Paying For Home Care – Live In Care & Respite Care Funding
IN-HOME CARE COSTS: PAYING FOR HOME CARE
When considering the cost of home care for yourself, or an elderly loved one, media reports often focus on the amount you will have to pay as opposed to how those costs will be met, which is why we have created this in-home care costs guide for you. The cost of care can seem daunting and leave people feeling fearful. However, we believe that being well-informed about the cost of care at home will help to empower you in the decisions you may have to make. In this guide, we have taken a constructive look at the various funding options available – putting you on the front foot when it comes to making important decisions about paying for home care.
At Helpd, we focus on putting people in control of their own home care, live-in care and respite care choices, whenever possible, as we believe it ultimately delivers the best outcome. This cost of home care guide is designed to provide a straightforward way to inform you of what funding assistance is available, how to find out if you’re eligible, and how to apply. We’ve also included a list of helpful publications, websites and frequently asked questions so that you can take your next steps with confidence.
Every effort has been taken to ensure that the information provided in this guide is correct at the point of publication. For definitive answers on eligibility and availability of live-in care funding, always speak to the funding agency involved – links to the relevant organisations are provided throughout this guide.
Live-in care costs
Live-in care is a form of home care where a carer will live in their client’s home and help them with their day-to-day care needs. Live-in care costs for the elderly will depend on the level of support needed. Live-in care tends to be tailored to the needs of the individual and can include personal care, companionship, medication prompting and helping with housekeeping.
If you need help with live-in care costs then you may be able to get some funding from several sources, such as the local authority, NHS and charities. Below, we go into detail on what funding is available for live-in care.
Cost of care at home
The cost of care at home can vary enormously and the amount of funding available may differ between NHS Trusts and Local Authorities. It is also worth noting that there may be differences in the funding available in Wales, Scotland and Northern Ireland, as social care funding is controlled by each country’s respective devolved parliaments.
NHS CONTINUING HEALTHCARE (CHC) FUNDING
What it is:
Funding provided by the NHS for those with long-term complex health needs.
If your primary need is a ‘health need’, the NHS is regarded as responsible for providing and fully funding care for all your needs in any setting, including:
- a hospice
- a care home
- your own home
In England, you have two choices for CHC funding:
- The NHS can arrange care for you
- The NHS will make payments directly to you in the form of a ‘personal health budget’ (PHB)
If you receive a PHB, it is then up to you to select, and pay for, the relevant care.
NB. Personal health budgets are not available in Scotland, Wales or Northern Ireland.
Need to know
Not means tested
Not restricted to care home environments
Payment can be made to the care provider or directly to you
CHC funding eligibility:
Eligibility is not means-tested but is subject to assessment by a team of healthcare professionals (a ‘multi-disciplinary team’) and is dependent on your needs rather than your diagnosis or condition. If your needs change then your eligibility may also change. It is possible to get home care funding from NHS Continuing Healthcare if you have dementia, however, a diagnosis of dementia is not a guarantee you will be eligible for this funding.
How to apply:
Ask your GP or social worker to arrange an assessment for you.
Alzheimer’s Society guide for NHS Continuing care (dementia focused)
What if my application is turned down?
In the case of NHS Continuing Healthcare (CHC) rejecting your application, you can contest the decision. Your local Clinical Commissioning Group (CCG), Health Board, or Health and Social Care Trust can assist you. You can also ask them to review their decision.
If you are still unhappy with the decision after it has been reviewed, you can escalate your case to the Parliamentary and Health Service ombudsman. The ombudsman investigates each case for free and promises to act “fairly and without taking sides.”
NHS-FUNDED NURSING CARE
What it is:
Funding provided by the NHS towards the cost of nursing or medical care within a care home. Please note: this fund does not offer funding for care within the home.
If you are fully or partially paying care home fees and receiving care from a registered nurse or doctor, the NHS may contribute towards the costs of your treatment. The payment is made directly to the care home.
Eligibility is not means-tested but is instead based on an assessment of needs.
How to apply for NHS-funded nursing care:
Contact your local authority.
LOCAL AUTHORITY FUNDING FOR CARE IN YOUR HOME
The Local Authority (LA) does provide some funding for the cost of home care and can help to contribute towards the cost of a live-in carer. However, Local Authority funding is generally means-tested and different LA’s will have different rules and frameworks. Whether you live in Northern Ireland, Wales, England or Scotland, always check with your Local Authority what funding is available.
Local Authority funding: funding home care
What it is:
Funding provided by your Local Authority to contribute to your home care costs or care home costs.
If you require support with carrying out day-to-day tasks in your own home due to ill-health, frailty, after being discharged from hospital, or you need assistance in moving into a care home, your Local Authority may contribute fully or partially towards the costs of paying for care at home. This could include:
- Modifications to your home
How to apply for local authority funding for care:
Contact your local authority to request a free care needs assessment. You can use this link to find out where your nearest Local Authority Needs Assessment service is.
Eligibility for local authority funding for care:
To find out if you are eligible for local authority funding for care, contact the social services department of your local authority. Eligibility is means-tested. If you have savings of more than the following amounts, you will have to pay for your own care: Savings threshold for Local Authority funding 2019/2020
|Wales||£24,000 (care at home) or £50,000 (care in a care home)|
|Source: Money Advice Service (Oct 2019)|
What it is:
Funding provided by the government to contribute towards care costs.
If you are aged 65 or older and have a disability that means that you need someone to help look after you, the government will make a weekly payment to contribute towards the cost of your care. The allowance has two payment rates, dependent on the outcome of your assessment.
Need to know
Does not affect other benefits that you may receive.
It is possible that you may get extra Pension Credit, Housing Benefit or Council Tax reduction if you get attendance allowance
|Weekly payment rate||Level of help required|
|Lower rate £58.70||Frequent help or constant supervision during the day, or supervision at night.|
|Higher rate £85.60||Help or supervision throughout both day and night, or if you’re terminally ill.|
|Source: Gov.uk Correct as of October 2019|
Eligibility for Attendance Allowance:
Attendance Allowance is not means-tested – it is open to anyone aged 65 or over who fulfils the following criteria:
- Has a physical disability, a mental disability, or both
- Has a disability severe enough to need help caring for yourself
- Has a disability severe enough to need someone to supervise you for your own safety
- Have needed help for at least 6 months
- Special rules apply for people who are terminally ill and are not expected to live for more than six months
- Attendance Allowance does not apply if you live in a care home, unless you pay all of the care home costs yourself.
How to apply for Attendance Allowance:
Download, complete and post the Attendance Allowance form. The form and postal address can be found here.
Alternatively, call the Attendance Allowance helpline on 0800 731 0122 to request a form.
Gov.uk: Attendance Allowance
Citizens Advice: What is Attendance allowance
What it is:
Funding provided by the government so you can choose the service you need for yourself.
If you or a loved one has been assessed as needing social services support, you can opt for direct payments so that you can choose the care that best suits your needs. Each Local Authority will have its own assessment criteria.
You can only get the payments if you have been assessed by social services as needing care and support. This is only available in England, Scotland and Wales. Direct payments can be made to:
- Disabled people aged 16 or over (with short or long-term needs)
- Disabled parents for children’s services
- Carers aged 16 or over (including people with parental responsibility for a disabled child)
- Elderly people who need community care services
CHARITY-BACKED HOME CARE FUNDING
There are a number of charities that may offer home care funding. To find out what you may be eligible for, we recommend visiting turn2us.org.uk. They are a national charity who help people who are facing financial hardship. They have a useful grant search, with an easy to use tool, which can help you find grants and charitable benefits that you may be eligible for.
What it is:
A financial contribution towards some, or all, of your care costs from a charity.
Charity-backed funding can be awarded in cases of severe financial hardship, life-changing events that result in financial hardship or if you have previously been a member of an organisation such as the Armed Forces or NHS. Typically, funding is awarded in the form of a grant – this could be a one-off payment to help with the purchase of equipment or to assist with the ongoing costs of care.
Need to know
May not affect benefits you are already in receipt of
Eligibility for charity backed home care funding:
Eligibility will vary depending on the charity involved. Eligibility may be determined by several factors, such as where you live, current or previous occupation, age, health condition and financial situation.
How to apply for charity backed home care funding:
Application rules will be dependent upon the individual charities involved.
Useful links:Turn2Us – a charity that provides practical help to people in financial difficulty Carers Trust – a charity that helps carers connect with resources that will help them or the people that they are caring for
HOME CARE COSTS – SELF-FUNDING
If you are not eligible for Local Authority, NHS or charitable funding then you may have to self-fund your care. Even if you do qualify for some of the care funds above, they may not cover all your care needs and you may be expected to make up the shortfall. Here are several ways that self-funded customers sometimes pay for their home care:
- Using savings
- Cashing in on shares and investments
- Downsizing your home – selling your home and buying a cheaper, smaller home may free up funds to pay for home care
- Immediate need fee payment plan – in essence, this is a type of insurance policy which provides a regular income in exchange for an upfront lump sum investment. For more information read this Money Advice Service guide.
- Equity release
- Investment bonds
- Rent out your home
- Depending on your condition, you may be able to claim compensation, which can help pay for care. This is especially true if you need home care or live-in care due to an industrial disease such as mesothelioma – a type of lung cancer that is caused by asbestos exposure.
PAYING FOR HOME CARE WITH INSURANCE
Another way to pay for home care is through insurance. You may already have an insurance policy, which may cover or partially cover home care costs. For example, if you have taken out an Over-50s plan, have life insurance that includes illness cover, terminal illness cover or a long-term care insurance policy, you may find that your care is covered by these policies.
What it is:
Care funding paid as the result of a claim against an insurance policy.
An often-overlooked source of funding is insurance – it’s important to check policies before paying for care services as some insurers may not make retrospective payments.
Policies that may cover some home care costs include:
- Life insurance with critical illness cover
- A joint policy that covers illness
- Terminal illness cover connected to a mortgage policy
- Some over-50s plans
Dependent on the terms of the insurance policy.
How to apply:
Again, dependent on the terms of the insurance policy.
The Money Advice Service provides excellent advice via the following link on how to make insurance claims and what to do if they are refused
Specialist service providers range from social enterprises to law firms. Below, we’ve provided a selection of organisations that demonstrate the variety of options available.
Fixed Fee – Social Enterprise
Beacon is a social enterprise operating on a not-for-profit basis. They charge a fixed fee for their services which, according to their website, is 50% lower than commercial providers. They also offer free advice on behalf of NHS England.
Fixed Fee – Commercial Enterprise
Compass Continuing Healthcare provides specialist advice and support on securing care funding, operating on a fixed-fee basis.
No Win No Fee – Law Firm
If you believe your need for home care is due to medical negligence and industrial disease or due to some other form of negligence, then you may be entitled to compensation. Find a local reputable law firm and speak to them about your case.