Who pays for my care?
If you have been assessed as having an eligible care need by the Local Authority, you will also have your assets and income assessed to determine whether you qualify for assistance with your care costs. They will also identify the maximum weekly contribution they would make to cover the cost of the care you require. This is called your Personal Budget.
Each local authority will have a limit as to the maximum Personal Budget they will provide. The BBC have provided a very helpful calculator showing how much your local authority might pay for your care. Access it here.
Assessment of Capital and Assets
In England and Northern Ireland, local authority assistance starts when you have assets and capital worth less than £23,250. Your assets and capital are fully disregarded if they are below £14,250.
If you have between £14,250 and £23,250
Capital between £14,250 and £23,250 is assessed as if you have an assumed (or ‘tariff’) income. For every £250 or part of £250 above £14,250, you are treated as if you have an extra £1 a week income.
If you have more than £23,250
You will be deemed a "self funder" and as such will be expected to pay for your care in full. This is when you should seek expert advice as to the most efficient ways to cover the costs.
Assessment of Income
Your income is assessed in full, however some state benefits will be disregarded. the local authority will allow you to keep a portion of your income, known as a Personal Expenses Allowance (PEA). This is currently £24.90 per week. The rest of your income will be used to pay for your care in conjunction with any local authority contribution.
Top-ups and choice of services
If you are receiving local authority support with the cost of your care and you need to live in a certain place to receive that care, such as a care home, you have the right to choose where you live (choice of accommodation).
The local authority must ensure you have at least one choice that is affordable from the amount identified in your personal budget, and ideally more than one. Some local authorities will have a list of preferred providers that they will usually recommend.
If you do not like the provider suggested, or you or the person you care for has a particular service in mind, you can ask the local authority to arrange it.
The local authority has a duty to explain this right of choice to you. This free choice is subject to conditions:
the preferred accommodation must be available
the preferred accommodation must be suitable to meet your assessed needs
it will not cost more than the amount set out in your personal budget
the provider is willing to enter into a contract
You may choose a care home that is more expensive than the amount set out in your personal budget. If you do, a third party such as a relative or friend must be willing and able to pay the difference in cost for the likely duration of your stay. This is known as a top-up payment.
Where a person agrees to enter into a top-up payment, they will need to sign a written agreement with the local authority. This will set out what the costs are, how often they have to be paid, and what will happen if the person is no longer able to make the payment.
In some limited circumstances you can make this payment. This is if you enter into a deferred payment scheme, or you benefit from the value of your property being disregarded for the first 12 weeks of your care.
The restrictions on paying this additional cost yourself will be lifted from April 2020, when the point at which means-tested support for care costs is increased.
The local authority can never require you to pay a top-up payment and must ensure there is at least one choice available within the amount set in your personal budget. Any arrangements to pay a top-up must involve your local authority, and should not be directly between you and your provider.