Paying for residential care

Paying for residential care

Current rates and background information about charging

Who will pay for my care?

Most people in residential or nursing homes pay towards the cost of their care unless your care is fully funded by the local Primary Care Trust or under Section 117 of the Mental Health Act 1983. 

Some pay the whole cost from their own income or capital. Others contribute to the cost according to what they can afford to pay. This is worked out using national guidelines. 

If you are placed with help from social services (adult social care) and have capital above the national capital limit set for charging purposes you will be expected to contribute to the cost. 

Your contribution is determined by a financial assessment based on the information supplied on the Financial Circumstances form,  which needs to be completed before your admission to the home.

How is my contribution worked out?

Your contribution is calculated using a system called The Charging Procedure - sometimes called the means test or Financial Assessment. 

The procedure takes account of your: 

•  income, including most benefits and pensions and 

•  your capital, such as savings, investments and property. This may include capital you own with someone else. 

The rules are as follows: 

•  If you have more than £23,000 in capital, you will be required to pay the full fee

•  If your capital is less than £23,000 and your income is not sufficient to meet the home fees in full, you may be eligible for financial support 

•  If the value of your capital is between £14,000 and £22,999, both income and capital are taken into account in the financial assessment 

•  If you have capital below £14,000.00, it will not be considered in your financial assessment. 

•  If you hold capital jointly with another person, our calculation will only be based on your share of the capital. 

What will happen to my property?

If you have moved to a care home permanently, we will not count the value of your former home when working out your contributions, if it is occupied by one of the following: 

•  your spouse or partner, 

•  a relative who is aged under 60 but is incapacitated, or 

•  a child under the age of 16 who is your dependent 

If you jointly own property with someone else who either does not live in the property or does not fit in to the categories above, your share of the property may be included in the financial assessment. 

The council will disregard the value of your property for 12 weeks from the start of your permanent admission into a care home. However, you will still be assessed on your income, assets and any other capital. 

If you sell your home within 12 weeks of moving to a care home, the proceeds will be counted as capital from the date of the sale. 

Deferred Payment Agreement

If you do not have enough money to pay the fees, you may apply for "Deferred Payment Agreement" (DPA).

The council may agree to deferred payments if you do not wish to sell your property, or are unable to sell it quickly enough. 

The DPA is for the difference between what you would be assessed to pay if your home was taken into account, and the amount you are assessed to pay from your income and other capital. 

If you wish to take up a DPA the council will place a charge on your property to secure the debt accumulated. Interest is payable on the debt and the full amount will be paid back to the council when your home is sold or after your death. 

While you are waiting to sell your property you may be entitled for income support for up to 26 weeks. 

Third party contributions 

If you have capital in excess of the upper capital limit or you own property, you can choose to move in to accommodation that costs more than social services will normally pay for, but you will be required to cover the costs of the difference.

If you are assessed as having to make a contribution towards the cost of your care and choose accommodation that costs more than social services would normally pay for, then a friend or relative (third party) will have to agree to pay the difference in cost for you.

In either circumstance you will be required to enter a third party agreement either with the home or the council. 

Free nursing care

The NHS contributes to registered nurse costs and continence supplies in nursing homes.

The district nurse assesses your nursing and other health needs to determine the level of nursing support to be provided. This is known as The Registered Nurse Care Contribution (RNCC) and determines which band you fall under.

If you are in a nursing home, you are entitled to get the cost of the nursing element of your care for free. This is regardless of whether you are paying the full cost of your care or get help from the council. The rates of RNCC payable and effective from 1st April 2009 are:

•  High  - £146.30 worth of free nursing care per week, for those with complex needs

•  Standard - £106.30 worth of free nursing care per week, for those with multiple needs.

If your condition worsens you or your family can ask for a review at any time.

Looking after your finances 

If you are admitted permanently into care and are unable to look after your financial affairs, or do not have someone willing to do so, you can get help from: 

•  your care manager, 

•  the income section, 

•  the client affairs ( formerly known as Receivership) service of the council 

Paying your care fees

If you are placed with the help of social services, whether you pay the full cost or a contribution towards the cost of your care fee, we will bill you monthly in arrears.

You can pay by:

•  posting your cheque (made payable to London Borough of Hammersmith & Fulham) to:

Community Services Department 
Charging team 
Floor 3, 77 Glenthorne Road  
Hammersmith, 
London, W6 OLJ

•  standing order
•  at the council's cashiers
•  debit/credit card 

Currently it is possible to pay your home care charges through direct debit and we are working to extend this facility for those in residential care.

Enquiries and advice

For any queries on placement, financial assessment and charges contact:

Placement team 
Tel: 020 8748 3020 
Extensions. 5374, 5023, 5394, 5393

Income section 
Tel: 020 8748 3020 
Extensions: 5137, 5143, 5034, 5015 

Client affairs service (Receivership) 
Tel: 020 8753 3020
Extensions; 5042, 5043, 2513.

For further information on financial assessment and charging please consult our guidance notes issued with the financial circumstances form. 

For further advice, you can also contact your local Citizen Advice Bureau or Age UK office.