Care Home Fees Issues Legal Help

With the various different types of care available for the different needs, from care for the elderly to caring for those with dementia, often people can get confused on what is actually needed and who should be paying. There are usually three initial questions that are asked:

  1. Who pays for the care fees?
  2. What is a Primary Healthcare need?
  3. Is there a Primary Healthcare need?

 NHS Continuing Healthcare (CHC)

“NHS continuing healthcare means a package of ongoing care that is arranged and funded solely by the NHS where the individual has been found to have a ‘primary health need’… Such care is provided to an individual aged 18 or over to meet needs that have arisen as a result of disability, accident or illness.”

If there is a primary healthcare need, this should be funded for free by the NHS Continuing Healthcare service. Outside of this, care fees are either funded by the families themselves, seek assistance from social services or the National Health Service (NHS). Any support given by social services is means tested and is free of charge to people on low income or with low capital. If social services arranges care in the community, they must pay the fees charged by the home provider and recover the cost from those not entitled to free care.

Should you or a spouse be in the unfortunate situation that you need to pay for nursing care or a residential home, it is often wise to plan ahead. If you have assets above £23,750 you will be paying care home fees in full unless your health needs entitle you to NHS continuing healthcare funding. Securing funding can be a very complex process and mistakes are often made when assessing how much an individual should be paying for care.

Where is the NHS Continuing Healthcare Provided

If you are eligible, you can receive the FREE NHS continuing healthcare funding in a variety of settings, for example:

• In your own home – the NHS will pay for healthcare, such as services from a community nurse or specialist therapist, and personal care, such as help with bathing, dressing and laundry.

• In a care home – as well as healthcare and personal care, the NHS will pay for your care home fees, including board and accommodation.

NHS healthcare assessment

To be entitled for the free NHS-CHC, the NHS must conduct an initial assessment. A multi-disciplinary team comprising doctors, nurses, and other NHS staff have a duty to consider all the factors and make a recommendation about the person’s entitlement to NHS-CHC.  The factors considered are:

  1. The person’s behaviour. How challenging is it?
  2. How well can the person communicate and understand?
  3. What are the psychological and emotional needs of the person?
  4. To what extent are they mobile? Do they need assistance to get about?
  5. Are they incontinent?  Is a catheter needed?
  6. What assistance is required to feed or drink?
  7. The types of drug therapies and medication prescribed.

When carrying out an assessment the NHS must apply a decision making tool designed to provide a fair and effective way of establishing individual entitlement to continuing healthcare.  The tool measures the extent of the person’s various healthcare needs, using it to decide whether or not these needs are met by the NHS or social services.  The needs are measured as no need; low; moderate; high; severe; or priority. It is considered that continuing care would be recommended if a person has a priority need in any one of the four domains that carry this level, or a total of two or more incidences in the severe category.  It is upon individual judgement if people with lower level needs than this qualify for NHS funding.

ME Law has a specialised team of experts in care fees advice and funding and want to support you and your families as much as possible. We offer a FREE no obligation consultation so if you are confused by any of the process, let us answer your questions. Book your appointment with us now!