Some people will have to pay for all of their care home fees whilst others won’t have to pay anything.   Wills, Trusts and Probate Partner Andrew Hitchon, who is based at our Market Harborough office, explains why this is and what you may be able to do to secure funding for care home fees instead.

Financial brackets for care home fees

In England, if your assets (including your home, providing that no-one else is living there) are worth £23,250 or more, you will usually have to pay the full cost of care home fees.

However, if you have what is called a ‘Primary Health Need’ there is funding available through the NHS called Continuing Healthcare (CHC) funding, which covers 100% of care fees for people aged 18 or over.  CHC funding provides 100% of funds for fees whether you need a residential home or a nursing home, as it does not take into account how much money you have or who you live with at home.

What is a primary health need?

NHS guidance says that a primary health need is ‘related to the treatment, control or prevention of a disease, illness, injury or disability and the care or aftercare of a person with these needs’.  These needs will have arisen due to a disability, illness or accident.

What is considered when assessing primary health needs?

The following considerations will be assessed when determining if a person has a primary health need which qualifies them for CHC funding:

  • Level of cognition (e.g. are they suffering from a mental illness?)
  • Psychological and emotional needs (e.g. do they have constant or severe anxiety?)
  • Behaviour (e.g. are they aggressive?)
  • Breathing (e.g. do they have emphysema?)
  • Mobility (e.g. can they get around by themselves or get up if they fall?)
  • Communication (e.g. can they speak for themselves?)
  • Nutrition (e.g. do they have difficulty eating or drinking?)
  • Continence (e.g. can they go to the bathroom by themselves?)
  • Skin (e.g. can they keep themselves clean and dry so that they don’t develop sores?)
  • Medication (e.g. do they need help administering drugs or injections?)
  • Altered states of consciousness (e.g. are they in a coma?)
  • Other significant care needs

How needs are assessed

The above needs are then assessed by how complex the care that the person requires is; how severe the person’s needs are and how unpredictable their needs are likely to become.

How to increase your chances of having care home fees paid by the NHS

Keep a medical history

First of all, it’s important to keep a full medical history for yourself or a person that you are caring for, for if/when the time comes that they need to go into a care home.  This will help you to have solid evidence of primary health needs, which will be useful for both the application process and an appeal process if your first application for CHC funding is rejected.

Don’t assume social care and health care is the same thing

Care at home is a good option for many people, but if you feel as though this is not providing the level of care that is required in accordance with their health needs (for example, if a person needs 24/7 care rather than people coming into their home to care for them several times a day), ensure that it is the NHS that is taking responsibility for that person’s care and not the local authority.

The local authority will be responsible for providing social care, but healthcare is the responsibility of the NHS.

Consider putting your assets in a trust

It isn’t legal to transfer assets out of your name into another person’s just so that they aren’t taken into account in a means test for care home fees.  People who are found to do this will usually be treated as though they still own the money or asset that they have given away, which may leave you in the position of having to pay the full fees without then having the assets to pay for them.

It is however, legal to give assets away for reasons such as tax planning, which is where it may be possible to put money away in a trust.  If this is done within a certain amount of time before you go into a care home, it will not be taken into account when you are means assessed for care home fees.

Legal advice about care home fees

For more information about this, see our Deliberate Deprivation page or call to speak to a solicitor specialising in care home fees, using the telephone numbers below: