Are You Means Tested For Care Home Fees?

People often ask us if they will be means tested for care home fees and assume that their relatives or loved ones are ineligible for Continuing Healthcare Funding on the basis that they have substantial assets or capital which would preclude them from obtaining NHS Funding. The simple answer is that this is a matter of “health, not wealth” – that is our moto which we have been advocating for many years now.

Essentially, if your relative has less than £23,250 in capital (correct as at September 2017), then they will not have to pay for the cost of their care. It will then become a matter whether the NHS or Local Authority meets the cost of care below this threshold.

Conversely, if your relative has over £23,250 in capital, then in principle, they may be asked to pay for their own care. However, eligibility for continuing healthcare funding is not means tested – again, we repeat, it is a matter of health not wealth. Therefore, if your relative has sufficient health needs across the twelve Care Domains and those needs meet the four characteristics, namely, nature, intensity, complexity and unpredictability of needs, then in principle they should ordinarily qualify for Continuing Healthcare funding, regardless of whether they are a millionaire, or billionaire. Wealth is irrelevant. It is the health needs that are paramount.

If, of course, your relative does not meet the criteria for eligibility for NHS Continuing Healthcare Funding i.e their health needs are not sufficient to trigger for NHS funding, then unless they are below the capital threshold, they will be asked to pay or contribute towards their cost of care.

Anyone can qualify for continuing healthcare funding regardless of their financial circumstances, as long as they have a primary health need, then the responsibility for providing that health need lies with the NHS, – even if the individual is a Local Authority Care Home, or in a Private Nursing Home, or receiving care at home. It is the health need which is the important factor, not the place where the care is provided. Nevertheless, the NHS through their various processes may try and ‘persuade’ families that their relative does not meet the criteria for funding (whatever the excuse), and instead, try and and palm them off to the Local Authority for care to be provided by Social Services; or alternatively, if the patient is of financial means, to suggest that they pay for their care privately. It is estimated that over 100,000 people in the UK are incorrectly paying for their care, and which should be met by the NHS if they were assessed correctly at the outset and/or re-assessed in time as their health deteriorated.

Please feel free to browse our website which provides a wealth of free information online and also get a copy of our free Guide to Care Funding Issues which can be downloaded or we can send you a copy in the post.

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Assistance with care home fees – can we help you with your case?

I have thought long and hard over the 8 years about the assistance with care home fees we provide to families about how best to offer this support.

This is something which families ought to be able to do on their own and yet the process is made to be so complicated, drawn out and often adversarial in nature that people often do not have the stamina or impetus to take on the mighty NHS on their own and navigate the process especially when they are already coping with the emotions of a close family member having to go into long term care and all that that entails.

Our website provides a lot of free information and guidance and we also publish a Free Guide to Care Funding Issues which can be downloaded or alternatively we can send a hard copy in the post. If having read it you would like to speak to us then we will always provide an initial consultation on the phone to gather the facts and advise on the best course of action.

Our ethos as an organisation is to try to establish as soon as we can whether we believe that there are reasonably good prospects of securing eligibility for CHC for the person concerned.

Depending on the circumstances we will either offer a Desktop Review where we ask you to complete a Questionnaire enabling you to provide us with the necessary details so that we can gauge whether we believe there is any possibility that your relative might qualify for CHC funding – this is not categorical advice at this stage but a ‘best gut feel’ only or alternatively we would arrange for one of our team of expert CHC nurse assessors to come out and complete a detailed assessment of need based on an observational assessment of the patient, a discussion with the care staff and family and a review of care plans and records so that we can prepare a full DST of our own and a robust categorical recommendation regarding eligibility. If we believe that the person is eligible at this stage then we will offer to support you going forward through the whole assessment/appeal process depending on the point in the process that you have reached on a no win no fee basis.

This shows our commitment to you and to the case and is truly reflective of our ethos as an organisation that we will only offer support where we truly believe that someone would be granted full funding. We will never take money off you to pursue something which we do not whole heartedly believe has reasonably good prospects of success. Although our success rate is very high we do not get it right every time and therefore there are situations where we end up not being paid a penny for the work which we have done.

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