Paying for dementia care in England

Dementia care isn't free, and you may need to pay for some of the care you or someone you know needs. We help you understand the different ways to pay for care, and the amount you might be expected to pay.

Many people with dementia will need care and support as their condition progresses. The types of care put in place will be different for everyone, according to their individual needs.

The laws around paying for care are different in Wales and Northern Ireland.

Care needs assessment

To work out what a person’s needs are, it can be helpful to get a care needs assessment from their local authority. This will show whether the person has ‘eligible care needs’. If they do, the local authority will then talk to the person and their carer (if appropriate) to produce a care and support plan.

Care needs assessments

Learn how a person with dementia can get a care needs assessment, how they are carried out and who makes the decision

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Who pays for social care in England?

Once a support plan has been made, the local authority will decide who will pay for the care and support provided. The rules about paying for care in England are set by the Care Act 2014. The decision will usually depend on:

  • the financial assessment of the person’s capital and income
  • the type of care and support that the person needs – this could be homecare, replacement care or permanent residential care
  • where they live (market rates can vary)
  • what care and support is available.

Some people will pay for all of their care costs – this is called being a ‘self-funder’. Most people will pay part of their care costs, with their contribution decided by the financial assessment. Sometimes, the person’s care will be fully-funded by the local authority or the NHS.

Types of care and support that cannot be charged for

The local authority may charge you for care and support services, and for arranging them, but some types of care and support must be free of charge. These include:

The person’s local authority has a legal duty to meet their eligible care needs. If the person does not have mental capacity and refuses to pay for their care costs, the local authority cannot withdraw the service.

They would therefore be expected to continue to meet the person’s needs, while attempting to resolve any dispute.

Sometimes the person does have mental capacity but refuses to pay. In this case, the local authority still has a duty to meet their needs. This may be necessary if the person would be unsafe without support. The local authority may pursue court action to recover any debt that the person owes.

The person with dementia or their carer may want to complain about a decision that was made concerning the person’s care. For example, they may disagree with a funding decision made by the local authority. 

If the person has a complaint, they must try to resolve it with the local authority, NHS body, care home or care company first. They should ask for the organisation’s complaints procedure. If it isn’t possible to resolve the complaint locally, the person may be able to take it to the relevant ombudsman. 

Where to make a complaint

When making a complaint, it’s important to have written records of all communication between the person with dementia and the local authority, care provider or NHS body. This can help to show how agreements have been reached and decisions made.

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