As we get older, it’s usually a necessity rather than a choice to get extra support or care to keep ourselves in good health.
Yet the care system can be confusing, particularly when it comes to figuring out eligibility for council support or whether someone needing care will have to pay for everything, which could be very expensive.
We have compiled this guide to help individuals who want to help arrange care for a loved one understand the various options available.
The cost of care depends on many factors. This includes the individual’s needs and whether they want to move to a residential or nursing care home – or receive care at home.
For example, the person needing care may have to fork out at least £14,000 annually for 14 hours of care a week at home, according to the United Kingdom Homecare Association (UKHCA). Of course, their local council may be able to help with the costs.
According to the Money Advice Service, if someone needs full-time care during the day, this could potentially cost more than £30,000.
If the individual opts for live-in care, the average price is £1,080 a week according to the Live-in Care Hub, who flags a third of nursing homes across the country charged at least £1,000 a week.
The last option could also be more cost-effective if a couple stay together and are cared for together.
There are several types of care, both short and long-term, including:
While day clubs don’t offer care, they can provide the chance for someone to socialise and take care in fun activities in a place with experienced staff.
Unfortunately, not all care homes offer the same rates, so the cost of care can vary in different areas of the UK.
In 2019/20, the amount someone paid weekly to stay in a residential care home was highest in the South East at £775 on average, according to LaingBuisson’s Care of Older People UK Market Report.
This rose to an average of £793 a week if the individual has dementia and needs special support.
Northern Ireland and the North West were among the cheapest areas for care at £534 and £542 per week, respectively.
For nursing care, average weekly costs soared to over a grand in the South East and was cheapest in Northern Ireland and the North East at £691 and £716, respectively.
We revealed back in 2017 how paying more for care doesn’t necessarily mean it’s better quality. It’s worth noting there is no new complete data on the cost and quality of care over the last three years.
So, while these areas may have offered the best care in 2017, that may not be the case now.
You can also check out consumer champion Which’s cost of care and eligibility calculator. This calculator can tell you whether your loved one will have to pay for their own care and estimated costs for different areas.
You can use Carehome.co.uk to compare different care homes, which includes reviews from spouses or family members of residents, photos and information on the facilities and management.
Before the council can offer any financial help to someone needing care, they need to figure out how much assistance is required.
A care assessment must be done to determine the amount of care needed, which will also take into consideration what the person needing support wants.
Anyone can get a care needs assessment free of charge regardless of their potential needs. If you care for someone else, you can also get a carer’s assessment (we’ll explore this more later).
Unless the council has started providing services before a care assessment has been completed, you have to make sure the person needing care gets in touch with their adult social services department.
You can arrange this for your loved one, but they have to agree to this.
The care assessment looks at how much the person needing care can do. So, for example, can the individual wash and dress, use the bathroom and generally live safely in their home?
If they need help with these tasks before the assessment, it’s important to let the assessor know.
If your loved one struggles with a pre-existing condition and is unsure how to explain its impact on their health, they should make sure a family member or friend is around to help explain everything.
Alternatively, they can ask for an independent advocate from the council.
Once the assessment is complete, the council can decide what care services are most suitable by comparing your loved one’s needs against national criteria.
Your loved one is unlikely to get help with the cost of care from their local council if they have savings and assets worth more than £23,250.
The value of their home may be included in the assessment, but this only applies if they’re moving into a care home and their partner is no longer living there.
If your loved one’s income is under £23,250 but over £14,250, they might get some financial assistance but may still have to pay for some of the care fees.
If the person needing care is unsure whether the council can support them, they can get a free financial assessment, so the council can figure out how much they’ll pay towards their care.
A Financial Assessment Officer will ask the person needing care about their earnings, pensions, savings, property and any benefits they might be receiving.
Stuff the individual used to own may also be included in this assessment, so if they spent money or gave property away, this won’t necessarily be excluded.
It’s best that they are honest about their wealth as any intention to reduce their wealth on purpose could prevent them from getting any type of financial help.
Once the council have the results, they’ll be in touch detailing how much care costs and how much your loved one needs to pay. This will depend on the type of care needed and your loved one's personal circumstances.
If they qualify for council help with care costs, a personal budget will be offered.
They have several options if they qualify for financial help, including:
Money Advice Service recommends that anyone needing care contacts their local council, even if they think their income and savings may exceed £23,250.
If your loved one disagrees with the council’s decision, they shouldn’t despair as they can challenge this by contacting the care manager to see if it can be resolved.
They can then escalate this to a formal complaint if there’s no resolution before seeking an independent review.
If you’re helping someone challenge a decision, it’s vital to get any responses in writing.
If a person with dementia has complex health and care needs, they may be eligible for NHS continuing healthcare, which is free and funded by the local Clinical Commissioning Group (CCG).
NHS continuing healthcare may also be offered to people suffering from long-term complex health conditions, and an assessment may be fast-tracked if care is urgently needed.
“Eligibility depends on the assessed needs, and not on any particular diagnosis or condition,” says the NHS on its site.
The person needing care will be assessed by a team of healthcare professionals, who will need to figure out what help is required and how complex, intensive and unpredictable their needs may be.
The assessment will look at the individual’s needs and consider:
Usually, a decision is made within 28 days of the initial assessment with each of these needs given a weighting, marked either: no needs, low, moderate, higher, severe or priority.
An individual will usually be eligible for NHS continuing healthcare if they have at least one priority need or severe needs in two areas.
For more information, check out this full guide from the NHS.
If the person needing care doesn’t qualify for NHS continuing healthcare, they may be referred to their local council, who may offer support if they’re eligible.
Alternatively, if nursing care in a care home is needed, they may be eligible for NHS-funded care. So, the NHS will pay a contribution towards the cost of nursing care.
It may not be necessary for someone to get dedicated nursing care or to move into a care home.
If your loved one wants companionship or a little help with everyday tasks, a homesharing scheme could be an option.
This scheme works by allowing someone to move in (a sharer) who then pays a small monthly fee. The sharer then offers help, usually around 10 hours a week, which includes cooking, shopping, cleaning and laundry.
An unpaid carer is anyone who looks after a partner, family member or friend who needs help with an illness, disability, addiction, mental health problem or frailty – and may not be able to cope without support.
Unpaid carers can offer a range of help, including (but not limited to) helping someone wash, dress and eat and they may live with the person they help.
According to Citizens Advice, unpaid carers can spend from a few hours a day to 24 hours, seven days a week taking care of someone else.
As they are unpaid, this can have a disproportionate impact on the person taking care of someone else although they can get support.
Carers Trust offers support to young carers, while parents caring for a child under 18 can get support from organisations such as Bliss and Carers Direct, as well as their local council.
Local councils can offer help such as a temporary carer or extra support for the person they are caring for.
A carer’s assessment will need to be carried out first, which the carer has to ask for.
This assessment is not a judgement on the quality of care provided. It looks at how caring affects a carer’s life and work, and whether they can do everything that’s important to them.
Carers UK has a handy guide to how the carer’s assessment works and what help you might get.
Carer’s Allowance is a taxable benefit that pays £66.15, with a one-off tax-free £10 payment around Christmas. To be eligible, you have to care for someone for at least 35 hours a week.
You can get a little extra money, which is known as a Carers’ Premium with the following benefits if you receive Carer’s Allowance:
Check out our full guide on Carer’s Allowance, including how to find out whether you are eligible and how you can claim.
Unpaid carers may also be eligible for National Insurance credits towards their State Pension thanks to Carer’s Credit. For more information, check out our guide on everything you need to know.
If you want care provided for a loved one in their own home, you can either help them hire a carer or find someone through an agency. A carer can help with cooking, cleaning and personal care among other things.
The average wage for a carer is between £10 and £12 an hour, according to the Money Advice Service.
Alternatively, if your loved one wants a carer to move in and provide round the clock assistance, it could set them back tens of thousands of pounds every year, but the value of accommodation could be part of their pay.
If the person needing care hires someone, they’ll technically be an employer under UK law, so they’ll need to set up an employment contract and offer the standard work benefits.
For example, the employee may be entitled to sick pay, holiday pay and rest breaks.
The person needing care may also be responsible for deducting Income Tax and National Insurance from their wages to pay to HMRC if they earn over a certain amount.
On top of this, they’ll need to register as an employer with HMRC and set up a payroll.
They’ll also need to verify the carer’s status to work in the UK by checking their passport or other forms of identification, and make sure they don’t have a criminal record.
And it’s vital they get employer’s liability insurance and public liability insurance to cover them if the employee has an accident and is injured in their home.
The person needing care could use an agency who is a member of the UKHCA to find someone, who will be responsible for taxes, insurance and police checks.
If someone decides to move abroad and then return to the UK to seek help with care, they need to prove their intention to settle permanently.
This means they’ll need to be classed as having ‘ordinary residence’ before they can be assessed to decide whether they are entitled to state help with medical care.
So, the individual may need to pay for a stay in a care home while they wait to be assessed and even then, state help isn’t guaranteed.
Unfortunately, the UK Government doesn’t have any arrangements to cover overseas residential or nursing care for Brits living abroad.
To find out more about the available options when you move abroad and want to return to the UK, check out this handy guide.
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