Long Term Care Planning

Age Concern England receives many queries about the system of funding for long-term care, and also about long-term care insurance. This Information Sheet gives a brief outline of the current system of paying for long-term care, and some information which you may wish to consider if looking at long-term care insurance. There are a number of Age Concern factsheets that you may also find helpful and these are referred to in this Information Sheet. This Information Sheet does not cover Scotland where the rules are different. The current system of paying for long-term care This Information Sheet explains the current situation at the time of writing. Up to date information will be available from Age Concern England should you need long-term care in a care home a later date. The NHS is responsible for providing a range of continuing health care services including fully funding care home places for certain individuals. Long-term care provided by the NHS is not means-tested, although State benefits such as State Retirement Pension or Attendance Allowance may reduce or cease over time. A report published by the Health Service Ombudsman in February 2003 suggested that in some areas unlawfully narrow criteria may have been used in assessing eligibility for fully funded care. For more details see Age Concern Factsheet 20, NHS continuing care, free nursing care and intermediate care. The NHS is responsible for meeting the registered nursing costs of all residents in care homes which provide nursing care. Residents are placed in one of three bands of funding according to an assessment by an NHS nurse. The NHS then pays the care home at the appropriate rate 2 leaving the resident or local authority to meet the cost of accommodation and personal care. The local authority social services department is intended to be the main source of assistance with the cost of accommodation and personal care in a care home. Residents are firstly assessed by the authority to confirm that they need the type of care being provided. If so, the resident is means-tested to establish how much he should contribute towards the cost of that care. Both capital and income are taken into account. Age Concern Factsheet 10, Local authority charging procedures for care homes, explains the rules and is updated on a regular basis as any change in the rules occurs. Anyone who has more than £19,500 is expected to pay for their accommodation and personal care in a care home in full. Capital may include the value of property in which the person used to live before moving to a care home. However, there are some circumstances when the value of this property is ignored and not included in the means-test. These are where a spouse or partner, a relative aged 60 or over, a relative under 60 who is incapacitated, a loan parent who is estranged from the resident, or a child under 16 for whom the resident is responsible, lives in the property. Where a person goes into a home on a temporary basis, the value is ignored. It is also disregarded for 12 weeks from the time it is decided that the stay in a home is permanent. In addition, a resident can ask his/her local authority to use their discretion to ignore the value of the property if someone (such as a carer) lives in the property who does not fall within the categories where the property has to be ignored. In circumstances where the value of property is included in the meanstest, a person may be able to rent the property and use the net income together with other income to meet the costs of their care. It is also possible to defer having to sell your property by using a deferred payment agreement with the local authority. This allows the resident to just pay out of income, and have a legal charge placed on the property so that the local authority can be refunded any outstanding debt at a later stage. In effect, this is like an interest free loan, but in the end the money you owe the local authority will still need to be paid out of the proceeds of the sale. For more details see Age Concern Factsheet 38, Treatment of the former home as capital for people in care homes. 3 When one of a couple enters a home, it is only his or her income and capital which counts. However the spouse remaining in the family home may have a reduced income and so may become eligible for benefits. There are provisions to disregard half a resident’s private pension if it is being passed to the spouse at home. The local authority also has discretion to increase the resident’s personal expenses allowance to allow for money to be paid to a spouse or unmarried partner. Sometimes, though, a spouse remaining at home may be asked to contribute towards the cost of their husband’s or wife’s care. These are called ‘liable relative’ payments, and only apply to married partners. For more details about the rules for couples, see Age Concern Factsheet 39 Paying for care in a care home if you have a partner. Some people want to give away their house or some savings to friends or relatives so that this will not be available to pay for care. However, this might be considered to be ‘deliberate deprivation’, and either the person who gave away something or the person who received it might be pursued for the value of the gift. If you do give away property or savings these will no longer belong to you but to the person to whom you have given it. This could cause difficulties for you if you still would really want or need access to these gifts in the future. See Age Concern Factsheet 40 Transfer of assets and paying for care in a care home. Local authorities do not have to charge for home care but most do. The charging policies of those that do should comply with certain minimum requirements set out in guidance issued by the Department of Health. Details of this guidance and further information on paying for nonresidential care services can be found in Age Concern Factsheet 46, Paying for care and support at home.