget. This means that they will manage the budget for you.
If this does not suit you, you can have the cash to arrange your own services (this will then be known as a ‘direct payment’) which will be paid into a nominated bank account.
Alternatively, you can ask your social worker to arrange some of your services and have a direct payment to arrange some of your own services. For example, you may enjoy going to a day centre but want to employ a personal assistant to help you to get up later in the morning, or go to bed later at night.