Paying for Care

There are three ways that care in your home, or in a care home, may be paid for: 

• The person being cared for (or their family or a friend) pays all the costs for their care. This is called ‘self-funding’. 
• The local authority pays for some or all of the care. 
• Sometimes the NHS may also contribute to the cost of all or some of the care.

Some care and support services are provided free of charge but you may need to pay for other types of services. See Hampshire County Council information on which services you might have to pay for. 

• The cost of care delivered in your home by a home care agency (sometimes called a domiciliary care agency) depends on the level of care you need. As a rough guide, the cost of a home care agency for a self-funder in the Hampshire County Council area is likely to be between £20 and 30 per hour. 
  
  
• If you employ a Personal Assistant yourself, you could expect to pay £11 to £15 per hour.  You would be responsible for other costs associated with being an employer. See Hampshire PA Finder for more information.
  
  
• 24 hour 'live-in' costs vary greatly according to needs. Typically, costs can start at around £800 per week and can go up to over £1,800 per week. This care cost will rise if there are two or more people that need caring for at the same time.

The costs of care homes vary greatly and will depend on whether it is a residential home or a nursing home, whether you have complex needs or dementia, whether you have a single or shared room, whether you have an en-suite bathroom and many other factors. 

For a guide to current average costs in the south east, you can use the Residential Care Costs calculator on the Paying for Care website.

If you have more than £23,250 in assessable savings and/or capital (usually including the value of your home), you will need to pay the full cost of care yourself.

'Capital depletion' and top up fees

It is very important that you and your family consider what will happen if your savings were to fall below the 'capital threshold' of £23,250.

Your local authority social care department will assess your care and support needs. You will always be offered at least one care home place that will meet your eligible needs. However, it will not necessarily pay for your current accommodation if this is more expensive than the authority would usually expect to pay in order to meet your assessed needs.

If you wish to stay in your current accommodation, you might need to ask your family or another third party to pay a 'top up' fee to the care home. A top up is where a third party (or, in some very limited circumstances, you) pay the difference between what the council would reasonably expect to pay and the rate charged by your chosen care home.

More information about top up fees.

Deferred payment agreement

You may have been assessed as having to pay the full cost of your care yourself but you cannot access your capital as it is tied up in your home. If you are finding it difficult to sell your home, or don’t wish to sell your home, you can request a long-term loan from your local authority known as a ‘deferred payment agreement’.

More information about deferred payment agreements.

Firstly, your local authority will need to carry out an assessment of your care needs. If you have ‘eligible care needs’ that qualify for help from your adult social care department, they will then carry out an assessment of your finances.

The financial assessment is a detailed process and every case is assessed individually. Below is a general guide.

If you have:

• more than £23,250 in assessable savings*, you will need to pay the full cost of care yourself
• between £14,250 and £23,250 in assessable savings, the local authority will look at your savings and assessable income to work out what, if any, contribution you will pay towards your care costs
• less than £14,250 in assessable savings, the local authority will take into account any assessable income you have to work out what contribution you will pay towards the cost of your care.

* The value of your home is usually taken into account if you are being assessed for residential care. There are times when the value of your home is not taken into account, such as a temporary stay in a care home or if a dependent relative lives in your home.

For more information:

Hampshire County Council
Southampton City Council
Portsmouth City Council

Before your local authority offers services, they will need to consider whether your primary need is health-related and whether you may be eligible for NHS continuing healthcare. (See next section).

You may be eligible for funding through a health fund called NHS continuing healthcare (CHC). This is care that is arranged and funded solely by the NHS for individuals who are not in hospital but have been assessed as having a ‘primary health need’. There are very high eligibility criteria for this payment.

If you think you may be eligible for CHC, you can contact your local Integrated Care Board (ICB) directly for an assessment. This will be Hampshire & Isle of Wight Integrated Care Board (for all residents living within the Hampshire County Council, Portsmouth City Council and Southampton City Council areas).

You may find our information page Health and social care roles explained useful.

If you are not eligible for NHS continuing healthcare, but

• have been assessed as needing care from a registered nurse, and
• you live in a nursing home

you may still be eligible for NHS-funded nursing care.  The NHS pays a flat rate directly to the nursing home towards the cost of your nursing care. It won’t pay for the other care home costs, such as the accommodation.

It is against the law to intentionally give away or decrease your savings or property (your assets) in order to avoid paying your care fees. Local authorities will only fund care after a thorough financial assessment and they can refuse to fund care if they believe that ‘deprivation of assets’ has taken place. Read more about deprivation of assets.

The idea of selling your own home to pay for the cost of a care home is something which concerns most people.

An independent financial adviser will be able to discuss your situation with you in detail. The Society of Later Life Advisers (SOLLA) specialise in advising on later life financial matters. You can find local SOLLA registered financial advisers in our Marketplace.

Further information: 
Deferred payment agreements
Self-funding your long-term care - your options
Do I need to sell my property to pay for my care home fees?  
Selling or downsizing to fund your care

Paying for care can be an expensive and open-ended commitment. If you are paying the full cost of care yourself, you should seek independent financial advice. Look for a financial adviser with specialist qualifications on advising on the funding of long-term care. They will be able to explain all the costs and risks involved and should be able to help with other things such as setting up a Lasting Power of Attorney.

If you are currently receiving care it is still advisable to seek specialist information and advice as there may be options available to you to protect your interests and those of your family.

MoneyHelper gives advice about all aspects of paying for care. Telephone 0800 138 7777.

The Society of Later Life Advisers (SOLLA) is a not-for-profit consumer organisation that aims to assist consumers and their families in finding accredited independent financial advisers who understand financial needs in later life. Telephone 0333 2020 454.  You can find local SOLLA registered financial advisers in our Marketplace.

Good planning will help make sure you or your family are ready to meet any of the costs that might arise. It will also allow you to provide for your loved ones and ease the burden on them. Comprehensive advice is available from the Money Helper about Planning for illness, old age and death including information about how to fund your long-term care.

Our information about Powers of Attorney may be useful.

It may also be a good idea to think about advance health care planning. Anyone can plan for their future care, whether they are approaching the end of life or not. Advance care planning can let people know your wishes and feelings while you're still able to. The NHS website has information about Planning ahead for the end of life.

Independent Age has produced a video about paying for care in a care home.

Check whether you are entitled to claim for any benefits.

Information on paying for permanent residential care from AgeUK.

Information about paying for care and support at home from AgeUK.