Types of Care Funding

Funding for care home fees can be paid by you, The Local Authority, The Clinical Commissioning Group (formerly the Primary Care Trust), a third party or a combination of any of the above.

Local Authority:

In order to be eligible for Local Authority funding your assets must be below £23,250, this includes any property, cash and investments. This can be assessed through a financial assessment by your dedicated County Council.

If your funds fall below the £23,250 threshold, you will be eligible for help with your funding from the Local Authority, however you will still be expected to pay a contribution of your income toward your care and a tariff income (£1 extra per week for every £250 over £14,250). Once you have under £14,250 you will only contribute towards your care from your income.

Third Party Top-Ups:

Third-party top-up care fees are additional payments made by a third party, such as a family member, friend, or organisation, to cover the difference between the cost of a care home chosen for an individual and the amount that the local authority is willing to pay for care.

When someone moves into a care home and their costs are partially funded by the local authority, the authority typically has a limit on how much it will contribute. If the individual (or their family) chooses a care home that costs more than the authority’s standard rate, the difference must be paid by someone else.

The person paying the top-up must sign a written agreement with the LA or the care home confirming they will pay the additional fees.

Before entering a Third Party Top Up agreement it is advisable to obtain legal and financial advice.

Continuing Healthcare Funding:

Continuing Healthcare Funding (CHC) is provided in the UK by the NHS. It comprises a comprehensive fully funded package of care based on the needs of the individual person.

It includes things like nursing care, help with personal needs (washing, dressing, eating) and other medical support. Unlike social care, which is means-tested and often paid for by the person receiving care, CHC funding is not based on income or savings.

To get CHC funding, a person must go through an assessment process carried out by a team of health and social care professionals. They look at how complex and intense the person’s needs are. If the person qualifies, the NHS arranges and pays for the necessary care.

The Decision Support Tool (DST) is a document used by the NHS to help decide if someone is eligible for NHS Continuing Healthcare (CHC) funding. An initial assessment is completed which comprises a checklist to see whether you are eligible for a full DST assessment with multiple healthcare professionals.

 It looks at 12 care domains:

• Behaviour
• Cognition
• Psychological and emotional needs
• Communication
• Mobility
• Nutrition – food and drink
• Continence
• Skin and tissue viability
• Breathing (DST version 2 only)
• Drug therapies (DST version 2 only)
• Altered states of consciousness (DST version 2 only)
• Other significant care needs (DST version 2 only)

The healthcare professionals score each one based on how complex, intense, or unpredictable the person’s needs are.

A team of health and social care professionals completes the DST together, using evidence from medical records, carers, and care staff. The scores help them make a recommendation about whether the person qualifies for CHC funding. The final decision is made by the local NHS Integrated Care Board (ICB).

If you would like support in understanding your options and applying for different types of care funding, our experienced team can advise and assist you. Your initial call is free, and we have offices in Northamptonshire and Leicester for your convenience. Contact a member of our team today for support!