Funding Care in Your Own Home
Unless a package of care services is being provided by the local council, a restricting factor of what care and support you have might be what you can afford to purchase privately. Here we look at how council funding works and the alternatives if you do not qualify for council support.
Once it has been agreed that services can be provided by the council they will then carry out a financial assessment to work out if you should contribute towards the cost. Again, there are no set rules for calculating how much the council can charge for services but there is national guidance the council must adhere to.
There are two stages to establishing how much funding might be available for your care, the assessment of needs described above and the means test.
If the local council has assessed you as needing and qualifying care at home, they can either provide it directly or arrange for it to be delivered through local private or voluntary agencies. They will then work out how much you should contribute towards the cost. Although local councils have the discretion as to whether to charge for home care services, in practice most will charge. To work out your contribution you will normally have to undergo a means test or as it is sometimes referred to, a financial assessment, to ascertain your financial position. This will look at both savings and income to assess how much you could afford to contribute towards the cost of your care and support.
Non-Means Tested Care
Care provided by the NHS, such as nursing services provided by community or district nurses, is free as is the first six weeks (four weeks in Scotland) of intermediate care provided to either avoid you having to go into hospital or to support you if you have just been discharged from hospital. Also, in England and Wales, if someone has been detained in hospital for assessment and treatment under sections 3, 37, 45A or 47 of the Mental Health Act 1983 aftercare services provided under section 117 of that same Act are delivered free of charge. More information on section 117 aftercare can be found on mind's website www.mind.org.uk
There is a national framework that provides guidance to local authorities on how to work out charges for home care provided or arranged by them. This is called 'Fairer Charging Policies for Home Care and Other Non-Residential Social Services'. England and Wales both use guidance of this name. In Scotland, personal care is free for those over 65 years, but charging still applies to non-personal care services, such as day care, luncheon clubs, meals on wheels and community alarms.
Each local authority should publish and make available to users and carers clear information about charges and how they are assessed. This information should be made available at the time a person's needs assessment is carried out and, after the means test, written information should be provided detailing how any charges are worked out and payable.
In principle, the fairer charging policy instructs councils to allow people to retain a minimum amount of money for their own personal use, rather than it all being used up paying for care. The minimum this amount should be is set as a 25 per cent buffer above the basic levels of the guaranteed credit of Pension Credit. For example, if Pension Credit was £130 per week, 125 per cent of that would be £162.50 and be the amount ignored in calculating the income assessable when charging for care.
However, in most areas if you have capital or savings in excess of the means test limit £23,250 2010/11 (£22,000 in Wales), you can be charged the full cost of your care. These are the minimum capital limits provided in the fairer charging guidance although, a few councils exercise their discretion by increasing the capital limits or might set a maximum level of charges people should be asked to pay. The value of your home is not taken into account in the means test for home care and, if only one member of a couple requires care, the means test should only take into account the resources of that person. Any joint accounts are treated as divided equally between the partners.
Local councils may charge differently depending on the services being used. For example, meals at home or in day care may be charged at a flat rate to all users, without applying a means test because they are a regarded as a substitute for ordinary living costs that you might be expected to incur anyway. There is no set national guidance for how services should be charged for but normally it would be based on the hours of service provided, whatever method is used it must be deemed to be reasonable.
The following welfare benefits can be taken into account as long as in doing so it does not reduce your income to below the 25 per cent buffer described above:
- The severe disability premium of Pension Credit
- Attendance Allowance
- Disability Living Allowance
- Constant Attendance Allowance
- Exceptionally Severe Disablement Allowance
The local council should provide an individual assessment of disability-related expenditure before taking these benefits into account and if necessary, ignore them if they are needed to pay for other care, support or costs associated with your needs. The mobility component of Disability Living Allowance should also be ignored.
The council will allow an amount to be deducted from your income for housing costs for example, rent, mortgage payments and council tax, some may also include water bills and home insurance.
Instead of asking for a contribution towards the cost of care services the council may offer direct payments, an amount of money they have assessed as you needing to enable you to buy in the services you need yourself. The money must be spent on meeting your assessed needs and records have to be kept as to how the money is spent. Receiving direct payments does give you the choice of who the supplier is and can be used to purchase most community services. They cannot though be used to pay a relative or someone else living with you unless they are specifically employed as a live in carer.
Paying a carer direct could mean that you are an employer and with that comes employer's responsibilities for example deducting and accounting for PAYE tax and National Insurance.
Direct payments can be stopped at anytime if you would prefer the council to arrange and provide the services you need.
Extending the model of cash instead of care, the Government has introduced individual budgets as a way of making money available for a person's social care with help in deciding how to use it. By bringing together monies available from different government agencies it becomes possible to include the cost of equipment and adaptations into individual budgets. For example, you may be entitled to direct payments from social services to cover your care costs and, from the housing department, a disabled facilities grant for adaptations to your home.
If you consider that the council are charging you too much or your direct payments are inadequate to meet your needs there is a process through which the council can be challenged. The council should make this information available to you should you wish to seek a review or make a formal complaint about any aspect of your assessment.
Paying for Care Privately
If you do not qualify for local council support it may be necessary to purchase the care you need privately through home care agencies, all of which have to be registered with the relevant social care registration authority who also inspect them to ensure the care they are delivering is up to the prescribed minimum standards. The cost of employing a home care agency will depend on where you live and the amount of care you need.
In order for you to continue living in your own home it may require some alterations, repairs or adaptations. Minor works or equipment for example grab rails or ramps costing under £1,000 would normally be provided and fitted free of charge in England. Elsewhere they may be charged for.
Following an assessment of your needs you may be entitled to a means tested Disabled Facilities Grant (DFG) to help with the cost of adapting your home. Further information about DFGs can be obtained from your local housing department although it might be quicker to have an assessment from the social services first to determine whether your needs would qualify for a grant.
In Scotland, there are housing grants from the local council similar to DFGs in England and Wales.
To find out more about adapting your home you should contact your local council housing department or a Home Improvement Agency (HIA), which are not-for-profit organisations often called Care and Repair or Staying Put agencies. Most HIAs will offer additional services such as handyperson or gardening schemes and have lists of approved contractors. The initial visit from the HIA is free and any subsequent charges will be discussed first and can usually be included in any grant if awarded.
If you need adaptations or alterations to your home but do not qualify for any grants or, do not have sufficient savings to pay for it, it may be possible to raise the money through a loan or, if you own it, by releasing capital from your home. Loans on favourable terms can be applied for from a not-for profit organisation known as the Home Improvement Trust (HIT) which runs a scheme called 'Houseproud' with many of the councils and home improvement agencies in England, Wales and Scotland but not Northern Ireland. To find out more about the HIT, visit www.houseproud.org.uk
If you cannot get the care or support you need from your local council and do not have sufficient income or savings to pay for services, equipment or adaptations privately you could consider equity release if you own your home. Releasing capital from your home is becoming more popular as property prices have substantially increased over the years. There is much to consider when embarking on this route and there maybe more suitable alternatives. Your equitycare adviser will be able to explain your options in detail should you wish.
Seek Specialist Advice
Combining advice to maximise the support you are entitled to from the state with appropriate financial advice could go a long way in mitigating care costs. There are especially designed financial products for meeting care costs, for example, Immediate Need Care Fee Payment Plans may make it possible to meet care costs for as long as care is needed whilst using up only part of the available capital. equityCare specialist care fees advisers can help or at very least assure families that they have considered the best options to provide their relatives with the financial security they would wish for.