Here at Liaise, we know from our experience of working with hundreds of families across the country that the process of considering residential care for a loved one can feel daunting. It’s natural to feel overwhelmed during this time, and the added pressure of understanding who will pay for the care fees and organising funding arrangements can add to the worry.
Many families are unaware of the costs associated with residential care and may worry that they do not have enough funds to cover them. As a result, they may delay thinking about it until the need arises. However, it’s important to know that there is support available for those in need.
Understanding the thresholds and eligibility criteria for local authority and NHS funding is important when planning for residential care. Seeking professional advice and support can be helpful in navigating this complex process.
Who Pays for Residential Care Fees?
If your loved one has autism, a learning disability or other complex needs and could benefit from residential care, you may be wondering if there is funding available to help cover the costs.
In the UK, there are three main ways to cover the cost of residential care:
- Local Authority Funding
- NHS Continuing Healthcare Funding
- Self-funding Residential Care
Understanding these options can help your family make informed decisions about the support your loved one receives.
Local Authority Funding
Local Authority funding (also known as social care funding) is a means-tested service provided by local authorities to assist individuals with the cost of residential care or supported living. The eligibility criteria for this funding varies from region to region, but typically it is provided to those who require some level of care and support due to complex needs, such as autism, learning disabilities or other health conditions.
Means testing is the process of assessing an individual’s financial situation to determine how much they are able to contribute towards their care fees. The local authority will assess your loved one’s income, savings, and assets to determine whether they are able to afford to pay for some or all of their residential care fees.
In England, if an individual has capital (which includes savings and property, but not personal possessions or the value of their home if a spouse, partner or dependent still lives there) of over £23,250, they will be expected to pay for the full cost of their residential care.
It’s important to note that means testing also considers an individual’s income. This includes pensions, benefits, and any other regular payments. If an individual’s income is above a certain level, they may be expected to contribute towards their care fees.
There are many benefits and other income that the local authority cannot consider as income during the means assessment, including:
- The families’ income – only the income of the person requiring care can be assessed
- If the individual’s income is solely made up of certain state benefits, such as Disability Living Allowance (DLA) or Personal Independence Payment (PIP), these benefits may not be counted towards the means test
- Disability-related expenditures such as day or night care
You can find the full list of benefits and income that is excluded in the Care and support statutory guidance (see Annex C).
In addition to local authority funding, the NHS also provides funding for individuals with ongoing healthcare needs. This is known as NHS continuing healthcare (CHC) and it is a package of care that is arranged and funded by the NHS. It can cover the cost of residential care, as well as other types of care, such as home care and respite care.
NHS continuing healthcare is intended for individuals with complex and ongoing healthcare needs. It is not means-tested, which means that the individual’s financial situation is not taken into account when determining eligibility. Instead, eligibility is based on the individual’s overall care needs, and whether those needs are primarily health needs.
If an individual is found to be eligible for NHS continuing healthcare, the NHS will cover the full cost of their support, including accommodation, meals, and residential care. The individual will have the choice of which residential care home they wish to live in, and they will also have a personal care plan developed with input from the multidisciplinary team.
Self-funding Residential Care
If your loved one does not meet the eligibility criteria for local authority funding or NHS Continuing Healthcare funding you will be responsible for covering the full cost of their residential care fees. This is known as self-funding care.
The cost of residential care can vary depending on the level of care required and the location of the home.
You may be responsible for paying care home fees if:
- Your needs were deemed ineligible by the local authority during the initial assessment process.
- You have a regular income that is sufficient to cover the cost of care home fees.
- Your assets and savings exceed the threshold of £23,250.
How Can I Access Funding?
To find out if your local authority will contribute to the cost of your loved one’s support, the first step is for your council to conduct a needs assessment to determine the extent of the assistance your loved one requires. This evaluation is referred to as a needs assessment.
Obtaining a needs assessment is free and available to everyone. Find out more about getting a needs assessment.
If it is determined that your loved one requires support, the council will conduct a financial assessment to establish whether they must contribute to the cost of their own care.
If your loved one has substantial or complex primary health needs, they may be entitled to CHC funding. The process involved in NHS continuing healthcare assessments can be complex. An organisation called Beacon gives free independent advice on how families can access NHS continuing healthcare.
How Liaise Can Support You
Here at Liaise, we’re proud to support people who live with a range of complex conditions including autism, learning disabilities, physical support requirements and complex behavioural needs. Oue vision is to ensure that people with support needs lead happy, purposeful lives with the inclusion and dignity they deserve.
All of our supported living and residential care homes are run by experienced and highly-skilled staff dedicated to providing safe and therapeutic community-based homes where people with complex needs can flourish.
We are here to support you and your family. To find out more about our high-quality residential and supported living services, do not hesitate to contact us. We can schedule time for you to discuss your loved one’s needs with one of our managers or specialist team members and provide guidance on funding options.