Qualifying for government support with long-term care

Qualifying for government support with long-term care

How could my relative be cared for? 

Long-term care may be provided in local authority care homes, in their own home or in nursing homes partly or wholly funded by the NHS. There are two kinds of long term care:

  • Social care is the umbrella term for the range of services that help frail, elderly and disabled people remain independent, safe and active 
  • Health care is a care package for people who, although they are not in hospital, have complicated ongoing healthcare needs.

Would my relative need to pay? 

Your relative may need to pay for all, some, or none of their long-term care. It depends on their:

  • health 
  • mobility
  • income – pensions, benefits and earnings
  • capital – value of savings, investments, property and assets.

These are assessed by a care needs assessment to see what type of care is needed and a financial means test to see how much, if anything, needs to be paid.

The care needs assessment 

A care specialist will visit your relative at home and assess their physical, social, psychological and cultural needs. It’s a good idea if you or a friend can be there too. Your relative can also submit a self-assessment for consideration.

After the assessment, the local authority decides what care and support it can offer locally. This may include:

  • help with shopping and housework
  • adaptations to their home and mobility aids 
  • day centres
  • residential care homes

The financial assessment (means test) 

If your relative has savings and assets of more than:

  • £23,250 in England and Northern Ireland
  • £23,750 in Wales
  • £25,250 in Scotland

… they will usually have to fund their own care. The system is due to be overhauled from 2016 to raise this threshold considerably and add a cap on the care costs that an individual will need to pay over their lifetime.

Will they lose their home? 

Your relative’s home can be counted as capital 12 weeks after they move into a nursing or residential care home, unless a partner, dependant or carer is still living there. They may have to sell it to meet care home costs.

If your relative is receiving home care rather than residential care, the home’s value doesn’t count, although they may be charged for the services.

What is NHS continuing healthcare?

If your relative has a complex medical condition and ‘substantial and ongoing care needs’ that need nursing support rather than social care by a carer, they may qualify for NHS continuing healthcare. NHS continuing healthcare is free.

Healthcare conditions include:

  • Disabilities, both physical and mental
  • Mobility problems
  • Terminal illness or rapidly-deteriorating health
  • Cognitive or behavioural conditions

You can arrange an assessment through your relative’s GP or social worker. The assessment is rigorous and standardised and is carried out by a multidisciplinary team of health and social care professionals who then make a recommendation to your local clinical commissioning group (CCG).

The care packages available vary from area to area depending on the services, capacity, and budgetary priorities of the clinical commissioning group.

What happens if my relative is not eligible for NHS continuing healthcare? 

The local authority will assess your relative’s care needs and provide services if they are eligible. They may be offered a joint care package between the NHS and social services, or the NHS may contribute towards some nursing care costs.

What if we don’t agree with the local authority’s decision?

  • Ask for a full explanation in writing of their assessment, and why they made that decision
  • If you’re still unhappy, explain why you think it is unfair 
  • Follow your social services department’s complaints procedure.

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