Do I have to pay for care whilst waiting for the Checklist Assessment?

Do I have to pay for care whilst waiting for the Checklist Assessment?

A nurse helps the senior womanWhether your relative is going back to their own home following discharge from hospital, or are going into a care home for the first time, they are entitled request an assessment as to their eligibility for NHS Continuing Healthcare Funding (CHC) – a fully-funded FREE package of care provided by the NHS to cover their healthcare needs and accommodation, which is not means-tested.

The initial screening Checklist is the usual starting point for any assessment for CHC Funding.

Your relative can request a Checklist assessment at any stage of their care.

If you are new to NHS Continuing Healthcare Funding, read some of our other helpful blogs on the Checklist assessment process and what to expect:

New to NHS Continuing Healthcare Funding? Here’s a guide to the basics you need to know…

If being discharged from hospital, your relative may be entitled to an interim package of care whilst waiting for this Checklist assessment to take place.

The NHS should aim to arrange the Checklist assessment promptly after discharge, once your relative is back in their own environment away from the acute hospital setting. As there should be no gap in providing for your relative’s healthcare needs, the NHS are obliged to pay for your relative’s care until the Checklist has taken place.

It is therefore quite usual for care homes not to charge your relative any fees for the first six weeks of a new placement in a care home, whilst the Checklist assessment is pending.

Read our blog: What’s new in 2018 NHS National Framework for CHC? Are you getting an interim care package?

The Twelve Week Property Disregard

Some people mistake the above six week interim period whilst waiting for a Checklist assessment with the 12 week Property Disregard provisions.

If your relative does not meet the eligibility criteria for NHS Continuing Healthcare Funding, then the next question is how are they going to afford to pay for their care? There are two options: either to get Local Authority funding, or to pay privately (self-fund).

If your relative is not able to self-fund their care from their own private means (which can be hugely expensive), their only other alternative is to seek funding from their Local Authority for their residential care.

Local Authority funding is means-tested, and therefore, your relative may be required to contribute the cost of their care home fees if they have capital or assets (including a property) valued at more than £23,250.

We have considered the Local Authority thresholds in more detail in our recent blog: What contribution do I have to make towards my care costs, and when?

If your relative owns a property (with no dependent living in it) and has less than £23,250 in other assets, such as cash, investments, or a pension, then the Local Authority should pay for the care home fees for the first 12 weeks of their placement in a residential care home.

Each Local Authority will have a standard rate it will pay towards the care home fees.

The purpose of this twelve week property disregard, is to allow your relative to sell their home and generate a sale value (or to arrange rental).  If the sale value of the property takes your relative over the £23,250 threshold, they will have to pay for their own care once the proceeds of sale are crystallised.

In practise, it often takes far longer than twelve weeks to sell a home. However, the Local Authority must disregard the property from any financial assessment for the first twelve weeks after your relative goes into a care home.  Be aware that if your relative’s property is sold within the twelve week period, then the twelve week disregard period ends, and the sale proceeds are taken into account when valuing their capital as at the date of sale.

Note: The property disregard provisions only apply from the date your relative’s placement in the care home becomes permanent. Or else, if your relative has been self-funding, the 12 week Property Disregard starts from the point at which Local Authority assistance is requested, and you should not pay care fees during this twelve week period.

Many people take advantage of the Local Authority’s Deferred Payment Agreement scheme (DPA), whereby your relative can agree to defer payment of their care home fees until (a) they have either sold their property (whilst living), or (b) out of sale proceeds of their home once they have passed away.

The rules on assessment and valuations are complicated, but for further reading, we recommend looking at the Care Act 2014 and a very helpful fact sheet provided by Age UK entitled ‘Property and paying for residential care (August 2018)’.

For further reading around the subject, look at these blogs:

This month’s top 5 questions are answered…

Should you agree to a means-test for care fees?

Do you have to have complex needs to get NHS Continuing Healthcare?

2 Comments

  1. Diane Ludkin 2 months ago

    We have already had a NHS Checklist which has been completed….awarded NHS Nursing care element £165.56 per week. What I need to know which no one is answering …..my Father has been Self -funding and his Financial Assessment submitted…..his Capital is below £23,250….do we need to still keep paying out of his funds until Lincolnshire County Council pull their finger out and start paying!! Everyone seems to be skirting around this question…..and what happens if We refuse to keep paying!! Thank You

  2. Andy 2 months ago

    Can care to be different offer me advice for the 12 week disregard. My mother owns a modest house and her savings were well below the 23k threshold. She had been living alone in the house but due to her rapid deterioration, I moved to my house in Cambridge and was her primary carer for 2 years. Finally when it got to challenging I decided to move her into a care home.
    The local authority refused a 12 week disregard on the basis that she hadn’t lived in her house for 2 years, yet still included her house in deciding she was not eligible for funding. This seems unfair but was their action correct?

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