Who needs to pay for their care package?

When you are or a loved one is offered a care package by the local authority Adult Social Services department you may be concerned about whether you/your loved one will have to pay for the care services, and if so, how much the local authority will charge. Charging for adult care is a complicated issue that has a huge impact on anyone needing a care package. This article explains more about this issue.

A lot of people are likely to think that there is no charge for care services, or if there is, it would only apply to people who have plenty of disposable income. What people often don’t realise is that even people with no savings and on very low incomes will usually be asked to contribute to the cost of their care packages arranged by Social Services.

These care charges depend on the policy of the local authority that provides the care package but also on national rules.

There is also a means test under the Care Act 2014. This was meant to be reformed this year to increase the capital limit (above which a person has to pay for their own care), from the current limit of £23,250 to £100,000. However, in a recent announcement the Government has delayed this change to 2025.

Also delayed was the plan to introduce a lifetime cap on care costs. (The lifetime cap means the amount of money a person will have to pay in total towards the cost of their social care over their lifetime, no matter what savings they still have or the value of their property.) The lifetime cap will be set at £86,000. However, at the moment, there is no lifetime cap on charges. Therefore, it is important that anyone who is assessed as having to pay towards their care package has a detailed financial assessment, where they can explain their daily costs and especially their Disability Related Expenditure. This can help to bring the charges down.

There are some types of care package that must be provided free of charge:

Reablement care

Reablement care is a temporary care package usually provided when someone comes out of hospital and needs a higher level of care for a short period of time to get them back to their best possible level of functioning. This is meant to be free of charge, whatever a person’s income or savings or the value of any house or property they own.

Continuing Healthcare

Continuing Healthcare (known as “CHC”) is free health and social care provided by the NHS in a care home, nursing home or in a person’s own home. Because it is NHS funding there are no contributions to pay, and it is not means-tested. If a person qualifies for CHC then all of their social care is paid by the NHS.

To obtain this funding, you need to be assessed under the Decision Support Tool (or “DST”), which is a formula for rating each of a person’s needs (known as “domains”) such as behaviour, mobility or nutrition. There are often disputes about the outcome of such assessments and there is an appeals process.

Section 117 Mental Health Act 1983 funding

Aftercare under section 117 of the Mental Health Act 1983 is another form of care funding that is meant to be free and available for anyone who has been detained under the Mental Health Act 1983 for treatment and who has on-going mental health needs. Like CHC, this is not means-tested and should be provided free of charge.

What our solicitors can do

Our solicitors can advise you on complex funding disputes, using their experience of current funding policies and public law. They can help you to appeal or advise you about judicially reviewing funding decisions or unlawful funding policies.

Associate solicitor, Monica Kreel, has secured refunds for a number of disabled clients in circumstances where they should have been receiving care free of charge under Continuing Healthcare, under a reablement care package or under section 117 of the Mental Health Act 1983.

Case study

Monica Kreel supported a client to receive a very substantial refund of fees.

Mr N was placed in a nursing home by the local authority and the local NHS Mental Health Trust. He had previously been detained under section 3 of the Mental Health Act 1983, meaning that he was entitled to receive free aftercare under section 117 to prevent a re-admission to a mental health hospital.

In 2020, his care was reviewed and he was told that his mental health aftercare would only cover some of his care package but that his other needs, due to his dementia and physical frailty, would be met under the Care Act 2014. Although he had a very modest amount of savings, he was assessed as having to pay over £350 per week towards his care.

The review was meant to be “an initial assessment” subject to a full review six weeks later. Close scrutiny of his personal records by his solicitor revealed that the sic week review had never taken place. Following a detailed complaint submitted on his behalf by his solicitor the council and NHS Trust agreed to fund the complete care package and refund all of the fees he had paid – over £33,000.

Please contact our team on enquiries@tvedwards.com or 020 3440 8000 to see if we could help with your situation.