The following assessments should be made, in this order:
- NHS Continuing Healthcare Assessment
An assessment will be made, for example on discharge from hospital. If the need is primarily for continuous medical care, ALL CARE NEEDS should be provided free by the NHS, whether at home or in a nursing home. A lesser need may qualify for Funded Nursing Care, a weekly allowance.
- Social Care Assessment
If Continuing Healthcare doesn’t apply, this assesses what non-medical care is needed and how severe the need. This care may be available privately or from the Local Authority but will be charged for. If there are eligible needs, Local Authority financial support may be available subject to means-testing.
- Financial Assessment – the means test
The Local Authority will supplement your income up to a limit, but if you have capital over £14,250* you must meet some or all of the remainder of the fees. Capital includes savings, investments and property. If capital exceeds £23,250* the Local Authority does not have to help. However, some pension income for couples may be ignored (‘disregarded’) as are certain assets (such as the home if the spouse still lives there, or certain types of investment). Other exclusions can also apply, so an individual discussion would help to identify how best to navigate this complex area.
- If your fees are higher than the Local Authority limit, the rest can only be paid by a third party unless you are entirely self-funding.
These assessments are not just for the person receiving care – if you are providing care for someone, you should be assessed too. Frequently, the health of carers is overlooked, which is not beneficial for either in the long run.
Only after considering all the above can you know whether you should be paying your own way at all, in full or in part. Then you can consider how best to use the cash and other assets available to you to meet current needs, and to allow for any future increase in care needs/costs.
The first step here is to make sure you are in receipt of all state benefits you are entitled to – Attendance Allowance is appropriate for most and is not means tested. If you are already getting the Lower rate check whether you are now eligible for the Higher rate. You may also get the Funded Nursing Care referred to earlier, although this is frequently paid direct to the care provider and just reduces your bill.
Then make sure your savings and investments are arranged appropriately. This is where a specialist financial adviser can really be worthwhile. They will check you have accounts in the right names without running the risk of ‘deliberate deprivation’, crucial for a couple to preserve assets for the non-cared-for spouse; and that any shortfall in care fees is met by using savings in the most efficient way.
A specialist adviser must hold certain qualifications as a minimum, but for extra reassurance, find an adviser who is accredited by the Society of Later Life Advisers (SOLLA) as is Karen MacDonald, our own specialist adviser.
* thresholds apply in England for 2016/17)
Levels and bases of may be subject to change