Paying for care is something that many people will face at some point in their lives. Unfortunately, the rules around who is eligible for care funding, and how to apply for care funding, can be very complicated. Here are some commonly asked questions that are often put to our specialist Community Care team.
Social care funding isn’t that straightforward. If you are assessed as having social care needs and not a primary healthcare need, Social Services will expect you to use your Pension, Benefits and most other income to pay towards your care fees at home or in a Care or Nursing Home. In some (but not all) circumstances, the value of your home may be counted as capital to be used to cover the cost of residential care. Put simply, Social Services do not fully fund your care – at the very least, you will have an income contribution (assessed charge) to make. If you need to challenge an inaccurate social care financial assessment by Social Services, our specialist community care team can help. Contact us to find out more.
No. The income of the person in care is always taken into account. This includes state pensions and benefits, occupational and private pensions, and income from other sources. However, the partner’s income should be ignored in the Social Services financial assessment. There are also rules about income disregards that can be helpful to a couple when the person in care has a private or occupational pension. However, the situation can be complicated when household income is received on a joint basis, such as Pension Credit. If you need to ensure that Social Services have properly assessed your wife’s income contribution to her care home fees, we can help.
The paying for care rules are complex, but put simply, you are expected to use your income and savings to fund your care if your savings and capital are more than £23,250. Despite a series of General Election manifesto promises to put a ‘‘Care Cap” in place to limit the amount that a self-funder has to spend on care home fees, no changes have come in to law. The Government is proposing a new period of public consultation lead by Jeremy Hunt and a Green Paper on social care funding is expected in summer 2018. Whatever new rules are eventually put in place, it is highly likely that you will still have to use some of your income & capital to pay towards your care costs.
This will depend upon how much capital you have and how your capital is split between your property and savings, investments, etc., and whether you can claim any disregards. Remember that the value of the home MUST be ignored for the first 12 weeks of admission to permanent care. However, if your assessable capital not including your home is above £23,250, you will normally be expected to self-fund from the start of your care home admission.
This is what causes many people most concern, as they fear that the home will have to be sold to pay for the costs of their care and there will be nothing to leave to their family to inherit. There are a number of factors relevant to the treatment of the family home and whether its value can be fully disregarded and/or whether you can borrow against the home so that you don’t have to sell it. Local Authorities (LA) are now obliged to offer ‘Deferred Payment Agreements’ to home-owners, meaning that instead of having to sell your house, the LA will ‘loan-fund’ part of the money needed to pay for your care.
Deferred Payment Agreements offer one way out of this dilemma. You may be able to enter in to a loan funding agreement with Social Services that allows you to “borrow” against the value of the family home instead of selling it. Social Services contribute towards your care home fees, and you contribute from your income. Social Services apply a Legal Charge against the property which needs to be paid back when the person in care dies, or when the property is sold – whichever is the sooner. Up to 31 March 2015 this scheme had been interest-free during the lifetime of the person in care. However, the new Care Act rules in force from 1 April 2015 include charging interest and other charges on deferred payment agreements arranged after that date.
Many people consider gifting their savings or their home to another member of their family in order to avoid the risk of having to sell their home at a later date to pay for care fees. However, the paying for care rules make it clear that giving away assets, such as capital or signing over your house to someone else, may be seen as an intentional “deprivation” of assets. In some cases, the Local Authority may treat you as if you still owned the asset even after you have parted with it. This may result in you being liable for all of your care fees as well as no longer owning the asset in question. This is a complex area of law and you should always seek appropriate legal advice before contemplating any gifting.
The rules are complicated and it depends which relative is occupying the property, how old they are, whether they have a disability, whether they are dependent on you, whether they have been caring for you and possibly also how long they have been living there. You should seek advice on this, as families and Social Services can both get the law wrong. If a property disregard can be claimed, it is very valuable. You can read Annex B of the Care & Support Statutory Guidance for more information.
The value of the home MUST be ignored if the stay in care is “temporary” and the resident intends to return to it or to sell it to find a more appropriate property to return to. Temporary stays can be up to 52 weeks and in some circumstances could be longer. You may need legal advice if Social Services seek to regard the care placement as permanent when you still have a realistic opportunity of leaving the care home and returning home.
Whether you have to pay anything depends upon the nature and purpose of the short-term care package that is being arranged. You need Health & Social Services to confirm whether this is “temporary care” or “Intermediate Care” as the funding rules differ. No charge should be made for a package of Intermediate Care, but you may not qualify for this particular source of help because there are other strict criteria. If in doubt, seek advice. The value of your home should be disregarded in any short term or temporary residential care package.
The surrender value of a life insurance policy, endowment policies and some Investment Bonds should be normally be disregarded (ignored) by Social Services. This may depend upon when and why you bought the policy. Social Services may dispute whether a policy is a life policy or not – ensure you get specialist legal advice on this point as there is case law to assist. Do not cash the investments until you get advice – as soon as they are cashed, they are no longer disregarded and you will have to use them to pay care fees. If you have cashed in a policy that would have been ignored, because you were given incorrect information or advice, talk to a health and social care law specialist.
Many people are shocked when they find out that the NHS does not automatically cover their care home fees – or care at home fees – even when they have a serious medical condition such as dementia or Parkinson’s, or after they have had a stroke. The NHS only has a legal duty to fully fund care costs if the individual has a primary healthcare need. It can be hard to persuade the NHS that you or your relative have a primary healthcare need and should qualify for NHS Continuing Healthcare. The latest Government statistics for 2017/18 show that only 57,114 adults in England were receiving NHS CHC funding.
People with a “primary health need” who want to remain in their home can have their care costs in their own home covered by NHS Continuing Healthcare but the amount of money offered may not cover the true cost of the care at home package. The NHS sometimes say that there are too many risks involved in a care at home package and try to persuade you to agree to a Nursing or Care Home. The introduction of NHS Personal Health Budgets should help. If your local Clinical Commissioning Group has a resource allocation policy that limits the amount that they will pay for your care at home to about the amount they would pay for you in a care home, contact our specialist Community Care lawyers for advice. Also look for updates from the Equality and Human Rights Commission who are challenging these restrictive policies.
This is when the NHS makes a small weekly contribution towards the cost of your care in a Nursing Home or a Care Home registered for nursing. The payment is currently £158.16 per week (2018/19 figure). In many cases individuals may not feel the benefit of this Funded Nursing Care (FNC) payment as the Home may put up their weekly charge to take into account the individual’s nursing needs, and Social Services usually “knock it off” the amount that they will pay. If you or a relative are eligible for an FNC payment, check with the Home how they propose dealing with this payment. You can ask the Home to confirm in the contract that they pass on the benefit of this additional funding by reducing the contribution that the resident has to make in their care fees by the equivalent amount to the FNC.
Following the 2017 General Election, the Government announced its plan to scrap their previous decision of introducing a ‘Care Cap’ of £72,000, on care home fees paid from your capital (property & savings). The Government has instead said it wishes to consult on the matter once again but with a ‘green paper’ set to be published in summer 2018. This means that the current rules remain in force.
We will have to wait and see if the cap is introduced and at what level it is set but you can be sure it will not be applied retrospectively.
If you have already paid more than any cap by the time one is introduced, the Government will not refund the additional fees paid.