Paying for care in Northern Ireland

5. Care and support for someone in their own home

HSC trusts can choose when to charge for care and support provided in a person's home (known as 'domiciliary care'). Once it has been decided that a person needs care provided in their own home, the trust will decide whether or not the person will need to pay for it.

Usually, trusts do not charge for services provided in a person's home, but there are some exceptions. These include the home help scheme and the meals on wheels service. The home help service is provided on a means-tested basis. This means that any charges are based on a person's ability to pay. The trust will take into account a person's savings and investments before deciding whether they pay themselves or whether they will get financial assistance to do so. People over 75 are not charged. A standard charge that is not means-tested is applied to meals on wheels.

The HSC trust will be able to provide you with further information on charges for services provided at home. If the trust decides to charge for these services, other than the home help scheme or meals on wheels, it must first conduct a financial assessment (see 'Financial assessment' above). Any charges must be 'reasonable', and if you feel they are excessive you have the right to complain.

If someone refuses to pay for care in their own home, the HSC trust cannot withdraw the service. The trust has a legal duty to care for vulnerable adults and meet their needs, so it must continue to meet these needs while resolving any disagreement.

Respite care

There are many different types of temporary care for a person with dementia (sometimes known as 'respite care') that can help carers to take a much-needed break. This can include day centres, home care services and residential stays for the person with dementia. Respite care can be of benefit to the person being cared for as well as the carer as it allows them to engage in new opportunities.

The need for respite can be identified as a carer's need, or a cared-for person's need, as part of a community care assessment. HSC trusts must charge for care in some settings (such as residential stays), whereas other types of respite care (such as respite provided in a person's own home) may be free.

If you are charged for respite services, you may find some financial help locally. It may be worth asking your HSC trust about local schemes to help fund respite care.

Direct payments

If a person is receiving care funded by the trust, they may choose to receive the funding in the form of a direct payment. This is money that the trust gives directly to the person to spend on meeting their care needs. The money will be paid into a person's bank account and they or their carer will need to keep a record of how they have spent the money, which can be on a wide range of products and services. This allows people to make their own choices about their care. 

Privately-funded care at home

When a trust carries out a financial assessment, it may decide that someone should fund their own care. If this is the case, the trust can provide information on local care agencies.

Some people may already be planning to fund their own care. Social services should still provide a community care assessment for these people as this can help them understand what level of support they need.

Local community groups and charities may offer help, or provide information about where to go for support or care. Some specialist charities and foundations, especially occupational ones such as those serving in the armed forces, may offer grants.