Paying for care

7. Types of care and support that cannot be charged for

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

These include:

  • intermediate care, including reablement (for up to six weeks)
  • aids and minor adaptations to the home costing less than £1,000
  • after-care/support provided under the Mental Health Act 1983 section 117
  • NHS services
  • any services that an authority has a duty to provide based on other legislation.

Care and support for someone in their own home

Most local authorities will charge for care that is provided in someone's own home. How much the person pays will depend on the financial assessment.

The Care Act (2014) states that any charges must be 'reasonable'. It says that people receiving care 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. Anybody whose income does not exceed the basic level should not be charged for homecare.

Individual local authorities can decide whether or not to count severe disability premium, Disability living allowance, Personal independence payment or Attendance allowance as income. If a person's care need means that they require a service during the day, the local authority should not count benefit entitlement linked to care that is needed at night. For example, if a person receives the higher level of Attendance allowance, and is eligible for this higher level because of the supervision they need during the night, the additional higher amount should not be counted in a financial assessment for care the person needs during the day.

Depending on the financial assessment, a local authority may ask a person to contribute a certain amount towards the cost of care, with the local authority paying the rest. Each local authority has its own guidance, so this can vary depending on where the person lives. A copy of the local authority's charging policy should be available online or can be requested. It may contain a savings and income threshold. Anyone with savings or income above this threshold is expected to pay for their own care. If their savings or income is below the threshold, the local authority should fund their care.

Once someone's savings or income have dropped below the threshold, the local authority should start paying for their care services. A local authority should regularly review a person's savings so that they are aware of when it should take over paying some or all of the care costs. If you feel that someone's savings have dropped below the limit, or are about to, you can contact the local authority to ask for a review.

Importantly, the value of the person's home is disregarded in assessing their contribution towards the cost of domiciliary care.

If someone refuses to pay for homecare, the local authority cannot withdraw the service. They have a legal duty to meet people's eligible care needs. They would therefore be expected to continue to meet the person's needs while attempting to resolve any dispute.

If someone feels they have been excessively charged for care, they (or their carer) have a right to complain (see 'Complaints' below).