Care and support

Paying for care home fees

Most people are expected to pay for all or some of the costs of their care in a care home from their own income or capital. The main exceptions to this are:

• People who receive a short stay in a nursing or residential home for rehabilitation or recuperation - this is known as ‘intermediate care’. Intermediate care is rarely longer than 6 weeks, and may be funded by the NHS or jointly funded by Adult Care Services (ACS) and the NHS.
• People who have previously been detained in hospital under certain sections of the Mental Health Act 1983, who have care in a care home provided or arranged by their local authority as after-care under s117 of that Act.
• People in care homes providing nursing care paid for in full by the NHS or whose place has been arranged by the NHS. This is known as ‘Continuing NHS Care’. If you are funded in this way in a care home, your care is free. However, you are treated as a hospital patient for benefits purposes. Most benefits are now unaffected by a spell in hospital although attendance allowance and disability living allowance are reduced or stopped after set periods of time however.
• The Veterans Agency, formerly the War Pensions Agency, can pay towards the cost of a care home providing nursing care for war pensioners in very specific circumstances. If you have a high rate of war pension and think you may need this type of care, seek advice from your War Pensions Welfare Officer.

Some people may find that they have paid for their care home fees themselves, out of savings or benefits, but are then told that the NHS should have been paying. They should get a refund of what they have paid. From the date that they are told that they are still the responsibility of the NHS (not from the date of admission to care) they are then treated for benefit purposes as hospital in-patients. If you think that you should be getting free care in a care home, contact NHS Direct, 0845 46 47 (local call rate) which can tell you which Primary Care Trust you need to speak to. It can also give details of the NHS complaints procedure and contact details of your local Patient Advice and Liaison Service (PALS). See also Department of Health website at:
www.dh.gov.uk/en/Policyandguidance/socialcare/socialcarereform/
continuingcare/DH_079276.

Further information about NHS support in a care home can be found in Age Concern’s Factsheet 20, ‘NHS Continuing healthcare, NHS-funded nursing care and intermediate care’. Age Concern produce an excellent range of factsheets on care homes and benefits, available on-line at www.ageconcern.org.uk or ‘phone 0800 00 99 66 (free call) or write to Age Concern FREEPOST (SWB 30375), Ashburton, Devon TQ13 7ZZ.

Who has to pay for care in a care home?

Unless you come into one of the groups listed above, you will have to pay some or all of the cost. What you pay depends on your resources, which include most benefits that you get as well as your savings.

As the amount that you have to pay is affected by the benefits you should be getting, it is very important that you claim everything you are entitled to. These pages explain the rules for benefits in a care home and some of the rules about the charges that Adult Care Services (ACS) will make for your place in residential or nursing care.

The rules can be complicated and these pages are for guidance only. If you are in any doubt about your situation, seek further advice from your social worker or a Citizens Advice Bureau. There are details of how to get in touch with these at the end of these pages.

If you are aged under 18, this leaflet doesn’t apply to you. Seek advice from your local Children Schools and Families (CSF) team.

These pages are divided into two parts. This first part covers how Adult Care Services (ACS) treat your capital and income when deciding how much you will have to pay toward your care home fees. The second part deals with the rules for benefits when you go into a care home.