Navigating Live-in Care Funding in the UK
When considering live-in care, one of the most pressing questions for many families is how it will be funded. The UK operates a multi-layered system, which can be difficult to navigate. Your payment route will typically fall into one of three main categories: self-funding, local authority funding, or NHS Continuing Healthcare (CHC).
The Three Main Funding Routes Explained
Self-Funding
If you have savings, investments, and other capital above the upper limit set by the local council, you will be expected to pay for your care in full. In England, this threshold is currently £23,250. You become what is known as a 'self-funder.'
- Income and Assets: This includes using your personal savings, pensions, and any income to cover the costs. The value of your property is disregarded in the financial assessment if you are receiving care in your own home.
- Benefits and Allowances: Even as a self-funder, you may still be eligible for non-means-tested benefits like Attendance Allowance (if over State Pension age) or Personal Independence Payment (PIP) (if under State Pension age), which can help cover some care-related costs.
- Financial Planning: Many self-funders use financial planning services to understand the best way to manage their assets, including considering options like equity release or home reversion plans, to fund long-term care.
Local Authority Funding
For those with eligible care needs and capital below the financial threshold, the local council may provide financial assistance. This process is triggered by a two-stage assessment.
- Needs Assessment: First, a social services professional will conduct a needs assessment to determine if your care requirements meet the national eligibility criteria under the Care Act 2014. This includes assessing your ability to perform daily living tasks and the impact on your well-being.
- Financial Assessment (Means-Test): If you meet the eligibility criteria, the council performs a financial assessment. This looks at your income and capital to calculate how much you are expected to contribute. The upper capital limit in England is £23,250, while the lower limit is £14,250. Those with capital between these limits will have a 'tariff income' calculated, and those below the lower limit will receive maximum support, though they may still need to contribute from their income.
- Direct Payments: If eligible for council funding, you may receive the money as direct payments. This gives you greater control and flexibility to choose and manage your own care provider, including a live-in carer.
NHS Continuing Healthcare (CHC)
NHS CHC is a package of ongoing care arranged and funded entirely by the NHS for individuals with a 'primary health need.' Crucially, it is not means-tested, meaning your financial circumstances are not considered.
- Eligibility: Qualification is based solely on a person's health needs, which must be complex, substantial, and ongoing. The need must be of a health nature rather than a social care need. A multi-disciplinary team of healthcare professionals makes the assessment.
- Assessment Process: The process begins with an initial checklist and, if necessary, progresses to a full multi-disciplinary team assessment. If you are eligible, the NHS will cover the full cost of your care package, including live-in care.
- Seeking Assessment: If you believe you may be eligible for CHC, you should speak to your GP or the healthcare professional in charge of your care. It is a detailed and sometimes lengthy process, and it's essential to understand the strict criteria.
Comparing UK Care Funding Options
| Feature | Self-Funding | Local Authority Funding | NHS Continuing Healthcare (CHC) |
|---|---|---|---|
| Financial Status | Capital over £23,250 | Capital under £23,250 | Not means-tested |
| Basis of Eligibility | Willingness to pay; no specific assessment | Care needs assessment and financial means-test | Primary health need assessment |
| Care Control | Maximum choice and control over provider and costs | Control via Direct Payments or council-managed care | Care package dictated by assessed health needs |
| Assets Considered | All income, savings, investments | Income and capital; disregards property for home care | Not applicable |
| Top-up Payments | Not applicable | Required for care more expensive than council rate | Not applicable |
What if Your Circumstances Change?
Many individuals start as self-funders and see their savings deplete over time. When your capital approaches the £23,250 threshold, it is vital to contact your local council for a financial assessment. They can then start assisting with funding to ensure there is no gap in care once your assets fall below the limit. Failing to inform them could lead to a delay in support.
Other Potential Financial Support
Beyond the main funding routes, several other benefits and allowances can help offset care costs. These include Attendance Allowance (non-means-tested for those over State Pension age), Personal Independence Payment (non-means-tested for those under State Pension age), and Carer's Allowance (for your carer). It is important to check entitlement for all applicable benefits.
The Path Forward
Securing the right funding for live-in care can be complex, but understanding the eligibility criteria for each route is the first step. For more general advice on paying for care, you can refer to information from a trusted source such as the Age UK website. By undergoing the necessary assessments and exploring all available options, you can put a robust plan in place to ensure your loved one receives the dignified and high-quality care they deserve in the comfort of their own home.
