Community Care: What if I need ongoing nursing care?
If you’re assessed as needing a care home that provides nursing care, and you’re eligible for NHS continuing healthcare, then the NHS may pay for all your care. If you’re not eligible for NHS continuing healthcare, then the NHS must still pay for the part of your care you need a registered nurse for, however much income or savings you have. You may have to pay some or all of the accommodation and personal care costs of the home.
If you’re assessed as not needing a care home with nursing facilities but you decide to pay to go into one anyway, you won’t be entitled to get the NHS to pay for the nursing-care part of your care. But if your needs change, your case can be reviewed.
Your care plan should set out the services that the council will provide, for which you may have to pay, and the care that the NHS will pay for. Once you’re in the home, if you think the home is trying to charge you for parts of your care that are already paid for by the NHS, you should speak to the home manager.
You may fall into one of the categories of people for whom residential care is free. If not, then how much you pay depends on a set of rules that take into account:
- how much ‘capital’ you have, meaning savings, stocks and shares, and property you own; and
- your income, including money you earn and any benefits you receive.
The council should always tell you how it has worked out the amount you will pay, and you can ask for this in writing.
The rules are complicated and we have set out only the main points here. Organisations such as Age Concern, Help the Aged, and Counsel and Care can give you more information (see ‘Further help’ for details).
The council looks only at your own income and savings when deciding how much you pay – it cannot normally take account of money or income that belongs to your husband or wife or family.
If you have more than a certain amount of capital (currently £21,500 if you live in England or £22,000 in Wales), then you will normally have to pay all the fees, whatever your income. You will also normally have to find a care home yourself. If you can’t find one yourself, and you have no-one willing to do it for you, then the council must help you (but you still have to pay the full fees).
If you have less than a certain amount (currently £22,000) or if your savings drop to this level, the council will look at how much you could afford to pay. All your income (except certain items that aren’t counted) will have to go towards paying your care costs, though you must be left with a small amount as a ‘personal expenses allowance’. If your income falls, you should pay less and the council should pick up more of the bill.
When your capital falls to a certain level (currently £13,500 in England and in Wales) it will no longer be taken into account at all, and your financial assessment will only look at your income.
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- Community Legal Advice