This is part seven of a series on planning and paying for long-term social care in later life.
We’ve previously covered:
- The gap between social care [1] need and provision.
- How the social care funding [2] means-test works.
- The social care thresholds [3] that determine your funding eligibility.
- How you can estimate care home costs [4] for future planning.
- A case study showing how social care costs [5] impact retirement finances.
- The financial products best suited to paying for social care [6].
In this final post, we cover free sources of support that can help everyone fund their care.
Long-term social care is not free at the point of delivery, unlike NHS treatment. Most social care is means tested – with complexity, arbitrariness, and under-provision shot through the system like tracer dye revealing contamination.
Very few people will get all the help they need. However there are some little-known free social care options that are universally available.
These avenues of support typically depend on your need, not your bank balance.
They fall into three main categories:
- NHS-funded care
- Home adaptations and equipment
- Non-means tested benefits
Let’s briefly review each free social care category. I’ll also link out to useful sources of further information.
NHS Continuing Healthcare (CHC)
NHS Continuing Healthcare [7] can fully fund your care and accommodation – if you qualify for it. You may qualify if you require complex, ongoing care to manage severe and unpredictable illness or disability.
You won’t necessarily be made aware of CHC, even if you’re eligible. The first formal step is to ask your GP for a CHC assessment.
However I recommend finding out more about the process first, through the Beacon social enterprise [8].
Why? Because qualifying for CHC is known to be difficult – so much so that NHS England fund Beacon to help guide people through it.
CHC has been replaced in Scotland by Hospital-Based Complex Clinical Care [9]. This scheme only covers people receiving long-term care in hospital.
NHS-funded Nursing Care (FNC)
If you don’t qualify for CHC then the next stop is NHS-funded Nursing Care [10]. This may cover your nursing care fees if you live in a care home that provides registered nursing care.
FNC pays a standard rate for nursing directly to your care home. The rate varies by UK nation.
Your home should demonstrate how this money will reduce your bill.
If you’ve had a CHC assessment then you should also get a FNC verdict. Contact your GP if this hasn’t happened.
Nursing care in your own home is provided free of charge by community nursing services. It should be arranged by your GP if you don’t qualify for CHC.
NHS Intermediate Care
The NHS Intermediate Care [11] service is meant to help you recover your independence and get back to normal after a hospital stay, short illness, or fall. Intermediate Care also gives you a chance to assess your needs when you’re considering a permanent move into residential care.
Care is free but short-term – lasting up to six weeks. It can be provided in your own home, a care home, or community hospital.
Hospital staff should arrange intermediate care for you before you leave. Speak to the discharge coordinator if that isn’t happening.
If you’re discharged without a care plan then contact social services. The hospital isn’t responsible for your care once you leave.
Speak to your GP (or local authority social services) if you need help because of a fall or illness at home.
If you don’t make a full recovery after six weeks of intermediate care then you should receive a plan to transfer to another service. That may involve paying for long-term care yourself.
Intermediate care is also known as re-ablement or aftercare.
Section 117 mental health after-care
Anyone detained under Section 3 of the Mental Health Act 1983 has a right to receive free aftercare [12] once they’re discharged from hospital.
A care package must be provided by the local authority and the NHS so long as the person requires ongoing support that is:
- Connected to their mental health condition
- Reduces the risk of their condition worsening
Support can include paying for care at home or in residential accommodation. An aftercare plan should be provided before you leave hospital.
Home adaptations and equipment
Home adaptations include stair lifts, ramps, walk-in baths, grab rails, lever taps and so on.
Essential adaptations and equipment costing less than £1,000 each are likely to be provided for free in England. The limit is £1,500 in Scotland and considered on a case-by-case basis in Northern Ireland and Wales.
Contact your GP or local authority1 [13] for an occupational therapy assessment or a full care needs assessment.
Means-tested Disabled Facilities Grants [14] are available for more expensive adaptations. The amounts and specifics vary by home nation.
For ideas on adaptations and equipment that can help maintain independence, check out these lists:
- Home adaptations [15]
- Mobility equipment [16]
- Kitchen appliances [17]
- Assistive technology [18]
Universal benefits
You should also look into some applicable benefits that aren’t means tested nor widely known:
Attendance Allowance [19]
Up to £89.60 a week is available if:
- You’re over State Pension Age
- Physically or mentally disabled
- Need someone to help care for you
If you permanently live in a care home, Attendance Allowance is not available if you receive local authority support.
Personal Independence Payment (PIP) [20]
This is similar to Attendance Allowance but is only available for people aged between 16 and the State Pension Age.
There are two parts:
- Help with daily living tasks – pays up to £89.60 a week
- Help with mobility – pays up to £62.55 a week
You may be eligible for one or both components.
Other benefits
Age UK maintain a wider list of relevant benefits [21].
Money Helper also have a good care needs benefits page [22]. It’s particularly strong on council tax discounts and exemptions.
Many people don’t claim all the benefits they’re entitled to. Use a benefits calculator to ensure you don’t miss out:
- Age UK benefits calculator [23]
- Entitled To benefits calculator [24]
Carer’s benefits
Thankfully carers can get help too. You don’t have to be related to or living with the person you care for.
Carer’s Allowance [25]
£67.60 a week may be available if you care for someone 35 hours or more a week. That person must also be eligible for certain benefits such as the Attendance Allowance.
If you qualify for Carer’s Allowance you’ll get National Insurance credits [26], too. Scroll down to the Carers’ section.
Carer’s Allowance can have a knock-on effect on other benefits. See the link to the benefits calculator on this government page [27].
The government also lists more benefits available to carers [25].
You may be eligible for the Carer’s Allowance Supplement [28] if you live in Scotland.
Carer’s credit
Carer’s Credit [29] helps people who care for someone at least 20 hours a week.
The credits increase the value of your State Pension by filling gaps in your National Insurance record.
Carer’s respite care
Local authority funding is available to enable carers to take a break occasionally. As ever, you must be assessed [30] to qualify.
This NHS page lists organisations that can assist with carer’s breaks [31] including charitable support.
Carers UK [32] offers advice and guidance to unpaid carers.
Free personal care
Personal care is available for free in Scotland [33] and Northern Ireland [34].
Personal care is a defined set of services including washing, getting dressed, going to the toilet, meal preparation and medication.
For those in care homes, your local authority pays a set rate [35] for personal care and nursing care in Scotland.
A set rate [36] is also available for nursing care in a home in Northern Ireland.
Personal care and nursing care is only available for free if your care needs assessment [37] recommends you for it.
Charitable grants
The final free social care option is to apply for charitable grants. Turn2us [38] has created a searchable database.
Care thee well
Needless to say, you can also explore all of the routes listed above on behalf of a loved one.
But for our part, that’s the end of Monevator’s series on long-term social care.
Researching it has been a sobering experience. I dare say reading it hasn’t been a barrel of laughs either.
If you knew little about long-term social care previously, then I hope the series has made it less of an amorphous threat.
If your research is more urgent then I hope these posts have provided some help when you need it most.
Take it steady,
The Accumulator
Bonus appendix: social care funding – the diagram
This flowchart graphically simplifies the complexities of the social care system:
[39]- Health and Social Care trust in Northern Ireland. [↩ [44]]