Paying for care and support in your own home
Find out how the costs for care are calculated by local authorities.
- Paying for care and support in England
- Meeting your needs
- Financial assessment
- Types of care and support that cannot be charged for
- You are here: Paying for care and support in your own home
- Nursing care in Wales: when does the NHS pay?
- Care home fees
- Care home fees for self-funders
- Paying for care - complaints and FAQs
- Paying for care - more resources
Paying for care and support in England
Paying for care and support in your own home
Most local authorities will charge for care provided in your own home. The amount you pay will depend on the financial assessment, and what a care service costs.
Depending on the financial assessment, a local authority may ask you to contribute a certain amount towards the cost of care, with the local authority paying the rest.
A copy of the local authority’s charging policy should be available online, or you can ask for it. It will include upper and lower limits for savings and income – known as thresholds. Anyone with savings or income above these amounts is expected to pay for their own care. If your savings or income are below the thresholds, the local authority may contribute to your care.
Importantly, when receiving care at home, the value of your home is disregarded in assessing your contribution towards the cost of this type of care.
In England, there are two threshold limits:
- Upper threshold – if the financial assessment shows that your capital is above the upper threshold (£23,250), you will be expected to pay all your own care fees.
- Lower threshold – if your capital is below the lower threshold (£14,250), this amount will be disregarded and the local authority will pay some of your care fees.
If your capital drops below the threshold, the local authority may start paying for your care, but your income will continue to be used towards it. If you or your carer feel that your savings have dropped below the limit, or are about to, you should contact the local authority to ask for a review of your finances.
The Care Act states that any charges for care must be ‘reasonable’. It says that people receiving care at home should not be expected to live on an income lower than a ‘basic level’.
This basic level is calculated as the income received on Income support or the guarantee credit element of Pension credit, plus an extra 25 per cent. If your income does not exceed this basic level, you should not be charged for care at home, unless you have savings or other assets above the threshold.
Local authorities can decide whether or not to count the following benefits as income in the financial assessment:
- severe disability premium
- Disability living allowance
- Personal independence payment
- Attendance allowance.
If your needs assessment identifies that you need a service during the day, the local authority should not count benefits that you receive for care at night.
For example, if you receive higher rate Attendance allowance, because you need supervision at night, the local authority cannot include this extra amount in the financial assessment if support is only provided during the day.
Your local authority has a legal duty to meet your eligible care needs. If you refuse to pay for homecare, the local authority cannot withdraw the service if you are deemed not to have the mental capacity to make this decision. They would therefore be expected to continue to meet your needs, while attempting to resolve any dispute.
However, if you do have the mental capacity to make this decision, and understand its consequences, the local authority is not required to continue to meet your needs if you refuse to pay.
If you feel you have been excessively charged for care by the local authority, you (or your carer) have a right to complain.
Replacement (respite) care
There are many different types of replacement (or respite) care. The aim of replacement care is to meet the needs of the person with dementia, however it also gives rest or relief to unpaid carers.
Types of replacement care include day centres, homecare services, residential stays and breaks for carers to attend a social function or appointment. If you are putting together the support plan jointly with your carer and the local authority, you can discuss these options. Local authorities can choose to charge you for this care, and many do on a means-tested basis.
If you are charged for replacement care services, you may find some financial help locally. It may be worth asking your local authority about local schemes or charitable organisations to help pay for replacement care. Carer break vouchers may be available. These are sometimes given by some local authorities and can be used to pay towards replacement care.
The Care Act makes it very clear that replacement care is to meet your needs, not your carer’s needs. You may be financially assessed and it is usually you who pays for the replacement care, even if it is the carer who appears to take the break. For more information, see Replacement care (respite care) in England.