Care home fees are not the kind of topic you may want to discuss however, the unfortunate truth is that a significant number of people over 65 years old may end up in either a care home or being cared for in their own home.
| The current scheme
From 1st April 2015, if an individual has care and support needs then the Local Authority (LA) has a duty to assess those needs irrespective of the level of their financial resources.
If it is found that care and support is needed then the LA must also determine whether any needs meet the statutory eligibility criteria and is therefore eligible for funding. More information about the different funding schemes can be found here.
| Can I appeal the decision?
Yes, if an individual believes that the assessment has failed to pick up on a primary care need then it is possible to appeal the decision.
| I don’t meet the funded health or nursing care, what do I pay?
If an individual does not qualify for:
- NHS continuing health care; or
- NHS funded nursing care
then the LA will assess the individual’s financial resources to see how much they are able to pay.
All assets are used to calculate this. However, the property where the individual normally resides may be disregarded for this assessment if a spouse or dependent relative lives there.
| The upper and lower limits of capital which are considered
- Lower limit – This is currently £14,250 for the period 2016-2017. If an individual is assessed to have less than this then they will receive maximum support towards their care costs;
- Upper limit – This is currently £23,250 for the period 2016-2017. If an individual is assessed to have more than this then they will have to use their capital to fund their care costs until it goes below the upper limit;
- Between the limits – If an individual is assessed to have capital in between the limits then the individual will be required to pay a contribution towards their care costs based on statutory tests.
| Deferred payment agreements
The Care Act 2014 made it mandatory for all LAs to offer a deferred payment to an individual if:
- Their needs are met in a care home;
- They have less than the upper capital limit (excluding the value of the home);
- The home is not disregarded.
Deferred payment agreements allow the individual to delay paying the fees – i.e. until their house is sold or after their death.
These arrangements can suit various needs however interest can be charged and there may be administration fees to set up the agreement.
| What about the cap on care costs we’ve heard about?
Unfortunately this has been delayed until 2020.