Paying for your loved one’s care

Funding options

If you’re wondering how you can afford to pay for the care of your loved one, you’ll be relieved to hear that there are several funding options you can explore. The three most common are:

• Council/local authority funding
  The council may pay for some or all care costs following a financial assessment and a care needs assessment.
• NHS continuing healthcare funding
  The NHS may pay for some or all care costs following a continuing healthcare assessment. Costs can also be split between you, your local authority and the NHS.
• NHS-funded nursing care
  Following a continuing healthcare assessment, if your loved one requires nursing care and isn’t eligible for NHS continuing healthcare funding, the NHS may pay a contribution towards the cost of a nursing home. The rest of the money can be topped up by your local authority, yourself or a combination of both.

Financial assessments

If the person requiring support has above £23,250 in savings (England and Ireland), £28,750 (Scotland) or £50,000 (Wales), they’ll likely to have to pay for the full cost of their care themselves. If they have savings beneath this threshold, they may be eligible for local authority funding.

To see if your loved one is eligible, you’ll need to ask for a free financial assessment to be carried out by your local adult social care service (part of your local authority). This is a means test where someone will come and speak to your relative about their finances, income (benefits, pensions etc), savings (joint accounts are usually split), property and their expenditure.

If the person requiring support plans on staying in their own home, the value of your property won’t be included, but if they want to move to a care home, the test will include the value of your property (providing their partner doesn’t live there). It’s likely that the assessment will include investigating finances several years back to make sure that money hasn’t been given to loved ones or property transferred which could have been used to pay for care.

Care needs assessments

If your local authority says they’ll contribute towards the cost of support for your loved one, they’ll also conduct a care needs assessments. This will be used to determine how much money they’ll provide to cover the cost of care. You can also request a care needs assessment online.

The assessor will typically be a social worker and will conduct either an in-person or telephone meeting. They’ll likely ask about personal care needs, health, mobility, ability, religious considerations and much more. By the end they should have a detailed picture about your loved one, their current situation and what they want to happen in the future.

Following the assessment, the assessor will typically speak to other health and social care professionals who support your relative. It’s important that when your loved one has their meeting they detail what their worst day looks like so it’s clear what support needs they have – I always find writing a list or some notes before can help steer the conversation.

Remember, if you’re an unpaid family carer, you can ask for a carers assessment to help you access respite care.

Once all the information is reviewed, you’ll be contacted to let you know how much can be contributed towards care costs.

Continuing healthcare assessments

If the assessor feels that your loved one’s needs are health based, they’ll arrange for someone from the NHS to come and complete an NHS continuing healthcare assessment (this is known as Hospital Based Complex Clinical Care in Scotland). You can also request one separately via the GP.

The criteria for continuing healthcare funding are strict and your relative will need to be able to evidence that that they have a primary health need such as a complex or an unpredictable medical condition due to a disability, illness or accident.

Continuing healthcare assessments are broken down into two stages:

• Checklist tool
  The assessor will carry out a brief assessment of needs to determine if your loved one is eligible for a full assessment.
• Full assessment
  A multidisciplinary team (two or more health and/or social care professionals) will complete a full assessment of needs, including health, cognition, mobility and communication. Other professionals already involved in the care of your relative may be contacted at this stage to help the assessing team build a full picture of care needs.

The outcome of the assessment usually takes up to 28 days, but if there are urgent needs, an assessment team can complete a fast-track decision support tool to provide a response within 48 hours.

Following the care needs assessment, the assessor will draw up a plan of support needs, costs and how much they will cover – similar to councils, they’ll also conduct a financial assessment. Assessors can also refer you to your local authority if you haven’t had an assessment with them.

Expect delays

Because of the pandemic, care assessments are backlogged and there are delays in processing these. I’d recommend making clear notes of the date and time you contact anybody, who you spoke to and their response. You can use this to help chase teams for assessments.

If needs be, you can make contact with your local MP and utilise other healthcare professionals such as the GP to make referrals.

Most importantly, preserve with the process and get the support you need for your loved one.