Paying For In-Home Care

22 February, 2021

Paying for in-home care can feel like an overwhelming process that leads to a lot of uncertainty.

  • How much is it going to cost?
  • Can I afford home care?
  • How much care is needed?

These are some of the questions that could be going through your mind right now.

We’ve put together a guide to help explain the average costs of home care and where you can go for financial help. There’s also information on the benefits you may be eligible for.

Unlike the NHS, social care is not free. The amount of money you’ll need for home care very much depends on your level of need and your assets.

We’ve put together a guide to help explain the average costs of home care and where you can go for financial help. There’s also information on the benefits you may be eligible for.

Typical in-home care costs

One of the first things you need to consider when choosing a home care provider is the fees. The price of home care services varies depending on where you live but you should expect to pay between £16 to £20 per hour with a provider like Elunow. More traditional care agencies, with higher overheads, will typically charge between £25-£30 per hour.

So for example, if you need home care two hours a day at a rate of £20 per hour, the weekly cost would be £280 (£40 per day for seven days) or £1,120 per month.

Generally, live-in care fees start at around £900 to £1,400 per week but 24-hour home care can be as much as £2,000 per week. The cost of live-in care varies depending on your needs, what services you require and what provider you choose.

To avoid paying for services you don’t need, you need to consider:

  • What type of care will I need and how frequently you’ll need it – for example, do you just need someone to visit a few times a week to help with housework or do you need someone every day?
  • How long you’ll need care – will you need ongoing care or do you just need short term support as you recover from illness?
  • What hourly rate will you have to pay?

Once you know the answers to these questions, you’ll be able to calculate the estimated cost and then budget accordingly.

Depending on your means, your local council might pay for some or all the costs. Additionally, there is a wide range of benefits available to those in need of home care.

Home Care support from your local council

You may be entitled to help with the cost of in-home care from your local council, but it depends on your circumstances. You should ask your council for a financial assessment (a means test) to check if you qualify for any help with costs.

  • If your capital is over £23,250, you will have to pay for the home care service in full
  • If you have between £14,250 and £23,250, the council will contribute some of the money required
  • If you have less than £14,250, your capital won’t be included in the test and the council will pay for your care but will take your eligible income into account

The council will work out how much you need to contribute to home care costs. How much you will pay depends on your salary and savings – the more money you have, the more you will pay.

As you’re not going into a care home, the means test won’t consider the value of your property.

If you choose to pay for care yourself, you don’t need a financial assessment but you can ask your council to do a needs assessment to check what care you might need. It’ll tell you whether you need home help from a paid carer for 2 hours a day or 2 hours a week and precisely what they should help you with. A needs assessment is free and anyone can ask for one.

If you suffer from complex health issues that require significant care, your care could be fully funded by NHS Continuing Healthcare (NHS CHC). You may also be eligible for benefits, like Attendance Allowance and Personal Independence Payment (PIP), which aren’t means-tested.

NHS Continuing Healthcare

NHS Continuing Healthcare (NHS CHC) is a care package for anyone aged over 18 funded by the NHS that covers all costs of your support needs if you require substantial long-term care. The scheme is not tied to specific diagnoses or conditions, instead it depends on the care you require. NHS CHC is not means-tested.

To be entitled to NHS CHC, it must be proven that you have a primary health need, which means your care needs are mainly for healthcare. There are two stages in the assessment process.

Stage one is a Continuing Healthcare Checklist which is completed by a qualified healthcare professional, such as a nurse or social worker. They will evaluate your care needs in 11 areas of care, which will determine if you are eligible for a full assessment.

The process for a Checklist will trigger automatically in particular situations, including if your physical or mental health deteriorates substantially or you are ready for discharge from hospital but need continued care. You can however request an initial assessment at any time, so speak to your GP or care assistant if you believe you are eligible.

If the results of the Checklist indicate that you could qualify for NHS CHC, you enter stage two in the process and you will be contacted to arrange a Full Assessment.

The Full Assessment is either organised by your local NHS Clinical Commissioning Group (CCG) or a third party commissioned to do the assessment on their behalf. A multidisciplinary team (MDT) of healthcare professionals, made up of at least two professionals from different care disciplines, will conduct the assessment.

It examines all your care needs; what assistance you require, the complexity and intensity of your needs and how unpredictable your needs are, including any related risks. The assessment includes reviews of care records and a face to face meeting, which should involve you or your representative.

All gathered evidence is used to complete what is called the Decision Support Tool (DST), which divides the information into 12 domains including cognition, communication, breathing as well as skin and tissue viability.

Each domain is given a level of need from ‘No Need’ to ‘High’, ‘Severe’ or ‘Priority’. The team then discusses whether you have a primary health need and sends their recommendation to the CCG who makes the final decision.

If you qualify, NHS Continuing Healthcare will cover the costs of care received, as agreed with the CCG. The agreed package is reviewed after three months, followed by at least once per year. If your needs change, your eligibility and funding plan could too, a decision you can challenge.

If you are ineligible for NHS Continuing Healthcare, you can appeal the decision. The letter with the decision should contain information on how to appeal.

Direct Payments

If you’re currently in receipt of social services, your local trust must offer you the option of direct payments, except in special circumstances, which your trust will talk to you about. You are required to be able to give your consent to receive direct payments.

You must also be able to manage them daily, whether you are able to do this yourself or have a ‘suitable person’ doing it for you. Direct payments are paid into a bank account by the trust to people who have been assessed as needing social care or home help and would rather organise and pay for their own services than receiving services from their local trust.

Direct payments do not affect any other benefits you receive. Your local trust decides how much you get, determined by your needs assessment. You can use this money to pay for whatever health service or equipment you need, for example, employing a care worker.

In general, you are eligible for direct payments if:

  • You have been assessed as needing help under health and personal social services legislation
  • You are over 16 years old and have a disability
  • You are an older person

Your local trust should still be involved in your care and check in with you regularly to ensure you receive the care you need.

If your situation changes, whether it is a long-term or short-term change, contact your local trust as that could mean your payments needs readjustment. You cannot use direct payments for everyday costs, such as utility bills and food.

What benefits can I claim when I need home care?

Always check if you are entitled to any benefits and if you are, make sure to claim them. Even if you have a substantial amount of savings, you could be entitled to benefits as some are not means-tested.

The figures below are for the 2020/21 tax year.

Attendance Allowance

To be entitled to claim Attendance Allowance, you must have reached State Pension Age (over 65 depending on date of birth) and:

  • You have a physical and/or mental disability, including learning difficulties
  • You require someone to care for you or have someone to supervise you because of your disability
  • You have needed that care for at least six months, unless you are terminally ill.

All people in the UK are entitled to this benefit.

There are two rates available, determined by the level of support you require. However, it does not cover mobility needs. You may need to be assessed by a healthcare professional if it is unclear how your condition affects you.

  • If you need frequent help or constant care either during the day or at night, you could receive £59.70 per week.
  • If you need help both day and night, or if you suffer from a terminal illness, you could receive £89.15 per week.

If you suffer from a terminal illness and your remaining life expectancy is six months or less, there is no qualifying period and if you are eligible, you are entitled to the higher rate. Attendance Allowance does not take into account your earnings or savings and you are not required to have someone helping you in order to claim.

If you receive Attendance Allowance, you could be eligible for other benefits, or a higher rate of benefits, including Pension Credit, Housing Benefit and Council Tax Reduction.

Personal Independence Payment (PIP)

People aged 16 to 64 (or have not reached State Pension Age) who require long-term care at home due to a disability or illness can claim Personal Independence Payment. The amount you receive is determined by how your condition affects you, not what it is.

To be eligible, you must have had trouble with everyday living (such as eating and communicating) and/or getting around for three months and you expect the difficulties to persist for at least nine more months. PIP is a tax-free, non-means-tested benefit you can receive whether you are working or not.

How much you get is decided by an assessment, conducted by an independent health professional, and the rate is frequently reviewed to ensure you receive sufficient support.

There are two components to PIP – daily living and mobility – and you could get both, but it depends on how badly affected you are by your condition.

The two parts have different rates:

  • The weekly daily living rate is either £59.70 or £89.15
  • The weekly mobility rate is either £23.60 or £62.25

If you are terminally ill and not expected to live for more than six months, you will receive the higher daily living rate, but the mobility rate is determined by your needs.

Industrial Injuries Disablement (IIDB)

If you are disabled as a result of an accident in the workplace, or an illness caused by work, you could be entitled to a benefit of up to £182 per week. IIDB also covers more than 70 diseases, including asthma, deafness and asbestos-related diseases.

All people in the UK are entitled to this benefit, except if you are self-employed. The incident must have taken place in the UK and the amount received depends on your circumstances. On a scale of 1 to 100 per cent, your disability level affects the amount you might receive, assessed by a medical advisor. In general, you need to be deemed 14 per cent disabled to be eligible.

  • The Government’s guidelines say if you are deemed 20 per cent disabled you could be entitled to £36.40 per week, up to £182 if you are assessed as 100 per cent disabled.

If you are eligible for IIDB, you could be entitled to Constant Attendance Allowance (CAA).

Constant Attendance Allowance (CAA)

If you are ill or disabled as a result of an injury and require constant care, you could be entitled to Constant Attendance Allowance. You must receive either Industrial Injuries Disablement Benefit (IIDB) or a War Disablement Pension to claim CAA.

Your entitlement to CAA will be automatically considered at the time of your IIDB medical assessment. You are unable to get CAA if you already get Attendance Allowance and it may affect your claim to other means-tested benefits.

You can apply for CAA if:

  • you claim IIDB and you have been deemed 100 per cent disabled (based on a medical assessment) and need constant, daily care.
  • you claim a War Disablement Pension of 80 per cent or more and need personal care for the same reasons that you get the pension.

Depending on your disability and how much it affects you, there are four different allowance rates available in 2020/21:

  • Part day – £36.40
  • Full day – £72.80
  • Intermediate – £109.20
  • Exceptional – £145.60

Pension Credit (2020/21 Tax Year)

Pension Credit is a means-tested, two-part benefit for people with a lower income who have reached State Pension age.

The two parts are Guarantee Credit (up to £265.20 a week) and Savings Credit (up to £15.62 per week). You can get Pension Credit if you have savings and whether you are working or have retired.

You can apply up to four months before you wish to start claiming.

Pension Credit can be claimed by single pensioners and couples (living with a partner) who live in England, Scotland, Wales or Northern Ireland. If in a couple, you can only start receiving Pension Credit if both of you have reached State Pension age or one of you is receiving Housing Benefit for those over State Pension age.

If you are single and receive Pension Credit but you start living with someone below the State Pension age, they must reach the State Pension age before you can get it again.

Pension Credit takes your income into account, including:

  • State pension and other pensions
  • Earnings
  • Most benefits, excluding Attendance Allowance, Christmas Bonus, Disability Living Allowance, Personal Independence Payment, Housing Benefit and Council Tax Reduction
  • Savings and investments over £10,000

You can have up to £10,000 in savings and investments (excluding your home) before it has any effect on how much you get. Every £500 over the £10,000 savings and investment threshold adds an extra £1 to your weekly income.

For example:

You have £11,600 in savings (£1,600 above the threshold). There are three parts of ‘£500s’ above the limit, which adds £3 to your weekly income.

Guarantee Credit tops up your income. Guarantee Credit is for single pensioners with a weekly income of less than £173.75 and for couples with a joint weekly income below £265.20

  • If you are single, Guarantee Credit will bring your weekly income to £173.75
  • For couples, Guarantee Credit will take the joint weekly income to £265.20

Savings Credit provides an income boost to people with some retirement savings. Savings Credit can only be claimed by people who reached State Pension age before April 6th, 2016 (65 years for men, 63 for women – 2016 State Pension ages).

  • Savings Credit can give single pensioners up to £13.97 extra per week and couples up to £15.62

To qualify for Savings Credit in 2020/21, your weekly income needs to be at least £150.47 if you are single and a combined £239.17 if you are in a couple.

Every £1 over these thresholds adds 60p of Savings Credit up to the £13.73 and £15.73 maximum weekly amounts.

Disability Premiums

A disability premium is extra cash added to other benefits, such as the Housing Benefit. There are three kinds of disability premiums and you can get more than at the same time.

 The three types of disability premiums are:

  • Disability premium
  • Enhanced disability premium
  • Severe disability premium

Claiming disability premium will get you £34.95 a week if you are single and £49.80 for couples.

To qualify for disability premium, you or your partner must be under State Pension age and either be registered blind or receiving any of below benefits:

  • Personal Independence Payment (PIP)
  • Armed Forces Independence Payment (AFIP)
  • Disability Living Allowance (DLA)
  • Attendance Allowance
  • Constant Attendance Allowance
  • Severe Disablement Allowance
  • Incapacity Benefit
  • War Pensioners Mobility Supplement
  • Working Tax Credit (with disability element)

If you are eligible for severe disability premium you will get £66.95 if you are a single person and £133.90 if you are in a couple and both of you are eligible.

To be able to claim severe disability premium, you must receive the disability premium or an Employment and Support Allowance related to income as well as one of these benefits:

  • Daily living component of Personal Independence Payment (PIP)
  • Armed Forces Independence Payment (AFIP)
  • Middle or highest rate of the Disability Living Allowance care component
  • Attendance Allowance or Constance Allowance funded with Industrial Injuries Disablement Benefit or War Pension

In general, you won’t be eligible if you live with someone over the age of 18 except if they receive a qualifying benefit, are registered blind, pay your landlord separately or if they are a boarder or subtenant.

Additionally, you are unable to claim severe disability premium if someone caring for you receives Carer’s Allowance or Universal Credit (carers element).

If you are in a couple you can still get the lower rate if someone is caring for only one of you and they claim Carer’s Allowance or the carers’ element of Universal Credit, or if only one of you are eligible and the other partner is registered blind.

If you are eligible for the enhanced disability premium you will be entitled to £17.10 a week if you are single. You get £24.50 per week if you are in a couple and one of you must be eligible.

You can only receive enhanced disability premium if you are under Pension Credit age and you must receive the disability premium or income-related Employment and Support Allowance, as well as one of the benefits below:

  • Higher rate of the PIP daily living component
  • Armed Forces Independence Payment
  • The highest rate of the care component of Disability Living Allowance

You are also eligible if you are in the Employment and Support Allowance support group.

ESA Support Group

The support group is for those who are assessed as unable to return to work because of their disability or health condition. There is no time limit for payments if you are put in this group and will get you £113.55 per week, even if you are under 25 years old.

To be eligible you must have a limited work capability, be under State Pension age, contributed enough to National Insurance, are not receiving Statutory Sick Pay and not currently work.