One of the most stressful parts of arranging care can be knowing how to pay for it. Currently, long-term care funding is a huge problem. The government have planned an overhaul of how means testing for care funding will be assessed. However these changes have at the moment been delayed until April 2020.
This means that, as things stand, anybody with over £23,250 in capital and savings will have to pay the full cost of care and anybody with between £14,250 - £23,250 will only receive a contribution towards some of the costs of their eligible care needs from the Local Authority.
Currently the average cost of residential care is £31,200 a year which rises to £43,700 a year if nursing care is necessary (Laing and Buisson Care of Older People UK Market Report 2016/17). This can obviously very quickly deplete somebody’s life savings.
Local Authority funding
If your assets do fall below £14,250 you will be entitled to Local Authority funding for your eligible care needs. The Local Authority can ask your family members to pay a top up fee if the cost of your care is higher than the amount that they are willing to pay. However they can only do this if they can show that there are other care providers in the area that can meet your needs within their budget.
When the Local Authority assesses the value of your assets you are entitled to a property disregard for the first 12 weeks of going into care which means that for that period the value of your property should not be included in the overall valuation of your assets. Similarly, your house should not be taken into account if you have a spouse, relative over 60, child or somebody with a disability living there.
Beware of gifts
Often people assume that they can avoid paying for care by giving their assets away to family/friends. The local authority can consider your reasons for making such a gift and if they suspect that you have done so to avoid paying for care they can try to reclaim the value of the gift from the person to whom you made the gift or even treat you as still having the asset that you have given away.
Protecting your home
Putting your property into trust
Sometimes people consider putting their house in trust to avoid needing to sell it to pay for care. Unfortunately, like gifting assets, if the Local Authority considers that you have done this solely with the intention to avoid paying for care then they can still treat you as owning the property. It may, however, be worth reviewing your will. For example, if you own a property jointly with your spouse/civil partner then rather than leaving the property to them absolutely it may be worth changing your will so that you leave your partner the right to remain in the property. This will mean that your partner then only owns half of the property but still has the right to live there for their life or until they require residential care.
Deferred payment agreements
If you do not wish to sell your property then the Local Authority can offer a deferred payment agreement whereby they will pay your care home fees then seek to recover these from the value of your property later. This is available if:
- You are in a care home
- You have less than £23,250 (excluding your home)
- Your home is not a disregarded asset when assessing how much capital you have
In all other circumstances the LA also have discretion to offer a deferred payment agreement so it can still be worth asking. Another option would be to rent out your property and to use the income received to pay for care. This can help to prevent the need to sell the property.
NHS Continuing Healthcare Funding
In some cases, depending on a person’s health needs, the NHS will pay the full cost of care. It is difficult to secure this funding. However it is obviously extremely worthwhile pursuing this if possible as it can potentially save thousands of pounds.
You are entitled to ask your local Clinical Commissioning Group to assess whether you are eligible for this funding and even if you are found to be not eligible, then you are able to appeal this if you do not agree with the reasons for their conclusion.
When undertaking an assessment for NHS Funded Continuing Healthcare the Clinical Commissioning Group are assessing whether somebody has a ‘primary health need’. This is assessed by way of a Decision Support Tool looking at health needs in a range of domains (for example, mobility or nutritional needs). Each domain is scored based on the severity of a person’s level of need in each area and this enables the Clinical Commissioning Group to build an overall picture of a person’s health needs. The assessment and appeals process can be complicated so if in doubt seek legal advice.
Common myths about NHS Continuing Healthcare funding
Unfortunately, there are a lot of misconceptions about NHS Continuing Healthcare funding – for example, people often think that you can’t be eligible if you own a house or you have to be in a nursing home to qualify for funding – both of these are false. NHS funding can apply just as much to home care as to care homes so it is always worth seeking an assessment. It is also possible to make a claim on behalf of a deceased relative if you believe that they should have been eligible for this funding.
s.117 Mental Health Act 1983 ‘aftercare’ funding
There is also separate funding available for anybody that has previously been detained under certain sections of the Mental Health Act 1983.
The idea behind this is to ensure that when a person who was previously detained under certain qualifying sections leaves hospital that they have the follow up care and treatment required to stop them needing to be re-admitted to hospital again in the future.
The scope of what can and can’t be covered under this section can be complicated as was seen in the recent case of R (CXF) v Central Bedfordshire Council  EWHC 2311 (Admin),  MHLO 30 where it was held that the entitlement to aftercare is only available when a person has ceased to be detained (and not, for example, when they are on leave from the hospital).
Finally, it may be worth seeking independent financial advice as there are financial products available (for example, an immediate lifetime care plan) which can be purchased to provide security and reassurance that future care fees will be met.
Do you think that you (or a relative) are wrongly paying for care?
Deciding how best to pay for care and navigating the assessment processes for Local Authority/NHS funding can be very stressful. If you believe that you or a relative are wrongly paying for care then it is important to keep as full a record as possible of any decisions made by either the Local Authority/Clinical Commissioning Group as well as proof of payment of the care fees so that these can be reimbursed if appropriate. If an assessment for NHS Funded Continuing Healthcare has been undertaken and you disagree with the outcome then a solicitor can advise you of the appeals process as well as the information that will be needed to pursue an appeal.