Four Seasons Health Care | Care home fees and funding

When choosing a care home, money is naturally one of the biggest concerns. How will care be paid for? Who pays for it? How much will it cost?

We know it can be confusing, so we hope the following guide on fees and funding will be helpful when deciding what to do. We also strongly recommend speaking to your social worker, doctor or family solicitor to answer any further questions.

Who pays for care?

The costs of staying in a care home are usually divided into three:

  • Nursing care - provided by a qualified nurse
  • Personal care - such as help with dressing, eating and washing, provided by a carer
  • Accommodation - including food, heating and living costs

In some cases, there is financial assistance available for those moving into, or helping a loved one move into, a care home. It's important to understand what that help is and how to get it.

Some people qualify for local authority assistance. For example, in England, if you've been assessed as needing a care home place and your capital (your income and assets, such as savings, stocks and sometimes your home) is below £23,250, you should be entitled to financial support from your local authority. If your assets are above £23,250 you will - in most cases - be expected to pay privately for your care home.

If you have capital below £14,250 you will be entitled to maximum support. However, you will still contribute your income, less £23.90 per week which you keep for personal expenses. If you have capital between £14,250 and £23,250 you will also pay a capital tariff of £1 per week for each £250 or part thereof between these two amounts.

Remember, the way care is paid for across the UK will vary. See how care is paid for in Scotland, Northern Ireland and Wales.

Choosing care

If a local authority in England is paying for your care, you can still choose where to live; it doesn't have to be in the same county as the one paying for your care. When you choose a care home, it should meet your needs as assessed by the local authority, meet their criteria, and not cost any more than they would usually pay.

If your chosen care home was to cost more than the local authority will pay for, you may be able to top up the fees through a third party, such as a member of your family. You are not allowed to top up the fees yourself if your capital is below £23,250.

Nursing care

If you're assessed as needing nursing care, the NHS contributes to the costs, whether it is you or the local authority paying for your care. This is called the registered nursing care contribution (RNCC). This is not paid to you. The NHS will pay it either directly to the care home or via your local authority.

If you're moving into a care home because your nursing needs are very high, or you need nursing care due to a long-term medical condition, you may be eligible for fully funded NHS continuing care. This will be determined during your assessment for nursing costs.

Channel Islands and Isle of Man

Funding arrangements for the Channel Islands and Isle of Man may vary. Contact your local social services department for advice.

Scotland

Your local authority may pay for the cost of your residential or nursing home care if your capital is below £16,000, the government-set lower capital limit for Scotland. However, you still have to contribute your income towards your care, minus a small amount each week that you keep for personal expenses.

When you have your financial assessment, the local authority looks at how much capital you have. Local authority assistance with care home fees is not available if you have capital above the upper limit of £26,000.

Capital includes:

  • Money held in a bank or building society
  • Stocks and shares
  • National savings certificates
  • Premium bonds
  • Cash
  • Trusts - the nature of the trust, as set out in the trust deed, will determine how it is taken into account in the financial assessment
  • Land
  • Property - there are some circumstances where property will be disregarded from the financial assessment

If you're assessed as having capital above the upper limit, you will not receive help from your local authority with paying for care home fees above any assessed entitlement to free personal and nursing care. This is known as "self-funded" care.

If you have capital below the lower limit, you will receive local authority help. This is known as "publicly funded" care.

If you have capital between the lower and upper limit, you will be assessed as having "tariff income" of £1 for every £250 or part of £250 between the two limits.

Northern Ireland

In Northern Ireland you have to contribute towards your care home fees. Your local Health and Social Care (HSC) Trust will work out how much you have to pay after a financial assessment. The assessment will look at your income and capital to calculate how much you have to pay.

Examples of income include:

  • Interest on any savings
  • Private and/or state pension
  • Some benefits like pension credit, attendance allowance or the care component of disability living allowance

Capital might include:

  • Savings
  • Investments
  • Any property you own, such as your own home or a holiday home

Before your financial assessment, make sure you're getting the benefits you're entitled to because your contribution to your home fees will be based on all income, including benefits.

No matter how much you have to pay towards your home fees, you must be left with £24.40 a week for personal expenses.

If your capital is:

  • Greater than £23,250 - you will be assessed as being able to meet the full cost of your care
  • Between £14,250 and £23,250 - capital between these amounts will be calculated as providing you with an income of £1 per week for every £250 of your savings
  • £14,250 or under - your capital will be ignored in calculating how much you have to contribute to the cost of your care

If you own your home then it will usually be counted as capital for 12 weeks after you move permanently into a care home. The value of your own home will not be counted as capital if certain close relatives still live there.

You will have a needs assessment before a financial assessment. Your local trust will be able to tell you how much they usually pay for a residential or nursing care home that meets your needs, then arrange a suitable care home for you. Or you can choose one yourself that charges a similar price.

You can choose a home that is more expensive than your local trust usually pays for a person with your assessed needs, but you may need to make up the difference yourself via a third party, such as family or friends. If the trust suggests a home that meets your needs and you still want to move into a more expensive home, you can ask a third party to pay the extra. You will not be able to pay the extra yourself, as your financial assessment will have already decided what you can afford.

If your assessment finds that your primary need is for health care, your trust will pay the full cost of your care. This is called "continuing health care".

Wales

For more information about care-home funding in Wales, contact your local authority. Also, you may want to visit Age UK Cymru for answers to some common questions.

Four Seasons and your care

Our care home managers are happy to talk to you about the costs of care, and the processes involved in paying for care. They will also fully discuss our fees before admission.

Whether you decide to stay at Four Seasons or another care home, we strongly advise you to seek expert financial help before making any final decisions.

Looking for more information?

Here are some more sites you may find useful:

"I am very happy living at Dolphin View and my brother lives here also."

Mrs Thomasina Shotton, resident at Dolphin View Care Home