Care Fees – What are my Rights?

There are TWO different types of “Care” available in England & Wales, being either HEALTH care or SOCIAL care, so in respect of care fees, what are your rights?

Firstly, if a person’s need for care is primarily health related, then they qualify for free HEALTH care under the NHS, either in their own home or in a residential nursing facility. However, if the need for care is primarily convenience based, otherwise known as SOCIAL care needs, then a person will be assessed (means-tested) for their ability to pay for that social care. The inevitable toll of the ageing process or difficulty in doing the weekly shopping would both be deemed to be social rather than health needs. An inability to communicate symptoms of pain or reliance upon professional medical care to survive are both examples of health needs.

Many people are incorrectly determined to have social rather than health needs because this saves the NHS a great deal of money. Very few people appeal an initial incorrect refusal for free health care.

When someone needs social care, the local authority will carry out a financial assessment. As part of this assessment, the local authority will calculate the cost of the care (and accommodation if relevant) and how much the individual can contribute from their own resources.

When carrying out a means test, the local authority may consider the value of a property as well as any income, savings, or pension provision. It is worth noting that a local authority may disregard the value of any premises or share of premises which is occupied in whole or in part by a qualifying relative of the adult requiring care. A qualifying relative is defined as a spouse/civil partner, partner, former partner, the person’s minor child, or a relative aged over 60 or one who is incapacitated.

If someone has total assets valued at above £23,250, they will have to fund their social care costs themselves. If someone has assets of between £14,250 and £23,250, they will need to contribute towards the cost of their care from income such as pensions.  There may also be a tariff based on their capital, then the local authority will fund any remaining shortfall.

Once someone’s asset value reaches below £14,250, they will no longer pay a ‘tariff’ fee based on their capital, but they must continue paying from income included in the means test. The local authority will pay the remaining cost of their care. There are proposals to reform this system by late 2023, however the status quo shall remain until then.

In summary, you would be well advised to NOT agree to any care or sign anything agreeing to proposed care before seeking professional independent guidance regarding the rights of the person in need of such care. The “Care” system focuses almost exclusively upon collecting in money rather than the legal rights of a patient and their representatives.

For further information without fear of consultation fees or obligation, please visit our NHS Care Funding page.