The Local Authority's Duty of Care
Under the Care Act 2014, local authorities have a legal duty to support people with eligible care needs. This includes providing or funding care for those who cannot afford to pay for it themselves. The process begins with an assessment of your needs and finances. Crucially, the law prevents a care home from simply evicting a resident for non-payment, particularly if the person is actively seeking or awaiting local authority funding.
Requesting a Needs and Financial Assessment
If you are approaching the point where your savings will fall below the funding threshold, it is critical to contact your local council's adult social services department. You should do this several months in advance to avoid a gap in payments. The council will carry out two main assessments:
- A Care Needs Assessment: A social care professional will evaluate your health, mobility, and ability to manage daily tasks. This determines what level of care you require and if a care home is the most suitable option.
- A Financial Assessment (Means Test): This looks at your income and capital (savings and property) to determine how much you will contribute towards your care fees. The outcome places you in one of three categories based on your financial situation.
Capital Thresholds in England
In England, there are key capital thresholds that determine the level of financial support:
- Capital over £23,250: You are considered a 'self-funder' and will pay for your own care in full. When your capital approaches this limit, you must notify the local authority for a new assessment.
- Capital between £14,250 and £23,250: The council will contribute to your care fees, and you will pay a contribution from your income and a 'tariff income' from your savings.
- Capital under £14,250: The council will provide a higher level of funding, though you will still contribute from your income.
Important Funding Options to Consider
If you qualify for local authority funding, several options may become available to you, depending on your circumstances.
Deferred Payment Agreements (DPAs)
A Deferred Payment Agreement is an arrangement with your local council that allows you to delay paying some of your care home fees. This is typically an option if most of your wealth is tied up in your home, and you don't want to sell it immediately. The council essentially loans you the money, and the amount is repaid when your home is eventually sold or from your estate after your death. The local authority will place a legal charge on your property to secure the debt.
NHS Continuing Healthcare (CHC)
If your primary need for care is due to a complex medical condition, you might be eligible for NHS Continuing Healthcare. This is not means-tested and, if successful, the NHS covers all your care costs. A comprehensive assessment is carried out by healthcare professionals. People with progressive conditions like advanced dementia may qualify, but the criteria are strict.
NHS-Funded Nursing Care (FNC)
If you don't meet the high bar for CHC but require care from a registered nurse, you may be eligible for NHS-Funded Nursing Care. This is a weekly, non-means-tested contribution that the NHS pays directly to the care home to cover the cost of nursing care. It can help reduce your overall care costs.
What if My Current Care Home is Too Expensive?
When moving from self-funded to council-funded care, the local authority will only pay a set amount for a care home placement. If your current home's fees exceed this amount, you have a few potential outcomes:
- Third-Party Top-Up Fees: A family member or friend can pay the difference between the council's rate and the care home's fees. This is a serious, long-term commitment that requires a written agreement.
- Negotiation with the Care Home: Some care homes may agree to reduce their fees or move the resident to a less expensive room. Care providers often want to avoid the disruption of a resident moving and may be flexible.
- Relocation: If no top-up can be arranged, the local authority must offer a place in an alternative, suitable care home that accepts its funding rate. The council must still consider the impact of a move on your well-being.
Deprivation of Assets
A crucial aspect to be aware of is 'deprivation of assets'. This occurs when a person intentionally gives away money or property to avoid paying for their care costs. The local council has the power to investigate and, if found guilty, can act as if the asset still belongs to the person for the purposes of the financial assessment. This can result in a significant back-charge and is a serious legal issue.
Comparison of Funding Routes
| Feature | Local Authority Funding | Deferred Payment Agreement | NHS Continuing Healthcare (CHC) |
|---|---|---|---|
| Basis | Means-tested (income & capital) | Means-tested on capital, secured by property | Health needs-based, not means-tested |
| Main Criteria | Savings/capital below £23,250 and assessed care needs | Owns property, meets capital limits, long-term care need | 'Primary health need' with high level of care |
| Covers | Care home fees up to a set amount | Postponed payment of care home fees | Full cost of care home fees and nursing |
| Repayment | Contribution from income, potential tariff income | Repaid from sale of property or estate | No repayment required |
| Home Value | Included in assessment if no spouse/dependant resides | Secured against value of property | Not relevant as it is not means-tested |
| Benefits | Leaves resident with a Personal Expenses Allowance | Allows delay of property sale | Provides free, comprehensive care |
Seeking Expert Advice and Support
Navigating the care funding system can be complex and intimidating. Fortunately, there are organisations dedicated to providing guidance. Seeking advice from charities or independent financial advisors specialising in later-life care can help you understand your options and entitlements. You can get free and independent advice from Age UK.
Appealing a Decision
If you disagree with the outcome of a needs or financial assessment, you have the right to appeal. The process for challenging a local authority decision differs from a CHC appeal, which has a specific multi-stage process. You should always obtain a copy of the assessment and decision in writing and follow the complaints or appeals process outlined by the authority. Legal advice from organisations such as the Citizens Advice Bureau can be invaluable during this process.
Conclusion
Running out of money for a care home in the UK does not leave you without options. A structured legal framework is in place to ensure you receive the care you need, primarily through local authority support and, in some cases, NHS funding. The key is to be proactive: initiate the assessment process well before funds run out, understand the available financial schemes like deferred payment agreements, and seek expert advice to navigate the system. This proactive approach ensures you and your family are prepared and can secure the best possible outcome for your care.
