Funding care: frequently asked questions
Life Matters for Lymington from Lester Aldridge: the funding of care can be expensive and it is worth exploring whether a loved one is eligible for financial assistance.
At Lester Aldridge, we frequently find that individuals and their families are left feeling ‘in the dark’ when it comes to understanding the funding of care. Many are not sure where to start and so the purpose of this month's Life Matters article, by James Pantling-Skeet of our Community Care Team, is to answer some of common frequently asked questions relating to how care is funded.
When it becomes clear that a loved one needs care, the whole subject can be highly emotive for all involved. It can also be stressful, in particular with worries over how to afford the care required.
Without doubt, funding care is expensive. When the potential cost is vast, it is worth exploring whether you or a loved one may be eligible for non-means tested, free, NHS Continuing Healthcare.
What is fully funded NHS care or NHS Continuing Healthcare?
Fully funded NHS care or NHS Continuing Healthcare means an individual has been assessed and identified to present with a ‘primary health need’ meaning the individual’s care needs go over and above what a Local Authority is lawfully able to provide.
If someone is eligible for fully funded NHS care or NHS Continuing Healthcare, it means the NHS must ensure any needs identified through the assessment process are met, which includes a need for care, support and accommodation.
Is fully funded NHS care or NHS Continuing Healthcare means tested?
No. Fully funded NHS care or NHS Continuing Healthcare is non-means tested (i.e. it is free and must be provided without a charge).According to a report by healthcare specialists Laing & Buisson in 2018, care home costs can range from:
- £27,000 to £39,000 per year for a residential care home or
- £35,000 to £55,000 per year if nursing care is required.
What is the eligibility criteria for NHS Continuing Healthcare? How is eligibility assessed?
In order to qualify for NHS Continuing Healthcare, it must be demonstrated through an evidence-based assessment process that an adult has a ‘primary health need’. In very simple terms this means assessor are required to decide whether an individual’s primary need is for healthcare (for which responsibility lies with the NHS) or for social care (for which a Local Authority has a duty to assess).
A detailed explanation of the assessment process can be found by clicking here.
If NHS Continuing Healthcare funding is refused, can the decision be challenged?
Yes. It is often extremely difficult to succeed with obtaining NHS Continuing Healthcare at the first stage of the assessment process and many do not succeed until decisions are challenged.
When the average cost of residential or nursing care is so high however, there is still likely to be a huge financial benefit to challenging refusals to award the funding.
Anyone appointed as an Attorney or Deputy has an obligation to act in the person lacking capacity’s best interests (P). Maximising P’s funds through obtaining NHS Continuing Healthcare funding where P is eligible is evidently in P’s best interests.
Is there a difference between fully funded NHS care or NHS Continuing Healthcare and the NHS Funded Nursing Contribution (FNC)?
Yes. The NHS Funded Nursing Contribution (FNC) is a set, weekly rate of £165.56 which is paid directly to a provider to assist with the cost of nursing care where an individual has been assessed not to be eligible for NHS Continuing Healthcare but requires care from a registered nurse and is living in a nursing home.
FNC is not available to those who require residential care only. The weekly rate is subject to change.
Is it possible to retrospectively claim for NHS Continuing Healthcare?
Yes. Often many are not told that they may be eligible for NHS Continuing Healthcare which may leave people self-funding expensive packages of care, support and accommodation
What is the eligibility criteria for support from social care?
To qualify for care and support provided by a Local Authority, the adult must answer “yes” to 3 questions:
1) Is the need for support because of a physical or mental impairment, or illness?
2) Is the adult unable to achieve two or more of the care outcomes?
3) Could this have a significant impact on the adult’s well-being?
The ‘care outcomes’ included things such as managing and maintain nutrition, maintaining nutrition, or managing toileting needs.
Is support from social care means tested? What are the means testing rules?
Yes. A financial assessment to determine eligibility for Local Authority funded care has to be completed.
What are the thresholds to be eligible for Local Authority funded care?
If an adult’s savings and capital are more than £23,250, they will not be eligible for Local Authority funded care unless a capital disregard applies or eligibility for non-means tested (i.e. free) NHS Continuing Healthcare is established. A jointly funded care package or the NHS FNC may be available but will require a financial contribution.
If the adult’s capital is between £14,250 and £23,250 the adult will be required to contribute £1 per week for every £250 of capital between these figures. The adult will also have to contribute all their income, minus £24.90 per week for the personal expenses allowance.
If the adult’s capital is below £14,250 the adult will be entitled to maximum Local Authority support however will still be required to contribute all their income, minus the £24.90 weekly personal expenses allowance.
Can NHS funded care or Local Authority funded care be provided at home?
Yes. It is possible for NHS Continuing Healthcare to be provided in any setting, which includes residential or nursing care, or a package of care and support at home. Local Authority funded care can also be provided in any setting.
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Life Matters for Lymington with Parisa Jones
In addition Parisa Jones, Lester Aldridge specialist in wills, estates, tax and trusts, is on hand whenever you need advice on any legal matters. She is happy to meet you in person at your home or at the Lester Aldridge offices in Bournemouth, or on the phone as preferred. You can talk over the specifics of your situation with Parisa, and take things from there.
Parisa qualified as a solicitor in 2012 and specialises in wills, estates, tax and trusts. She joined Lester Aldridge covering the New Forest in July 2019, having previously worked in Lymington so she knows the area well. It is important to ensure that your legal affairs are always up to date and Parisa offers a friendly face to support you during the various stages of life. She has a wealth of experience in dealing with a broad spectrum of clients with different needs and requirements. Parisa deals with matters with sensitivity and empathetically but also offers a proactive approach with practical solutions.
Life Matters for Lymington and the New Forest
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Lester Aldridge Solicitors are based in London and Bournemouth where the office covering the New Forest is situated conveniently close to the main Bournemouth train station. Their specialist teams in the various fields of law will be happy to advise and assist you, starting with a completely free initial consultation during which you can decide whether you feel able to trust them with your confidential information. For more information please click here.