Does your relative need full time care?
Beware the 5 biggest myths about care fees…
The whole subject of care fees can be a minefield. Much of the information on the internet, in the press – and from the health and social care authorities themselves – is misleading, and often just plain wrong! It simply reinforces the 5 biggest myths about care fees.
Maybe you’ve been told your relative has to pay for care. Or perhaps you’ve heard about NHS funding for care and you’re wondering if you can apply for NHS Continuing Healthcare.
Mistakes about paying for care are made right at the start. People are told that if you have a certain level of savings and assets you have to pay. Not true. What should happen at the very beginning is an assessment of your health needs, not your money.
Most people are led to believe that care is just ‘care’. However, there is social care and, separately, there is healthcare/nursing care. Healthcare and nursing care are free in the UK, in law. Social care is means tested.
When someone goes into care the very first thing that should happen is an assessment for their health needs and their nursing needs. And it’s only if they’re not eligible for NHS funding that money should even been discussed. This almost always happens the other way round, though. People are asked straight away whether they have a house and/or how much money they’ve got. This is one of the reasons care funding mistakes are made.
If this happens to you, simply say: ‘At this point in time this is not about money, this is about health needs.’ Then ask for an NHS Continuing Healthcare assessment. This is the funding that covers 100% of care costs for someone in care who has a certain level of health or nursing care needs. You can also ask for an assessment if your relative has been in care for some time.
Very often the first point of contact anyone has with the care authorities is with a local authority or local council. However, local authorities and councils provide (means tested) social care, and very often nobody mentions that there is also NHS funding for full time care.
People just don’t know about NHS funding and they’re not told about it; it’s one of the biggest scandals in our care system
As a result, many thousands of people are paying for healthcare and nursing care – care that should be provided and paid for by the NHS – regardless of a person’s age. If care homes didn’t exist those people would be in hospital and paid for 100% by the NHS.
Let’s look at the 5 biggest myths about care fees. They are myths that may have been told to you as fact…
5 biggest myth about care fees
- “All care is means tested and so, if you have a house, you always have to pay.” Not true. The decision as to whether you have to pay for care does not depend on whether you have a house; it depends on your health and care needs.
- “If you have savings over £23,350 you always have to pay for care.” Not true. See point 1 above.
- “If you have health/nursing needs – but you also have savings and/or a house – you have to pay.” Not true. Healthcare needs come before money – and it doesn’t matter how much money you have, if you need healthcare or nursing care it is these things that determine who pays, not what’s in your wallet.
- “It’s not worth applying for NHS Continuing Healthcare funding because it only covers specialist needs – and it doesn’t apply to people with dementia.” Absolutely not true! So many people are told this – by people in all parts of the care industry. NHS Continuing Healthcare funding does not depend on any specific diagnosis or any particular specialist needs. It’s about your day-to-day health and care needs – whatever the underlying diagnoses or problems are, and regardless of whether or not you have dementia.
- “If your spouse needs care and you own a house together, you will have to move and sell the property to pay for their care.” Not true. No one should be asked to pay for anyone else’s care (aside from top-ups, which are linked to social care) – and you don’t have to sell your house to fund someone else’s care.
There are also many other myths flying around about care fees.
The health and social care authorities often seem to be complicit in perpetuating these myths, and it leaves families exasperated, exhausted and seriously out of pocket trying to uncover the truth.
Always remember, it is only social care that is means tested, not nursing care.
What’s the difference between a healthcare need and a social care need?
Hi Adrienne – thanks for you comment. There are three things you can do at this point: 1) If you haven’t already done so, subscribe to our free information bulletin (scroll up on the right hand side) and you’ll receive a link to an extra free guide that explains the basics. 2) Take a look at this article, which highlights some of the assessments you may come across: http://caretobedifferent.co.uk/assessments-needed-for-long-term-care/ and 3) This article outlines the stages of the assessment process: http://caretobedifferent.co.uk/what-are-the-different-stages-of-nhs-continuing-care-assessment-and-appeal/
Hi. My Dads just been Sectioned 1st July 2014 under the Mental Health act nr 2 and he`s in Clatterbridge Hospital. Im living abroad so not easy to speak to the right People at the right time. It was all done pretty quick actually and even though I know Dad is now in the best Place, it was a big shock for it to happen like it did. He`s now under assessment but, what assessment? Will he have the NHS continuing Health Care assessment or the will it be the assessment process that takes two stages, an initial screening to estimate if he`s eligible for NHS Funding With a full assessment?
Glad the book was helpful Gary – and that you succeeded in securing CHC funding. You’re right that CHC funding is transferable, and moving your mum to a different area should not affect her immediate funding. When the new area does a regular review in due course, they may make their own decisions – but CHC is the same throughout – it covers 100% of care costs and you should not be asked to pay any kind of top-up. It is generally only local authorities that have a ‘rate’ above which top-ups may apply, but not CHC.
We have just had Mums CHC ratified by panel! (Thanks in no small way for the advice in your guidebook!).
We want to move Mum closer to us in a different County/NHS region to that where Mum was assessed, and are being told that our NHS ‘rate’ is £453 and that if we want any more ( to cover the home we want to place her in) Mum’s case will have to be assessed by a CCG Complex case review. £453 per week will not cover the fees of our intended home.
Following the CHC assessment we were told that Mums area would pay £668. I’m confused as I thought it would be a National rate? Transferable from one area to another.
Any advice would be welcome. Thank you.
Continuing health care can be done at home, so doesn’t have to be in a care home. Is this true or false?
So does the same rule apply
Yes, at home, in a care home – in any setting. Same rules, same funding.
Thanks for your comment Debbie. If your mum needs full time care and she has health needs, then she should be assessed for NHS Continuing Healthcare. She may have been charged for healthcare if this wasn’t/hasn’t been done. Ask for a Checklist assessment before she is discharged from hospital. If she is placed in a rehab unit, she shouldn’t ordinarily be charged for that. You may find this page helpful in terms of getting assessed: http://caretobedifferent.co.uk/paying-care-home-fees/how-to-get-assessed-for-continuing-care/.
Thanks Angela – she does not need full time care at present, although she is not far from needing to go into a care home.
However when she has gone into respite care those periods have required full time care. On the 1st occasion she was in respite for almost 2 months and on the 2nd occasion she was in for 1 month.
After hearing your interview on 5 Live this week and reading Marks comments that “any Primary Health care need resulting from illness,disease or accident IS the responsibility of the NHS, including social care. This is the law” I feel very strongly that we have been forced to pay for healthcare for my mother when it should have been provided free by the NHS.
“Most people are led to believe that care is just ‘care’. However, there is social care and, separately, there is healthcare/nursing care. Healthcare and nursing care are free in the UK, in law. Social care is means tested.”
Untrue. If there is a primary health care need (a need resulting from illness, disease or accident) then ALL care is the responsibility of the NHS. Including social care. This is the law.
Yes, you’re right Mark. The point I was really making was that people are often told they have social care needs (means tested), when in fact they may have health needs and nursing needs (free) – so I was highlighting the distinction between these two things, as not everyone is aware of that. You’re correct that all care costs are covered when someone is shown to have primarily health needs, and I’ve alluded to that in the middle of the article.
I am looking for some help around ‘short term care’. My mum is 92 yrs old and has been placed into respite care twice in the last 5 months by her social worker because she was so poorly. However, I now discover that this was done via a Social Care Assessment not a Health Care Assessment and subsequently we have had to pay almost £3,000 in fees. My mother has no savings and lives in sheltered accommodation. She is in receipt of benefits.
My mum is currently in hospital once again suffering from pneumonia and the hospital have said that they are going to transfer her to a rehabilitation unit. I have been contacted this evening by her social worker telling me that she is coming to the hospital in the morning to carry out another Social Care Assessment. I challenged this immediately with the social worker and stated that this is not a social need but is a health need. She hesitated but then told me that she absolutely agreed with me that it is indeed a health need.
Can you or anyone give me advice on whether my mother has been made to pay for healthcare because it has been wrongly assessed as social care. On the previous two occasions in respite she was unable to walk, stand or dress and the only other option would have been to put her in hospital.
Were do I stand with this?