Who Pays for Care Fees?

Many families are unsure who is responsible for paying care home fees when a relative requires long-term care.

Depending on a person’s circumstances, care may be funded privately, supported by the local authority, or in some situations paid for by the NHS through NHS Continuing Healthcare funding.

Understanding how care home fees are funded can help families determine whether they may be responsible for the cost of care or whether funding may be available.

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Self-Funding Care

Many people entering care homes initially pay for their care privately. This is often referred to as self-funding.

Individuals may be required to fund their care if their savings or assets are above the financial thresholds set by the local authority, the higher cap is currently £23,250 while the lower cap is £14,250.

Care home fees can be significant, particularly where nursing care is required. Costs often exceed £1,500 to £2,000 per week, depending on the level of care and the location of the care home.

Local Authority Funding

If a person’s savings and assets fall below the thresholds (higher cap is currently £23,250 while the lower cap is £14,250), the local authority may contribute towards the cost of care.

This type of support is generally based on financial means testing and usually applies where care needs are primarily related to social care rather than healthcare needs.

When the NHS Pays for Care

In some situations, the NHS may be responsible for the full cost of care through a funding package known as NHS Continuing Healthcare (CHC).

NHS Continuing Healthcare is provided where a person’s primary need for care is related to health needs rather than social care needs.

Where eligibility is confirmed, the NHS becomes responsible for paying the full cost of care regardless of the person’s savings, income or property.

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How NHS Continuing Healthcare Is Assessed

Eligibility for NHS Continuing Healthcare is determined through a detailed assessment carried out by a Multi-Disciplinary Team (MDT). The MDT consists of medical, healthcare and social care professionals and can include participation from anyone relevant to the individual being assessed care such as, the family, carers and advocates.

The assessment process considers a person’s health needs across a number of areas using a document called the NHS Decision Support Tool (DST).

A Multi-Disciplinary Team (MDT) must consider whether the (DST) shows the person’s needs amount to what is known as a Primary Health Need.

What Happens If Funding Is Refused?

Some families only become aware of NHS Continuing Healthcare after they have already begun paying for care privately.

If NHS Continuing Healthcare funding has been refused following an assessment, families have the right to request a review of the decision.

In some situations it may be possible to challenge the outcome through the NHS Continuing Healthcare appeals process.

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