Understanding the eligibility process
Determining whether you have to pay for carers in your own home in the UK involves a two-stage process run by your local authority. This begins with an assessment of your care needs, followed by a financial assessment, or 'means test'.
The care needs assessment
The first step is for your local council's adult social services to conduct a free care needs assessment. Anyone can request this, regardless of their financial situation. The assessment will evaluate how your health and social circumstances impact your day-to-day life and well-being. It considers what help you need with tasks like personal hygiene, meal preparation, and getting dressed, as well as your ability to participate in the community.
If the assessment shows you have eligible care needs, the council will then look at your finances to see if they can offer support. If your needs are not deemed eligible, you will have to arrange and fund any home care privately.
The financial assessment (means test)
For those with eligible needs, the council performs a financial assessment to determine how much, if anything, you will have to pay. The key factors considered are your income and savings.
- Capital limits: In England, if you have over £23,250 in savings and investments, you are typically required to pay for all your own care. This is often referred to as self-funding. If your assets fall between £14,250 and £23,250, you are expected to contribute a weekly 'tariff income' based on your capital. Those with assets below £14,250 will contribute based on their income, but the council will likely provide substantial funding.
- Income: A portion of your income may be taken into account for contributions, but the council must ensure you are left with a minimum income known as the Minimum Income Guarantee. Certain benefits, like Attendance Allowance, may be disregarded.
- Property: Crucially for home care, the value of your main residence is not usually included in the financial assessment. This is different from care home funding, where it can be considered after a specified period.
Public funding routes for home care
There are two primary public funding routes for covering the cost of home care, which are not means-tested.
NHS Continuing Healthcare (CHC)
If your care needs are primarily health-related, you might be eligible for NHS Continuing Healthcare (CHC). This is a package of care funded by the NHS for adults with significant, ongoing healthcare needs. Eligibility is determined through a detailed assessment by a multidisciplinary team (MDT) and focuses on the 'nature, complexity, intensity, and unpredictability' of your health needs. If you are eligible, the NHS will cover the full cost of your care, regardless of your income or savings.
Local authority support and personal budgets
If your needs are primarily social care and you pass the financial assessment, your local council will create a care and support plan with you. You will be given a 'personal budget' to pay for your care, which you can receive in a few ways:
- Direct payments: A sum of money is paid directly to you, giving you control over how you arrange and pay for your care, including employing a personal assistant or hiring from an agency.
- Council-managed: The local authority arranges and pays for your care services on your behalf.
- A mix of both: A combination of direct payments and council-arranged care.
What if you have to pay for care yourself? (Self-funding)
If you have savings and capital above the threshold, you will need to pay for your care yourself. This is known as self-funding.
Understanding private care costs
The cost of private home care varies depending on the level of care required, your location, and whether you use an agency or hire a carer directly.
- Hourly visiting care: For carers who visit your home for a few hours, rates typically range from £22 to £38 per hour.
- Live-in care: For round-the-clock support, a live-in carer can cost upwards of £1,250 per week, varying based on care complexity.
Ways to manage self-funding
Even when self-funding, there are ways to manage costs and make sure your money goes further:
- Ensure you are claiming all eligible benefits: Many benefits, such as Attendance Allowance (for those over State Pension age) and Personal Independence Payment (PIP) (for those under), are not means-tested and can help pay for care.
- Use your property wisely: Options like equity release or a deferred payment scheme (where the council pays for care home fees, not home care, but it's important to know the difference) can help.
- Explore insurance options: Long-term care insurance policies can cover care costs, but they must be purchased in advance.
- Seek financial advice: Speaking to a specialist care fees adviser can help you compare all your options and create a sustainable financial plan.
Funding eligibility at a glance
| Assessment | Funding Source | Eligibility Criteria | Home Value Consideration | Where to Apply |
|---|---|---|---|---|
| Care Needs | N/A | Must meet eligible needs criteria based on impairment and impact on well-being. | N/A | Local Authority Adult Social Services |
| Financial (Means Test) | Local Authority | Income and savings below set thresholds (e.g., £23,250 in England). | Not included for home care. | Local Authority Adult Social Services |
| NHS Continuing Healthcare (CHC) | NHS | Primary health need and significant ongoing care requirements. | N/A | NHS Integrated Care Board (ICB) |
| Self-funding | Private funds | Capital above the local authority threshold. | N/A | Private care agencies or via direct hire |
For more detailed information on paying for care, including links to resources and helplines, you can visit the Age UK website.
Conclusion: Your pathway to funding care
The journey to securing home care in the UK is a multi-step process, with the answer to "do you have to pay for carers in your own home?" being determined by two key assessments. The Care Act 2014 sets out the framework, ensuring that everyone receives a needs assessment, and that financial support is directed to those who need it most. By understanding the difference between local authority, NHS, and private funding options, you can make informed decisions and ensure the best possible care for yourself or a loved one.
