How to get funding for care

We appreciate that the issue of funding for care is an emotive subject, and one that worries many people, particularly at a time when they are looking for extra support.

Scroll down the page to find the information that will help you decide whether you may be eligible for help with funding the type of care you would like.

We have tried to keep the jargon to a minimum and cover all eventualities.

The first point of contact for care funding should always be your Local Authority Adult Services department. They have an obligation to provide you with an initial assessment to ascertain eligibility and possibly a full needs assessment. This will ascertain:

1. What your individual needs are.
2. How those needs are best supported.
3. Whether you are entitled to any assistance with funding.

Whether you know you are going to be funding your care yourself, or you are unsure if you are entitled to funding you are entitled to an initial assessment to determine if you meet eligibility criteria

Below we will take you through the process of Surrey Adult Care Services ‘needs assessment’ so you know what to expect and can prepare.

You can request an assessment via the Surrey County Council Website www.surreycc.gov.uk by using their online form, or by telephone by calling 08456 009009

Step 1- The Initial Assessment.

This first step is a telephone conversation with an Advisory Officer who will discuss your particular situation with you to decide whether you may be eligible for provision of services

Step 2 – The Assessment.

The second part of the assessment process is carried out by a Care Manager who will visit you to chat about your needs in confidence. You can have a partner, friend or family member there with you at this meeting. The Care Manager will ask you questions about your daily life and what help you feel you need to stay independent.

With your permission the Care Manager may want to talk to your GP, nurse or carer if you have one, or seek the advice of a specialist.

Once the ‘needs assessment’ is complete the Care Manager will chat to you about whether you do need any support, and give you information on the services available. If you already have a carer, they may also be eligible for a Carers assessment to assess whether they are entitled to assistance being a carer.

Your ‘needs assessment’ will then be written as a care plan. You will be asked to read the care plan and sign to say that you agree with your identified needs and the services to be provided to meet those needs.

Step 3 – The Financial Assessment.

You will be asked to complete a financial assessment form, to determine whether Adult Social Care will be able to help you to fund your care. You are entitled to refuse a financial assessment, however if you do not wish to disclose your financial details, you will have to pay the full cost of your care.

If you are disabled and over the age of 16, and eligible to receive social care services, you should be offered ‘Direct Payments’ that allows you to source and arrange your care for yourself.

For further information, click on the pages titled ‘Direct Payments and individualised budgets’.

A Benefits and Charging Adviser will call to arrange to meet you at your home, if you want help with completing the form. You may want to have a partner, friend or family member at this meeting to support you.

The financial assets they take into consideration vary depending on the type of care you are requiring, for example whether it is home care or residential care.

A guide on funding for Non residential services such as Home care and Day Care.

If you have savings or capital (that does not include the home you live in) of over £24,500 you will be required to pay the full cost of your care.

If you have less than £24,500 the Benefits and Charging Adviser will calculate the amount you are able to contribute towards your care. If your weekly income is below the following thresholds ,you will not have to contribute towards your care:

• £162.50and you are a single person aged over 60
• £114.75and you are single aged between 25 and 60
• £98.06and you are single under 25 years of age

You may have more income than this, but still qualify for funding as Social Services ‘disregard’ certain types of income and have allowances for other types.

Allowances and disregards include such things as:

• Basic income support or pension credit (Guarantee Credit) + 25%
• Savings credit
• Council tax payments
• Rent or mortgage payments and water charges
• Disability Living Allowance (DLA) mobility
• Night time element of higher rate DLA care or Attendance Allowance (if surrey Social Services do not provide any night time care for you)
• War widows and war disability pensions =£10 disregard
• War widows special payment

The Benefits and Charging Adviser will also ensure that you are claiming all the benefits you are entitled to, and if necessary will help you make your claim.

It is helpful to have financial information to hand for your meeting. The 3 main financial considerations are Capital, Income and Expenditure.

Capital.

This includes money in the bank in current accounts, building society accounts, bonds, stocks and shares, and any other financial investment. Unlike the assessment for residential care they do not take your Home into consideration, but will take into consideration any second homes or additional land that you own.

Income.

This includes all benefits, although some will be disregarded later, state pension, occupational or private pensions, income from annuities and trust funds, and any other form of income.

Expenditure.

This is certain unavoidable expenditure, including rent or mortgage payments, council tax and water charges, and disability related expenditure.

Disability related expenditure is additional costs incurred due to disability. Some people find it hard to identify these costs and Adult Social Care will automatically allow a minimum £20 per week in the assessment. However, if you feel that your disability related costs are higher than that they will ask you for proof of expenditure. Some of the things to consider are:

• Extra Heating and laundry costs
• Community alarm system (where it is not covered by housing benefit or through the supporting people grant)
• Additional costs for clothing, bedding or specialist footwear
• Special dietary requirements
• Respite care not provided by Surrey Social Services
• Private payments for domestic help or gardening
• Disability related equipment
• Transport costs.

Calculating the Charges.

The Benefits and Charging Adviser will review your assessable income and capital, deduct an allowance (that is set by the government) and deduct household expenditure. The total remaining income is known as your ‘net available income’. Surrey County Council then asks you to contribute 80% of that figure towards the cost of your care.

If you feel the assessed contribution is more than you can afford you can ask for it to be reviewed. A Team Manager will then review the calculations and will write to you with the outcome.

If you still consider your contribution to be unreasonable you can request an appeal, which is considered by a Service Manager and the decision confirmed to you in writing.

A Guide on funding for a Residential Care Home or Care Home with nursing.

The Benefits and Charging Adviser will need certain information from you to assess whether you are entitled to help with funding your care, it is helpful to have this to hand for your meeting. The 2 main considerations are Capital and Income.

Capital.

This includes money in the bank and building society accounts, stocks, shares, bonds, national savings, property and land.

• If you have more than £23,000 in capital you will have to pay the full cost of your care.
• Between £14,000 and £23,000 you will have to pay £1 a week for every £250 over £14,000 (in addition to a contribution from your income)
• Less than, £14,000, Social Services do not take your capital into account.

What if my property is occupied by another member of my family?

If you are to become a permanent resident in a care home or care home with nursing, a property will not be taken into account in the following circumstances.

• Your partner or spouse still live in the property
• A relative aged over 60 lives in the property
• A relative aged under 60 who has a disability lives in the property
• A divorced or estranged partner with a dependent child lives in the property
• A child under 16 maintained by you lives in the property.

If you own a second property or land, this will be taken into consideration.

Income.

Income includes pensions and benefits, rental income, net earnings, annuities and trust income and other available income.

Some types of income are classed as ‘disregarded’ by Adult Social Care. These include Disability living allowance (mobility component), and 50% of an occupational or private pension if it is available to your spouse at home.

Deductions.

Adult Social Care obviously realise that people need a certain amount of income for general outgoings and make weekly deductions and allowances for these, for example

• £21.90 for personal expenses
• Up to £5.65 from savings credit
• Up to £20 if you receive a charitable payment
• £10 if you receive a civilian war injury, war widow, war widower, or war disablement pension

The Benefits and Charging Adviser will also ensure that you are claiming all the benefits you are entitled to, and if necessary they will help you make your claim.

Calculating the Charges.

The Benefits and Charging Adviser will then add your total income to any income from your capital, deduct any allowances and calculate how much you need to contribute towards your care fees.

If you disagree with the amount you are expected to pay, or you feel it is more than you can afford, you can ask social services to review the charges. The outcome of the review would be sent to you in writing.

NHS Funded Continuing Care.

This is a complete package of ongoing care arranged and funded by the NHS. This funding is not means tested, unlike social services care. It can be provided in any setting including, but not limited to, a care home, hospice or a person’s own home.

As part of your ‘needs assessment’ by the Adult Social Care team they will identify whether you are likely to be entitled to this care. The entitlement is clearly defined as ‘your primary need being a health need’. If you are assessed as having a primary ‘health need’, then your Care Manager will arrange for a representative from the local Primary Care Trust (PCT) to assess you. If you are eligible for an NHS funded care package the PCT will inform you verbally and then put it in writing once a decision has been made, in most cases within 2 weeks of a referral for consideration.

The PCT must provide a care package it considers most appropriate to meet your needs. Your preferences and those of your family and friends should be taken into account, together with any risks associated with the type of care that is your personal preference, for example the risk of you staying at home with additional support, compared to the risks for you entering a residential establishment.

Will my benefits be affected if I receive NHS Funded Care?

If you are already living in a care home as a self-funder, or are moving into a care home and are eligible for NHS funded continuing care, you will no longer be entitled to Disability living allowance (DLA) Care Component or Attendance Allowance (AA) from the 29th day after you begin to receive NHS funded continuing care.

Pension credit and guarantee credit can be affected if you lose AA, as AA can influence the amount of pension credit you receive.

f you are going to continue to live at home with an NHS funded care package to support you, you are still entitled to receive DLA and AA.

Being awarded NHS funded continuing care does not affect your pension regardless of where you are going to be living.

Self Funding Home Care, a Care Home or a Care Home with nursing.

If you have greater capital or income than the above stated levels and you are not entitled to NHS funded continuing care, you will be expected to fund your care yourself. This is the case until such times as your capital and/or income drops below the threshold to start receiving financial support from the local authority.

This can be a daunting thought, and many people at this time consider such issues as a reduction in inheritance to leave to family and loved ones, concerns over costs of care, and any benefits available.

There are ways to make your capital in particular go further and there are benefits that are not means tested and therefore available to everyone to assist with care costs.

Benefits available.

Attendance Allowance (AA) is available to anyone aged 65 or over who needs help with personal care. AA is paid at 2 rates; a lower rate for people who require personal care day or night, and a higher rate for those requiring care day and night. Attendance allowance is payable whether you purchase care at home or reside in a care home or care home with nursing.

Disability Living Allowance (DLA) is payable to you if you are disabled, and make a claim before your 65th birthday. It has 2 components to it; a mobility component and a care component. The mobility component is payable at one of two rates depending on assessed need, and is for people who cannot walk, have great difficulty walking or who need someone with them when walking outside.

There are 3 rates to the care component. The entitlement to the middle and higher rates are the same as for Attendance Allowance, the lower rate is aimed at people not assessed as disabled enough to meet one of the other two rates.

Free Nursing Care (FNC)) is different to NHS Funded Continuing Care. It is funding provided by the NHS towards the cost of care given by a registered nurse in a care home with nursing.

If you are purchasing your own care in a care home with nursing, and have been assessed as requiring assistance from a registered nurse, you will be entitled to this contribution regardless of your financial situation.

Ways to make your capital go further towards the cost of care.

It is always recommended that you get independent financial advice from an organisation specialising in the provision of additional income from capital investment, long term care insurance and Home Equity Release Plans. Advice can be sort from: Citizens Advice Bureau, NHFA, Age Concern, Alzheimers Society, Mencap, Solicitors and insurance companies. You can link directly to them from our ‘Links’ Webpage.