Local Authority & NHS funding for care
The following information is also available as a leaflet that can be downloaded.
Click to download our Local Authority & NHS funding for care PDF
There are four methods of funding available:-
- Local Authority Funding
- After Care for an individual Sectioned under the Mental Health Act
- NHS Funded Nursing Care (formerly Registered Nursing Care Contribution)
- NHS Continuing Healthcare
1. Local Authority Funding
If you have less than £23,250 (from April 11) of capital you are entitled to apply to the Local Authority for funding for care fees. Each Local Authority has a “Standard Rate” that they will pay towards care fees and that rate varies across homes that provide different types of care.
Any income (including benefits) that you receive will be included in calculating how much you will pay towards your own care. You are however allowed to retain £22.60 (from April 11) per week of your income as pocket money!
Your income is worked out by including your benefits, any occupational or private pensions and income from annuity etc. However, in addition, if you have capital between £14,250 and £23,250 (from April 11) every £250 of capital is deemed to give rise to £1 of income and this is included in your income calculation – this is called “tariff income”. If you have less than £14,250 of capital this is disregarded.
You have the choice of which care home you wish to enter but if the cost of that care home is in excess of the Local Authority Standard Rate, the Local Authority will only agree to your choice if the shortfall can be paid by a Third Party Top-Up.
There are various disregards of both capital and income excluding them from an assessment of your means.
The most important disregard is YOUR HOME. Your home is automatically disregarded for the first 12 weeks after you enter the home. Thereafter it may continue to be disregarded but only in specific circumstances. The most common being that the property is still required for the occupation of:-
- your partner or former partner (except where you are estranged or divorced from your partner)
- a lone parent who is your estranged or divorced partner and who has a dependent child
- a relative of yours or a member of your family who is
- aged 60 or over, or
- aged under 16 and is a child that you are liable to maintain, or
- is incapacitated
Where the Local Authority considers it reasonable to do so, they can disregard the value of premises in which a third party continues to live.
2. After Care for an Individual Sectioned
Section 3 of the Mental Health Act 1983 states that a patient may be admitted to hospital for treatment if he is suffering from a mental disorder of a nature or degree which warrants the detention of the patient in a hospital for treatment (or assessment followed by medical treatment) and he ought to be detained in the interest of his own health or safety or with a view to the protection of other persons.
If a person is detained in a hospital under the above section and then ceases to be so detained the Local Authority and the Health Authority have a duty to provide and fund all the relevant aftercare services until they are satisfied that they are no longer needed.
3. NHS Funded Nursing Care (formerly called Registered Nursing Care Contribution)
When a care home provides nursing care a client will be entitled to have his nursing care that is provided by a registered nurse paid for by the NHS. This is paid in two bands, the standard band paying £108.70 per week and the higher band of £149.60 (from April 11).
The contributions are paid directly to the care home who will then charge you or the Local Authority the balance outstanding. They may however charge you or the Local Authority the full costs and then, once the NHS payments have been received, refund these you or the Local Authority, as appropriate.
When you first go into a care home you will be assessed by a registered nurse to ascertain if you are entitled to this funding. Three months later you will be re-assessed. This is because your nursing care needs will usually decrease after you have been in the home a while. You will then be re-assessed on a yearly basis. You can however request a re-assessment at any time if there has been a material change in your condition.
Where an interest in a property is beneficially shared between relatives, the value of the resident’s interest will be heavily influenced by the possibility of a market amongst his fellow beneficiaries. The Guidelines recommend that, if no other relative is willing to buy the individual’s interest, it is highly unlikely that an “outsider” would be willing to buy into the property unless the financial advantages far outweigh the risks and limitations involved. Therefore the value of the interest, even to a willing buyer, should in such circumstances effectively be NIL.
4. NHS Continuing Healthcare
The NHS are required to fund care, whether it is in a care home or in the individual’s own home, if their needs are primarily health care needs. The difference between health care needs and social care needs is quite a hard one to grasp. Basically help with dressing, washing and other things that don’t need specialist training are considered social care needs. Healthcare needs are those that need medical training to provide. The fact that you may need help washing and dressing because of a medical condition does not make them health care needs.
The National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care was introduced on the 1st October 2007. Historically the test for eligibility for this funding was set by each Primary Care Trust within the NHS. From the 1st October 2007 a nationwide new criteria was introduced.
They have also introduced a Fast Track Pathway when individuals with a rapidity deteriorating condition, which may be entering a terminal phase require immediate provision of funding because they need an urgent package of care. Strict time limits are not relevant and are directed not to be imposed.
If the local Primary Care Trust decide after an assessment that you are not entitled to this funding, this is not necessarily correct. You can appeal their decision and/or you can ask for a re-assessment if your condition declines.