The Reality of "Free" Elderly Care in Scotland
In Scotland, eligible adults receive free personal and nursing care regardless of age or income [1, 2]. This policy, including all adults since 2019 under 'Frank's Law', covers assistance with daily tasks and clinical nursing [2, 4]. Costs for accommodation in care homes ('hotel costs') and non-personal support at home are generally not included and may require payment based on a financial assessment [3, 5].
Distinguishing Between Personal Care and Other Support
Free personal and nursing care covers essential support like help with hygiene, continence, eating, mobility, and clinical tasks by a nurse [1]. However, services such as housework, laundry, shopping, meal deliveries, and day care centres are typically not covered and may incur charges [1].
Who is Eligible and How is it Assessed?
Eligibility for social care support begins with a free care needs assessment conducted by your local council's social work department [1, 7]. This assessment determines the type and level of care required [7]. If personal or nursing care is needed, these services are free [1, 3].
The Financial Assessment for Non-Personal Care Costs
A separate financial assessment is needed for non-personal care or care home residency [3, 5]. This assessment evaluates income and capital for contribution determination [5]. For 2025-2026, those with capital above £35,500 may pay the full cost, those below £22,000 receive maximum support, and a sliding scale applies between these limits [5].
Cost Comparison: Care at Home vs. Care Home
Costs vary between care at home and care homes. Care needs assessments, personal care, and nursing care are free in both settings (NHS provides nursing care at home) [1, 3], but accommodation and living expenses are personal responsibilities [5]. Non-personal support at home is chargeable based on assessment, while in a care home, these services are often included in accommodation costs [1, 5]. For 2025-2026, the council contributes weekly payments to care homes for eligible residents, £254.60 for personal care and £114.50 for nursing care, with the individual covering the rest [5, 9].
| Service/Cost | Care at Home | Care in a Residential/Nursing Home |
|---|---|---|
| Care Needs Assessment | Free | Free |
| Personal Care Services | Free (if assessed as needed) | Free (paid as a weekly contribution to the home) |
| Nursing Care Services | Free (provided by NHS) | Free (paid as a weekly contribution to the home) |
| Accommodation & Living Costs | Paid by individual (mortgage/rent, bills, food) | Paid by individual ('hotel costs') |
| Non-Personal Support | Chargeable (subject to financial assessment) | Included in accommodation costs |
How to Apply for a Care Needs Assessment
Contact your local council's social work department to start [7]. You can request an assessment for yourself or someone else. A professional will discuss your needs, often at your home [7]. After the assessment, you receive a care plan, and a financial assessment follows if needed [7].
Taking Control with Self-Directed Support (SDS)
Self-Directed Support (SDS) in Scotland offers choice in care delivery [8]. Options include direct payments, council-managed payments with your choice, council-arranged services, or a combination [8]. SDS applies to all social care services. Explore SDS further via {Link: Care Information Scotland https://www.careinfoscotland.scot/} [8].
Conclusion: A System of Support, Not a Blank Cheque
In summary, free personal and nursing care is a key feature of elderly care in Scotland, but it doesn't cover all expenses. Understanding the distinction, the assessment process, and options like SDS is crucial for accessing appropriate assistance.
