Paying for residential care

If you have been assessed as needing respite, residential or nursing home care and you choose to do this, you may be entitled to help with the costs of this care.

Paying for care

As a resident in a care home you would have to pay something towards the cost of your accommodation, but only what the law says you can afford. The amount is worked out on a sliding scale and depends on your weekly income, capital (if you have any), and on some of your outgoings. You might also be entitled to benefits that can be offset against the costs. A member of staff can help you claim for these if necessary.

After you have had a needs assessment, if it is identified by yourself and the assessor that your needs would best be met in a care home, then we will carry out a detailed financial assessment with you. This will determine your contribution to the cost of care and is referred to as your ‘assessed contribution’.

• Needs assessments – more detailed information on what needs assessments are, who does them and what happens.

We will need to know about your

• Income – this can be from retirement pensions, pension credit or wages.
• Capital – this includes bank and building society accounts, national savings accounts, premium bonds, stocks and shares and property (buildings or land).
• Outgoings – these can be maintenance payments, mortgage, rent, water rates, council tax etc.

The Government sets out the upper and lower amounts of capital that we have to take into account every year when working out your entitlements. They also determine the minimum amount you must receive every week to spend as you choose, this is called a personal allowance.

The following information applies from April 2008 to March 2009:

• We do not take into account the first £13,500 of your savings or capital.  
• If you have savings or capital of between £13,500 and £22,250 we will count £1 for every £250 (or part of £250) over £13,500 as income.
• Your personal allowance will be at least £21.15 per week and you may also be entitled to an extra £5.45 a week in savings credit.

Will I have to pay extra for my nursing needs?

If you are assessed as needing nursing care you will need to move into a care home that can meet your nursing needs. The NHS will pay for your assessed nursing care costs, this is referred to as ‘funded nursing care’. There is a standard fee of £103.80, paid by the local NHS Heywood, Middleton and Rochdale directly to the care home.

What happens if I have savings?

If you (or as your share held jointly with your spouse or partner) have more than £22,250 in savings or capital you will have to pay the full costs of your stay, (excluding any funded nursing care). If you do not wish to give information on your savings, capital or income then you will be expected to pay the full cost of your stay (excluding any funded nursing care). When your own or your share of savings or capital is reduced to £22,250 then we can give you some financial help.

When you know that your savings or capital are going to reduce to below £22,250 you can contact us again to arrange for another assessment. This will determine what assistance the council can provide towards your care home fees.

What benefits and income can I keep?

There are certain benefits that we can ignore or partially ignore (disregard) when working out your income.

• We can completely disregard Disability Living Allowance (mobility component) and War Widows Special Payments.
• We can partly disregard a War Disablement Pension and War Widows Pension up to a total of £10 per week. Half of certain pensions, for example occupational and personal pensions and payments from retirement annuity contracts, can be disregarded as long as at least half of that pension is passed to your wife or husband where they are still living at home.
• If you are receiving Attendance Allowance or Disability Living Allowance (care component) when you move into a care home, then these will both cease after 28 days if we are contributing to the cost of your fees. It is your responsibility to inform the Disability Benefits Unit at Blackpool in order for them to stop these payments. If you have transferred from hospital into a care home then your stay in hospital will count towards the 28 days. If you are paying the full cost of your care in a care home then you will continue to get Attendance Allowance or Disability Living Allowance (care component).

What if I am on a low income?

If you are on a low income and are living permanently in a care home then you may be able to claim pension credit or income support to help pay for your care.

For people taking a respite break (for a period of time under 8 weeks in a care home) then if you have a spouse or partner, the amount of pension credit or income support you get will also depend on their income and savings. The amount that you contribute towards the care home costs may be reduced depending on the costs of keeping your home going.

How much will I actually pay?

The maximum we will usually pay:

• For residential care homes from April 2008 for single & shared rooms - £347.71 to £354.53 per week
• For Nursing homes (without the NHS contribution to nursing care) from April 2008 for single & shared rooms - £357 to £364 per week
• The maximum we will pay towards residential care for elderly mentally ill people from April 2008 for single & shared rooms - £357 to £388 per week
• There are different rates for younger disabled residents and those with a mental illness.

If you are taking a respite or short term break in a council or privately run home and have less than £13,500 in savings or capital then weekly charges are as follows:

For people who are getting Attendance Allowance or Disabled Living Allowance care component, at the middle or highest rate:

• under 25 years old - £59.65 per week
• aged 25-59 - £72.20 per week
• over 60 years old - £109.90 per week

For people who are not getting these benefits are as follows:

• under 25 years old - £49.65 per week
• aged 25-59 - £62.20 per week
• over 60 years old - £99.90 per week

If you have between £13,500 and £22,250 in savings or capital then the charges and the amount you pay are worked out in a similar way to people with less than £13,500 in capital. The difference is that you will have to pay an extra £1 per week for every £250 of savings or capital you have in excess of £13,500 up to the £22,250 limit.

If you have more than £22,250 in savings or capital then you will be charged the full costs of your stay.

Paying for short-term care

For some people, the cost of care will depend on their savings or capital, but for most people there will be fixed charges for stays of less than eight weeks. For stays of over 8 weeks we work out the cost in the same way as a long term permanent resident.

For short stays or respite breaks up to 8 weeks as with a long term move into a residential or nursing care home, most forms of savings or capital of over £13,500 are taken into account. The main difference is that the value of your home is not counted as capital. Your share of any joint savings or jointly owned capital (excluding the value of your home) will be taken into account.

Will I have to sell my house to pay for long term care?

The value of your home or former home is counted as capital and this means that you may have to sell your home unless:

• Your husband, wife or partner lives there
• A relative aged 60 or over lives there
• A relative under the age of 60 who is ‘incapacitated’ (receives certain sickness or disability benefits) lives there
• A child who is under 16 and for whom you have financial responsibility lives there

You must let us know if a spouse, partner or relative stops living in your home as it will then be taken into account for working out the payments for your care. It is important that at each stage you are considering disposing of your assets that you discuss your plans with us.

We realise that the decision to sell your home may be a difficult one so, to give you time to consider this carefully, you can delay this decision for up to three months. During this time we will ignore the value of your house for up to 12 weeks from the date it is confirmed that you are a permanent resident. For this period your contribution to your care fees will depend on your income and savings and the council will pay the difference.

After 12 weeks the value of your house will be taken into account - if it exceeds the limit of £22,250 you will be expected to pay the full cost of your care. If you decide to rent out your property then the income, less the costs of acceptable maintenance to the property, must be put towards the cost of your care.

If you do not sell your house straight away any costs towards maintenance, insurance or security cannot be paid by the council. Also if there is any money owing on the mortgage you will need to be sure you can pay the mortgage as well as the care home costs.

Deferred payment scheme

It may be possible to delay any decision to sell your home for a longer time under a scheme called ‘deferred payments’. If it takes time to sell your home, we can help you to pay for your care in the interim. To do this, we put a legal charge against your home, which allows us to get the money back when it is sold.

If you are thinking about selling your home and giving some money away to friends or relatives, please check with the council first. This is because we may assume that the money you give away can still be used to pay for your care.

Can I give away my house, savings or investments?

If you give away assets to avoid or reduce care home fees we will charge you what you would have to pay if you still had those assets.

What if I choose a home that costs more than the maximum amount the council can pay?

If you want to choose a home that costs more than the maximum amount the council pay, then either:

• Someone else will have to make up the difference, known as a third party ‘top up’.
• You will have to show that the care homes we offer you as an alternative do not meet your needs.

If someone agrees to pay the ‘top up’ for you, for example a relative, friend or charity and they do not keep up the payments then you may have to move to another care home and there will be an outstanding bill for any ‘top up’ payments not made.

In general you cannot ‘top up’ fees from your own savings. The exceptions to this are:

• Where your property is being disregarded for up to the first 12 weeks of entering into the care home and where you can pay the top up from your own money or savings, not out of the equity on your property.
• If you are on the deferred payments scheme and the council has agreed to pay the cost of accommodation including the top up, to be recovered when your property is sold.

How do I make a payment to the care home?

For long term stays in a private or voluntary run care home, you should only pay your assessed contribution direct to the owner. The council will pay its share direct to the owner of the care home rather than to you. You must ensure that you retain your personal allowance allocation to spend as you choose and not as a contribution to care home costs. For short stays and respite care, you should not pay the owner of the care home while you are staying there. Instead, we will send you the bill after you leave.

Are there any benefits in arranging care for myself directly with the care home?

If you are a home owner you may be better off arranging care in a care home for yourself. This is because you may still be able to claim Attendance Allowance or Disability Living Allowance as well as income support and or pension credit to offset the cost of any fees. Whether it is best to arrange your own care will depend on your circumstances and we strongly advise you to get independent financial advice before making a decision.

Information for husbands, wives and partners

The amount paid for care is based on individual income, savings and capital so it does not include your husband, wife or partner’s assets. If your spouse moves into residential or nursing care and you stay at home, you will be entitled to half of any occupational pension that they get and only half of this will be taken into account to pay for care.

Standards you can expect

You can expect to receive care services that are delivered by appropriately trained and skilled staff who will treat you at all times with respect for your privacy and personal dignity. All records of the care support you receive will be kept in confidence and shared only with your permission. You will be involved in all aspects of your care planning and if and when necessary an advocate will be sought for you to ensure that your wishes and preferences are taken into account whenever your circumstances change.

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