Paying for a residential care home

How much you pay towards care home costs depends on:

• what nation of the UK you live in
• what type of care you need. For example, do you need nursing care?
• the price the care home charges. This varies a lot across the country
• how much you have in assets, including savings and property

The costs of staying in a home are split into:

• ‘hotel costs’. These are your daily living costs for your accommodation, laundry, meals, heating and lighting
• care costs. These cover things like personal care. This is help with getting in or out of bed, washing, showering, dressing, eating or using the toilet. They also cover nursing care if you need that

A place in a care home costs many hundreds of pounds each week, and nursing homes cost even more. To work out what you pay towards it, you’ll have a ‘means test’. Your local council, or Health and Social Care Trust in Northern Ireland will look at what you have in assets (income and capital).

Each of the four UK nations has its own means test. You might hear it called a ‘financial assessment’. They all look at:

• your income. This doesn’t cover wages you get from a job. Here ‘income’ means pensions, some benefits, and money you get from renting out any property you own
• your capital. This covers savings, investments like stocks and shares, and property, including your home if you own it

How much you can have in assets and ‘income’ and still qualify for help with paying care home costs is different between the four UK nations. But this is the same in all four:

• With assets over a certain amount you become a ‘self-funder’, paying all the costs yourself, using the capital you have. For some people this means selling their home.
• With assets above a certain amount but below another amount, you share the costs with your council or Trust. You use your capital to find the money.
• With assets under a certain amount you pay nothing. Your council or Trust pays, with you just paying what you can afford from your income (such as your pension)

See what the different limits are for England

See what the different limits are for Wales

See what the different limits are for Scotland

See what the different limits are for Northern Ireland

If you qualify for help with care home costs, your council or Trust will have a limit on how much they’ll pay. But they must show this limit is enough to cover the level of care and support you need.

If no other home meets the needs written in your care and support plan, then your council or Trust must agree to pay for a more expensive home that does.

If you just prefer a more expensive home, there’s a way you might get this. If your council or Trust agrees, you can arrange for a ‘third party top-up payment’. They pay what they’re prepared to pay and you find someone else willing to pay the difference for you.

If you own your own home, you might have to sell it to pay care home fees, but that’s not always the case. Your council or Trust usually include the value of your home in their means test. But they won’t if these people live in it:

• your husband, wife, partner or civil partner
• your ex-husband, ex-wife or ex-partner who’s a single parent
• a close relative who’s either 16 or younger, disabled, or 60 or older

Are you a homeowner who wants to move into a care home, and you know the value of your home will be included in the means test? Then you can delay paying for care home charges with a deferred payment agreement.

Your council pays your care home costs for you (up to the value of your house). You pay them the money back when you choose to sell your home later, or when it’s sold after you die.

In Northern Ireland some Health and Social Care Trusts might also offer deferred payments in some cases.

Find out more about deferred payment agreements.

Some people might think that, if having lots of assets means they must pay more for their social care or care home, why not get rid of the assets? For example, why not give their house to their children?

This is called ‘deprivation of assets’. When your council or Trust gives you a means test to look into your money situation, they’ll be on the lookout for signs of this. If they decide you’ve done this, they’ll just count the assets as still belonging to you.

So you’ll end up having to pay the same social care costs as when you had the assets - only now you’ve given a valuable asset away. It’s a good idea to get legal advice before you give assets away.

It can be helpful to review what benefits you and your family or carers are getting. If you qualify for a benefit, your council or Trust will assume you're getting it when they calculate how much you pay towards your care, even if you don't actually claim that benefit. So it's worth making sure that you're getting all the benefits you qualify for.

Some benefits you may get, including Personal Independence Payment (PIP), will stop when you go into a residential care home.

Even if you think you’re getting what you're entitled to, it may well be worth doing a check each year.

Find out more about benefits.

If you need to pay care home fees, you might worry about how long you’ll need to pay them for.

There are financial products that can help you pay care home fees over a long period. Always get expert advice about which of these products would be best for you:

• Immediate care annuity. You pay a single lump sum. In return a fixed sum of money is paid towards your care costs for the rest of your life.
• Equity release. You raise money against the value of your home but without having to sell it. Read more about equity release on the Moneyhelper website. 
• Investment plans. You put some money into a fund with the aim of making a profit. You use this profit to pay for your care when it’s needed.

In England, Wales and Northern Ireland, some people who need very complicated medical care might qualify for continuing health care (CHC). This is sometimes called fully-funded NHS care. This care is provided by the NHS, so you’re not charged for it.

Continuing health care doesn’t happen in a hospital but at home or in a care home. It can pay for all the costs of a care home that provides nursing. If you live in your own home, it can help with personal care like bathing, getting dressed and laundry.

CHC isn’t easy to get. The first step is for health care professionals to assess your condition. If you do get it, you’ll have a Personal Health Budget. This is money to spend on meeting what’s important to you in your ‘health and well-being needs and goals’. This includes healthcare and support such as treatments, equipment and personal care. This budget is agreed between you and your NHS team.

Read more about this Personal Health Budget.

If you live in England, Wales or Northern Ireland, read more about NHS Continuing Health Care  

For people in England the organisation Care To Be Different also has information and advice over the phone about getting Continuing Healthcare  

If your MS gets worse, and social care no longer gives you enough support, ask your social worker about continuing health care.

Scotland no longer has NHS continuing health care. It has Hospital Based Complex Clinical Care (HBCCC). Only people who need ongoing hospital based care qualify for HBCCC, and you can only get this kind of care in a hospital. So it’s very different from NHS continuing health care which people in Scotland used to get at home or in a care home.

If you don’t need complicated hospital care, you’ll be discharged back to your own home, a care home or to supported accommodation. Your healthcare there is free (because the NHS provides it). Any personal care or nursing care you need is also free.

You may have to pay towards the cost of your social care services. A means test will decide this. And if you move into a care home, the means test also decides if you must pay towards the part of the care home charges that covers accommodation costs.

Find out more about Hospital Based Complex Clinical Care