The Truth Behind Free Care in Scotland
For many years, Scotland has held a reputation for its more progressive approach to social care funding. The reality, however, is more nuanced than a simple 'free' sticker. While the nation provides certain types of care without charge, understanding the specific components that are funded and those that are not is crucial for families planning for the future.
The Free Personal and Nursing Care Guarantee
The cornerstone of Scotland's social care policy is Free Personal and Nursing Care (FPNC). This service is available to any adult who has been assessed by their local authority as requiring it. Importantly, eligibility is not dependent on your income or capital. This policy, initially for those over 65, was extended to all adults in April 2019, thanks to Frank's Law.
What is included in free personal care?
Free personal care covers a range of practical, day-to-day tasks. According to the Scottish Government, this includes assistance with:
- Personal hygiene: Activities such as bathing, showering, and getting dressed.
- Continence management: Help with toileting, catheter care, and laundry.
- Food and diet: Assistance with eating, special diets, and food preparation.
- Mobility: Support with moving around and using mobility aids.
- Medication assistance: Including eye drops, creams, and monitoring.
- General wellbeing: Psychological support and counselling.
What is included in free nursing care?
Free nursing care, similarly based on need, covers care requiring the skills of a qualified nurse. This might include administering injections, managing pressure sores, and other medical-related tasks.
The Costs You May Still Need to Cover
Despite the provision of FPNC, a substantial portion of care costs, particularly for those in a care home, are not covered. These costs are often subject to a financial assessment by the local council.
Care at Home vs. Care Home Costs
The distinction between receiving care at home and in a care home is significant in terms of funding. While personal care at home is fully covered following a needs assessment, other services are not. Conversely, while FPNC payments are made for care home residents, they still face potentially high fees for accommodation and daily living.
| Feature | Care at Home | Care Home |
|---|---|---|
| Personal Care | Free following assessment | Free via FPNC payment |
| Nursing Care | Free via NHS | Free via FPNC payment |
| Accommodation & Living | Not applicable | Means-tested contribution required |
| Other Services | Non-personal care services (e.g., housework, shopping) are means-tested | Included as part of accommodation costs |
| Financial Assessment | For non-personal care services only | For all accommodation and living costs |
The Role of the Local Authority and Financial Assessment
To receive free personal care or financial assistance for other services, you must first undergo a care needs assessment with your local council's social work department.
The Assessment Process
- Initial Contact: Request a needs assessment from your local social work department.
- Needs Assessment: A social care professional will visit to understand your needs and how they affect your daily life.
- Eligibility Decision: The local authority determines if you are eligible for services, including FPNC.
- Financial Assessment: If services are needed, a financial assessment (means test) is conducted to see if you must contribute towards costs not covered by FPNC.
Financial Thresholds for Care Home Funding
In Scotland, capital limits determine if the council will help with care home fees (beyond FPNC):
- Below £22,000 (2025/26 rate): You won't contribute from your capital, but a contribution from your income is expected.
- Between £22,000 and £35,500: You will contribute a weekly amount from your capital and income.
- Above £35,500: You are considered a 'self-funder' and are responsible for all care home fees, minus the FPNC payments.
Important Benefits and Schemes
Beyond FPNC, other support exists to help with care costs. It's important to understand what is available and how it works.
Pension Age Disability Payment
Since 2024, Pension Age Disability Payment (PADP) has been replacing Attendance Allowance in Scotland. This is an extra payment for those over State Pension age with a long-term illness or disability affecting their daily life. Importantly, it is not means-tested and does not have to be spent on care. Existing Attendance Allowance recipients are being automatically moved over to this new benefit.
Self-Directed Support (SDS)
SDS is an important option that gives people more choice and control over their care. Rather than the local authority simply arranging services, you can opt for a direct payment to manage your own budget and source your own care and support. There are four options for receiving SDS, from direct payments to having the council arrange services on your behalf.
Final Word on Funding Elderly Care
While the concept of Free Personal and Nursing Care is a major benefit, it is not a complete solution for covering all elderly care costs in Scotland. Families must undertake a local authority needs assessment and be prepared for a means-tested financial assessment that will determine their contribution towards accommodation and other non-personal services. Leveraging benefits like PADP and exploring Self-Directed Support are key strategies for managing the financial aspects of care.
For more detailed information and guidance on financial assessments, you can visit the mygov.scot website.
What the Future Holds
Plans for a National Care Service in Scotland were announced in 2021, aiming to improve fairness and standardise the social care system. However, these plans have faced delays. Changes to non-residential care charging are also still under review, with some councils hardening their stance. Staying informed through official sources is therefore vital for those navigating the system.
