Care home fees: paying them in England

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1 Guide Guide 16 Care home fees: paying them in England This guide explains the system of funding for people who need to live in a care home in England, whether they are able, or unable to pay their own fees. Our free advice service offers expert independent advice on social care, welfare benefits, and befriending schemes. Call to arrange an appointment to speak to one of our advisers or All our free guides and factsheets can be ordered by phone or (as above) or downloaded from

2 Contents Moving into a care home Page 3 Paying for a care home Page 4 The financial assessment Page 6 Your income Page 9 Your savings and capital Page 12 Treatment of the value of your home Page 14 A council loan while your property is being sold Page 17 Jointly-owned property Page 20 Deprivation of capital Page 25 When couples move into a care home Page 27 Choice of home and top-ups Page 28 Paying your own fees Page 30 Seeking advice about care fee planning Page 32 Temporary stays and respite care Page 33 Temporarily being away from a care home Page 35 Making a contract with a care home Page 36 What to do if things go wrong Page 39 Future changes to paying care home fees Page 41 Guide 16: Care home fees: paying them in England 2

3 1 Moving into a care home If you are finding it more difficult to cope in your own home, you can ask your local council s social services department to arrange for an assessment of your needs. For more information about the needs assessment, please see guide Assessment and services from your local council in England (Guide 12). If the assessment of your needs shows that the only way to meet your needs is for you to move into a care home, then this should be written down within your care plan. Your care plan should say which sort of care home can meet your needs, for example, a nursing home or residential home or a specialist dementia care home. To find out about care homes in your local area, you can contact the Elderly Accommodation Counsel ( , housingcare.org) and the Care Quality Commission ( , cqc.org.uk). Both organisations can give detailed information about registered care homes. More information about choosing a care home can be found in our Wise Guide: Choosing a care home. Call to order your free copy. Guide 16: Care home fees: paying them in England 3

4 2 Paying for a care home Most people will be expected to pay something towards the cost of their accommodation in a care home, using their income and capital. Once you have been assessed as needing to move into a care home, the council will need to know how much you have in savings and capital, as well as your weekly income. What happens if you have nursing care needs? If you have been assessed as needing nursing care in the care home, you may be eligible to receive the nursing part of your care costs through the NHS. This is known as NHS-funded Nursing Care. A registered NHS nurse, will assess and record your nursing needs. Ideally this should be carried out before you move into the care home. If you are assessed as eligible, you will receive a standard rate of per week from the NHS to pay towards your nursing care, which is paid directly to the care home. If you are paying for your own care, the nursing care contribution is deducted directly from the cost of the care home fee before you pay. However, if you receive funding from the local council, this amount will be deducted from the council s contribution, and will not actually reduce the amount you are paying. Your nursing care needs should be reviewed within three months of first entering a care home and then on an annual basis. Guide 16: Care home fees: paying them in England 4

5 NHS continuing healthcare You may be entitled to full NHS funding to pay for your care home or home care fees. This is called NHS continuing healthcare, which offers a package of care and support to meet all of your individual assessed needs, including physical, mental health and personal care needs, and is arranged and paid for by the National Health Service (NHS). This care can be provided in a variety of settings, including a hospital, a care home with nursing, a residential care home and in the person s own home. There is one single national criteria which should be used by every Clinical Commissioning Group to define who is eligible for NHS Continuing Healthcare. To work out whether you are eligible, the final stage of a continuing care assessment must be completed by at least two professionals from the health or social care team. For more information please see our guide Continuing Healthcare: Should the NHS be paying for your care? (Guide 27). Guide 16: Care home fees: paying them in England 5

6 3 The financial assessment The financial assessment sometimes called the means test or charging procedure is the way of working out how much you may have to contribute to your care home fees. It applies if you move into a care home permanently and may apply if you are a temporary resident, for example, in respite care (see chapter 12 for more information about temporary residents). If you have savings and capital of less than 14,250, you will not have to use any of this money to pay towards your care home fees. However, you will have to contribute all of your weekly income towards the fees - with a few exceptions - except for per week, which you can keep to spend on personal items (see below). You may also keep any Pension Savings Disregard you have been awarded of up to 5.75 a week (see chapter 4). If your savings and capital are worth between 14,250 and 23,250, the council will contribute toward the fees of your care home, but you will have to pay a charge known as tariff income (see chapter 5) of 1 for every 250 between 14,250 and 23,250 in savings. You will still have to contribute all of your income (with a few exceptions) apart from your Personal Expenses Allowance (see below) and any Pension Savings Disregard. If you have savings and capital worth over 23,250, you will have to pay all of the fees of the care home until your money reduces to this limit. If your capital is less than 23,250, but your weekly income is more than the rate for care, with enough left over for the Personal Expenses Guide 16: Care home fees: paying them in England 6

7 Allowance, you will have to pay all of the fees, as long as you can realistically find a care home within that income level. In most cases, if you are entitled to financial assistance from the local council towards the cost of the care home fees, you have to use all of your income, including Pension Guarantee Credit if you receive it, as a contribution towards the fees. However, some types of income are not included in the council calculation. These include: - the mobility component of Disability Living Allowance - the War Pension Scheme mobility supplement - War Widows special allowance (also referred to as War Widows special payments) - some charitable payments - Pension Savings Disregard. The Personal Expenses Allowance After your income and capital has been assessed to pay for your care fees, you will be left with a Personal Expenses Allowance of per week from your income, which you can spend as you wish. The council also has the discretion to allow you to keep more than This could be to allow you more money because you have to pay ground rent, or standing charges, for a house that you are trying to sell. You can also ask to have your Personal Expenses Allowance increased to help support your partner at home, (for example, if they need to make repairs to the house or if there are still joint debts to pay). Guide 16: Care home fees: paying them in England 7

8 Does your spouse, civil partner or partner have to pay towards your care home fees? You should be assessed as an individual to pay your care home fees if you move into a care home permanently or on a short term basis. The council does not have the right to make your spouse, civil partner or partner give details about his or her income and savings. Spouses or civil partners (but not unmarried partners) were previously considered by councils to be able to pay some money towards the cost of your care home fees. This was called a liable relative payment. However, the government repealed the law[1] in 2009 so that local councils can no longer seek a liable relative s payment. If your spouse, civil partner or partner is still paying towards the cost of your care as a liable relative, ask the council to review this arrangement and contact an advice service, such as Independent Age ( , independentage.org). Guide 16: Care home fees: paying them in England 8

9 4 How your income is considered Occupational and private pensions During your financial assessment, the council must ignore 50% of your occupational pension as long as you use the whole of that half to support your husband or wife at home. The same rule applies if you receive income from a retirement annuity. This rule only applies to married couples and civil partnerships. If you are not married, nor have a civil partnership, and you would like to use some of your pension to support your partner at home, you have to ask for your Personal Expenses Allowance to be increased under the discretionary rules explained in chapter 3. Insurance policies Any income from an insurance policy is generally taken into account in full. The only exception is income from a mortgage protection policy. Pension Guarantee Credit People who live in care homes can claim Pension Guarantee Credit if they are on a low weekly income. This will be included in the council s financial assessment and will be used to pay towards the care home fees. If you were receiving Pension Guarantee Credit before moving into the care home, you should tell the Department for Work and Pensions and ask for a review of your entitlement. If you are in a couple and only one of you is moving into a care home permanently, you should both claim Pension Guarantee Credit as separate individuals (see chapter 9). Guide 16: Care home fees: paying them in England 9

10 However, you may lose your entitlement to Pension Guarantee Credit because of the value of your property or because you have a high income. If you lose this benefit, you will also lose any premiums attached to it. The Department of Work and Pensions may agree to continue your Pension Guarantee Credit for six months if you can show you are actively seeking to sell your property. If you have been given a deferred payments agreement in order to postpone selling your property, you will also lose your Pension Guarantee Credit. Pension Credit Savings Disregard A Savings Disregard assessment is carried out by the council when people aged 65 and over move into a care home permanently. This is similar to the Pension Savings Credit that you would receive if you lived in your own home. The Savings Disregard will be paid to you up to a maximum of 5.75 a week for a single person and 8.60 for a couple, depending on your weekly income. This is paid to you as well as your Personal Expenses Allowance of Attendance Allowance and Disability Living Allowance You will continue to receive Attendance Allowance and Disability Living Allowance care component if you are paying your care home fees in full. However, if you are receiving financial assistance towards the care home fees from the council, Attendance Allowance and the care component of Disability Living Allowance will stop after you have been in the care home for 28 days. This rule also applies if the council is applying the 12-week Guide 16: Care home fees: paying them in England 10

11 disregard to your property (see chapter 6). You will need to re-apply if you are then paying the full cost of the fees after the 12-week disregard period ends. However, if the council provides you with a loan while your property is being sold (interim funding) or if you do not wish to sell the property (deferred payments) the rules are different. If you are receiving interim funding you can receive both Attendance Allowance or Disability Living Allowance and Pension Guarantee Credit if you are entitled to do so. Likewise, if you have been given a deferred payments agreement in order to postpone selling your property, you are eligible to receive Attendance Allowance or Disability Living Allowance care component. The mobility component of Disability Living Allowance is ignored in the financial assessment. Guide 16: Care home fees: paying them in England 11

12 5 How your savings and capital are considered Your savings and the value of any capital that you own in your name will usually be taken into account within the financial assessment. This will include bank and building society accounts, national savings accounts, premium bonds, stocks and shares and property (buildings and land). Any savings or capital you own jointly with someone else (your spouse, civil partner, partner or friend) will be divided into equal shares between you. If you hold money in a joint account which is shared in unequal proportions, you could close the joint account and open your own new account with your portion of the savings, as long as you can show written proof of this. You may want to consider splitting a joint account with equal shares into two equal separate accounts anyway, as this is likely to make handling your affairs much easier. Disregarded savings and capital Some savings and capital are completely ignored by the council. Capital which is completely ignored includes the surrender value of life insurance policies, the value of money held in trusts which derive from a payment for personal injury, and personal possessions (as long as they were not bought deliberately with the intention of avoiding paying for your care). Currently when your local council assesses your finances, they are allowed to take into account any income you receive from bonds, with or without a life assurance. However, councils must ignore the capital part of an investment bond which contains one or more life assurance Guide 16: Care home fees: paying them in England 12

13 policies, although the surrender value of an investment bond without life assurance is taken into account. How your capital is worked out as income Any actual income you receive from capital, such as interest, is not counted as income but is added to your capital. Instead, for every 250 or part of 250 of savings you have between 14,250 and 23,250, you will be assumed to have 1 a week, which is called tariff income. This amount is then added to your actual weekly income and you will be expected to use this weekly amount towards your fees. Guide 16: Care home fees: paying them in England 13

14 6 Treatment of the value of your home 12-week property disregard If you move into a care home permanently (ie not a trial period) and you own your own property, have less than 23,250 in savings and income below the rate for care, the council must ignore the value of your property for the first 12 weeks of your stay. OR If you are living in a care home permanently (ie not a trial period), own your own property, and have more than 23,250 in savings, when your savings run down to less than 23,250, the council must ignore the value of your property for 12 weeks. This means that the council must arrange a contract with the care home to pay your full fees, and ask you to pay them from your assessed contribution from your income. If your property is sold before the 12-week disregard period then the disregard ends. After 12 weeks, the value of your property will be counted as part of your capital. Local councils must provide a 12-week disregard for your property. If you do not receive this, the council could be liable to reimburse you for any additional costs. What happens if someone else lives in your property? Even if the house is in your name, the value of your property will not count as capital if your spouse, civil partner or partner lives there, or if your estranged or divorced partner, who is a lone parent, lives there. The Guide 16: Care home fees: paying them in England 14

15 value of your property is also ignored if a close relative continues to live there who is: - incapacitated (they receive or would qualify for a disability benefit) - a child you are responsible for under the age of 18 - aged 60 or over. A close relative means a: - parent - son or daughter - step-parent, step-son or step-daughter - son-in-law or daughter-in-law - brother or sister - grandparent - grandchild - uncle or aunt - nephew or niece - half-brother or half-sister - adopted child - the partner of any of the above. The council can use their discretion to ignore the value of your property in other circumstances, for example, if someone gave up their own property some time ago in order to live with and care for you before you moved into a care home. Since this decision is discretionary, it can be reviewed by the council at any time. If the carer moves out of the property or the property is sold, the value will then be included in your financial assessment in the usual way. Guide 16: Care home fees: paying them in England 15

16 Sometimes, the council may allow a person, such as a younger relative, to remain living in your house, but the council can place a legal charge against the property so that they can recover their money when it is sold (see section below). If a discretionary disregard is provided, it is wise to make a request for this decision to be put in writing. Guide 16: Care home fees: paying them in England 16

17 A council loan while your property is being sold While your property is for sale, the council can loan you the fees to pay for the care home. This is sometimes referred to as interim funding. This financial assistance will stop once your property sells if it is over 23,250 (minus any selling costs up to a maximum of 10% of the value of the property and any outstanding mortgage). You will usually be expected to sign an agreement known as a deferred payment (see section below). You will have to pay back to the council the money it has paid towards your fees while you waited for your house to be sold - the council will usually place a legal charge on your property to make sure that this money is repaid. If your property is in the process of being sold, you will still be able to claim Pension Guarantee Credit. If your council refuses to financially assist you while your house is being sold, you can contact our Independent Age advice service ( , for further information and support. Delaying the sale of your property If you do not wish to sell your property while you are living in the care home permanently and you do not have enough money to pay your fees, you can request a long-term loan known as a deferred payment agreement. This means the council loans you your care costs and claims them back once your property is sold. Guide 16: Care home fees: paying them in England 17

18 The local council can ask you to cover the costs of the land registry searches and other legal expenses. These expenses should be paid upfront so will not be included as part of the deferred payment contribution. The council will then pay your care home fees whilst you are in the care home and, while you are still alive, no interest will be added to the loan. Fifty-six days after you die, interest will be added to the amount the council social services have paid for your care home fees. When the property is sold, the money the council paid for the care home fees, plus any interest, will need to be paid back by the executor of the estate. Local councils can set their own interest rates, although the interest charged should not exceed the County Court Judgement rate which is about 8%. You may cancel the deferred payments agreement at any time, but only if you have found an alternative way of meeting the care home fees. If you are refused a deferred payment, you should receive the council s reasons in writing and be given the opportunity to make a complaint. It is unlawful for councils to operate a blanket policy on how they distribute their deferred payments. Each case must be looked at individually. If you have chosen to sign a deferred payments agreement because you do not wish to sell your property, you will not be entitled to Pension Guarantee Credit. This is because you have chosen not to access the capital in your property which the Department for Work and Pensions (DWP) will see as a form of deprivation of capital (see chapter 8). It Guide 16: Care home fees: paying them in England 18

19 is advised that you seek independent financial and or legal advice to consider whether the scheme is the best option for you. What happens if your property is rented out? If you rent out your property to tenants, its value will be taken into account in the financial assessment. If the property is valued at over 23,250, you may be viewed as being self-funding. You will then need to ensure that the rent you charge, when added to any other income you have, covers the full cost of the care home. Some local councils award the 12-week property disregard even though the property is being rented. If they do, you should get confirmation of this agreement in writing. Whatever arrangement is agreed, the rental income would have to be paid to the local council towards the fees. Following the 12-week property disregard, if the rental income, when added to your other income, is not enough to cover the full cost of your care home fees, you can ask for a deferred payment for the remaining fees (see chapter 3). Again, this rental income will be treated as weekly income and will need to be used to reduce the amount that has to be paid back. You may also want to bear in mind that if you have income above Pension Guarantee Credit level ( for a single person), you may be liable for income tax on that income. You can get more information from HM Revenue and Customs ( , hmrc.gov.uk). Guide 16: Care home fees: paying them in England 19

20 7 Jointly-owned property If you jointly own property with someone who either does not live in the property or who does live there but they do not come under the categories mentioned in chapter 6, then your share of the property may have a value, depending on the circumstances. However, the council should not automatically assume that a joint share means you have a joint value of the property, but should instead consider the beneficial or financial value of your share based on: - your ability to sell your share of beneficial interest to someone else and - there being a willing buyer to purchase your share of beneficial interest (given the circumstances). Establishing the value of your joint share in a property Since it is unlikely that someone on the open housing market would be willing to buy a part share in a property, it then depends on whether the other joint owner would be able and willing to buy your share. If they are not, government guidance suggests that the part share could have a low, or even nil, value. It is also important that someone proposing to buy your joint share makes a reasonable offer. If the joint owner or another relative, for example, offers an unreasonably low amount, the council may consider this to be deprivation of capital (see chapter 8). Guide 16: Care home fees: paying them in England 20

21 Some local councils may not want to accept a nil value as the value of your share, because there are now various ways of releasing capital in a property, although the council are only supposed to attach a value to your share by identifying a specific willing buyer. The Charging for Residential Accommodation Guide (CRAG) is currently being reviewed, and it is hoped that this issue will be addressed during the process. It also appears that some councils and some companies have offered to become willing buyers themselves by buying a share of beneficial interest in a jointly-owned property. This would mean that a monetary value could be placed on your share of the property by the council. However, at the time of writing, it is unclear whether this practice is feasible or legal, or what the long-term impact might be on the other joint owners of the property. If you find yourself in this situation, you may wish to seek further advice from an organisation such as Independent Age ( ). If you are a legal owner and a beneficial owner You can own property as a legal owner, ie you have your name on the title deeds. However, to be entitled to any profits of the sale of a property, you must also be a beneficial owner. If you are the only legal owner and the only beneficial owner, then you will be entitled to all of the profits of the property sale and the council will take the full value of your property into account in your financial assessment. If you are a legal owner but not a beneficial owner Guide 16: Care home fees: paying them in England 21

22 If you legally (either individually or jointly) hold property in your name, but have not contributed money in any way toward the purchase, improvement or maintenance of the property, then the council will not normally consider you to have any beneficial interest, ie entitlement to receive the value of the property. Councils have also, in the past, accepted written proof of agreements signed by joint legal owners when the property was purchased, which detailed the arrangement of beneficial ownership and made this clear to the Land Registry. However, if you are a council tenant who bought your council property through the discounted Right to Buy scheme, but you now need to enter a care home, you may be treated as having a beneficial interest in your property, even if you did not buy the property yourself. This is because a legal decision has prompted several councils to take a different view of this situation. Some councils have, since the court decision, been treating the amount of the 'discount' given to the council tenant, as if it was the tenant s financial contribution to the value of the property. Please contact Independent Age ( , ) for further advice if this is happening to you. Valuing your beneficial interest According to government guidance[2], councils should establish an agreed professional valuation; if possible during the 12-week property disregard period. This enables you and the council to be clear about what charges should be paid. Guide 16: Care home fees: paying them in England 22

23 In reality, many councils do not always seek a professional valuation of your beneficial interest, which may be unlawful. Instead, what happens is that councils allow a debt to accrue for the outstanding care home fees, and if you leave the care home or die, the council sends an invoice for the outstanding fees to your next-of-kin or the person managing your finances or estate. Often it is this person who is pursued for the money. If you feel there is a discrepancy between the value of your share of beneficial interest and what the council state is the value, you should seek an independent 'professional valuation'. If the council arranges this, it will usually be through their own district surveyor's department. You may prefer to seek your own professional valuation from a qualified property surveyor. The Royal Institute of Chartered Surveyors ( , rics.org/uk) may be able to help you find a qualified property surveyor who is registered with them. You should check that the surveyor has a good understanding of the current government guidance (Charging for Residential Accommodation Guide or CRAG) which can be downloaded from dh.gov.uk. Section 7 of CRAG focuses on the Treatment of Property and explains how joint beneficial interest should be valued. It is important to consider the impact of your future care arrangements if your share of the property has a nil or low value as you will not be able to benefit from the capital you have invested in your home. If, consequently, you do not have capital or savings above 23,250, you will have to rely on the state to pay your care home fees. This Guide 16: Care home fees: paying them in England 23

24 will limit your choice of accommodation and you will only have your Personal Expenses Allowance ( 24.40) and Pension Savings Disregard ( 5.75), if entitled, as income to live on in the care home. Guide 16: Care home fees: paying them in England 24

25 8 Deprivation of capital However, if you give or sign away your property or savings deliberately in order to avoid paying for your care home costs, this is called deprivation of capital. The Department for Work and Pensions (DWP) and the council are entitled to consider this capital as if it were still owned by you, and can seek to make you pay the care home fees accordingly. Both the Department for Work and Pensions and the council must look at: - your reasons for giving the capital away and - when you gave it away. For example, if you gave each of your grandchildren some money three years before you needed care, it may be unreasonable for the council to assume that you gave the money away in order to avoid paying care home fees. However, if you signed your property over to your son at a time when your health circumstances indicated that you may need residential care in the future, the council might decide that you did so in order to avoid having to pay the care home fees. There is no time limit on how far back the council can look at what they consider to be deliberate deprivation of capital. Some of the ways in which you may be considered to have deprived yourself of capital include: - giving away money - transferring the ownership of property, or - spending your capital on something not necessary, for example, a very expensive painting or holiday. Guide 16: Care home fees: paying them in England 25

26 There may be other issues to consider. If you were thinking of 'signing over' any shares in a property that you own in order to avoid paying care home fees, then you may put your right to remain in the property at risk, which would be a problem, especially if you don t need care in the future. Additionally, if the person you sign your share over to decides to sell the property, with you as a sitting tenant, then this could have consequences for income tax and also could be viewed as 'deprivation of capital'[3]. Guide 16: Care home fees: paying them in England 26

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