If you are moving into a nursing home or residential care home with help from Social Services you will be expected to contribute towards the fees. They will work out what you will have to pay on the basis of a national set of rules. If the NHS is arranging your care in hospital or a nursing home, they will meet the costs. To find out briefly how the system works, see below.
What is the difference between a residential and nursing home?
In general, people who are assessed as needing nursing home care are in need of constant nursing care. In residential homes emphasis is on providing personal care and social support. If there is limited need for nursing care in a residential care home, this would usually be provided by the Community Nursing Service who would visit the home to see you. There are some care homes that are dual registered and provide both residential and nursing care in separate units in the same home.
First Step
The first step is to contact your local Social Services Department. They are part of your local council and their telephone number will be in the phone book for the area in which you live. Your local GP will also know what to do and whom you should contact.

Your local Social Services Department will help you look at your needs. They will carry out an assessment of need, which involves working with you to determine how these needs can be met. The main people involved in the assessment will be yourself and the people involved in caring for you, for example a district nurse or, with your agreement, your GP. At all times you would be helped during the assessment process by a member of Social Services called a Care Manager.

Who Pays?
Social Services will decide what help they can offer you. If it is considered that residential or nursing care is suited to your needs, you will be required to contribute to the cost of that care and a financial assessment will be carried out to work out how much you can afford to pay.

During the financial assessment you will be asked about information about your income, savings and assets, for example, pensions, benefits, property, savings accounts, shares etc. Any information given will be treated in the strictest confidence. They will always let you know prior to any move how much you will have to pay and the method of payment.

Your Social Services Department will generally pay the fees and will ask you to pay your contribution direct to the home.

How much will I have to pay?
The Government has issued local authorities with guidance on how charges are calculated. The financial assessment will calculate your total income and, after taking off your personal allowance, the balance is the charge that you will pay.
What if you have savings?
If you have savings of £14,250 or below, your savings will be ignored for financial assessment. If you have savings of between £14,250 and £23,250 they will need to take this into account. You will be required to pay £1 per week for every £250 for savings between £14,250 and £23,250. If you have savings of over £23,250 you will have to pay the full cost charged by the home. This is known as the maximum charge and no matter how much you have you will not pay more than this.
What if your savings fall below £23,250?
You will need to give Social Services 6 months notice before your savings reach £23,250. In these circumstances, you will need to have an assessment to check that the home is still appropriate to your needs and a financial assessment will be carried out to work out how much you can afford to pay when you reach the £23,250 threshold.
What if you own property?
If you are admitted to a home permanently and have property valued at £23,250 or more, you will pay the full charge. The local authority will pay for the first 12 weeks until the property is sold. If the property is not sold within the first 12 weeks, you can apply for a loan from the local authorities to pay the care home fees until the property is sold. However, once the property is sold, you will need to repay the full amount. If someone else continues to live in the property, its value will be ignored if they are one of the following:

  • Your partner or
  • A member of your family who is
  1. aged 60 or over
  2. aged under 16 and is a child or whom you have responsibility to care
  3. incapacitated
What if you are married?
Social Services will assess your charges solely on your own income and assets and not those of your partner. However the regulations state that a husband is liable to maintain his wife and vice-versa. Social Services would ask the partner to make a contribution. The amount would depend upon individual financial circumstances and is often negotiable.
Will your family have to pay anything?
The Social Services Department will only pay up to a certain limit each week. If you choose a home which charges more than this limit, someone else must pay the extra. This is known as ‘Third Party Top-Up’ and must come from a third party, for example family members, charities or friends. It cannot be paid out of your own money as you have already been assessed on that, nor can it be paid out of your personal allowance and neither can it be paid out of any money you have in the bank that has not been included in the assessment (i.e. under £23,250).
Can you go into the home of your choice?
Social Services will usually arrange for you to go into the home of your choice providing that:

  • The home provides the service, which meet your individual needs and is your preferred choice.
  • The cost to them is no more than they would normally pay for such a place. Each local authority has a set rate they will for the different categories of residential and nursing care.
  • There is a place available in the home.
  • The home is prepared to enter into a contract with them.

You may also choose a home outside the local authority boundary if, for example, you wish to live closer to relatives or you have particular reasons where a home within your area cannot meet your needs.

Next Steps

Moving into a residential or nursing home and giving up your own home is a big step to take and it is particularly important that you find a place that suits you. All homes are different and some will be more suitable for you than others. When you find a Home that you think meets all of your individual criteria, call the Home and ask the Manager any questions you may have or alternatively, simply visit the home.

When you have made a choice, contact the local Social Services Department, who will go through the above process with you and your loved ones.

Carers are wonderful; they take very good care of me. I’m quite happy here. I class Reuben Manor as my home and other residents are like family to me.

Family of resident – Reuben Manor