Residential Care Funding

The current financial options available for Residential Care.

The position now is that virtually all older people entering care homes will be entitled to some element of public funding, but that the components of such funding will vary from person to person and may alter over time. The main components available to fund residential care are currently as follows:-

National Health Service funding, irrespective of means, for those whose primary need is for healthcare. Whether this primary healthcare need can be demonstrated is determined by the nature, intensity, complexity and unpredictability of a person's needs. There is a general duty on the NHS to assess a person's eligibility where it appears to them that a person may be so eligible and in particular where a person is being discharged from hospital.

Partial Relief on nursing care fees, provided by the NHS, irrespective of means. This applies where the person does not qualify for NHS continuing healthcare (as above). Since October 2001, all older people who have been assessed as requiring nursing care but are self-funding have been 'relieved' from paying for the element of their care which is attributable to a registered nurse. From 1 October 2007, residents in or moving into nursing care homes are no longer allocated to a registered nursing contribution band based on the level of input from nurses. Instead, a flat rate is payable to the care home from the Primary Care Trust in respect of the resident. This is currently £108.70 per week but  people assessed before 1 October 2007 on the High band benefit of £149.60 will continue to qualify for this higher payment unless their nursing needs have diminished or no longer exist.

Local Authority funding, for those with capital below £23,250 in England and Wales (2012/13), subject to means-tested contributions. From April 2011, individuals with capital of more than £23,250 in England/£22,500 in Wales (the prescribed limits) are expected to pay for their own care in full, irrespective of the amount of their income. Where a person's capital is less than the prescribed limits at the outset (or is later reduced below that threshold) the local authority must determine his or her income resources under the charging regulations. If income is inadequate to meet the full cost of the placement, the local authority must still discharge its own contractual obligation to the provider to pay the full placement fee, and must subsequently calculate and recover the appropriate contribution. Certain capital, such as personal possessions, are disregarded under the charging regulations, as is certain income such as 50% of the person's occupational pension where he or she normally passes on that much to his or her spouse.

Local Authority funding for some people whose actual capital exceeds £23,250 in England and Wales (2012/13), but which is disregarded under the local authority charging regulations. At present, as soon as an elderly person becomes permanently resident in a home, the charging regulations require that the value of his or her beneficial interest in any property is taken into account subject, however, to a number of disregards on occupation which, in practice, protect a significant number of properties against assessment; for example, where the resident is only temporarily in residential accomodation and intends to return home, or alternatively, where the resident is permanently in residential accommodation and the house is still occupied either by a spouse or partner, or by a specified relative of the resident or family member who is (i) aged 60 or over or (ii) is aged under 18 and is a child whom the resident is liable to maintain or (iii) is incapacitated. Even if the aforementioned disregards do not apply, a local authority is still required to disregard the value of a resident's property for 12 weeks from the date of permanent admission to a residential care home or nursing home.

Pension Credit, which is similar to income support for those over 60 and has no upper capital limit. The guarantee credit is available for those whose income falls short of a baseline which is referred to as the 'appropriate amount' or the appropriate minimum guarantee. For most people, this will be a 'standard amount', but it will be higher for some disabled people, carers and certain homeowners. For example, the standard amount of £142.70 per week for an individual is raised by £58.20 per week for individuals who are 'severely disabled'.  A savings credit element may also be available to individuals over 65 who have qualifying income above the savings credit threshold (currently £111.80 for a single person and £178.35 for a couple).

Disability Living Allowance (care component) or Attendance Allowance, payable irrespective of means to those who meet the qualifying conditions and who self-fund their care. Both these benefits are available for people who need personal care. Attendance allowance can now be claimed only by people over the age of 65, whilst DLA (care component) is available to any claimant below the age of 65 who meets the prescribed conditions. Once a successful claim has been made, both benefits will continue to be paid as long as the claimant lives, unless his or her circumstances change. Most of the entitlement rules are identical for both benefits. In each case, the maximum benefit payment will be £77.45 per week (2012/13). The majority of older people who fall within the conditions of entitlement are in fact paid the highest rate of benefit.

Contact Julian Lee at our Billingshurst office (01403 782710) for further advice.