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Residential
or Nursing Care?
The first thing to decide is whether you are seeking nursing or residential care. Nursing care, as the term suggests, is 24-hour care by qualified nursing staff aided by care assistants and visiting doctors - the home's or your own GP. In addition to nursing care, the nursing home will also provide all your personal care: help with washing, dressing, feeding etc as required. Residential care by contrast is limited to these personal care needs, without the dedicated nursing support involved in the administration of medication etc. |
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How is my care paid for?
As noted above, if you are a nursing patient you receive both nursing and personal care in a nursing home. Regardless of your income or wealth, the government will pay for 100% of the nursing element of your care through your local PCT - it is not "means tested".
Historically, a Nursing Assessor would look into the extent of your Nursing Needs, and would put you into one of three categories: low, medium or high. In 2008, this system was replaced by a single category of care. Your Local Authority pays your chosen Nursing Home directly, the sum of £101 per week, to cover the cost of your nursing care.
As far as your personal care is concerned, a "means test" will determine whether or not your local authority will fund some or all of the cost of your personal care in a nursing or residential care home. From 12th April 2007 if you have capital exceeding £22,250 you will not normally receive any local authority funding - you will be a "privately-funded" patient until such time as your capital falls below the £22,250 threshold. If your capital does not exceed £13,500 your local authority will pay for all of your personal care costs at a nursing home which accepts "funded" service users. And if your capital is somewhere between these two amounts, £22,250 and £13,500 your local authority will pay part of your personal care costs.
If your local authority does fund your care, they will partially reimburse themselves from your weekly pension. They will take the majority of it from you and then give back to you a weekly "personal allowance" (or "pocket money"). Currently, this weekly allowance is £21.15.
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If you are a privately-funded patient or resident over 65, you may be entitled to a weekly non- means tested payment from the Department for Work and Pensions. The allowance is paid directly to you at one of two rates: the lower for those needing day-time or night-time care; and the higher for someone needing both. The lower rate is currently £44.85 per week, while the higher rate is £67.00 per week. What about fees? If you are privately-funded, when asking prospective nursing homes about fees it is |
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important to find out whether the fees quoted to you are gross or net - i.e. whether they are before or after the payment of the nursing care element by the government. For example:
| Home's
Gross Fee: |
£580 per week |
| Less: Nursing Element | £101 |
| Home's Net Fee | £479 |
This "Net Fee" is the amount payable by you. However, if you are entitled to the Attendance Allowance - say, at the higher rate - your actual net expenditure per week will be £479 less £67 = £412.
'Top up' payments & choice of home
If you are a funded individual, you need to know about "top up fees". Regrettably, the amount of money which Local Authorities pay to individual Nursing Homes is not always enough to cover the services provided. The cost of providing care in the UK has escalated beyond the Rate of Inflation, whilst Fees received from Local Authorities have not always kept pace with these increases. To balance their books, the majority of Nursing Homes now ask Funded Residents to make an additional payment to "top up" the Local Authority rate.
However, under the Charging for Residential Accommodation Guidelines (CRAG), top ups by the resident themselves in such circumstances are not permitted. Instead, relatives or other 3rd parties make these payments to the home.
