Discussing the payment of care costs at any stage in life can be difficult, but as the demands upon both the Health Service and Social Services are increasing, evidenced with limited resources being diverted and depleted through the COVID crisis, it is now even more critical to consider what the options may be.
Funding care from your own resources provides choice and flexibility but generally is only an option if sound financial planning has been put in place. Privately funding care can be through savings, equity release or care annuities. Financial thresholds are determined each year in which the limits are set to identify if you are eligible for assistance by the state.
For the financial year 2020-2021, if your capital is:
- Less than £14,250 you will be entitled to maximum support frchilom the Local Authority. You won’t have to contribute from your capital, but you may be expected to contribute from your income.
- More than £14,250, but less than 23,250 you have to contribute towards the cost of your care – £1 for every £250 of savings between £14,250 and £23,250. This is known as tariff income.
- More than £23,250 you will have to pay the full cost of your care. If you have less than £23,250 in capital, but a weekly income that is considered to be high enough to cover the cost of your care, you will have to pay all of your fees.
The Adult Social Care Department of your Local Authority have a duty and are responsible for undertaking a ‘Needs Assessment’ as directed under the Care Act 2014. In the event a Financial assessment becomes necessary this is also arranged through the Local Authority and under the Charging Regulations – Care and Support (Charging and Assessment of resources) Regulations 2014.
This assessment will depend upon individual circumstances. The assessment will look at your capital (savings and assets), and income to determine how much you will need to contribute towards the cost of your care.
In our experience, clients main concern is being able to remain in their own home and to preserve their assets. Faced with poor health and the need for care, together with the potential threat of losing one’s home in order to pay for the care can be so stressful. Navigating your way through the organisations, assessments and care provision is not always a straight forward process. Knowing if your home is safe or whether it can be protected requires expert advice and guidance. If you choose to receive care in your own home, the value of your home is not included in the financial assessment. If you are being assessed for residential care in a care home or nursing home, the value of your home will be assessed as part of your capital. If a ‘qualifying relative’ remains in the property then the property can be disregarded. Professional advice at this time is critical to ensure the Local Authority makes the correct assessment and appropriate disregards – this is where our Anne Reed can help and advise you.
Such financial assessments are subject to means testing. If, however, you have what are assessed as ‘health needs’ then the NHS becomes responsible for paying for such care fees and this is not means tested. In order to qualify, you will be subject to a very detailed assessment of your clinical and health needs – this is known as a ‘Continuing Healthcare Assessment’. If you believe your needs may fall into this category then you can request your local Clinical Commissioning Group (CCG) conduct an assessment. The initial assessment is a Checklist which is the first stage of the assessment process – both yourself, your family and/or Attorneys are entitled to be present at these assessments. Such assessments should be conducted in line with the National Framework for NHS Continuing Healthcare and NHS Funded Nursing Care (revised Oct 2018). When considering requesting a CHC assessment it is advisable to seek the help of an expert. Our Anne Reed specialises in supporting families through this process so please do call and chat through how she may be able to assist you.
Since March 2020 and the restrictions placed upon organisations and professionals, both financial and CHC assessments have been halted. Where a patient has been diagnosed with a life-threatening condition a Fast Track CHC assessment can be conducted which provides immediate decisions and enables funding to be put into place at short notice. In general, all patients requiring assessments between March and September 2020 have been delayed. Where patients have been discharged from hospital and required onward care, such placements have been funded through COVID monies. As at the 1st September 2020 new guidance has been issued by the Department of Health in which the Reintroduction of NHS Continuing Healthcare (NHS CHC) published on the 21st August 2020 – these assessments have been recommenced.
For all patients discharged from hospital and who require additional care and support on discharge, the provisions under the Hospital Discharge Service: Policy and Operating Model published on the 21st August 2020 and those requiring onward care will be assessed under ‘discharge to assess’ provisions. Under the provisions of this scheme, additional costs of post-discharge recovery and support services will be funded until the person’s long-term care needs are assessed, or for up to the first six weeks. In the event that a decision is not reached within the timeframe the parties paying for the care i.e. NHS or Local Authority, should continue to do so until the relevant ongoing care assessments are concluded.
Unfortunately, there is no one manual that provides you with all the information as to which avenue or funding stream you may be entitled. Our Anne Reed has a wealth of experience and works across the whole of the UK supporting families and clients through both the funding and care planning maze. Seeking professional advice could save not only time and expense but also alleviate the stress and emotional impact upon yourself and your family.