What's the difference between NHS funding and local authority funding?

NHS funding (e.g., NHS Continuing Healthcare) covers healthcare needs and is not means-tested, meaning it's free at the point of delivery regardless of your financial situation. Local authority funding, on the other hand, covers social care needs and is means-tested, so your financial situation will determine how much you contribute.

Can I choose my own care home if the local authority is funding my care?

Yes, you generally have a right to choose your preferred care home, even if the local authority is funding. However, the council will only pay up to the amount they would usually pay for a suitable home that meets your assessed needs. If your chosen home costs more, a 'third party top-up' payment might be required, usually paid by a family member or charity, but not by the person receiving care themselves.

What if my capital falls below the threshold while I'm self-funding?

If your capital (savings and assets) falls below the upper capital limit (£23,250 for 2024/25), you should immediately contact your local council's social services department to request a new financial assessment. They will then assess your eligibility for funding, and you may become eligible for partial or full local authority support.

Does my home always count towards the financial assessment for care home fees?

No, not always. If you are receiving care in your own home, its value is usually disregarded. If you move into a care home, your main home's value is generally disregarded for the first 12 weeks. It may also be permanently disregarded if certain people still live there, such as your spouse or partner, a dependent child, or certain relatives who are over 60 or disabled. It's crucial to seek advice on your specific circumstances.

What is a 'deferred payment agreement'?

A deferred payment agreement is an arrangement with your local council that allows you to delay paying the full cost of your care home fees. The council effectively lends you the money, secured against the value of your home, which is then repaid when your home is sold (e.g., after your death). This is an option for eligible individuals who own their home but don't want to sell it immediately to pay for care.

Understanding Local Authority Funded Care

Understanding Local Authority Funded Care: A Comprehensive Guide for Families

Navigating the complexities of care funding can feel overwhelming, especially when you or a loved one needs support. This guide aims to demystify 'council funded' or 'local authority' care in the UK, helping families understand how it works, who is eligible, and what steps to take to access this vital support. We'll explore the assessment processes, financial contributions, and where to turn for further advice, always focusing on practical, actionable guidance.

What is Local Authority Funded Care?

Local authority funded care refers to social care services arranged and paid for, either fully or partially, by your local council (also known as social services). This funding is available for eligible individuals who have care needs and meet specific financial criteria. It's important to understand that this is distinct from NHS funding, which covers healthcare needs regardless of financial means. Local authority funding primarily covers social care, which includes help with daily living activities, personal care, and support to maintain independence.

The aim of local authority care funding is to ensure that individuals who need care and support, but cannot afford to pay for it themselves, can still receive the necessary services to maintain their well-being and quality of life. This could be in their own home (home care), in a residential care home, or in a nursing home (for the social care component).

Who is Eligible for Local Authority Funded Care?

Eligibility for local authority funded care is determined through two main assessments: a care needs assessment and a financial assessment (means test).

1. The Care Needs Assessment

This is the crucial first step. Anyone can request a care needs assessment from their local council, regardless of their financial situation or perceived eligibility. The assessment is carried out by a social worker or another qualified professional from your local authority's social services department. They will assess your or your loved one's ability to carry out daily activities and identify what support is needed.

What they assess: The assessment looks at various aspects of daily living, such as personal care (washing, dressing, eating), managing toilet needs, maintaining a safe home environment, mobility, access to work, education or volunteering, and social activities.
Outcomes: Based on the assessment, the council will determine if the individual meets the national eligibility criteria for adult social care. These criteria are set out in the Care Act 2014 and focus on whether your needs impact your ability to achieve two or more specific outcomes, causing a significant impact on your well-being.
No charge: The care needs assessment is free of charge and anyone can request one.

Before the assessment, make a list of all the difficulties you or your loved one experiences with daily tasks. Think about what support would make a difference. It can be helpful to have a family member or advocate present to ensure all concerns are raised.

2. The Financial Assessment (Means Test)

If the care needs assessment determines that you or your loved one is eligible for care and support, the local authority will then conduct a financial assessment (often called a 'means test'). This assessment determines how much you can afford to contribute towards the cost of your care. It looks at your income, savings, and certain assets.

Income: This includes state benefits (excluding certain disability benefits), private pensions, occupational pensions, and any other income.
Savings and Capital: This includes bank accounts, ISAs, shares, bonds, and property (though the value of your main home is usually disregarded if you're receiving care in your own home, or for a temporary period if moving to a care home under certain circumstances).
Capital Thresholds (2024/25): * Upper Capital Limit: £23,250. If your capital is above this amount, you are expected to self-fund your care in full. * Lower Capital Limit: £14,250. If your capital is between £14,250 and £23,250, you will be expected to contribute £1 per week for every £250 (or part thereof) above £14,250, in addition to your assessed income contribution. * If your capital is below £14,250, it will not be included in your financial contribution, but your income will still be assessed.

Local authorities have rules to prevent people from deliberately giving away or spending their assets to avoid care costs. This is known as 'deprivation of assets'. If the council believes you have done this, they can treat you as if you still own those assets, and you may still be assessed as having to pay for your care.

How Does Funding Work if You're Eligible?

If you meet both the care needs and financial eligibility criteria, the local authority will contribute to the cost of your care. The amount they contribute depends on your financial assessment.

Full Funding: If your capital is below the lower capital limit (£14,250 currently) and your income is low, the council may fully fund your care, after allowing you to keep a certain amount for personal expenses (called the Personal Expenses Allowance or Minimum Income Guarantee, depending on your care setting).
Partial Funding: If your capital is between the lower and upper capital limits, or your income is higher, you will be expected to contribute part of the cost of your care, with the council paying the rest.
Self-Funding: If your capital is above the upper capital limit (£23,250 currently), you will be expected to pay for the full cost of your care. However, the local authority still has a duty to arrange your care if you ask them to, even if you are self-funding. This can sometimes lead to better rates due to their purchasing power.

Direct Payments

If you are eligible for local authority funded care, you may have the option to receive 'Direct Payments'. This is money paid directly to you, allowing you to arrange and pay for your own care and support services, rather than the council arranging them for you. This offers greater control and flexibility over how your care needs are met, as long as it meets the outcomes identified in your care plan.

Benefits: Greater choice and control, ability to employ personal assistants, flexibility in how and when care is delivered.
Responsibilities: You are responsible for managing the payments, employing staff (if applicable), and ensuring care is delivered safely and effectively. The council will provide support and guidance.

What if Your Needs Change or Funds Run Out?

Care needs can change, and so can financial situations. It's important to know what to do in these circumstances.

Reviewing Care Needs: If your or your loved one's care needs increase or decrease, you should contact social services to request a review of the care needs assessment. Your care plan should be adjusted accordingly.
Reviewing Financial Contributions: Your financial situation should be reviewed periodically by the local authority, or you can request a review if your income or capital changes significantly. For instance, if you've been self-funding and your capital falls below the upper capital limit, you should inform social services immediately to request a new financial assessment.
Section 117 Aftercare: If you have been detained under certain sections of the Mental Health Act, you may be entitled to free aftercare services under Section 117. This funding is not means-tested and covers both health and social care needs related to your mental health condition. Your mental health team should advise you if this applies.

What if You Disagree with a Decision?

Sometimes, families may disagree with the outcome of a care needs assessment or a financial assessment. You have the right to challenge these decisions.

Informal Resolution: Start by discussing your concerns with the social worker or financial assessment officer involved. Often, misunderstandings can be clarified at this stage.
Formal Complaint: If you're not satisfied, you can make a formal complaint to your local council. Each council will have a complaints procedure, which should be available on their website.
Local Government and Social Care Ombudsman (LGSCO): If you've exhausted the council's complaints procedure and remain unhappy, you can escalate your complaint to the LGSCO. They investigate complaints of injustice caused by maladministration or service failure by local authorities.

Independent advocacy services can provide invaluable support if you're struggling to navigate the care system or challenge a decision. These services can help you understand your rights, express your views, and represent your interests.

Key Things to Remember

Request an assessment early: Don't wait until a crisis point. Request a care needs assessment as soon as you identify a potential need.
Be prepared: Gather all relevant financial information and be ready to discuss care needs thoroughly during assessments.
Understand the thresholds: Familiarise yourself with the capital limits for financial assessments.
Seek advice: Don't hesitate to seek independent financial advice or guidance from organisations specialising in care funding.
Your home: Your main home is usually disregarded from the financial assessment if you are receiving care in your own home. If you move into a care home, it's typically disregarded for the first 12 weeks, or permanently if certain people still live there (e.g., a spouse, dependent child, or certain relatives who are elderly or disabled).

Understanding local authority funded care is a journey that requires patience and a good grasp of the processes involved. By being proactive and informed, families can better navigate the system and ensure their loved ones receive the support they need and are entitled to.

Need Help and Further Information?

Navigating care funding can be complex. Here are some trusted organisations that can offer advice and support:

Your Local Council (Social Services) - Find contact details on Gov.ukVisit →

Age UK - Advice on care and supportVisit →

Carers UK - Information and support for carersVisit →

Independent Age - Free advice on care and financesVisit →

Citizens Advice - General advice on benefits and careVisit →

Society of Later Life Advisers (SOLLA) - Find accredited financial advisers specialising in later life care fundingVisit →

Local Government and Social Care Ombudsman (LGSCO) - For complaints about local councilsVisit →

We use cookies