Who pays for home care, and when the council helps

Under the Care Act the council has to carry out a needs assessment for anyone who appears to need care, whatever their money. It looks at whether you can manage things like washing, dressing, eating, getting around the house and keeping safe, and whether the gaps have a real effect on your wellbeing. If you meet the national eligibility threshold the council must meet those needs.

Only after that does it do the financial assessment, which decides how much of the cost you pay. Ask for the needs assessment first, even if you expect to pay yourself: it gets your needs on record, and it is the route to a direct payment later if your savings run down.

Above £23,250 in savings and investments you are a self-funder: the council will still assess your needs and can arrange care for you, but you pay the full cost. Between £14,250 and £23,250 you are treated as having an income of £1 a week for every £250 above the lower limit, on top of your real income. Below £14,250 your savings are ignored and only your income counts.

Savings means bank accounts, ISAs, shares, premium bonds and a second property. A couple’s joint savings are split in half for the person being assessed; the partner’s own money is not touched.

For care at home, the property you live in is disregarded entirely. It does not matter how much it is worth. This is the rule that makes care at home affordable for many owner-occupiers whose only real asset is the house, and it is worth knowing before anyone suggests a care home “because the council will help”: for a care home the house is counted unless a partner or certain relatives still live there.

Staying at home keeps the house out of the means test. Moving into a care home puts it in.

A second home, a buy-to-let or a share in a property you do not live in is counted as capital in both cases.

If the council contributes, it works out what you can afford from income: state pension, private pensions, most benefits, and the tariff income from savings. It must leave you with at least the minimum income guarantee, about £229 a week for a single person over pension age, plus your housing costs (rent, mortgage, council tax) and disability-related expenses you can show, such as extra heating, laundry or a gardener you cannot manage without.

Attendance Allowance and the daily living part of PIP are counted as income, but only if the council is actually meeting the needs they are paid for. Ask for a disability-related expenditure assessment: many people are assessed to pay more than they should because nobody listed those costs.

Councils pay agencies a set hourly rate for the people they fund, and it is usually below the private rate: often £22 to £28 an hour against a typical private rate of £32. If the council arranges your care it chooses an agency at its rate. If you take a direct payment and choose an agency that charges more, you pay the difference yourself, so it pays to check an agency’s private rate against what the council will give you before you commit.

1. 01
   Ask for a needs assessment

   Ring the adult social care team at your council, or ask the GP or hospital to refer you, and ask for a needs assessment under the Care Act.
2. 02
   Keep a diary for a week

   Write down what help is needed and when, including nights. Assessors see a snapshot; the diary shows the pattern.
3. 03
   Have someone with you

   You are entitled to an advocate if you would find it hard to take part on your own.
4. 04
   Get the plan in writing

   Ask for the care and support plan, with the personal budget figure, before the financial assessment.
5. 05
   List every disability-related expense

   At the financial assessment, list extra heating, laundry, help you pay for, and ask how the minimum income guarantee has been applied.
6. 06
   Ask for a direct payment

   If you want to choose your own agency or carer, say so now.