A Guide to Care Home Fees

The requirement for long term care is often associated with the aging process, however the need for long term care can arise at any term in a person’s life as a result of a serious illness, accident or disability. Regardless of age there are two types of care a person may require: Healthcare or Social Care.

It’s important to understand the difference between the two, particularly when it comes to funding of the care a person will receive. Healthcare is provided for by the NHS and is free to everyone entitled to NHS care; Social Care is provided by Local Authorities and may mean a person has to pay for their own care.

Often people will require a mixture of both types of care which can lead to uncertainty as to who should pay for the care a person receives.

The financial struggles of both the NHS and Local Authorities are well publicised in the press and therefore it is not surprising that the funding of care is a big issue. If the NHS can show that a person does not have a primary health need they can pass the responsibility of care to the Local Authority. This often means a person will be means tested and may have to pay for their own care.

This situation can lead to a person paying for care when they actually have a Primary Health Need and the NHS should have funded their care. The issue of unfair assessments has been going on for years. The Parliamentary and Health Services Ombudsman have looked into the conduct of the NHS and criticised the approach to the funding assessment issues.

The big questions is, how do the NHS determine whether or not someone requires Healthcare and not just Social Care? The NHS are required to undertake a Continuing Healthcare assessment to determine whether a person is eligible for NHS Continuing Funding. This is a two stage assessment.

Firstly, a Checklist Assessment is completed. This must be carried out by a Healthcare Professional who is trained and qualified to undertake the assessment. The Checklist has 11 criteria and the Assessment Score will determine whether or not the person moves to the second stage of Assessment or the person is discharged and the responsibility for care is passed to the Local Authority. In this situation the person, or their relatives, should be given a written copy of the checklist and information about the Appeal process.

If a person passes through the Checklist Assessment the second stage is a Full Assessment using the Decision Support Tool.

It is important to remember that although at the time of the initial assessment it may have been decided that a person did not qualify for NHS Continuing Funding circumstances can change. A person’s condition may deteriorate over time and their needs may change. While a person is in care a Checklist Assessment can be requested at any time and should be carried out within 14 days of being requested. So, although a person may have had to fund their own care initially they may later be able to claim NHS funding.

Care Fees and the Funding of Care is an issue that is not likely to go away. With an aging population and already stretched budgets, in both the NHS and Local Authorities, it is something many people are concerned about.

Here at Town & Country Law we are often asked about giving away assets and how people can avoid paying Care Home Fees. In this situation we must always consider the issue of deliberate deprivation of assets. Local Authorities have to power to include Assets you have given away in your financial assessment if you transferred these assets to avoid paying Care Fees.

So, what is the test for deliberate deprivation of assets? The main issues a Local Authority will consider are intention and foreseeability. If you made the transfer or gift for the sole purpose of avoiding paying for your care or avoiding paying for your care was a significant factor that you may be found to have deliberately deprived yourself. This is something the Local Authority must prove. Secondly, they will have to consider foreseeability. Essentially at the time you disposed of your assets could you foresee the need for care. If you were fit and healthy and you could not have foreseen the need for care, it would be unreasonable to assume you disposed of the asset to avoid paying for your care.

Early planning is therefore essential, and our fully trained consultants will be able to advise you on our range of Will Trusts that can help you plan ahead.