Funding is one of the most stressful parts of arranging care. The system is complicated, the language is confusing, and most families come to it with no prior knowledge while dealing with everything else a care situation brings.
This article explains the main funding routes for home based care in plain language. It will not answer every question, because every situation is different and the rules change. But it should give you enough of a map to know where to start.
Note: Funding thresholds and benefit rates change regularly. This article deliberately omits specific figures. Check current thresholds with your local authority or at gov.uk when you begin the process.
The four main funding routes
There are four main ways that home based care gets funded in the UK: local authority funding, NHS Continuing Healthcare, personal budgets, and private funding. Most people end up using one or a combination of these depending on their needs, assets, and circumstances.
Local authority funding
If a person needs care, the starting point is usually a care needs assessment carried out by the local authority. In North Yorkshire that means contacting North Yorkshire Council’s adult social care team.
The assessment looks at what the person needs help with and whether those needs meet the eligibility threshold under the Care Act 2014. If the person’s needs meet that threshold, the local authority has a legal duty to arrange and part fund their care.
Whether the local authority contributes financially depends on a means test. This looks at the person’s income and assets including savings and, in most cases, property. The thresholds that determine how much you contribute are set nationally and reviewed periodically. Your local authority adult social care team will explain the current thresholds when they carry out the financial assessment. It is worth asking directly what the figures are at the time of your assessment rather than relying on anything you have read online, including this article.
NHS Continuing Healthcare
NHS Continuing Healthcare, usually called CHC, is fully funded care provided by the NHS for people whose primary need is a health need rather than a social care need.
CHC is not means tested. If a person is eligible, the NHS funds their care in full regardless of their assets or income. The eligibility assessment looks at the nature, complexity, intensity, and unpredictability of the person’s needs across a range of care domains.
CHC is frequently misunderstood and frequently refused at the first assessment when people may be entitled to it. If a person has significant health needs, particularly mental health needs, neurological conditions, or complex physical health needs, it is worth pursuing a CHC assessment and understanding the process before accepting a refusal.
Our founder has worked as a CHC assessor. If you have questions about whether CHC might be relevant to your situation, we are happy to talk it through with you.
Personal budgets and direct payments
If a person is assessed as eligible for local authority funding, they have the option of receiving that funding as a personal budget or direct payment rather than having the local authority arrange the care directly.
This route gives families more flexibility and more choice over their care provider. It also comes with more administrative responsibility. If you are considering a personal budget or direct payment, your local authority should provide support with managing it.
Private funding
If a person does not meet the local authority means test threshold, or chooses not to go through the local authority process, they can fund their care privately. Private funding means paying the care provider directly at their standard rates. The advantage is speed and simplicity. The disadvantage is cost.
If you are privately funding care it is still worth having a care needs assessment carried out by the local authority, even if you do not intend to use local authority funding immediately. Needs change. Having an assessment on record means the process is faster if circumstances change.
Attendance Allowance and other benefits
Attendance Allowance is a benefit for people aged 65 and over who need help with personal care or supervision because of a physical or mental disability. It is not means tested. It is paid at two rates depending on the level of need. Current rates are available on the gov.uk website and are reviewed annually. Many people who are entitled to this benefit are not claiming it.
For people under 65, Personal Independence Payment covers similar ground.
What to do if you are refused funding
Refusals happen. Sometimes they are correct. Sometimes they are not. If a person is refused a care needs assessment, refused eligibility under the Care Act, or refused CHC funding and you believe the decision is wrong, you have the right to challenge it.
For local authority decisions, the process starts with a formal complaint to the local authority. For CHC decisions, there is a formal review and appeal process. NHS England, the charity Beacon, and some solicitors specialise in this area.
Where to start
If you are not sure which route applies to your situation, start here: contact your local authority adult social care team and request a care needs assessment. This costs nothing and commits you to nothing. If the person has significant health needs, ask specifically about NHS Continuing Healthcare eligibility at the same time.
If you are in North Yorkshire, the contact point is North Yorkshire Council adult social care. And if you want to talk through the options before you make any calls, we are happy to do that. We will not push you toward any particular route. We will just help you understand what the options are.